Nearly every modern dental lab is involved in some form of CAD/CAM manufacturing. This change in the production process has been gradual over the last 10 years, however, many labs are reporting that designed restorations are now 80-85% of their total production.
This change has created a new dynamic in the industry. Experienced technicians have had to adapt to new methods, design software, scanning, milling and 3D printing to name a few. If that is not enough, there is a critical shortage of dental technicians, so owners are forced to hire computer-literate personnel and train them in dental technology.
Originally, it was thought, since computers did most of the work, it would be relatively easy to train inexperienced people in the dental fundamentals necessary to enable them to produce acceptable work, but history has shown that is not necessarily true. We have learned that while the CAD software does give certain advantages and shortcuts, it does not make the precise final decisions necessary for a quality restoration. Herein lies the fundamental problem for owners and managers. Ultimately, we are asking the computer technicians that have had basic training and little experience to refine the last 10-15% of each restoration, which is what we expect of our most experienced technicians. In most cases they just do not have the knowledge or experience to do that. We know it is this 10-15% that dentists look at when determining the quality of a restoration.
Unfortunately, a similar problem exists with experienced technicians, only it shows up in their inability to perceive, manipulate and create precise contours on a digital monitor. These problems are compounded when a lab has more than one designer. As was so common in the past, technicians that have not been trained in the same way with the same procedures, do not produce the same results.
To further complicate this digital transition, restorations that have not been accurately designed are now milled in zirconia, an extremely hard material. The task of re-contouring or adding to a restoration is now given to the contouring technicians. Their sometimes daunting job is to bring the “approximated” digital restoration to the last 15% of quality that represents the laboratory standard.
This scenario should sound very familiar to any experienced owner or manager. While many things have changed in the digital lab, what hasn’t changed is the need for technical knowledge and a common technical policy.
A number of lab owners have told me that they had put PTC training on hold because they felt digital didn’t require the traditional training procedures of the past. These owners are now experiencing growth and are coming to PTC for “emergency” training because not only have they not prepared to expand their technical personnel, they also realize they had neglected their existing technical foundation.
PTC has been the leader in training dental technicians in hands-on (analog) dental technology for nearly 40 years. It now is evident that the missing element in training excellent digital technicians is the same knowledge and experience gained in physically producing restorations. We have seen dramatic improvement in the quality of posterior CAD designers after training them in posterior dental anatomy and a modified course in Anatomical Waxing. The same results can be seen in anterior CAD designers and contouring technicians after training them in the PTC Porcelain Application and Contouring course.
The lesson to be learned here is that traditional methods of analog training, when modified to apply to digital design and contouring are as necessary today as they have ever been in the past. After all, it is always the precise application of knowledge that leads to high quality restorations.
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