Deciding between Exocad & 3Shape Dental System & More

[DrMJF]

I need some input from the lab techs...
I'm a fairly tech-savvy dentist and do a lot of my own tooth, tissue, and bone-supported stacking surgical guide designs, screw-retained implant provisional crowns on Ti-bases, and 3D print my own occlusal appliances and lab-designed all-on-x temps. I'm just getting into CAM, and the BlueSkyPlan software I've been using isn't up to snuff for more advanced processes like designing/exporting custom titanium/zirconia abutments and doesn't support CAM nesting (as far as I'm aware).
I'm looking at a Roland DWX-53DC (or DWX-52 DCi) and DWX-42W to support my dry and wet CAM needs, respectively. I have no plans to do same-day crowns. I run 3 (soon to be 4) offices and have roughly 30-60 fixed units and 10-15 arches of removable weekly, total. **We use 3Shape Trios scanners in each office**
My question: given these positions, should I look at investing into Exocad or 3Shape CAD software?
I've heard 3Shape is more intuitive because it keeps you in a fixed workflow and might be more friendly for somebody who doesn't do design full-time. I also like the AI design feature and the ability to outsource design to meet volume demands. The lab management software (LMS) feature sounds helpful to somebody with busy practices and cases coming in and out constantly. It also seems like it would play well with our office Trios scanners.
BUT...
every lab tech I've spoken to swears by Exocad. I know a prosthodontist who uses it too. I would need to be able to design All-On-X prostheses with ASC (Vortex screws), dentures, partials, abutments, and implant/tooth crown&bridge. To me, money is secondary to efficiency, throughput, and ease of task-delegation/training.
1. Help me decide between the two options!
2. Any recommendations for sintering / crystallization ovens? I was looking at the Ivoclar S1 and CS2, respectively. Is the CS-4 good to do both?
3. Any recommendations for better/different mills from the ones I listed?

Thanks in advance!

 

[zero_zero]

I need some input from the lab techs...
I'm a fairly tech-savvy dentist and do a lot of my own tooth, tissue, and bone-supported stacking surgical guide designs, screw-retained implant provisional crowns on Ti-bases, and 3D print my own occlusal appliances and lab-designed all-on-x temps. I'm just getting into CAM, and the BlueSkyPlan software I've been using isn't up to snuff for more advanced processes like designing/exporting custom titanium/zirconia abutments and doesn't support CAM nesting (as far as I'm aware).
I'm looking at a Roland DWX-53DC (or DWX-52 DCi) and DWX-42W to support my dry and wet CAM needs, respectively. I have no plans to do same-day crowns. I run 3 (soon to be 4) offices and have roughly 30-60 fixed units and 10-15 arches of removable weekly, total. **We use 3Shape Trios scanners in each office**
My question: given these positions, should I look at investing into Exocad or 3Shape CAD software?
I've heard 3Shape is more intuitive because it keeps you in a fixed workflow and might be more friendly for somebody who doesn't do design full-time. I also like the AI design feature and the ability to outsource design to meet volume demands. The lab management software (LMS) feature sounds helpful to somebody with busy practices and cases coming in and out constantly. It also seems like it would play well with our office Trios scanners.
BUT...
every lab tech I've spoken to swears by Exocad. I know a prosthodontist who uses it too. I would need to be able to design All-On-X prostheses with ASC (Vortex screws), dentures, partials, abutments, and implant/tooth crown&bridge. To me, money is secondary to efficiency, throughput, and ease of task-delegation/training.
1. Help me decide between the two options!
2. Any recommendations for sintering / crystallization ovens? I was looking at the Ivoclar S1 and CS2, respectively. Is the CS-4 good to do both?
3. Any recommendations for better/different mills from the ones I listed?

Thanks in advance!

 

[CoolHandLuke]

there is a lot to unpack here, you are a doc, you want to eventually buy a mill, you dont have your own oven, don't know CAD, and are asking what to buy to do it all for you.

pump the brakes.

how much time do you want to spend playing lab tech?

you buy that equipment, you will have two jobs: clinician and lab tech. you cant do both in the same 8 hr schedule. richer men than you have tried.

 

[NYJHL]

3shape = Apple
Exocad = Android
to some extent lol

 

[Andrew Priddy]

3sheep is more intuitive? S*, buy it!

 

[CatamountRob]

You should wait for Grant, he runs the DLN “Dentists who wanna be techs” outreach program. He’ll tell you which way to go, or at least where to go.

 

[DrMJF]

View attachment 45200

there is a lot to unpack here, you are a doc, you want to eventually buy a mill, you dont have your own oven, don't know CAD, and are asking what to buy to do it all for you.

pump the brakes.

how much time do you want to spend playing lab tech?

you buy that equipment, you will have two jobs: clinician and lab tech. you cant do both in the same 8 hr schedule. richer men than you have tried.

Thanks for your response.
I don't want to spend a whole lot of time playing lab tech. I do like to be familiar with the software so I can be better at communicating with my team who has to use it. If I understand software strengths/weaknesses and limitations, I can have more realistic expectations and collaborate more effectively.
Without getting into the numbers (I can share if you want), I can assure you that at our volume, hiring a full-time tech to bring *most* things in-house would save us a lot of $$, and the cherry on top is I can work directly with the tech on cases to deliver better patient outcomes and faster turn-around times. That's a win-win.
Do you have insight on the two CAD systems (exocad vs 3shape)? Or any recommendations for mills/ovens?

 

[DrMJF]

3shape = Apple
Exocad = Android
to some extent lol

I've heard this analogy before! Do you have a preference? Can you make any recommendations for mills or ovens? Thanks!

 

[DrMJF]

3sheep is more intuitive? S*, buy it!

Thanks. I'm only repeating what I've heard. I'm here to get a broader understanding from a larger community than what I've heard directly by word of mouth. Do you have any recommendations?

 

[DrMJF]

You should wait for Grant, he runs the DLN “Dentists who wanna be techs” outreach program. He’ll tell you which way to go, or at least where to go.

I don't want to be a lab tech. I want to understand more about each program so I can make an informed decision which networks well with our clinics. When the doctor understands the software, it makes collaboration more efficient. It also comes in handy in a pinch when, for example, your team member who does a lot of the designing wants to go on vacation or gets sick.

 

[zero_zero]

I can assure you that at our volume, hiring a full-time tech to bring *most* things in-house would save us a lot of $$, and the cherry on top is I can work directly with the tech on cases to deliver better patient outcomes and faster turn-around times. That's a win-win.

Exactly, that's my business model, but in reverse... not bad from a lowly lab rat, eh ?

 

[Car 54]

Thanks for your response.
I don't want to spend a whole lot of time playing lab tech. I do like to be familiar with the software so I can be better at communicating with my team who has to use it. If I understand software strengths/weaknesses and limitations, I can have more realistic expectations and collaborate more effectively.
Without getting into the numbers (I can share if you want), I can assure you that at our volume, hiring a full-time tech to bring *most* things in-house would save us a lot of $$, and the cherry on top is I can work directly with the tech on cases to deliver better patient outcomes and faster turn-around times. That's a win-win.
Do you have insight on the two CAD systems (exocad vs 3shape)? Or any recommendations for mills/ovens?

There's your answer, ask the tech, the cherry on top who you're going to hire, what they would prefer to use as far as Exocad, 3Shape and of sinter ovens. Since they are the one(s) who will be using it, and possibly training your staff for the misc. things they could do as far as appliances etc. commonly done in office (I get that part).

I don't want to be a lab tech. I want to understand more about each program so I can make an informed decision which networks well with our clinics. When the doctor understands the software, it makes collaboration more efficient. It also comes in handy in a pinch when, for example, your team member who does a lot of the designing wants to go on vacation or gets sick.

Again, let the lab tech you're going to be hiring understand and make those decisions for you, otherwise it can seem like you're just trolling this forum for information to be self sufficient, lab tech free, all except for the harder cases that get sent for the labs to do (all on 4's, layered emax and zirconia etc.).

As for CRobs joke about Grant showing up and setting things straight, is partly because the lab business has been decimated over the years by the conglomerate, merged race to the bottom dental labs undercutting $$ the average 1-5 man labs. Of Dr's outsourcing to Glidewell, overseas. Of Dr's setting up self staffed in house labs for convivence for them and the patient (again, I get that, as far as offices that need to be competitive) and to supposedly save money (but not staff training and time) can leave most of us lab techs reluctant to want to continue to help bring about our own demise with these type of threads and questions. I'm just letting you know from my end, and maybe some others here as well, why we may not be falling all over ourselves to say exactly for you to buy this or that and why, for you to make informed decisions.

Just an aside, I thought this was a very revealing post about where things are at now:

I Tried a new idea, Pressing Feldspathic Veneers ...

Hello everyone ! I was wondering for a long time if there's a way to creating feldspathic veneers with a pressing technique, i made an ingot from Layering porcelain GC initial MC using a 10 Cc syringe and baked it, then i pressed it and it came out not so bad. but anything thinner than 0.7 mm...

dentallabnetwork.com

Talked to a doc recently at a conference who said he thought dentistry was talking a step backward in esthetics, no layering of porcelain or feldspathic veneers. I just bluntly told him we don't do that anymore either, they are a lot of extra work and Docs aren't willing to pay for them. He didn't have a good response.

 

[Andrew Priddy]

it took all of us Technicians a very long time to become proficient in what we do. One degree takes years of blood and bull**** at the bench, the other does not. Practices are looking for "in house" techs.. masters of what they do, and able to do everything..

a local practice is offering $35 an hr on the Central Cali Coast. this is a fking insult. and we get insulted all the fking time. Im a Chimpanzee slaving away.

our line of work is classified as unskilled labor, and corporate dental labs control our "so called" certification.
An AAS in Dental Technology doesn't mean sh*t but a CDT designation does? im sorry, but i may as well put GED behind my name. Tech Schools have closed. There is no "new blood" entering the workforce, and the quality in our profession is in a spiral dive.

The lab of the future isn't corporate controlled, it is the smaller compact labs that will own the technology simply because they will have the ability to maximize it. our industry dental IQ is in the toilet. Talented people are leaving in droves for a brighter future elsewhere.

The technician that is capable of digital/analog all phases is now the most valuable person in the dental industry. this will never change only intensify.
AI won't replace "Technicians", it will replace workers that call themselves technicians. gamers will go back to "gaming", and Technicians will become "much more advanced". Good luck finding one.

i charge 6k a weekend to fly out and train/consult on the direction you are headed...

maybe you should at least donate to DLN if you intend to keep posting

 

[CoolHandLuke]

Thanks for your response.
I don't want to spend a whole lot of time playing lab tech. I do like to be familiar with the software so I can be better at communicating with my team who has to use it. If I understand software strengths/weaknesses and limitations, I can have more realistic expectations and collaborate more effectively.
Without getting into the numbers (I can share if you want), I can assure you that at our volume, hiring a full-time tech to bring *most* things in-house would save us a lot of $$, and the cherry on top is I can work directly with the tech on cases to deliver better patient outcomes and faster turn-around times. That's a win-win.
Do you have insight on the two CAD systems (exocad vs 3shape)? Or any recommendations for mills/ovens?

hire the tech first. your tech will assumedly have working knowledge of a start-to-finish system, complete with experience using it, and will inform the cost of working with that tech.

don't shoehorn a tech into a system they don't know. more to the point don't shoehorn yourself into playing tech on the weekends.

familiarity is nice, but ultimately leads to lack of mastery if you arent playing tech - or overqualification if you do.

exocad and 3shape both sell Clinical versions of their software for you as clinician to use and have fun integrating in office chairside milling units like trios+cerec. that should be all the familiarity you could want.

the purpose of an oven is to crystallize emax, or to bake porcelain. its a glorified heater. the differences between ovens is not which one crystallizes the product better, or how fast you can bake porcelain. its the ease of use and the serviceability of the parts within. there is exactly no difference between the result of any two furnaces, only in how easy they are to use and how cheap they are to maintain. everything then works.

in much the same fashion, the function of a mill is to use tools to cut blocks. the difference is in how easy or hard that process is, and how reliable the machine is to produce the parts at the correct size. all mills can make this happen - the difference is how hard it is to do.

no matter what you buy you want to have access to support for using this equipment and/or a tech who knows this already.

 

[rkm rdt]

As a lab technician, I bought a Trios so I could better communicate with my drs about what I needed to do my job. I don’t want to be a dentist . I don’t see the point in advising dentist’s how to be technicians especially when they are only interested in saving money at my expense. Kinda like asking a local doc where is the best place to book my dental vacation .

 

[TheLabGuy]

As a lab technician, I bought a Trios so I could better communicate with my drs about what I needed to do my job. I don’t want to be a dentist . I don’t see the point in advising dentist’s how to be technicians especially when they are only interested in saving money at my expense. Kinda like asking a local doc where is the best place to book my dental vacation .

Love that analogy. We have really pulled back on some vendors we used to use because of that. You want to be my competitor, then lets dance, but don't try to be my business partner with me and my competitor at the same time, you'd be stepping on my feet bro. Who'd we axe? Evident, TruAbutment, and Henry. More to come I'm sure.

 

[mmbh]

Love that analogy. We have really pulled back on some vendors we used to use because of that. You want to be my competitor, then lets dance, but don't try to be my business partner with me and my competitor at the same time, you'd be stepping on my feet bro. Who'd we axe? Evident, TruAbutment, and Henry. More to come I'm sure.

What are you doing for custom abutments nowadays?

 

[DrMJF]

hire the tech first. your tech will assumedly have working knowledge of a start-to-finish system, complete with experience using it, and will inform the cost of working with that tech.

don't shoehorn a tech into a system they don't know. more to the point don't shoehorn yourself into playing tech on the weekends.

familiarity is nice, but ultimately leads to lack of mastery if you arent playing tech - or overqualification if you do.

exocad and 3shape both sell Clinical versions of their software for you as clinician to use and have fun integrating in office chairside milling units like trios+cerec. that should be all the familiarity you could want.

the purpose of an oven is to crystallize emax, or to bake porcelain. its a glorified heater. the differences between ovens is not which one crystallizes the product better, or how fast you can bake porcelain. its the ease of use and the serviceability of the parts within. there is exactly no difference between the result of any two furnaces, only in how easy they are to use and how cheap they are to maintain. everything then works.

in much the same fashion, the function of a mill is to use tools to cut blocks. the difference is in how easy or hard that process is, and how reliable the machine is to produce the parts at the correct size. all mills can make this happen - the difference is how hard it is to do.

no matter what you buy you want to have access to support for using this equipment and/or a tech who knows this already.

Thank you. That is good advice. I definitely want to hire a lab tech.
One issue I can see myself running into is this: if I hire a tech who uses one system and I buy the system on his/her recommendation, but they quit after x number of years...a new tech may use a different software. Now I'm back to square one and I either have to restrict my applicant pool to those familiar with the program I already set up, or know the program well enough to train a tech who is unfamiliar with the existing setup.
I run multiple practices. Respectfully, it's easy to say: "just hire somebody qualified, plug and play, and they'll produce because they know what they're doing." Sadly, it rarely ever works out like that in real life. People leave. People move. People go back to school. People have kids. A tech will go start his own lab because he knows he can do it better (and probably rightfully so). This is the reality and I have to be prepared to manage employment gaps and not put my full faith in a tech just because they know more about the software than me. I don't want to put my decision *fully* in the hands of a lab tech I meet on Indeed who's willing to work for me. I do want to put in effort and understand what I'm doing, at least to some extent. By no means am I trying to be a lab tech, and respect the field immensely.

 

[CoolHandLuke]

fair point, but people generally don't do that when they are partners or equals in business. when they are treated poorly, sure, but not when they are equals.

you assume the techs trust you the dds or gp or prostho to do your jobs, but you can't commit that trust to have them make the prostho based on the data you send

a full partner in your business means you trust them to bring their side of the bargain to the table, and if after some time that partnership has collapsed you should take a look in the mirror to figure out why. not seek to assume the other side's knowledge and start a one man band.

you are not Bert and this is not Mary Poppins.

this is why lab techs as youve seen in this very conversation, have such trust issues.

 

[mmbh]

Thank you. That is good advice. I definitely want to hire a lab tech.
One issue I can see myself running into is this: if I hire a tech who uses one system and I buy the system on his/her recommendation, but they quit after x number of years...a new tech may use a different software. Now I'm back to square one and I either have to restrict my applicant pool to those familiar with the program I already set up, or know the program well enough to train a tech who is unfamiliar with the existing setup.
I run multiple practices. Respectfully, it's easy to say: "just hire somebody qualified, plug and play, and they'll produce because they know what they're doing." Sadly, it rarely ever works out like that in real life. People leave. People move. People go back to school. People have kids. A tech will go start his own lab because he knows he can do it better (and probably rightfully so). This is the reality and I have to be prepared to manage employment gaps and not put my full faith in a tech just because they know more about the software than me. I don't want to put my decision *fully* in the hands of a lab tech I meet on Indeed who's willing to work for me. I do want to put in effort and understand what I'm doing, at least to some extent. By no means am I trying to be a lab tech, and respect the field immensely.

I guess you are realizing what we labs have to deal with daily. Digital has brought many incredible benefits to this industry as well as massive headaches and expense that we deal with on a routine basis. It used to be skilled labor, some metal and what porcelain to choose. Now its skilled labor ( analog and digital cad cam applications), expensive equipment and software, upkeep and replacement of said equipment, continuous testing of milled and printed materials, continued ed on software, and on and on. All while costs of everything seem to continually rise while clients want cheaper prices for work.
My advice to you if you go down this path is REDUNDANCY. You still need a system in place to get work done if someone leaves etc, and that most likely would be sending your work out until you find a replacement. May be more expensive than you want but its the cost of doing business as a professional.