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    How to Evaluate a 3D Printer for Your Dental Lab or Practice

    Discussion in 'Smart Dental Cad Studio' started by tomas, Oct 21, 2017.

    1. tomas
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      tomas Member Sponsors Full Member

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      [​IMG]

      If you are managing a dental laboratory or practice, additive manufacturing is no longer a decision that can be postponed. With many new 3D printers being released constantly, the market continues to expand at all levels.

      But for the first time, several 3D printing solutions offer a way to make digital dentistry an affordable, no-nonsense business choice to improve patient care, quality, and outcomes; broaden your product and service offerings, through surgical guides, retainers, aligners, orthodontic arches, crown & bridge models, and more; and reduce material and labor costs significantly through streamlined digital workflows.

      What’s involved in integrating 3D printing into your business? What are the different technologies on the market? Why do some printers cost less than $5,000, and others $80,000+?

      In this guide, we’ll look at the digital workflow, the different technologies and all the aspects you should evaluate before investing into a 3D printer.

      The Digital Dentistry Workflow and Prerequisites
      Every dental product that can be 3D printed follows the same basic workflow involving these steps. Adapting a digital workflow is an absolute must before you can introduce additive manufacturing into your business.

      Scan
      [​IMG]
      Every dental product that can be 3D printed follows the same basic workflow which involves scanning, designing, printing and preparing.

      Like traditional dental product fabrication, digital production requires information on the patient anatomy. The simple difference is that data on the patient’s dentition can be collected digitally, with an intraoral scanner, removing the need for alginate impressions. Alternately, desktop optical scanners can be used to scan manual impressions or plaster models. For treatments that require patient osteotomy, such as implants, an additional dataset needs to be collected using CBCT scanners.

      Design
      Patient anatomical data is then imported into dental CAD systems, where treatments, prosthetics, and other dental products can be designed. The specifics depend on the treatment, but typically the design process is similar to traditional workflows, done on a computer. With digital design, treatments can be created with increased ease, precision, and care. After the treatments are designed, models can be exported for manufacturing.

      Print
      In order to physically realize a digital model of a dental product, 3D models are uploaded to the 3D printers, which then solidify the object layer by layer, forming the shape of the dental product with digital precision. For 3D printing dental appliances and models, smooth surface finish, fine details, high precision, and advanced material properties are key ingredients of successful prints.

      Prepare
      Once the models are 3D printed, there are often a few post-processing steps before a product can go back to the patient. For the most common resin-based technologies, all parts must be washed, dried, polished, and post-cured. Depending on the particular product, assembly with prefabricated accessories might also be necessary, such as metal guide tubes for surgical guides.

      Required Resources
      Intraoral scanner or desktop optical scanner: Allows you to replace manual impressions with fast and accurate digital impressions. Intraoral scanners are used in the dental practice to capture scans directly from the patients. Desktop scanners are used to scan PVS impressions or stone models, and are recommended for dental labs.

      [​IMG]
      3D printed surgical guides enable quick and high-precision implant placement for just $2-5 per guide.

      Dental CAD software: Allows you to process scan data to design treatments, prosthetics and other dental products, and export them as 3D models for milling or printing.

      Optional Resources
      CBCT Scanner: Allows you to acquire patient osteotomy. This is only required for select applications, such as for creating surgical guides for implants.

      Technologies
      Today there are three common technologies to create polymer-based dental products. Each of them cures photoreactive liquid resin with light to form very thin solid layers that stack up to create solid parts.
       
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    2. tomas
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      tomas Member Sponsors Full Member

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      Technology Comparison
      Digital Light Processing (DLP)

      • Pros: High accuracy, Wide range of materials, Desktop footprint, Easy to use
      • Cons: Expensive machinery, Small build volume
      • Price: Starting at $12,000
      Material Jetting (MJP, PolyJet)

      • Pros: High throughput
      • Cons: Expensive machinery, Limited material options, Large footprint, High maintenance
      • Price: Starting at $35,000
      Stereolithography (SLA)

      • Pros: Great value, High accuracy, Wide range of materials, Desktop footprint, Easy to use
      • Cons:
      • Price: Starting at $3,500
      For a deeper insight into the different technologies and digital workflows, we recommend watching this webinar by Dr. Michael Scherer DMD, MS, APC.

      Evaluating 3D Printing Solutions
      Accuracy and Precision
      Guaranteeing high-quality final parts is the most important concern with any part made at a dental practice or lab–hence why accuracy and precision of 3D printers are major concerns. Accuracy is the closeness of a measurement to the true value. Precision measures the repeatability of a measurement–in other words, consistency of results over a batch of parts. For dentistry, it is imperative that both an acceptable level of accuracy and a high degree of precision are achieved.

      [​IMG]
      3D printed models provide high accuracy as they eliminate numerous steps, and possible errors, from the manual process.

      It is a common misconception that there’s a direct relationship between the specifications of a 3D printer–such as resolution, layer height, laser spot size or pixel size, and the accuracy of final parts. Resolution is simply the smallest feature that can be printed in a particular plane, and a lower layer height might give you a smooth surface finish, but it does not mean that you have an accurate product.

      Accuracy is dependent on the 3D printer, the material, the print settings, the calibration of the machine, and how well these building blocks are integrated. Consequently, a printer can be more accurate with one material than another–which can be perfectly fine, as long as it’s in between the clinically acceptable limits for the specific use case. For example, crown and bridge models require superior accuracy to fit restorations and removable dies, while orthodontic models for vacuum-formed appliances are less demanding.

      To evaluate if a 3D printer provides high enough accurate for your application, don’t rely on marketing or technical specifications. Always inquire with the manufacturer for clinical accuracy studies and real scan data of printed parts. Even better, ask for a sample part of your own design that you can measure yourself against the original design. This is something Formlabs and other high-quality 3D printer manufacturers are happy to offer.

      For more information on accuracy and precision, we recommend reading this white paper, and an independent study comparing the accuracy of three popular 3D printers.

      Ease of Use
      In order to be able to take advantage of new technology in your dental business, your team is going to have to learn how to use a new piece of equipment and maintain it on a daily basis.

      First, try to get a sense of the learning curve that will come with a new 3D printer. In some newer printers, you will find user-friendly design and user interfaces, which will help you get printing straight out of the box. Other printers can be much more complex to get started with, some requiring a service technician to spend time on-site to set up, tune, and calibrate the machine.

      Another major consideration is everyday interactions and maintenance once the printer is up and running. Automatic resin dispensing can make a big difference keeping a low-maintenance production environment but is only available on select SLA machines, as well as material jetting printers. Easily switching between materials can help make a single printer useful for many different applications, which is where SLA or DLP printers with removable resin tanks and build platforms can offer a user-friendly solution.

      Materials
      [​IMG]

      Professional 3D printers are some of the most versatile tools found today in dental labs and practices, and the key to their versatility are dedicated materials. Various dental applications have different requirements–some have to be sturdy and machinable, others require biocompatibility, or look transparent for aesthetics.

      One the first things to consider when evaluating your options is if a given 3D printer is capable of printing the dental product(s) you require. Some 3D printers work with proprietary materials, in which case your options are limited to the offering of the manufacturer. Others have an open system, meaning that they can use materials made by 3rd party manufacturers. However, in this case, it’s important to make sure that the printer model is suitable for the specific application, and that it can print parts with a clinically acceptable quality and accuracy.

      The list of available applications varies by printer model. Most 3D printers can produce orthodontic models, surgical guides, or castable/pressable restorations, while advanced models can manufacture a range of dental products from highly accurate crown and bridge models to long-term dental applications like splints, night guards or dentures.

      Manufacturers are releasing new materials on a regular basis, so there’s a good chance that the printer you buy today will become capable of creating an increasing variety of dental products in the near future.

      Speed and Scalability
      In thinking about speed and scale, remember to find the most cost-efficient way to power the production you need, and consider how you’ll implement production in your business. Finishing a build full of prints within an hour sounds enticing, but it may be more beneficial and economical to balance cycle times with how your business runs. Running two prints per day on a batch of machines, and simultaneously finishing a set of parts only twice per day, often makes more sense than having a technician constantly switching out parts from a printer all day.

      Production with multi-machine print cells often enables more affordable up-front costs than larger-format machines. By buying one low-cost desktop machines at first, businesses can test out production methods before ultimately scaling up production. And, as they scale, they can simply increase the number of printers they use when demand requires it. This provides the opportunity to pay for the production you need, only when you need it, rather than making large long-term investments in a market that’s rapidly evolving.

      Print cells also offer additional benefits beyond cost-effectiveness, including lowering risk through redundancy. If one machine needs servicing, production can be balanced across the rest of the print cell.

      Return on Investment
      Most importantly, adopting new technology needs to simply make sense for your business. Remember to consider:

      1. Up-front costs, which could include not just the machine cost, but also training and setup for larger-format machines, as well as, potentially, software.
      2. Running costs, which are best estimated with per-unit material costs.
      3. Servicing & maintenance costs, which can sometimes be compulsory and account annually for as much as 20% of the cost of the printer.
      These will all have a direct impact on how fast you can make a return on investing in 3D printing technology. The good news is that with smaller format, low-cost machines that offer high-output quality, it’s now possible for dental labs or even practices to make their initial ROI within months.

      Conclusion
      Much has changed since the first desktop 3D printers became available for the dental industry. While a few years ago 3D printers were only affordable to the largest dental labs, now they are more and more common in labs and practices of any size. So why should you invest in a printer that costs less than $5,000, or one that’s $80,000?

      Well, if it were this simple, there would be no need for this guide. Consider all the factors above and the needs of your lab and practice. Different solutions might be more suitable for some business than others. Depending on the application, desktop printers can produce dental products with high accuracy, similar or even better than those made with traditional industrial 3D printers. Make sure to do your research, evaluate actual parts, and avoid paying a hefty premium.
       
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    3. zero_zero
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      zero_zero Well-Known Member Full Member

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      It sonuds like a Form2 infomercial...o_O
       
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    4. Car 54
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      Car 54 Well-Known Member Donator Full Member

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      For me who is so far behind in keeping up with printers, I found it to be informative :)
       
    5. CoolHandLuke
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      CoolHandLuke Well-Known Member Full Member

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      not very, its a lot of sales pitch. not a lot of quantitative analysis.
       
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    6. Car 54
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      Car 54 Well-Known Member Donator Full Member

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      After a better read through, than skim through, you're right, it's pretty vague.

      Now if only tomas would replace his siggy picture, I could sleep at night.
       
    7. CoolHandLuke
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      CoolHandLuke Well-Known Member Full Member

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      i'm going to break down this sales pitch into unverifiable facts, misdirections, and untruths.

      1. from the 2nd paragraph :
      no it certainly doesnt. its not streamlined in any way unless you work with IOS. model based scanning offers no streamlining when incorporating a 3d printer because you are merely replacing the waxing up of substrate. there are no solutions avalable to 3dprint clear material for essix retainers, mouthguards, or any plastic to be used longer than 7 days intraorally. they all contain Bisephanol A. 3d printing an essix takes longer than pouring and making a suckdown.

      2.
      only if you buy a specific printer from your "list" that contains exactly 3 printers. this is a misdirection. SOME printing solutions can get the cost down this far, but it depends entirely on the size, geometry, and whether or not ou have already paid off your investment.

      3.
      the silence here is deafening. the form2 is a printer that is not intended for mass production. it is constructed from plastic, and a projector. you can get many problems with this flimsy setup down the road and it will likely mean investing several times into several machines in order to get both consistency and quality as the machine degrades over time. this wide range of materials must be discarded because it is a moot point. every printer is capable of multiple materials, and in the case of the form2 you must physically dispose of material that has been exposed to UV for any length of time as it will catalyze and harden, and other materials that come in contact with it will degrade over time. these materials in some cases are open source and thats a Pro, but to get them properly working is more time sunk into development - it is not an off the rack solution that you can just swap in and expect to work.

      4.
      there is no need for that, as inspection software is free in some cases, and even if you don't have inspection software you will be able to scan your prints and compare to designed stl files internally in 3shape and exocad. this isnt a huge difficult thing to do. people have been doing it for years, the difference is most industrial applications use geometry of a known part. a sphere or cube with known size. scanning against known size data ensure you know how good your input will be, to gauge how well your output tolerance should be. eg if yu kow your input to be >8um and you know your field density to be 10um then you should expect your final output to be +/- 18um, so you scan your printed part and account for 8um. any deviance from that if it is within 18um is standard output. anything more and you know your equipment will need adjusting.

      5.
      this is true, however its not as versatile as the article would lead you to believe.

      the same printer that prints clear aligners should not print models, cannot print metals, and is incomplete. a multi-tiered approach to incorporating 3dprinting will adapt to all the materials for use in the lab and clinic, but involves a LOT more money than simply the 'affordable' formlabs. its also way more time consuming because now you still have to do fitting, analyzing final outputs, and QC before it reaches the hands of the end user, be that a ceramist, denturist, or doctor.

      Professional 3d printers are flexible sure, but not until you spend 1million+ on elastomer printing in a connex500 and actually use it for printing wild, wierd, amazing, full colour parts do you even begin to find flexibility in the 3dprinting world.

      6.
      duh lol but who among the professional cheapos who looks at a formlabs printer even remotelyconsidered spending 340k plus the cost of the oven plus the extra upgrade cost for titanium, on a Desktop Metal brand Titanium printing solution? these are not the same league of printer, not even close to the same ballpark of people interested in investing in technology. formlabs buyers are people who want to think they are high tech but can't wrap their wallets around the real cost of additive manufacturing, and so stick to plastics which everyone can do. people who would rather bang rocks together to get their products out than actually wrap noodle around how to make digital work.

      i'm done with debunking this tripe i'm going for a nap.
       
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    8. Car 54
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      Car 54 Well-Known Member Donator Full Member

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      Wow, talk about an informative post and breaking it down for me (and us)...no wonder you and zero saw past what I at first thought was informative.
      Thank you for taking the time to post what you did, CHL. I hope you had a good nap :)
       
    9. vurban210
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      vurban210 Active Member Full Member

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      I don't understand. I thought this was a sponsor's thread? Is this really necessary?
       
    10. CoolHandLuke
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      CoolHandLuke Well-Known Member Full Member

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      have i been unkind ?
       
    11. Car 54
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      Car 54 Well-Known Member Donator Full Member

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      No, I think you just expounded on what was already posted by tomas, the Sponsor.

      I think it may have been more of an issue if we started talking about another companies/sponsors printer.
      So if tomas wants to post what may have been a sales pitch or infomercial for
      something his lab uses, more power to him.

      I hope it doesn't get to the point where a sponsor thread is locked, and any other thoughts
      or ideas on what was posted, would have to be posted in the general forum threads?
       
    12. DylandeBoer
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      DylandeBoer Active Member Full Member

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      I feel it is necessary to point out problematic information, having worked with $3500 printers and $150,000 printers I can confirm your points are accurate and if you hadn't said them I or someone else would have hopefully done the same.

      If we didn't have the option to critic or dissuade information that was posted then we would not know valid information from bias opinions.
       
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    13. eyeloveteeth
      Innocent

      eyeloveteeth Well-Known Member Donator Full Member

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      We own a few form2s and lease a Carbon M1.

      Yes, there are many cons that OP did not address. But overall this is a forray into it and an organized post. We need more ppl like this even if it's not 100% accurate - CHL just likes to stir the pot :D
       
    14. Bryce Hiller
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      Bryce Hiller Active Member Full Member

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      Asiga. That is all.
       

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