New inLab MC 5-Axis "Open" Mill

[BobCDT]

I saw the mill in Japan at a show a couple of weeks ago. Not running, no pricing available. Seems like it will be a while before they start to ship.

 

[Ron.Ferland]

I'm really not sure why any laboratory would support this system or company. I heard first hand Sirona and Patterson reps work over doctors and show them an ROI on how they can replace their lab bill with an MCXL. I bet the R&D for this new milling system came in-part from MCXL sales to dentists. Am I wrong with this way of thinking?

 

[Mohammad Khair]

This false and misleading statement ( the chair side cad/cam system will cancel or replace the lab bill),
will really encourage dental techs to hate that system and the company who made it, but on the other hand the very same statement will fool the docs out and encourage them to buy the system.

So why don't we think wisely and speak fairly, from a real experience, simply by telling the facts,
and declare our disagreement with such a statement, and yes it will reduce the lab bill, but absolutely not for free it will be on the account of the doc's time.

Try to be positive and fair by giving the docs a practical honest advice and a professional opinion about those system, without supporting the false claims proposed by anyone.

What a doc will gain back from the lab bill will be paid directly from the doc's time, and the best benefit of such systems is to back up docs on their urgent cases.

Any doc who will read this statement coming and claimed to be true from a professional lab tech,
will most likely to call the company the very next day to order the system because of the very wrong reasons and facts while expecting the very false return.

I think many docs are visiting this site, and could count on our professional opinions.
Hopefully my point of view is clear to everyone now.

 

[Ron.Ferland]

This false and misleading statement ( the chair side cad/cam system will cancel or replace the lab bill),
will really encourage dental techs to hate that system and the company who made it, but on the other hand the very same statement will fool the docs out and encourage them to buy the system.

So why don't we think wisely and speak fairly, from a real experience, simply by telling the facts,
and declare our disagreement with such a statement, and yes it will reduce the lab bill, but absolutely not for free it will be on the account of the doc's time.

Try to be positive and fair by giving the docs a practical honest advice and a professional opinion about those system, without supporting the false claims proposed by anyone.

What a doc will gain back from the lab bill will be paid directly from the doc's time, and the best benefit of such systems is to back up docs on their urgent cases.

Any doc who will read this statement coming and claimed to be true from a professional lab tech,
will most likely to call the company the very next day to order the system because of the very wrong reasons and facts while expecting the very false return.

I think many docs are visiting this site, and could count on our professional opinions.
Hopefully my point of view is clear to everyone now.

Units milled in the dental office means units not fabricated in my laboratory. I lost major accounts to CEREC that have not come back, except for the large/hard cases. I will support companies that do not attempt to take my clients away. Sirona is not one of them. My point should be very clear.

 

[Mohammad Khair]

Units milled in the dental office means units not fabricated in my laboratory. I lost major accounts to CEREC that have not come back, except for the large/hard cases. I will support companies that do not attempt to take my clients away. Sirona is not one of them. My point should be very clear.

By this statement you just support Sirona.
and if they are really major accounts, they should really have no time for in-office designing and milling, unless you have only a couple of patientless docs and call them major accounts.

 

[RileyS]

This false and misleading statement ( the chair side cad/cam system will cancel or replace the lab bill),
will really encourage dental techs to hate that system and the company who made it, but on the other hand the very same statement will fool the docs out and encourage them to buy the system.

So why don't we think wisely and speak fairly, from a real experience, simply by telling the facts,
and declare our disagreement with such a statement, and yes it will reduce the lab bill, but absolutely not for free it will be on the account of the doc's time.

Try to be positive and fair by giving the docs a practical honest advice and a professional opinion about those system, without supporting the false claims proposed by anyone.

What a doc will gain back from the lab bill will be paid directly from the doc's time, and the best benefit of such systems is to back up docs on their urgent cases.

Any doc who will read this statement coming and claimed to be true from a professional lab tech,
will most likely to call the company the very next day to order the system because of the very wrong reasons and facts while expecting the very false return.

I think many docs are visiting this site, and could count on our professional opinions.
Hopefully my point of view is clear to everyone now.

Dude, I've been talking with rep, doc, and pt all together in docs lobby and the sirona rep blamed me, and therefor all labs, for high cost of dentistry and said that he can bring that cost down with his chairside mill. This means doc doesn't have a lab to pay. This obviously means doctor won't be using the lab. This means Sirona is purposely taking business from labs. This means labs that support Sirona are dumb.
I understand it's the way of the future. But that doesn't mean I have to support it with a stupid smile on my face.
I used an mcxl for 3 years. From that experience I will never allow any of it's work in my mouth or my families. I have talked with neighbors and in-laws with cerec crowns and heard their complaints of discomfort, chipped and broken crowns, and complaints of completely and obviously wrong colors and overall look. I understand the doctor using it determines the quality that comes out of the machine and I've followed differnet forums and seen good work...but most of the posted work is crap they call awesome. But most docs realize they bought a $100k gizmo and they need to put it to use. If they don't have the right shade in stock, use anything. Margin chipped or not sealed? Cement will fill it. What once would send the doctor furious to a phone to let his lab know the shade was off or wrong is now accepted when they milled it.
Wow, I better stop.

 

[RileyS]

By this statement you just support Sirona.
and if they are really major accounts, they should really have no time for in-office designing and milling, unless you have only a couple of patientless docs and call them major accounts.

Again, Dude, Sirona took away from Ron's lab, leaving him the "large/hard cases." If Sirona had not taken away that account, Ron's lab would have all the other cases the doc wasn't milling chairside which equals MORE work. Does that make sense?
Maybe this will help. If you were a seller of goat cheese and one of your clients started to buy 95% of their cheeses from the chicken cheese vendor, what percentage of his cheese comes from you? What percentage of goat cheese sales have you lost to this account?
Did I miss the part where ANYTHING Ron said shows his support for Sirona?

 

[Mohammad Khair]

Dude, I've been talking with rep, doc, and pt all together in docs lobby and the sirona rep blamed me, and therefor all labs, for high cost of dentistry and said that he can bring that cost down with his chairside mill. This means doc doesn't have a lab to pay. This obviously means doctor won't be using the lab. This means Sirona is purposely taking business from labs. This means labs that support Sirona are dumb.
I understand it's the way of the future. But that doesn't mean I have to support it with a stupid smile on my face.
I used an mcxl for 3 years. From that experience I will never allow any of it's work in my mouth or my families. I have talked with neighbors and in-laws with cerec crowns and heard their complaints of discomfort, chipped and broken crowns, and complaints of completely and obviously wrong colors and overall look. I understand the doctor using it determines the quality that comes out of the machine and I've followed differnet forums and seen good work...but most of the posted work is crap they call awesome. But most docs realize they bought a $100k gizmo and they need to put it to use. If they don't have the right shade in stock, use anything. Margin chipped or not sealed? Cement will fill it. What once would send the doctor furious to a phone to let his lab know the shade was off or wrong is now accepted when they milled it.
Wow, I better stop.

Again, Dude, Sirona took away from Ron's lab, leaving him the "large/hard cases." If Sirona had not taken away that account, Ron's lab would have all the other cases the doc wasn't milling chairside which equals MORE work. Does that make sense?
Maybe this will help. If you were a seller of goat cheese and one of your clients started to buy 95% of their cheeses from the chicken cheese vendor, what percentage of his cheese comes from you? What percentage of goat cheese sales have you lost to this account?
Did I miss the part where ANYTHING Ron said shows his support for Sirona?

Sirona or any other one who state this is just bushing doc to do their work and the technician work under a false statement and misleading opinion.
the doc who have his/her time filled with patient real treatments will never offer the time to just follow the sick dream of any chair-side company.
What a stupid dream to change the doc from a doc to technician,,, the milling designing finishing and glazing in-office need someone to do it, the milling machine will never dance by itself.

 

[LA Ceramics]

Again, Dude, Sirona took away from Ron's lab, leaving him the "large/hard cases." If Sirona had not taken away that account, Ron's lab would have all the other cases the doc wasn't milling chairside which equals MORE work. Does that make sense?
Maybe this will help. If you were a seller of goat cheese and one of your clients started to buy 95% of their cheeses from the chicken cheese vendor, what percentage of his cheese comes from you? What percentage of goat cheese sales have you lost to this account?
Did I miss the part where ANYTHING Ron said shows his support for Sirona?

Mmmmmmm,...cheesy

 

[Pronto]

I'm really not sure why any laboratory would support this system or company. I heard first hand Sirona and Patterson reps work over doctors and show them an ROI on how they can replace their lab bill with an MCXL. I bet the R&D for this new milling system came in-part from MCXL sales to dentists. Am I wrong with this way of thinking?

I have heard this many, many times at lectures at Patterson and at the Yankee Dental Congress. Make no mistake, this company is out to destroy dental laboratories, especially the smaller ones. For the life of me I can not understand why a dentist would want to be a dental technician unless it's pure greed. It's sad to think of all the talented dental technicians that are no longer able to make a living b/c of this evil company and it convincing it's doctors they are going to make maximum profit. So now they believe in a machine that will supposedly bring them piles of money and have a huge bill to pay to Cerec instead of a much more modest lab bill. Then they are on the hook for blocks, burs, acquisition upgrades and less personal time. By the time they figure out how much it really costs to run the Cerec they are in too deep.

 

[KentPWalton]

Docs never do that, they will save 150$ of your price and add mostly the same amount for the same appointment delivery so the extra gain is 300$, 100000/300= 333.33 units-days
which is nearly a year.
and yet if they have enough patients the gain is more if they send you all the cases.

And I Quote...



So realistic numbers would be good. 10 units a day at 5 days a week 52 weeks a year is only 2600 units.

Plus, they're going to have vacation and holidays. So let's go practical with our numbers and not 100,000.

Let's say that they take off a total of 4 weeks out of the year. Now you have 48 working weeks. That's

still only 2400 units a year. So if you're doc is a rock star doing 10 units a day, which I highly doubt, he

would save $360,000 at your $150/unit. So now you have to subtract the overhead that he has from making

his crowns in house and it's really a minimal true savings. Some docs love saving minimal and tinkering with

things in-house. I say more power to them. But if they could do 5 more units a day without having the

in-lab and having to do all of his own crowns, that's increasing production by 50%! The monetary difference

in making the crowns in house and outsourcing them to a lab is null then. I would guess to say that it would be

more advantageous to outsource them in stead of doing them in house. Wouldn't you like to increase

your production by 50%?! I don't think anyone would argue with that one. Then again...

 

[KentPWalton]

When it's all said and done, the Docs are only saving money on the singles. I understand that is

the 'bread and butter' of most dental labs. You need to see the way the market is trending and start

to look a the cost of doing those anterior cases. Charge more and start to concentrate on making

really nice restorations. There are ways around the Cerec work flow. Also bridges. The machine

cannot do it all guys. I've yet to find a machine that does all things well consistently and look forward

to the day that someone comes out with one.

 

[CoolHandLuke]

guys, lets stop panicking and remember a few things.

1. docs who fall for sirona always (without exception) have issues producing crowns.

2. when that happens they push the lab harder to make crowns in speedy turnaround, theyve made promises and are under the gun. some dentists resort to really shallow bottom line crimping and send those cases to china all by themselves. theyre paying through the teeth for the sirona already so they arent willing to wait for your overpriced crown. then again they might also turn back to what has worked in the past instead of again venturing into the unknown and uncharted. so hopefully youve made a good impression. hopefully your sales dudes and dudettes can identify these issues and bring them to the forefront.

3. this is the window of opportunity to remind them that no tabletop device can take the entire weight of a lab; after all there is more to the lab than its handpiece. a lab is not merely its roland or its haas. those are only what a lab needs; what a lab truly is, is a service, and no machine can be a service without input. and being a machine that input better be 100% because you get what you give.

so let them buy their sironas. let them fail. it may take a few months and i know it sounds colloquial and patronizing and cliche, but they will be back.

sirona cannot replace a lab in an office. you know what will? an actual, factual, balls-to-bones lab in the office. that's what replaces labs.

 

[rkm rdt]

This is why they invented Cerec Connect. The next portal to hell.

 

[KentPWalton]

guys, lets stop panicking and remember a few things.

1. docs who fall for sirona always (without exception) have issues producing crowns.

2. when that happens they push the lab harder to make crowns in speedy turnaround, theyve made promises and are under the gun. some dentists resort to really shallow bottom line crimping and send those cases to china all by themselves. theyre paying through the teeth for the sirona already so they arent willing to wait for your overpriced crown. then again they might also turn back to what has worked in the past instead of again venturing into the unknown and uncharted. so hopefully youve made a good impression. hopefully your sales dudes and dudettes can identify these issues and bring them to the forefront.

3. this is the window of opportunity to remind them that no tabletop device can take the entire weight of a lab; after all there is more to the lab than its handpiece. a lab is not merely its roland or its haas. those are only what a lab needs; what a lab truly is, is a service, and no machine can be a service without input. and being a machine that input better be 100% because you get what you give.

so let them buy their sironas. let them fail. it may take a few months and i know it sounds colloquial and patronizing and cliche, but they will be back.

sirona cannot replace a lab in an office. you know what will? an actual, factual, balls-to-bones lab in the office. that's what replaces labs.

I agree. And the number of in office labs are less than 1% here in the US. So take your hand slowly off the panic button!

 

[BobCDT]

And I Quote...

View attachment 16918

So realistic numbers would be good. 10 units a day at 5 days a week 52 weeks a year is only 2600 units.

Plus, they're going to have vacation and holidays. So let's go practical with our numbers and not 100,000.

Let's say that they take off a total of 4 weeks out of the year. Now you have 48 working weeks. That's

still only 2400 units a year. So if you're doc is a rock star doing 10 units a day, which I highly doubt, he

would save $360,000 at your $150/unit...

Mohamed, I love your thought process. However, Cerec is showing up in many average Dental practices. I would guess the average dentist works four day week and does one unit a day possibly a little more. So, let's say the production is more like 20 units a month less the four weeks vacation or 220 a yr. Cerec cost about $125 K and the doc needs significent continuing Ed to get it right, $25K more in Arazona. Now let's look at what the real ROI would look like.
Cost of system. $125k
Education $25k
Create inventory of blocks, coolant and tools $10K
Total up front investmet $160K
Over five years this will cost about $2800 a month.

Now let's look at the cost per unit.
Block $32
Tools $4
Labor $0 (let's say the labor is similar to making the temp even though it's likely more).
Net materials and labor $36.

Your average doc that does 20 units a month times 11 months will be paying $162 a unit for the lease plus $36 for material.
BOTTOM LINE $198 ($0 labor) a unit plus the headaches of inventory, cost of obsolete inventory, education, maintaince and the need to keep producing to pay for the mill. In addition, Sirona is constantly developing new better?? Scanners and mills resulting in continued reinvestment of revinue into the system.
Obviously the more work put through the mill the lower the unit cost. In addition, Cerec grinds on glass and many ceramic units have chipped margins coming out of the mill. Most docs don't glaze the work, just mill and posilish. Are they really providing a lab like restoration? Do they need to? On the other hand, I do get the benifit of a crown in one appointment. I know I am constantly busy and if I needed a crown I would love to take care of it in one apt. That said, we, as lab people need to offer a crown in a day.
I have attempted to be as non bias as possible here. If there is a cerec doc out there and you figure it differently please pipe in.

 

[BobCDT]

This is why they invented Cerec Connect. The next portal to hell.

The good thing about Cerec connect is the comittment need from the lab to get files. The lab must have a Cerec scanner and CAD. This makes the barrier of entry big. As a result, docs will generally be forced to go analog or send to labs they would rather not work with. It all goes back to buying into closed systems. The labs get it. The docs, not yet.....

 

[CoolHandLuke]

great post bob, additionally try convincing a doc to buy an additional yearly dongle to connect his sirona to you the lab. that adds a chunk. then float a conservative 20% remake factor. some labs experience as high as 60% on emax tho.

 

[KentPWalton]

Mohamed, I love your thought process. However, Cerec is showing up in many average Dental practices. I would guess the average dentist works four day week and does one unit a day possibly a little more. So, let's say the production is more like 20 units a month less the four weeks vacation or 220 a yr. Cerec cost about $125 K and the doc needs significent continuing Ed to get it right, $25K more in Arazona. Now let's look at what the real ROI would look like.
Cost of system. $125k
Education $25k
Create inventory of blocks, coolant and tools $10K
Total up front investmet $160K
Over five years this will cost about $2800 a month.

Now let's look at the cost per unit.
Block $32
Tools $4
Labor $0 (let's say the labor is similar to making the temp even though it's likely more).
Net materials and labor $36.

Your average doc that does 20 units a month times 11 months will be paying $162 a unit for the lease plus $36 for material.
BOTTOM LINE $198 ($0 labor) a unit plus the headaches of inventory, cost of obsolete inventory, education, maintaince and the need to keep producing to pay for the mill. In addition, Sirona is constantly developing new better?? Scanners and mills resulting in continued reinvestment of revinue into the system.
Obviously the more work put through the mill the lower the unit cost. In addition, Cerec grinds on glass and many ceramic units have chipped margins coming out of the mill. Most docs don't glaze the work, just mill and posilish. Are they really providing a lab like restoration? Do they need to? On the other hand, I do get the benifit of a crown in one appointment. I know I am constantly busy and if I needed a crown I would love to take care of it in one apt. That said, we, as lab people need to offer a crown in a day.
I have attempted to be as non bias as possible here. If there is a cerec doc out there and you figure it differently please pipe in.[/QUOTE


Thank you Bob for clearing that one up for me! I like what you said better than how I put it.

 

[Mohammad Khair]

Nice post guys, i really like realistic posts, if we should be fair we always must mention the good and bad about any system, just because if we said as professional techs that the chair side cad cam is the doc's paradise then every doc will go for it, we need to mention also the price, all of us know exactly how much it takes to deliver a cad cam crown, but the docs really don't, the doc must know that the system will mostly not help except for urgent cases that fact i saw it so many time.
let the doc go for a real demo on a real patient from a to z done by a real professional from the company itself, and he/she will discover this fact.

on the other hand i found cerec to be very much more successful in the lab, simply because it got the right operators, however a scanner in the clinic that give stl file format + wet small mill in the lab will do the best for docs and for labs and that actually is the new trend.
if a doc got a good scanner that can send stl files, every lab is willing to do a very fast restoration for such a doc with relatively reduced price.

now cerec and other companies actually figure out that so they start to focus more on lab-office network and a good mills to the labs+ good scanners for labs and clinics.

to be like close wide exclusive chain as Luke and Bob said.