Innovation at Every Turn in Cologne
By Jason Mazda and Daniel Alter, MSc, MDT, CDT
Henry Schein Chairman of the Board and CEO Stanley M. Bergman spoke passionately at the International Dental Show (IDS) in Cologne, Germany, about increasing access to oral care globally. Bergman stressed the importance of a collaborative approach to advocating for the recognition of oral health as primary care.
Surrounding Bergman at the IDS, hundreds of innovative manufacturers from around the world were doing their part to improve oral care by providing better tools for the dental teams providing that care. Additive technology, digital facial data acquisition devices, and automation were three of the most significant trends among the new launches at IDS, but innovation could be found at every turn, from materials to software to hardware.
As expected, 3D printing was the dominant theme of the IDS, with new additive technologies, materials, and workflows being brought to the market.
Ivoclar Vivadent introduced the PrograPrint line, headlined by the PrograPrint PR5. The printer's automatic material recognition and intuitive operation ensure a reliable printing process, and the specially developed Homogeneous Light Processing (HLP) technology facilitates an even light output. An innovative cartridge system enables easy, contactless handling of the materials and protects against polymerization caused by ambient light during storage.
Carbon unveiled its fully scalable production solution, providing an integrated technology platform that combines advances in software, hardware, and materials. Part of this launch was the new M2d printer for mid-sized dental and orthodontic laboratories with lower volume needs, as well as the L1 Production Solution for high-volume production of clear aligner models. Carbon also announced new dental resins and a materials initiative for creating recyclable dental models.
HeyGears showed its new Ultracraft A2 printer, with Smart-Separation technology and an AI machine learning algorithm to adjust the peeling strength of each layer in real time, increasing the printing speed and enhancing the printing stability. The printer uses a smaller build plate with a camera sliding back and forth via a robotic arm to achieve optimal accuracy.
Shining 3D launched the EP-M100T direct metal fusion printer and the AccuFab-D1 DLP printer. The latter is a desktop unit with a build volume of 144 mm x 81 mm x 180 mm and a print speed of up to 40 mm per hour.
Dekema launched a new 3D printer that is integrated seamlessly with the company's pressable oven and pressing ring system. The printer can print up to 33 veneers and incorporates the ingot(s) and plunger(s) for the lost wax technique. This process links the pressable ceramics with 3D printing.
EnvisionTEC showed the Envision One cDLM, utilizing a patented continuous 3D printing method for a wide range of applications and delivering accurate parts with minimal supports.
Bego launched the new Varseo XL, Varseo L, Varseo M, and Varseo XS DLP printers. The company says the handy build platform of the Varseo XS makes the production of permanent and temporary restorations possible, and that the build speed is independent of the number of elements being produced. Bego also billed the new VarseoSmile Crown material as the first tooth-colored, ceramic-filled hybrid material for the 3D printing of permanent single crowns, inlays, onlays, and veneers.
Lithoz introduced its LCM (lithography-based ceramic manufacturing) technology to the dental market with the CeraFab 7500 Dental, which it says can produce complex geometries such as ultrathin occlusal veneers; implants that were previously impossible to fabricate with conventional tools; and patient-specific bone augmentation implants.
DWS showed several new printers and materials, including the DFAB Desktop printer with Photoshade technology to reproduce the chromatic variation in tooth color from the incisal to the cervical. The operator can select the necessary shade's extremes from A1 to A3.5 and then choose the exact position and width of the gradient. The company says the DFAB Desktop can produce a bridge with up to five elements in less than 20 minutes and uses disposable cartridges.
Veltz3D displayed its D2 series printers and several materials. The company says its distinct advantage is manufacturing the D2 using digital calibration systems, all of which are individually manufactured to ensure the highest level of accuracy.
Dentis launched the Zenith DLP printer, with a new heated resin tank, plus the Zenith Cure, which offers two LED wavelength options (405 nm and 385 nm) in the same unit.
Spanish manufacturer Microlay displayed the Versus 385 DLP printer, which uses an internal radiometer to supply the exact same dose of UV energy on each layer for optimal accuracy.
Rapid Shape introduced several printers, including the D30+ and D40+ laboratory printers, along with DMG resins for semi-permanent crowns (lasting 4 to 5 years). A temperature-controlled resin reservoir in the printer provides process stability and increases part quality.
Ultimaker, a 7-year-old company, made its first foray into the dental industry with the Ultimaker S5 and Ultimaker 3 series printers, plus two materials optimized for dental applications: an ivory PLA material for models, and a sky-blue, biocompatible class I material for trays. The company says these materials are safer, cheaper, and require less post-processing than resins.
Alpha Laser made its first foray into the dental market as well. The manufacturer of 3D printers for the jewelry industry was gauging interest in its AL3D-Cartridge 50 intelligent cartridge system for safe and economical powder handling, and said it could be ready for the dental market within 6 months.
GC introduced a 3D printable light-cured composite material for temporaries that is completely MMA-free.
Keystone Industries showed its KeySplint Soft resin for night guards and bite splints, which are being optimized with Carbon's Digital Light Synthesis technology for an efficient workflow to produce durable yet flexible clear appliances.
Formlabs revealed a broadened spectrum of digital denture shade options, with two color base options and a range of four tooth shades, as well as improvements to its dental model materials, which can be used to create models and clear aligners at 140-μm settings.
Digital Facial Data Acquisition
One trend that has gained traction in recent years is acquiring patient data beyond impressions to use when designing restorations. Zirkonzahn's Face Hunter, DOF's SNAP Face Scanner, PiC Dental, and Bellus 3D have offered innovative solutions, and all were on display again at IDS, in addition to several new launches.
Shining 3D introduced its own 3D face scanner, the EinScan Pro 2X, a handheld device that captures full-color texture with geometry with the add-on Color Pack. The EinScan Pro 2X is compatible with several file formats and is accurate up to 100 μm.
3Shape showed the X1 CBCT scanner with 360° 3D face scanning, a technology that the company had unveiled at IDS 2017 as a concept.
Ray Co. unveiled a 5-in-1 scanner, the RAYSCAN Studio, that includes 3D face scanning along with panoramic, cephalometric, CBCT, and impression scanning. The result of this collection of data is what Ray Co. calls the 3D Virtual Patient, with all patient information coming from one integrated source.
Imetric introduced its ICam4D, a device that scans the patient from the facial position to measure the position and orientation of implants and abutments to combine with impression data.
Meanwhile, zebris Medical introduced the JMAOptic system, an optic jaw motion analyzer with latest-generation optical sensor technology. Additionally, Amann Girrbach announced it has fully integrated the system into the Ceramill workflow as a digital facebow.
The trend of automation shows no sign of slowing. Whether for 3D printing, milling, or various other processes, manufacturers continue to make workflows more user-friendly.
Structo showed its Elements automated factory solution. The modular, scalable system automates the printing, washing, and curing processes via an integrated gantry robot and conveyance system.
Rapid Shape introduced the RS Wash and RS Cure, automated systems equipped with data links to Rapid Shape printers to preselect the correct cleaning programs, matching cleaning agent, and curing program. The fully automatic cleaning and curing take approximately 6 to 8 minutes and 4 to 8 minutes, respectively.
Voxeltek unveiled the Voxeltek Flow system, with a model scanner, SLA printer, post-polymerizing chamber, and storage compartment fitting together on a desktop.
On the milling side, Amann Girrbach launched the Ceramill Matik, which it calls the first "Digital Native Automation" unit that "caters" for itself. The mill has a fully automatic stock management system, with intelligent tool management and an integrated cleaning unit, enabling an automatic change between wet and dry modes. Amann Girrbach estimates that 40% of the dental technician's working time was previously occupied by operating the mill and now can be devoted elsewhere.
Meanwhile, vhf showed its new R5 mill, with DirectDiscTechnology for material loading and an automatic changer that holds up to 10 discs, 60 blocks, or 60 prefabricated abutment blanks. The machine's DirectCleanTechnology is self-cleaning and includes an ionizer and a built-in dryer for easy switching between wet and dry milling.
Orotig introduced its Whitec 5.3 mill, with automatic tool-exchanging integrated with a device measuring tool length and detecting breakage.
HeyGears unveiled an automated solution for 3D printing clear aligners, but like many innovations at IDS, the system is not quite ready for the market. The HeyGears system prints models and automatically washes and cures them within the same machine. It then continues to heat the thermoplastic and sucks down on top of the models before a drill or bur trims it right at the teeth and produces a finished product.
Several companies introduced 3D printing resins that could reach the market soon. Lithoz showed its LithaCon 3Y, a 3 mol% yttria-stabilized zirconia. DWS previewed Irix Max (nanocomposites) and Irix Z (zirconia) materials for permanent restorations. Both printed zirconia materials still require sintering developments before they will be suitable for long-term restorations.
Israeli startup iotech showed an additive technology concept for producing single and multi-material functional objects, including multi-color ceramics in high resolution, allowing for complex geometries, limited waste, and superior esthetics with its customizable gradients/translucency.
DOF showed a prototype of an intraoral scanner that it expects to be available next year, exclusively through Imagine in the US. The device includes a detachable piece that allows it to also be used as a model scanner.
Laon People unveiled the use of artificial intelligence for its Deep Learning 3D Tooth Segmentation and Automatic Tooth Alignment.
Other innovations at IDS included scanners, sintering ovens, digital dentures, and more:
• 3Shape introduced the TRIOS 4 intraoral scanner with infrared scanning to provide identifiable caries detection highlighted in the scan.
• Aidite unveiled its new all-in-one multilayer zirconia as well as a speed-sintering oven that guarantees the same results as regular sintering, without chalkiness or opacity.
• Align Technology introduced the iTero Element 5D imaging system, which it calls the first hybrid dental imaging system that simultaneously records 3D, intraoral color, and NIRI images (for caries detection) and enables comparison over time using iTero TimeLapse technology.
• Amann Girrbach launched two new zirconia options: Ceramill Zolid Gen-X is for all indications, and Zolid RS can be coupled with the Ceramill Therm S speed-sintering furnace to produce a 20-minute sintered crown.
• AvaDent Digital Dental Solutions showed its Integrated Bar Hybrid and Digital RPD solutions.
• Bausch unveiled OccluSense, a handheld, battery-powered device for capturing masticatory forces via sensor and transmitting them wirelessly to the OccluSense app on a tablet.
• Dentsply Sirona introduced the Primescan intraoral scanner, which it says is easier and faster than ever, and the inLab Prosinter speed-sintering furnace for both zirconia and non-precious metal.
• GC introduced the Aadva Lab Scanner 2, with three unique features: Hybrid scan to combine the impression and the gypsum model, Smart scan dedicated scan strategy, and 3-Point Occlusion scan of three reference points applied on a gypsum model.
• Good Fit showed its Instant Overdentures and Denture Tray, both of which utilize materials that become moldable in hot water.
• Hexagon Manufacturing Intelligence displayed the new WorkNC v2019 software.
• CIMsystem showcased its integration with 3Shape to help bridge the gap between open and closed systems.
• Keystone displayed the KeyMill Denture Base Disc, high-impact acrylic discs featuring Keystone's Diamond D.
• Kuraray Noritake introduced a new high translucent multilayer zirconia.
• OneBite displayed its OneBite Evolution system for dentists to capture the true position of the maxillary arch and accurately communicate it to laboratories. The system is intended to replace the traditional facebow workflow. It allows the occlusal bite plate to move freely, and a piece called the Cube locks into place to capture the position. That is then used by the laboratory in conjunction with a universal mounting table that is fully magnetic. An integration with exocad is upcoming.
• PREAT Corporation unveiled the Implant Buddy, with color-coded drivers for 99% of implant cases in one handy kit.
• Primotec showed its new PREMIOtemp CLEAR FLEX, a milling blank for night guards. The material is a transparent PMMA acrylic with thermo-effect, and when pre-heated to 40°C to 50°C in warm water, it automatically adjusts to the patient's arch without losing surface hardness.
• VOCO introduced the IO SCAN with digital holography; the company says it uses infrared technology to see through and under the gingiva.