Printed Efficiency: Revolutionizing Your Practice with a 3D Printer

I think we're several years away from printing zirconia at the same strength, compression strength, and tensile strength that we can get out of a milled unit of zirconia. But I'm really comfortable with like the inlay-onlays printed. And my mill, I mill one unit at a time. And on the printer, I can print five, six units at a time or even more on a very small platform. Welcome to the Phil Klein Dental Podcast, 3D printing. We keep hearing about this new technology, but what does it actually do for our practice? What does it take to implement this into our workflow so we can start printing models, occlusal guards, surgical splints, clear aligners, provisionals, retainers, and even inlays and onlays? To talk about 3D printing and how it became a game changer for her practice is our guest, Dr. Susan McMahon. Dr. McMahon has devoted her professional career to the pursuit of advanced technologies in cosmetic and minimally invasive dentistry. Dr. McMahon will be joining us in a moment, but first... dental professionals, we know that the right autoclave can enhance your patient flow and help build a more profitable dental practice. It's all about keeping things moving. Chamber autoclaves are great for reprocessing large loads, but sometimes you need a few hand pieces fast, and you don't want to wait to fill a chamber. That's why a lot of dentists choose the Sycan Statum 5000G4. While the look has changed over the years, inside, Statham still uses a reliable, innovative steam technology developed 30 years ago that continues to deliver instruments in some of the fastest times in the industry. It's one of the best-selling autoclaves in the world, and its reliability has made it the workhorse sterilizer in dental offices across the United States. To learn more about how Statham may be right for your practice, visit scican.com. Dr. McMahon, it's a pleasure to have you on the show. Hello, Phil. It's a pleasure to be here again with you. Yes, absolutely. And your previous podcasts are doing fantastic. Tons of engagements, thousands for that matter. So we're really happy with the way the show is going. And it's due to the fact that we have guests like you who we interview and who have such incredible insight into what's going on in dentistry these days. So to begin, tell us about 3D printing and how have dentists begun to embrace this new technology? It's been really an interesting trajectory, right? I would give a lecture and ask how many people have scanners in here, inter-oral scanners, and maybe like 20%. Now, when you ask, 70% of the room has scanners. Now, five years ago, how many people have mils? Maybe 10% of the room. Now, 30-ish percent of the room have mils. And 3D printing is just kind of the next logical step, I think. I actually think it might be a step that you would... people might be interested in taking before they get a mill, because they're so accessible, you know, from a price point standpoint, and they're so accurate. And it's a pretty easy, it's pretty easy thing to pop into your workflow. So regarding printing, what are you actually printing in your office that's working very well for you? Well, I think once you have a scanner in your office, you can move to printing really easily, especially some of these new printers that have like an AI transition from your scanner right to printing makes it really simple for pretty much anyone in your office to load it and get it going. So we print models in our office all the time. We've been putting models in a long time. We print occlusal guards. We've been doing that for quite a while too. We print retainers. We've been printing digital small design mock-ups in our office too. But now we're moving toward more restorations, which has been really fun and exciting and pretty simple. So now I'm printing a lot of inlay onlays with like the ceramic composite material. I do the occasional, maybe half the time I'm using it for bicuspid crowns. I also do a lot of provisional prints on there, which I really like because they're fast and accurate. And they last a long time and they're really beautiful provisionals. And we use it also for on X prototypes and provisionals. So dentists are always looking for things that are more efficient. They're faster. Save time. That's the name of the game as long as you can maintain quality. Tell us how 3D printers can add efficiency to the office and create things in a very efficient way where the 3D printer quickly becomes an irreplaceable tool. I think that there are a lot of applications for a printer that are easier than going directly to milling for doctors. So if you're already scanning your patients, let's say you're scanning all your new patients with your intraoral scanner, you already have that digital information. So you could go right from that to printing occlusal guards if you need to. So instead of sending it off to a lab or scanning again and sending to a lab, you can use that information right away. And it's really simple. And 3D printers, you know, they cost anywhere from maybe like $7,000 to $12,000, right? That's the range where you can get a really nice, accurate printer that has a small footprint but has a lot of material options for it. So you really don't have to make too many guards in your office to warrant the cost of the printer. But you can also print all your models simply from that. And now there's a lot of printer companies that are working on the digital software for clear aligners. So you could go right from your scanning to your clear aligners. And that's kind of exciting too. Yeah, that's going to be a major disruptive technology for the companies that are selling these aligners to the dentist. Because the cost of that is going to change dramatically. And I mean, just make it so much less expensive to print it in the office. Oh, I 100% agree with that. I think it's going to be really disruptive because now there's a few companies that are doing almost all of our clear aligners, right? And it's already out there. There are already printer systems that are doing this, and it's getting more and more refined by the day, the software that does the design work to take you from your current state to your finished state and print the aligners at the in-between. But it's because printing is so fast and cost efficient. I really think you're right about that. It's going to change the way the clear liner market is. Yeah, certainly bring the price down for whatever it is now. It's going to come down, you know, to meet the competitive price of in-office printing. It has to, right? It just has to. Absolutely, absolutely. So we're all aware that zirconia is the buzzword for materials these days. The labs are pushing it, the manufacturers are pushing it, the dentists are prescribing it. So as we stand now, how far away are we from being able to print a zirconia restoration in the office? I think we're several years away from printing zirconia at the same strength, compression strength, and tensile strength that we can get out of a milled unit of zirconia. And, you know, that's the basis. That's when I have a mill in my office and that's what we're milling on our office is single unit zirconia. Mostly my associates milling those kind of all day long. And she is not, you know, we can't print those to get the same clinical properties out of those yet. But I'm really comfortable with like the inlay onlays printed. And my mill, I mill one unit at a time. And on the printer, I can print. five, six units at a time or even more on a very small platform. So you can really speed production up. And the cost per unit is really affordable. It's really inexpensive. So take us through the scenario of a dentist who does not have a 3D printer in the office. They have a scanner. So they're familiar with that part of the digital workflow. How do they implement 3D printing into their workflow? And who's critical on the team to make this happen? Right. You always need somebody that has a propensity, has like. like, you know, has a kind of a higher skill set with technology, right? So I have one, she's a hygienist actually, but she's kind of our lead on that. But it's really pretty simple to do. So anything, some of these intraoral scanners will link directly to your printer software and others, there's a bridge to get them there. And I know sometimes that makes people feel... like it's complicated, but it really isn't. You're simply taking the STL file from your intraoral scanner, uploading it into the software, design software or the software that allows the supports to be put on it to be printed. So something as simple as models, you can take the scans that you that you do in your intraoral scanner and print models directly from them onto a printer with a little bridge that comes with all the printers. Really easy. It's basically two clicks. The AI takes care of it for you. If you want to design other things, if you need to make other things, like you want to make an occlusal guard, you want to make retainers, you want to make... a custom tray perhaps, or you want to make a provisional model, then you have to have a design component to it. So you scan what you're going to scan. And then just like if you were milling it, you have to design your restoration. And ExoCAD has design software for that, modules that you buy individually. Some of the printers have their own modules. The Trio scanner has its own modules. And that's what we use in our office, the Trio scanner. So if I want to make... for somebody say I'm making an anterior you know doing an anterior case and I want to print my provisionals as opposed to the old-fashioned way of this acryl in a in a stent you know hand making them I would prep my teeth I'd do the scan for you know my final scan for my final restorations and at the same time I'd take that scan run it through my digital design and then put that into the printer and print it. 15, 20 minutes later, I have beautiful provisionals. Any preference on design software or printer? I think that depends on what technology you already have in your office and what printer you choose to get. I have a couple of printers in my office. I have a Formlabs and I have an Acureta. And the Acureta is kind of our new favorite in the office. It's a very small footprint, but it's super accurate and super fast and it has a lot of material options for it. The thing about printers is every time you use a different material, you sort of have to store that material. So the material is on a tray that's loaded into... into your printer. And like we keep tray material, mouth guard material, occlusal guard material. We keep the restoration, the ceramic composite blend material. And then we take a provisional material and maybe one more. So I've kind of have five trays of this material that's in a little rack in the office. And I like this Acurata printer because the trays are small and it's very neat. And my Formlabs is a... a bigger printer and it'll print, I can print 10 models at a time on it. But we pretty much only use that for models these days because it's a little bit of a beast. It's a bigger thing to manage as far as keeping different materials. We'll be right back with Dr. McMahon in a minute, but first... to GC America, we're now able to incorporate all the advantages of glass ionomer into a beautifully aesthetic, strong, long-lasting restoration. That's a great reason to try GC Fuji Automix LC. You'll love the convenient automix delivery system and ergonomic dispenser. which allows precise placement into the preparation. And GC Fuji Automix LC is bioactive, allowing for a high rechargeable fluoride release, which is ideal for high caries risk patients. And because it forms a chemical bond to tooth structure, even in the presence of saliva, there's no need for etchant and adhesive bonding. This saves steps and is ideal for challenging patients where access and isolation are difficult. And the small filler particles in the material allow for superb polishability and excellent aesthetics. So when you're thinking glass ionomer for your clinical cases, think GC America, a world leader in dental materials. To learn more, visit gc.dental. Tell us in your experience how you progressed with the applications of 3D printing. Did you start with models and then move on to these other applications like you discussed? Yeah, I think that's where a lot of us start. That's certainly where I started. And we sort of did like a hybrid situation where we were printing models and then still using a drufomat to suck down guards on it. So I'd print a model and then suck down the guard or I'd use it to suck down a retainer and then, you know, cut it out the old fashioned way. But it's still so much cleaner. Now, if I ask my assistant. You know, every once in a while, the printer will be being in use and we need a model right away. And I'll say, do you want to pour that up? She will look at me like I am crazy. Like there is no way I'm getting out. You know, there's there's no way I'm getting out alginate. There's no way I'm getting out stone and finding that vibrator again and making that mess like it just never happens anymore. Yeah. So that whole mess in the lab is just days that's in the past now. And like you said, it's hard to find staff. to do things that are just not done anymore. It's like finding a programmer. We have a technology company here at Viva Learning. It's an online learning company, but it's a lot of technology behind it. And if we don't use the newest platforms of programming, it's hard to find people to hire that could fix things that need to be fixed based on older platforms of coding. So it's very similar to that in the dental practice. What do you see the future of 3D printing down the road? Yeah, I just think it's going to keep getting better and more accurate and faster. I think we're going to see zirconia being printed very soon because, you know, they're working on that. They're printing already with zirconia in other parts of the world. So we'll definitely see that here. And I think that we talked about the clear aligners a little bit. I think that's going to change the whole clear aligner market and make it so much more accessible to so many dentists. I think that we'll just continue to see a neater application. I think that the materials will get delivered in a simpler way. At the IDS a couple of years ago, I saw the printers that were using little pods for material, kind of like a Keurig machine. You could just pop the pod in whatever material you chose and print whatever you needed to print. And there's issues with waste and earth -friendly. earth-friendly disposal with things like that. But I think we're going to see more and more of that. So tell us about the learning curve. How do you get the team up to speed when you purchase this new technology that your staff is not familiar with? How do you get them to seamlessly integrate this into your workflow? What kind of training, for instance, is involved here? Right. That's always our challenge, isn't it? We come home on Monday with something new and we're all excited about it. And then it kind of sits in the corner sometimes. I have a... evoke facial contouring machine that's doing that at my office right now a pricey one but um i think the important thing is um buying it from a company that has some support and they're super simple like they came to our office boxed up no one comes and set them sets them up for you it's really easy to set up and i am not like a techie person um and i set mine up in about i don't know less than an hour unbox and set up so you have a printer and then you have a wash station and then you have a curing unit so they all come like that they all you print and then you wash with alcohol and then the materials need to be cured before they're ready for use. And that's simply, that's pretty much it. And most of these companies now... aren't closed systems anymore, and you can use different materials from different companies in their machines. So Voca is making some incredible products these days. I use their provisional material. They have a soft guard material. You can actually print a soft night guard, which is kind of amazing to me, but I use them so often. Most of our patients are using those. I think that in order to get the team on board, you need somebody, a company that has a little bit of support. And you have to find that right person who's excited about taking that next step in technology. That person, maybe. I mean, we all have them. The one that's constantly on their phone, that's constantly on social media. Those are the people that are the right one. I guess if they took your 3D printer away right now, Dr. McMahon, you'd be like, wow, we're in trouble, right? If somebody said you can't have it for a month. There'd be a lot of sad faces in my office. It's pretty easy to become very dependent on new technologies. So 3D printing has really, really brought efficiency into your office. As we wrap up this podcast, tell us your thoughts on that. Oh, absolutely. Absolutely. You can have a guard printed, surgical guides. That's the other thing we didn't talk about. I knew there was one more. We're printing surgical guides for implant placement. And so I can consult somebody today. design tonight, have them in the surgical chair in two days, as opposed to, you know, waiting for a company to give you a guide that might take a week or two weeks to get to you. And it's, I love having that control. I love having the control to do that. Yeah, it's fantastic stuff. And I know you don't do a lot of dentures in your practice, but also printers are very good for interim dentures, certainly for try-in before. creating a milled denture, which could be done at the lab. But there are a lot of, there are companies that are making these milled denture blocks that are turning out to be fantastic where the teeth and the base are one piece. And before that's milled, they do a try-in and they print the denture right in the office. And that's the try-in. They sit with that for a couple of months if that's the case. And then they go to the final. So it's... Really incredibly different than it was when we were in, at least when I was in dental school, for sure. Me too. I hated making dentures in dental school. That was the worst thing for me. You're talking to an endodontist. So how much did I enjoy that? Yeah. I'm the last guy that enjoyed making those. But I hear you. Very happy we had this time together, Dr. McMahon, and our audience could listen to your insight into using 3D printers and the efficiency that it brings. And we look forward to future podcasts soon. Thank you so much. Thank you so much. All right. Have a great day.