Inside Dental Technology
July 2015
Volume 6, Issue 7

Stepping into the future

Looking ahead to new innovations and concepts that may impact your business in the future

As immersed as we are in today’s business realities, it’s always wise to step back and look to what tomorrow may bring. Getting a firm grasp on where the industry may be heading, what new technological concepts are on the horizon, and which business management solutions may prove valuable as the receipt and storage of digital data becomes more standard will help prepare your company for a business environment that promises to evolve into one very different than it is today.

In the following pages we will step into the future where you will meet a potential new mechanized “employee” as man and machine learn to work side-by-side, then take a peek at a revolutionary approach to 3D printing that halves the time it takes to create parts and end-user finished goods. Finally, we examine how to protect your sensitive and confidential digital data safe from hackers. These are but a few of the next evolutionary steps in the digital journey. ­— Pam Johnson

Robotic Arms Lend a Helping Hand

By Scott Mabie

Collaborative robots may be the next step in optimizing automated production

Most people, when imagining a robot programmed to replicate human tasks, describe huge, unwieldy cyborgs in large factories that work in safety-shielded areas far from their human counterparts, or conjure visions of futuristic bionic humans mimicking our motions and behaviors. However, today, between these two scenarios is emerging a new type of mechanical human: a class of industrial robots that work alongside their human counterparts, dubbed collaborative robots.

Collaborative robots, unlike their predecessors that perform superhuman tasks behind heavy safety glass at automobile plants and other big assembly lines, are lightweight and flexible. They also can be moved easily to new positions and reprogrammed to solve manual tasks that meet the production challenges faced by companies adjusting to ever more advanced processing. The automotive sector comprises an estimated 65% of all robot sales in the U.S., while the Robotic Industries Association believes only 10% of all companies that could benefit from installing the use of robotic automation have done so to date.

That percentage is low primarily because of three challenges: cost, user-friendliness, and applicability. The use of collaborative robots addresses these factors. According to the old rule of thumb, the cost of an integrated robot would be equivalent to 2 years’ worth of an average salary. However, collaborative robots are closer to one-fourth of that price. This lower price point combined with the faster turnaround time that robots bring to the workplace demonstrates the ability of robotic technology to challenge the offshore manufacturing business practices. These new robots are becoming a high-tech currency that’s changing the low wage wars into a competition over higher product quality and quick turnaround.

DIY Automation

For traditional robots, the capital expense of the actual robot accounts for only 25% to 30% of the total system costs. The remaining costs are associated with engineering design, robot programming, dedicated setup, shielded work cells, and installation/setup at the customer site. By contrast, the “out of box experience” with a collaborative robot is typically less than an hour. That’s the time it takes to unpack the robot, mount it, and program the first simple task. Instead of requiring skilled programmers, this new class of robots is equipped with a tablet-sized touchscreen interface, on which the user guides the robot arm by indicating movements on the screen. Alternatively, programming can also be accomplished by simply grabbing the robotic arm and showing it the desired path of movement, which is called the teach method. The interface is compliant with most industrial sensors and programmable logic controls.

Eye on Universal Robots

Although the concept of using robotics in the dental laboratory is more futuristic than a reality today, some forward-thinking laboratory businesses are reaping the benefits of these robotic technicians. In Newport Beach, California, David Leeson, engineering manager with Glidewell Dental Laboratories, had his eye on the Universal Robot (UR) robotic arms as he researched potential automation solutions.

“I had followed the collaborative robot development for a while. Hearing that the robot models from Universal Robots were used at BMW was a vote of confidence in this new type of technology. I finally got to play around with a UR5 at Automate 2013 and realized it was a real industrial piece of machinery and not just a toy,” says Leeson, who bought Glidewell’s first UR5 robot 2 years ago and is now waiting for the seventh to be delivered. The UR5 robotic arm weighs 40.6 pounds and has a maximum payload of 11 pounds. It has a reach of 33.5 inches and repeatability of 0.004 inch.

Leeson’s goal was to use the robots to improve the laboratories’ automated efficiencies by eliminating the labor-intensive and disruptive task of manually loading milling blanks into CAM machines and removing the blanks once milled. Production cycle time for a single crown was usually 5 days from receipt of the impression from the dental office to delivery of the finished product. By utilizing robotic technology, Glidewell has now optimized the process by using the UR5 to seat and remove milling blanks and milled crowns from the CAM machines. The UR5 robotic arm picks a blank to be milled from dispensers that contain milling blanks in 16 different shades. The arm then places the blank in the milling lathe, and once the 10-minute milling cycle is complete, it picks the milled blank out of the machine and places it on a conveyor. A vision camera monitors the dispensers and communicates with the robot on which shaded blank should be milled. If a dispenser is empty or jammed, the vision guidance system enables the robot to work on a crown in a different shade, ensuring continued production while an operator is alerted to fix the dispenser issue.

The Benefits of Single-Part Flow

Because each milling cycle was only 10 minutes, it was not feasible for the laboratory to have an operator stationed at the machines to manually load and unload each blank. Initially to improve efficiency, the blanks were inserted in batches of 15 each, which needed to be replenished every 2 hours.

“Now with the UR robot, we can insert each blank immediately into the mill as the CAD design scan file is received without waiting for 15 cases to arrive and then have the operator nest them into the 15-piece block,” Leeson says.

Achieving a dynamic, single-part flow has cut the production cycle time from 28 hours to 17 hours.

“That is less time that our customers are waiting and it has efficiency benefits throughout our production process,” Leeson says. “We’re also able to generate a Numerical Control (NC) program for each blank automatically without user interaction for nesting. Automating the NC program also means that we can transport the job information digitally (instead of physically with a box on a cart) and apply simple rules to automatically route crowns to the correct milling center.”

In addition, the optimized production cycle means that Glidewell can save 2 operators per shift in the milling room.

“We run a 24/7 operation, and the robot has freed up our employees to focus and improve on handling the complex tasks, which also improves our overall product quality,” says Leeson.

No Separation of Human and Robot

Being collaborative means that the UR robot can work directly next to employees without any safety fencing due to the built-in force-sensing technology that enables the robot to stop operating if it comes into contact with an employee.

“In the past, we have used conventional industrial robot technology. However, that required building a large enclosure to separate the people from the robot, which is expensive, takes up space, and is less flexible. It is also a safety concern if somebody defeats the interlocks on a robot enclosure. Using the collaborative robot technology with force-sensing control, we don’t have to worry about machine/technician interaction,” says Leeson, who believes having the collaborative robots heightened the awareness of the benefits of gradual transition from manual to automated processes.

“Working with a collaborative robot still requires some degree of human interaction, and our employees like that. They see the robot as less threatening.”

Interfacing with External Machinery

Automation engineer Daniel Phee had no experience with collaborative robots and was surprised at how easy programming them was (Figure 1 through Figure 4).

“The interface on the touchscreen makes the robot very easy to program. I used a combination of the teach method and my own script. I really liked how reliable the UR robot is; you don’t have to worry about maintenance and we have had no big operational issues.”

Glidewell took about 5 to 6 months to fully integrate the first application, but this was mostly due to building custom milling machines and working with heavy IT infrastructure.

“But after this it was easy. With the next robots, it only took us 2 to 3 days to install the complete system,” Phee says.

Leeson was struck by the fact that interfacing with external equipment was a native capability of the robots.

“We wanted to use TCP/IP to easily work with inexpensive, non-industrial hardware instead of having to buy Modbus or something costly like that. As a result, we’ve employed simple integration with a machine vision that we did all the coding in-house for while avoiding having to buy a proprietary expensive system.”

Enabling Sustained Growth

Glidewell Laboratories’ business has grown every year since the company’s inception in 1970. Leeson sees robotic automation as key to sustaining this trend.

“We will likely get 3 to 4 more UR robots in the near future. The only limiting factor right now is that we need more blocks for the individual crowns. As soon as we have those, we’ll get more robots to handle the one-crown one-batch process. We’re also looking into automating other steps in our production cycle where we see the robots playing a key role.”

Breaking Barriers

New breakthroughs in 3D printing speed and flexibility

By Pam Johnson

3D printing technology could be on the verge of disrupting and transforming the global industrial manufacturing industry. Previously used to produce only prototype parts, additive printing technology and materials now offer the capability of creating acceptable end-use consumer products, thanks to recent advances. Take, for example, the 3D printing demonstration at the 2014 International Machine Tool Show held in Chicago. Local Motors printed a CAD-designed automobile chassis in just 44 hours. The carbon-reinforced thermoplastic car body needed only assembly of its steering wheel, electric motor, tires, and shocks before the $18,000 car rolled “off the assembly line” and was driven up to 40 mph. If consumers in the future have the ability to order a customized car online with a click of a mouse and pick it up 48 or fewer hours later, the potential disruption that on-demand 3D-printed automobiles could hold for the current structure of the automobile distribution chain and retail market as we know it is unimaginable.

Perhaps one clue as to what happens when an industry is confronted with a new disruptive technology lies in the transformation of the US hearing-aid industry. In an article recently published by the Harvard Business Review, “The 3-D Printing Revolution,” writer Richard D’Aveni explains that in less than 500 days most of the hearing-aid industry converted to additive manufacturing, leaving in its wake only companies that clung to traditional methods and subsequently disappeared.

The dental industry appears to be nowhere near such a transformative precipice. However, the rapid advances that additive manufacturing technology is making in other industrial manufacturing markets are now trickling into the dental industry and new advances specific to the dental industry are emerging. For the first time this year, 3D printing companies exhibited the ability to simultaneously print multiple materials and multiple colors in the same production cycle, produce printed full-arch denture try-ins, and demonstrate the capability to print crowns and bridges from a new composite material that has the potential for long-term use in the mouth. Now a new approach to 3D printing technology is on the horizon, and a new 3D open print file format waits in the background, ready to replace the STL file.

Growing Parts

Called continuous liquid interface production (CLIP), this innovative 3D printing technique is coming from Carbon3D, based in Redwood City, California. What makes this technology unique is that commercial-quality parts are grown from a pool of material rather than parts being built layer by layer. It does so 25 to 100 times faster than current technologies on the market. Joe DeSimone, CEO and cofounder of Carbon3D and professor at the University of North Carolina at Chapel Hill, likens the process to the scene in “Terminator 2: Judgment Day” in which the T-1000 Terminator emerges from a pool of liquid. That imagery inspired DeSimone and his colleagues as they began to reimagine 3D printing technology and solve some of the challenges that current additive technologies have yet to overcome such as long build times, the inherent mechanical weakness of printed parts, and the limited range of print materials.

So how does CLIP technology differ from the conventional processes being used in the industry today? The current technology is available in various forms, but the print process is what DeSimone calls 2D printing over and over, meaning that a thin layer of material is laid down and cured with a laser or a UV light and the process is repeated with each successive layer cured on top of the last until a complex 3D object is built from the top down. No matter if the 3D print machinery uses direct laser sintering, direct laser melting, inkjet technology, fused deposition modeling, stereolithography, or digital light processing technology, they all feature the same 2D layer-by-layer process and all take significant time to complete one production cycle. The fact that each of the current processes can simultaneously process batches of objects helps offset the slow build speed factor somewhat; however, 3D printing thus far has not been able to reach mass production volumes.

The new groundbreaking CLIP process has the same reservoir of liquid build material but uses a photochemical balance of UV light and oxygen projected through a window underneath the liquid material for the print process (Figure 1). Transparent to light and permeable to oxygen, the window underneath the liquid material carefully balances the interaction of UV light, which triggers photopolymerization, and oxygen, which inhibits polymerization, to create a 3D object from a digital 3D model. By controlling the oxygen flux through the window, CLIP creates a “dead zone” in the resin pool just tens of microns thick (about 2 to 3 diameters of a red blood cell) where photopolymerization cannot occur. As a series of cross-sectional images of a 3D model is played like a movie into the resin pool from underneath, the physical object emerges continuously from just above the dead zone. The build platform sits above the vat of liquid material and rises to extract the growing object from the build material (Figure 2). The process is said to produce parts that exhibit consistent and predictable mechanical properties, with smooth surfaces on the outside and solid on the inside, akin to injected molded parts.

“This 3D process results in parts that are no longer prototypes but the end-user product,” DeSimone says. This opens the door, he says, to personalized medical treatment where the needed surgical replacement part such as a stent is customized to the individual patient or point-of-service manufacturing as in dentistry where the temporary restoration is printed while the patient is in the chair (Figure 3).

How CLIP technology will eventually be commercialized and where it will be applied is still not fully developed, but the promise of a technology that can produce complex, commercial-quality parts more quickly and from myriad materials has attracted powerful investment players such as Sequoia Capital and Silver Lake Kraftwerk and an influx of money to develop commercial models for various industries, one of which may very likely be dentistry. Lyndon Cooper, DDS, PhD, Stallings Distinguished Professor and director of the prosthodontics program at UNC School of Dentistry, was introduced to the Carbon3D at the university. “The Carbon3D printing process demonstrates that very intelligent individuals are interested in improving the processes we use in dentistry. Advances embodied in technology such as this suggests an even brighter future for digital technology in dentistry,” says Cooper. “The potential to create objects in just minutes opens alternative avenues to work flow in dentistry.”

3MF Battles STL

A breakthrough in a new and faster 3D printing process is not the only challenger to conventional additive technology. At the end of April 2015, Microsoft, along with a consortium of seven additive technology software manufacturers, called the 3MF Consortium, which includes such notables as Hewlett Packard, Autodesk, and Shapeways, Inc., announced the launch of a new 3D file format. They claim 3MF is, and will be, more supportive of current and next-generation 3D technologies and will “unlock the full capabilities of 3D printing.” The development of the 3MF file format is to address shortcomings of the STL file format, which has been criticized as not being suitable for taking additive technology to a level that allows seamless 3D file sharing with other more robust applications, platforms, services, and 3D output devices.

Alon Ganon, Technical Support for DTG3D, who has been researching the new format, says the file format will be better able to adapt to new 3D additive technologies as they are developed. “Currently, the issue is that the software is not being advanced as quickly as the hardware.”

Although Microsoft has integrated the new 3MF software into its Windows 8.0, the actual specifications of the open-source software format have not yet been finalized, Ganon says. “It still has a ways to go, and it will take some time for the file format to take shape.”

Ransomware on the Rise

How to avoid paying hackers for your own data

By Bruce McCully & Chris Brown, BSEE

Everyone has heard Ben Franklin’s adage that “an ounce of prevention is worth a pound of cure.” That advice is good for any number of situations—even today.

Consider some of the recent headlines: “Forty Million Target Customers Affected By Data Breach,” “Cyber Attack Could Cost Sony Studio as Much as $100 Million,” and “Hackers Penetrate West Wing Computer Network.” As consumers, most people think a computer virus or cyber attack would be only a minor inconvenience, slowing their computers or launching annoying popups. After all, credit card transactions are supposed to be secure and most consumers aren’t trading emails with government leaders or movie stars. As a small business owner, though, have you given it enough thought? After all, you might think: What is the actual possibility that a hacker group would target the data stored on your servers? Why would hackers be interested in infecting your computer, and what would the impact be?

The reality is that if you have a computer in your dental laboratory, you are at risk from the same threats that all businesses and governments face: viruses and malware. Also, a new trend in viruses might hurt your business more than slow computers and spam might. You may have to fork over cold, hard cash to fix the problem. Welcome to the phenomenon known as ransomware.

It’s Digital Extortion

It sounds like a convoluted soap opera plot, but ransomware is real and already has caused significant damage. One version was estimated to have led to the collection of more than $27 million from its victims.

Ransomware works like this: A virus infects a workstation and then demands a ransom be paid to its creators (usually in the form of some hard-to-trace cyber payment) to rid the system of the problem software. Some versions simply lock the system and display messages to lure the user to pay the fee. Others are more sinister and actually encrypt the files on a hard drive with unbreakable cryptography.

A Brief History

Ransomware is not new. One of the first known instances occurred in 1989 with a piece of software called PC Cyborg Trojan. Created by a Harvard-trained anthropologist and World Health Organization consultant, the virus encrypted a user’s hard drive and masqueraded as an expired software license. Users were asked to renew their licenses by sending money to a post office box in Panama.

Since then, the number of ransomware incidents has increased. In 2006 a program called Krotten inserted Russian profanity throughout a computer’s user interface and disabled files in the Windows directory. WinLock arrived in 2010 and locked users from the system, displaying lewd images on the screen until a code was purchased. And Reveton, in 2012, went so far as to impersonate a law enforcement agency, informing users that they had committed illegal activity on their computers. Paying a fine would allow them to work again.

The first mainstream piece of ransomware was CryptoLocker, discovered in 2013. Similar to PC Cyborg Trojan, it encrypted hard drives and demanded $300 within a certain timeframe or the files could never be accessed again. At its peak, CryptoLocker infected more than 150,000 computers per month.

The Coming of CryptoWall

The current top ransomware threat is called CryptoWall. Targeting Windows-based machines, it typically spreads via virus tactics such as phishing—when users are tricked into infecting their systems by opening a malicious email attachment—and demands a payment ranging from $500 to $1000 per workstation. These payments use the virtual currency Bitcoin and are passed through an anonymous network of servers, making them almost impossible to track.

CryptoWall’s scope is staggering. Between March and August 2014, Dell SecureWorks logged approximately 625,000 infections, more than 250,000 of which were in the US. Some of the phishing emails told recipients that an update was available for their Google Chrome browsers. Other systems were infected by malicious résumé attachments embedded in phony job applications.

Is Your Laboratory at Risk?

Recently, a moderate-sized dental office that had been self-managing its 15-computer network decided to enlist the services of an IT company to stay on top of software updates and installations. The IT company immediately implemented a comprehensive backup strategy for every workstation and server. During the process of backing up the data and programs on each workstation, the office was hit with a ransomware infection. A significant number of systems became unusable. Because the office needed its data and had no previous backups, the only choice was to pay the $570 ransom and wait for a code to be sent. The process of purchasing the Bitcoin, wiring it to the specified address, and then waiting for the code to be delivered took 5 days. Could you effectively run your laboratory without access to your CAD/CAM and laboratory management software for 5 days?

Conversely, another business working with the same IT company encountered a ransomware situation in which the office manager checked her personal email during her lunch break and opened a PDF that launched a CryptoWall phishing attack. Her computer and others in the office became infected. However, the IT company had set up hourly backups of this office’s workstations and data. The IT company performed a quick restore to a snapshot backup saved an hour before the attack. The customer lost only 1 hour’s worth of data and productivity and did not have to pay the ransom. In this case, an ounce of prevention was the difference between losing 5 days and 1 hour.

These infections can happen to anyone—from Fortune 500 companies to dental offices to dental laboratories. Fortunately, you have opportunities to protect yourself from ransomware (see sidebar).


Even though ransomware can be an intimidating threat to business owners, tools are available to minimize risk. Regularly evaluate your IT policies. Plenty of certified IT administrators/service providers are willing to help.

The use of computers and networks was not common decades ago in dental laboratories. Today, some laboratories have more computer workstations than traditional laboratory workstations. Each is a potential path for unscrupulous software to find its way into your network. Problems can start small and grow into major issues if not dealt with swiftly and effectively. Just as dentists want to see their patients being proactive about their oral health, laboratories need to be proactive about protecting their growing IT infrastructure.

3 Steps to Protect Your Laboratory

1. Train employees to surf safely. This old advice still protects against the new threat of ransomware. Today’s computer systems have come a long way, but they still can’t protect themselves from their users. Train your staff to not open unexpected email attachments—even an unexpected job application or label from a shipping company. Tell employees not to click on any ads or popups.

2. Set up a super firewall. You should have an IT administrator/provider look after your computer systems. Have that company upgrade your standard firewall with one that can filter potentially dangerous websites or restrict the non-work–related websites your staff can access.

3. Establish a solid backup strategy. The biggest headache with today’s ransomware is that it encrypts your files. The only way to avoid paying the ransom is to completely restore your system from a clean, recent backup. Your IT provider should have an automated backup procedure that is transparent and comprehensive.

About the Authors

Robotic Arms Lend a Helping Hand Scott Mabie is General Manager of Universal Robots’ Americas Region overseeing the rapid market expansion of the company’s collaborative robots.

Breaking Barriers
Pam Johnson is editor-in-chief for Inside Dental Technology.

Ransomware on the Rise
Bruce McCully is CEO of Dynamic Edge, Inc, a Fixed IT computer services company with offices in Ann Arbor, Michigan, and Nashville, Tennessee. Chris Brown, BSEE, is an application engineer and the manager of Aclivi, LLC a dental CAD/CAM consulting company in Pinckney, Michigan.

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