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Dr Andreas Kurbad, who runs a private practice in Viersen in Germany, has lectured widely on the topic of computerised dentistry. For 3Shape’s upcoming 24-hour global online symposium, Kurbad will be giving a presentation on an in-house workflow for CAD/CAM-based single-tooth restorations. Prior to the event, the expert talked to Dental Tribune International about his own in-house workflow and why such procedures offer advantages, especially in light of the restrictions imposed by SARS-CoV-2.
Dr Kurbad, I understand that you were the first in the world to use the TRIOS intra-oral scanner and TRIOS Design Studio with PrograMill One. What has been your experience with these products in your own daily practice?
Yes, I believe I was the first-ever clinical user of the PrograMill One, and I am very happy with the workflow. Scanning with the TRIOS intra-oral scanner works very well, especially with the new generation of the TRIOS Design Studio software, which includes artificial intelligence scans. Hence, many of the working steps with the optical impressions are managed automatically, speeding up the process. This is also why the in-house technology allows treatments to be performed in only one appointment.
The PrograMill One is revolutionary in many ways. You can manage the whole machine with an app which allows you to be connected to the machine at any time and from any place. In addition, you can process up to five mills in a row without accessing the machine. In my dental practice, we use it every day, and my experience with this product has been very good. In 2017, I published a scientific article about the ProgaMill One milling machine in the International Journal of Computerized Dentistry.
There are many scanners and a great variety of software on the market. In your opinion, why should dentists familiarise themselves with 3Shape/Ivoclar Vivadent products and use them in their daily practice?
They possess some extraordinary features. An example is the wireless camera, which allows you to use only the scanner and perhaps a screen in the treatment room. Everything else can be stored in a different place.
Also, the workflow with the software offers some unique opportunities for design. The milling machine differs from all other milling machines in that the ceramic block from the material is held by a robotic arm. This technology is unique and the milling results are a great improvement on the results of the other 5XT (five-axis turn-milling technique) milling machines that I know of.
What are the advantages of an in-house workflow?
Owing to SARS-CoV-2 concerns, an in-house workflow has become the centre of interest, on the one hand, because you should make as few appointments as necessary in order to reduce infection risk and cover as many treatment steps as possible in one appointment. On the other hand, this workflow is also very economical. Of course, we need a dental laboratory for larger restorations, but single-tooth restorations do not have to be manufactured off-site. Another advantage is that the entire treatment takes only 1 hour or a maximum of 2 hours, making it very comfortable for patients.
What has changed through PrograMill One in terms of materials?
The new technology allows the use of modern materials made from composites such as Tetric CAD, which cannot usually be processed with conventional methods in a dental laboratory. With the help of CAD/CAM technology, the use of these materials becomes very simple. For example, the Tetric CAD material produces very satisfying results and can be produced within a short time. It also shows good results for longevity.
Processing zirconium dioxide is also possible, but I think it is not very useful for an all-in-one appointment, since it needs sintering. However, small restorations made of zirconium dioxide will be possible in the future.
Editorial note: Dr Andreas Kurbad’s webinar, titled “The in-house treatment concept for CAD/CAM based single-tooth restorations—the TRIOS and PrograMill One workﬂow”, will be broadcast live on 20 June at 10 a.m. CEST. Participants will be able to earn a continuing education credit by answering a questionnaire after the lecture. Dental professionals who would like to join the webinar may register free of charge at www.3shapesymposium.com.