It's the Year of 3D Printing: Enjoy the Convenience and Profitability

You're listening to the Phil Klein Dental Podcast So these days we're hearing a lot about the 3D printer. When the topic comes up, many of us are asking ourselves and our team members, do we really need a 3D printer in our practice? Is it worth the money and time to learn how to use it? And is this just another gadget that my rep is trying to sell me? Or on the other hand, is there something much bigger that I'm missing here? Perhaps a 3D printer can actually transform the way I practice dentistry. And perhaps it's pretty easy to learn how to use. Let's talk to someone who has gone through all the decision -making on this and can speak firsthand. Our guest is Dr. Susan McMahon. She is a successful clinician. world-respected speaker and dental practice owner in Pittsburgh, Pennsylvania. She has devoted her professional career to the pursuit of advanced technologies in cosmetic and minimally invasive dentistry. As always, we're very happy to have Dr. McMahon as a regular contributor on VivaLearning.com and on this podcast. Before we get started, I'd like to mention that Dr. McMahon's webinar, titled 2024, is the year for 3D printing, convenience for your patients, profitability for your practice. That webinar is now available as an on-demand webinar on VivaLearning.com. Simply type in the search field McMahon, M-C-M-A-H-O-N, and you'll see it. It's an excellent webinar. If you're in the market for a 3D printer or looking to enhance your digital workflow, it is definitely worth watching. Dr. McMahon, it's a pleasure to have you back on the show. Hello, Phil. It's a pleasure to be here. Thanks for having me. Yeah, and it's wonderful that you're broadcasting from beautiful Hawaii. I know you're lecturing there, so thank you so much for joining us from such a beautiful part of the world. So let me ask you this. Over the past 10 years or so, we've continued to see a profound change in dentistry, in large part due to new technologies that are being introduced into the operatory and into the lab. And one of those most talked about components is 3D printing. So why do you think 3D printing is all the rage right now? And will this be the must have technology for 2024 in the next couple of years? Yeah, I think it's absolutely going to be the must have technology. And I think the reason why is, you know, we've seen such an uptick in the number of offices that have intraoral scanners. It's just. you know, really been climbing every year. And when I ask a room full of people, like I asked the doctors that were here listening to me yesterday, you know, how many people in the room have scanners? And it used to be like, 10%, then 20%. And now over 50%, 60% of the room has scanners. So it is such an easy transition from an intraoral scanner to doing some production in your office. And 3D printers and the AI that connects the scanner to the printer make it so easy. And I also think because the printers have sort of a... reasonable entry point. You can buy a printer for $10,000, $12,000 and be up and running in one day in your office from your scanner. So for the most part, do dentists use 3D printing mostly for models and just so they can obviate the need for that messy alginate? That's where I started. I started with... I started with a Formlabs printer about five years ago, and we just started printing models from that. And we found it really easy and convenient to start moving to other things. So now I have an Acureta sole that I really like, and we are doing lots of different things in our office that we used to send out to labs. So we will not only just print models, we're doing occlusal guards, hard and soft occlusal guards. So you can scan a patient and... have a guard ready for them within 24 hours. And I find that people, you know, convenience is the number one thing for so many patients and they're accepting of treatment. They like that they're getting it right away. So models, guards, we do a lot of surgical guide printing with our 3D printer. I also just started printing final restorations, which is kind of cool. We're doing like a ceramic resin blend on bicuspids, inlays, onlays. And I print a lot of my provision. on my printer now. So they're really durable and they fit really well and you can print them in like 15 minutes. It takes almost the same amount of time to print it as it does to hand make it and you just get such a better outcome. So incorporating a 3D printer into the practice from the standpoint of the learning curve, there's obviously new materials that you have to work with and they come in a different form. You have to understand some aspect of the design process and the workflow and doing it the traditional way, the analog way is completely different. So what are we looking at as far as a learning curve regarding the dentist and the staff? Yes, yes. Great question. So I think that my staff immediately... loved, embraced the no more model pouring and no more powder everywhere, the alginate bowls. They loved getting rid of that. So first thing we did was teach everyone in our office. So every assistant, every hygienist, and even our front desk people know how to enter oral scan. So every patient of ours has a scan. And I think that was the... the step-off point for us. And to get from a scan to be able to print an occlusal guard is pretty simple. You know, there's a little software that's in between. You have to design the guard, but it's pretty simple to get there. And then there's AI involved in the printers that will take your design and put it on the supports that are necessary. And I know that sounds kind of, you know, sounds like a... a big hurdle. And it, and I thought it was too, until you do it. And you're like, Oh my gosh, that's so easy. I am not the techie person in my office and I do this all the time now, but it cleans up everything so much that my staff loves it. And it makes it really simple for them to go from diagnosing to. actually delivering an appliance same thing with surgical guides we can get someone in our surgery chair inside of three days instead of like the two weeks out things like that so i think that you know for us we had to kind of identify our one person that was the lead techie person Everybody got trained to scan. And then from there, we started to offer bonuses around things like occlusal guards and things that we were printing in our office. And it allowed them to see how easy it was to present that to patients and deliver to patients. It flowed from there pretty easily. So flowed from there is a good term for this type of device. What about the design software? Does that come with the printer or did you get that separately? Is that an open source design software that you can use with any printer? Tell us about that. Yeah, that's a lot of dentists kind of get hung up on that. So it's just like if you're milling, you have to scan whatever you want to make, right? So you have a digital inter-oral scan, and then you have to design the restoration or the guard or the surgical guide. You have to design that. And then from that design, you send that to the printer and pick a material that you're going to make your restoration or your guard or your guide from, right? And there are some... have trios. You can purchase design software and you can go right from your scanner. You can design right on your trios and it will link directly to your printer. Your printer has a little AI program in it that puts it on the supports that it needs. So it's really simple to do that. I know we were intimidated by that when we first started doing it. We're like, ah, supports, what does that even mean? I don't understand that. So who taught you how to do the design stuff? Did the sales rep come in and say, here's how to make an occlusal guard? You just pull these coordinates down over the model. the virtual model. I mean, how big a deal was that to get that design understanding where you're at the point where you can knock these off pretty quick? Right. Like occlusal models are super simple. You don't need to design anything. You go right from your model to printing. But occlusal guards are also pretty easy. Like the software is easy. So we do it on our trios design. You can buy ExoCAD and there's some like there's modules of all of these design software that you purchase individually. So you can start with maybe just doing occlusal guards. And it's very simple to do. And AI has changed everything for us. Right. It just it's doing a lot of the thinking for us. But, you know, you're telling it what you want. It helps you design it. And a couple of clicks later, it's on its way to the printer. Yeah. Could you imagine what AI is going to be doing like five years from now? It's just moving so quickly. You know, I mean, I just hope we all have jobs. It's crazy. I was thinking the same thing. I hope that they still need me. I think, I don't think AI can anesthetize the patient. I don't think AI is going to be able to, you know, do the prepping. But, you know, I probably am wrong about that part. Yeah, everybody doubted everything when it came to AI. And now it's just doing about everything. So tell us about the materials. Tell us about how it's delivered into the printer, how it's stored, shelf life. how the materials differ from one application to the other, and those kind of things. Right. So if you're milling things, you have blocks in your office, you have lots of different shades, you're stocking lots of different materials in your office. For printing, I stock about six different printing materials. And depending on what your printer is, like my Formlabs had this very big well, and it was sort of hard to manage. So you have a well for each of your materials. And as you're... Changing from different production. So if I'm producing occlusal guards, I might be able to put three or four of them on a platform or get a bigger platform and put six and I can print them all at the same time. So I take my guard material and I have them stacked in light, tight. almost like Tupperwares, if you will. You buy them, they come with the printers or you can source them from the printer manufacturers. And there's a little tray where you keep your materials in and you then switch them out according to what you need. So it's pretty manageable. I love the Acureta because the footprint of it is very small, but it's still sort of a powerhouse printer. And the storing for those materials is pretty manageable. What are some of the materials specifically that you like to use for 3D printing applications? Yes, I've actually been using so much of the VOCO materials. I just really like them. We're getting great results with them. They're easy to use. They deliver what we need them to. So VOCO has a surgical guide material, really easy to use. So we use that. We use their two both occlusal guard materials. You can print a regular hard occlusal guard or you can print a flexible one. So two different materials both work really well. My new favorite thing that I've been using from VOCO is their provisional material, provisional crown and bridge material. So I'm printing bridges with that, individual crowns, whole six units with it. It's really nice. So that's a one shade material, right? So you don't have to stock a whole bunch of different stuff. But then I will use OptiGlaze from GC America and stain and glaze it. So I've been getting so much better at staining and glazing it, and it only takes a few minutes. I can't sort of believe how easy it is to do it. And that's the part I enjoy. Like, I love that customization. I love to be able to deliver a provisional that's... prototype for my final restoration. And that's just part of the thing that I enjoy doing. So we prep somebody, we scan them, we might design for five minutes, and then it'll take maybe 10 to 15 minutes to print. The material comes out of the printer. You have to rinse it in an alcohol rinse, which is about a five minute rinse. And then you can cure it in an oven. And when it's cured, you can... can glaze it at the same time. So the whole process might take 20, 25 minutes, something like that. The patients must be amazed at the beauty of their temporaries. You know, so often for me, people will say, I'm doing a lot of anterior work and a lot of like rework. And people will say, I kind of hesitate to do this work because last time I had temporaries on, they look terrible. I hear that all the time. And I'm able to say with confidence, you are going to love these provisionals. You can go to your big event in them. You're going to smile. You're going to really like it. It's nice to be able to say that with confidence to know that I can deliver that for them. And it really helps people move forward on treatment, I think. Yeah. So there's no doubt that for most dental patients, convenience is a big factor, but that holds true for almost all of us. And with everything digital these days, it seems like everyone wants everything immediately. I don't know if you know this comedian Ronnie Chang, but anyway, he did a special on Netflix where he mocks the Amazon shopper who expects the product to be delivered before even clicking the purchase button. It was really very funny. So yeah, it was a funny segment. So we all know that convenience is just like out of control right now. So how does having a printer provide the ultra convenience that your patients are looking for? And you talked about it in this podcast already, but also the efficiency. How does it combine that convenience, speed, efficiency in a dental practice where once you have one of these machines, you just never look back? I think it's... completely agree with you that convenience is like the number one factor for people in deciding whether to move forward with treatment. It's not even about fees anymore. It's about how quickly can I get this done? How many times do I have to come back and see you? Can you do it all here in your office? Those sorts of things. So there's so many opportunities for us to. you know, we diagnose implants. I say, we can get you in our implant and with our surgeon inside of, you know, before the end of the week. And I'm able to turn that design, design, you know, do the full restoratively driven implant placement with a surgical guide in a day, really. I can do that in a day and have it ready for the surgeon. I also find it convenient, like, how often are you having people that are, I lost my retainer, I lost my guard. I always see right around all the holidays, all my college kids are coming back. And they're always like, oh, no, I don't have a retainer anymore. And, you know, what did we used to do back in the day? I'd say, well, go back to your orthodontist and have him make you one, which has never happened. They never do that. But, you know, we take a scan and we have a retainer made for them. In an hour and a half, go get a cup of coffee and come back and bring us one and we'll have one ready for you. So it's made a huge difference on so many levels. So if somebody took your printer away, how would that affect you and your staff? Like what would be the reaction in the first week of working without it? We would hunt them down and eliminate them. You'd hunt them down, eliminate them. Yeah. So how long have you had a printer? I mean, you've been doing dentistry for a while. You have one of the biggest practices, what, in Pittsburgh, right? Yeah. So when did you start realizing all these conveniences and speed? And now if I say I'm going to take your printer away, you're going to go crazy. So what'd you do before? I used to hand make provisionals. I used to hand wax, hand make provisionals, just like the whole analog situation. If I wanted a surgical guide, even before I have a digital intraoral scanner, but now we've an intraoral scanner and a CT scanner and we do the planning. But if I wanted a surgical guide, I would be lucky to get that in my office inside of 10 days. I would do the design. Someone has to manufacture it. They've got to send it from the lab. That's a 10-day out for me. It used to be a 10-day out for me. occlusal guards, and you can get them pretty fast from big production labs, right? You can get them like in five days, maybe. Now it's an overnight. But let me ask you this. Suppose you have a complex design on an occlusal guard. You know, it's just more complex than the typical one that you do. Can you send that out to the lab to design your favorite lab person? And then they just send the file back to you and then you print it. That's a great question. And yes, and we do do that. Right. I don't have the capability to design everything I need. Like we are also doing prototypes for all on X cases. And I don't have the skill set to design that. But I work with my lab and we have the, you know, we do a pre-workup and have a sort of a prototype design going. And then surgery day comes and teeth out, implants in. We put the scan bodies on the implants, scan that right off to the surgery. and he's waiting for it you know we all plan this ahead of time so but instead of having somebody you know used to come to my office that a lab tech used to come to my office spent the whole day there would have a to have a denture ready he'd ream it out to you know retrofit it onto the implants um now we scan that do the scan bodies we have the design done it comes back to us in about maybe like 45 minutes or so And then I can print a entire prototype on all on X. I'll print it, wash it, take off all the little nubs that hold the supports on it, which takes about a minute with a burr and then glaze it. And it's, it's in the mouth, like same day, an hour, two hours later. So it's been, there's, there's definitely things I need help with that I'm not designing myself for sure. Yeah. So we talked about convenience and there's no question this is like ultra convenient for the patient and the practice, no doubt about it. But what are you seeing in regard to increased production and increased revenue from adding an in -office printer into the digital workflow? I think just basic, basic increase in production are occlusal guards because my hygienists are more cognizant of that. And they are looking for wear, they're looking for parafunction, and they're recommending them. And, you know, we incentivize them a little bit to look for those things. But because they're able to offer them to the patients and say, I can have this for you tomorrow, we've seen an increase in production. And just from that sort of pays for the printer already. But we've also seen a big increase in implant placement. I think because we're all more comfortable with designing, getting those stents ready, making provisionals to go on them. And we recently, maybe he's been with us about two years, we have a periodontist that comes to our office to put the implants in now. So that all used to get referred out for me, and now it's in my office. And that's been a really nice bottom line sort of situation. So it seems to me, as we wrap up this podcast, And it's been very enlightening, Dr. McMahon, as usual. And you have some really good podcasts with us and great webinars. I encourage everybody to visit vivalearning.com and search McMahon to find some of the stuff. It's just really, really good stuff. So in closing, how do you see the next five years? I mean, what happens to the dentist that just doesn't adopt this new technology? And they don't have a scanner. They don't have a printer. And I know we're talking about printers today. But how does a dentist like that compete? in the digital world, I mean, they kind of need to jump on board, right? And move forward from the traditional ways of doing things. I think their patients will notice it. Their employers will notice it if they don't. And they'll be kind of left in the dust. What's your feeling on that? I completely agree. I think that, you know, looking into our future, into our crystal ball, I don't know. But I think the same thing is going to happen. that we're seeing like 5% or 10% of offices have printers now. I think we're going to be at 70% in five years. There's always going to be the dentists that kind of lag behind and they don't get on board, but they're the ones whose practices really aren't thriving, really aren't, you know, they're just kind of surviving, if that. And printing... is easier to access than milling. It's easier to design. There's more material versatility. There's more options. You can make many different things with one printer. And like companies like Voca that make all these fantastic materials, you could, they have a denture material. I don't do a lot of dentures in my office, but can you imagine, you know, having that denture ready for somebody in? a day. You go through the process of making a denture. You keep their file there. They lose their denture. They break their denture. You're like, hey, no problem. I'm going to print you another one. It'll be ready in 24 hours. And I think that it's definitely going to be the standard of care, especially as younger dentists are moving forward. They're used to working with technology. And the way we did things before had its day, but we have to keep offering the convenience to patients and offering the technology that helps drive us forward. No question. Digital technology has brought an incredible conveniences, speed, efficiency, opportunities into the practice. And it's an exciting time to practice dentistry. Thank you very much, Dr. McMahon. We really appreciate your input today. Really do. Thank you so much. Thank you, Dr. Klein. 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