In the fully analog days of dentistry, the completion of the laboratory component of restorative work was handled with one simple workflow: all of the physical impressions, photographs, measurements, etc were mailed to an outside laboratory that would then design and fabricate the final restorations by hand. However, the introduction of digital technologies for scanning and restorative design and fabrication and their subsequent improvement changed that paradigm, resulting in the hybrid workflows of today in which dentists or their teams are doing some or all of the work that was once exclusively handled by dental technicians. In our May cover story, Inside Dentistry examines how the performance of laboratory work has evolved and discusses the roles that dentists and technicians play and the factors shaping the future of collaboration.
I became an early adopter of in-office fabrication technology when I acquired a CEREC® 1 in 1989. Although I was excited about the potential benefits, I ultimately realized that milling my own restorations didn't fit my practice model and philosophy. Today, I work with one operatory and one assistant, and I couldn't live without my technician. Some dentists want to fabricate their own restorations based on a laboratory-produced design, some want to do the design work and have the laboratory handle the fabrication, and others want to do all of the laboratory work in-house. Personally, I never wanted my practice to become a laboratory, but there's no right or wrong—the model selected is about the type of dentistry that a dentist wants to do and what's best for the needs of his or her practice. Whatever the extent of the laboratory work being done in-house, the most important thing is that the practice is appropriately structured and that the dentist has a sufficient number of team members with the appropriate education to accommodate it. Otherwise, he or she will not be able to maximize productivity and profitability.
As the ability of 3D printers to produce esthetic final restorations improves, I believe that in the future, most dentists will be using technicians to design restorations and then printing them in-house. But who knows? Although the evolution of laboratory work is ongoing, one thing is certain: technicians will evolve with it to provide whatever services their dentists require.
Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa