Once you've selected a CAD/CAM scanner or milling system, phase two is implementing the equipment into production and training your technicians.
When an experienced technician is handling scanning and design and you're working with ideal preps, introducing a stand-alone scanner can be fairly straightforward. Manufacturers have made improvements to their software, decreasing training time, and a technician can usually master simple copings within a few days, while more complex cases like bridges or Hader bars take longer. The key is to select a technician who is computer oriented and can visualize in 3-D, meaning he can take his traditional waxup skills and apply them to a digital format.
But when it comes to training a non-technician, there's a consensus among lab owners that the learning curve is longer; you can't just "feed" a prescription into the unit and produce copings. "Can I hire a high school kid off the street to scan and design?" asks Chuck Warren, a CAD/CAM consultant and owner of Tempus Dental Lab and Wasatch Milling Center in Springville, Utah. "Sure, but he'll only be successful if I sit him down and teach him about anatomy, what a margin looks like, what a pontic is and where to place it, etc. The operator has to have that knowledge because the machine does what you tell it to do; this isn't push-button technology."
The training required for a complete system can be even more difficult--especially for higher-priced units with more sophisticated features. For instance, at Knight Dental Lab, the transition from a two-axis mill to a four-axis mill presented challenges and obstacles during the learning process. "We needed a greater knowledge and understanding of operating our complex multiple-axis system as opposed to our basic two-axis milling unit," says Kevin Hudi, vice president quality systems at the Oldsmar, Florida laboratory.
And although the manufacturer offered excellent in-house training and other support, it did not provide a step-by-step operation and troubleshooting manual, so the lab spent several hours on the phone with tech support during the first few months of implementation. As a result, the laboratory is now developing its own procedure manual which will be helpful for future training.
In addition to training your staff, you also need to educate your clients in certain areas, like learning the new prep design required by your system. Since Ryan Haupt's clients were receptive to learning a new technique, his implementation went smoothly. "Our clients were eager to learn what would make the restorations they place more predictable, they just needed a little guidance," says Haupt, manager of operations, Haupt Dental Lab, Brea, California, who uses diagrams and hands-on models to illustrate the prep design the lab needs.
On the other hand, when clients are resistant to providing a new type of prep--or to metal-free restorations in general--the implementation can be more difficult. This is the case at Western Dental Arts in Billings, Montana and, as a result, the lab hasn't yet automated procedures the way it had anticipated. However, given the potential the technology has to increase the lab's overall productivity, Owner Teri Henrichs is still committed to her system. "We're communicating with our clients on the benefits of CAD/CAM restorations and hope this--along with the rising prices of alloys--will help get them on board," she says.
Despite the challenges, buyers say their investments are worth it. "It was expensive both in purchasing the equipment and working through the initial few months but, much like all investments, the more you put into it the greater the return," says Dene LeBeau, owner of LeBeau Precision Aesthetics, Renton, Washington, who bought a milling system last year. Currently about 25% of the lab's caseload is CAD/CAM fabricated and, since clients are raving about the results--especially milled lithium disilicate restorations--LeBeau anticipates it being closer to 60% within the next six months.
Similarly, once David Nunnally's milling system was up and running, he was delighted with the boost in productivity and the degree of labor savings it offered. "In an eight-hour day, our digital waxer can do 50 zirconia units, including the scanning, designing, milling and finishing," says Nunnally, owner of Derby Dental Lab in Louisville, Kentucky. "That's about double what a traditional waxer and finisher can do."