Supporting An In-Office Orthodontic 3D Printing Lab

Alison Werner
Hello and welcome to the Orthodontic Products podcast. I’m your host Allison Warner. Today we’re going to look at 3D printing and orthodontics. And to do that, we are joined by Chuck Stapleton, vice president and general manager for dental at 3D Systems. The company offers entry level dental 3D printers, and mid and large range platform batch 3D printers, along with software and materials to support an in office 3D printing lab and a digital workflow. Chuck, thank you for joining me.

Chuck Stapleton
Thank you for having me, good to be here.

Alison Werner
So before we dive into our topic, I know 3D Systems manufactures industrial 3D printers for use in a number of sectors, including aerospace and automotive. And it also has a healthcare component that manufactures printers for medical devices, 3D, bioprinting and dental. Can you talk about the company’s dental focus and how it fits into the company’s kind of overall profile?

Chuck Stapleton
Yeah, absolutely. So the dental space is, is very important to the company overall, and the company’s growth strategy. It’s driving a lot of innovation within 3D Systems. And that eventually also leads to growth and, you know, better outcomes for all the patients in the orthodontist that are out there. And it’s a key area for the organization, because we’re already heavily invested in it. But also, you know,  it’s a market that continuously grows at a pretty steady pace. And everyone at some point in their life is going to need something with their teeth, right? Whether it’s fixing something or replacing something. So it’s a market that, that, you know, we can rely on to continue to grow.

Alison Werner
Right. So what’s your biggest takeaway, when you think about how 3D printing in dental has evolved in recent years?

Chuck Stapleton

So really, the evolution has come on two fronts on the material side and on the hardware or the printer side. So typically, in some industries, you’ll see like, okay, materials are very mature, and the innovation is only on the hardware or vice versa. And really, 3D printing has been experiencing fast innovation in both areas, the materials are getting better, stronger, easier to print. And the printers are becoming more robust, they’re becoming smarter, and they’re also becoming faster and more compact.

Alison Werner
So now we’re going to focus in on 3D printing in the orthodontic practice, and more and more practices are creating space and incorporating that digital workflow needed to expand into 3D printing, what does in office 3D printing bring to the orthodontic practice? And what are the benefits?

Chuck Stapleton
So the first thing is it just it cuts down on the turnaround time to deliver the product. So no longer having to send the product to the lab and wait a week or two weeks or longer to get the product back. You won’t be stuck in that situation where you know, the patient shows up for an appointment, and you’re like, oh, do I actually have the appliance I need to deliver, like, did it show up or not. So those kinds of situations will go away. You know, in some cases, you’ll be able to deliver the same day or within the same hour to the patient on certain things. But other things, you know, it may take an overnight print in order to fabricate the device, whether it’s a direct or an indirect, but overall, that’s going to lead to faster delivery for the patient. And then also better comfort for the patient. So when you’re taking things digital, they’re just more accurate, the fit is better and patient comfort and acceptance and compliance overall will get better.

Alison Werner
So can you talk a little bit about kind of how that digital workflow within the practice fits into 3D printing?

Chuck Stapleton
Yeah, absolutely. So I mean, the place you start is with the intraoral scanner, right. And some places still, they will take an impression and pour a model and scan. And then it will come to the design software, whatever that might be. So if the dentist is printing the model, then that’s pretty simple. If they’re doing something like designing aligners, and you know, it’s a little bit more complex. But it all starts with that input device and goes to the software. Then on the output side. Currently, if somebody doesn’t have a 3D printer, they’re probably sending that to a dental lab to have the final appliance fabricated. In the future. There could be a 3D printer sitting in the dentist’s office and they’ll just say look, I want to make a series of aligners, and right now it’d be indirect. So print me a set of models, the models will come out in a few hours, and then they’ll sit there and thermoform the aligners on them. It could be an indirect bonding tray, right, so print the model with all the brackets in place on it, and then we’ll thermoform on that. And then we’ll have our indirect bonding tray. Or you could potentially go to directly printing the indirect bonding tray. And that happens pretty quickly and allows for patient delivery, theoretically in the same day.

Alison Werner
Now let’s talk about orthodox applications for 3D printing. You talked a little bit about it there, but I’d like to break it into two parts. Let’s talk about kind of large scale applications because I know 3D Systems dental 3D printers are used by several large or that automatically extras including Align Technology and DenMat. Can you talk about how the technology is being used there?

Chuck Stapleton
Yeah, absolutely. So,  the large scale manufacturers particularly the ones you mentioned, are using it for aligner production. And these are large format machines, you know, can print hundreds and hundreds of models per day. And it goes through a thermal forming process, sometimes automated sometimes not. But that is the major use case for the 3D Systems equipment in the orthodontic space. Another application that we see emerging actually is using metal printers out there for things like space maintainers, or other items that require that you would typically do in stainless steel, you can 3D print in chrome cobalt, and still weld to and solder to if needed. So there are different applications for those two customers in particular, are using it for large scale, you know, aligner manufacturing, but there are other things out there that large manufacturers are using it for.

Alison Werner
Okay, so now let’s take it down a level and talk about the same technology and how that can be incorporated into the orthodontic practice. And it’s up in office 3D printing lab. What does today’s 3D printing technology allow them to do you talked a little bit about before, but let’s go a little bit more in depth.

Chuck Stapleton
Yeah, absolutely. So, currently, I mean, I mentioned the indirect bonding trays, right. So that’s a, that’s a pretty straightforward one, right with your intraoral scanner, you can then design the tray and within you know, a day or two or potentially even the same day, you could have that indirect bonding tray ready to go for the patient to seat the brackets. Additionally, I, you know, some people will use it to do an entire set of aligners for a patient. But you can definitely use it to start off the case, right. So the sooner that patient gets that aligner, the more compliant they are, you don’t have to worry about the teeth shifting or anything like that. And then the, the last situation that comes to mind would be for a retainer, right, a clear retainer, you could go ahead and print the model, do a thermal form on that and get them the retainer the same day again, you don’t have to wait for bracket removal or digitally remove them. Right, you can just print it in the office right there. Some other things you know, there are, it is becoming more common for dentists and orthodontists to have a lab that you know, a technician in the office. So again, you can take a scan of a patient print the model, and then you can do something like a Hawley retainer on it. Right. So it still has application, even traditional manufacturing. But you know, those three I mentioned are probably the big ones that come to mind that allow the orthodontist to do more in office.

Alison Werner
Okay, so let’s talk about the actual solutions that they can incorporate into their practice from 3D systems. I know you have the NextDent 5100 printer. Can you talk a little bit about that one?

Chuck Stapleton
Yeah, absolutely. So the NextDent 5100, I actually, really, really like this machine. So when I was with 3D Systems, about four or five years ago, we had launched the equipment then. And it’s a very robust machine, it’s a very mature platform and proven technology, it has a unique aspect to it, which is the membrane that’s on the machine that allows it to print incredibly fast. So the technology, I’ll try and give a quick summary, but basically, the resin is kind of floating on a bed of oxygen, so it doesn’t stick to the platform. And what ends up happening is it can almost be a continuous print where the part is just constantly being pulled out of the liquid, other printers on the market, that it sticks to the film and it has to be peeled off, and you have to worry about you know, accuracy issues or distortion issues. But with the 5100 that’s not the case. It’s a bulletproof machine. So people that purchase them and use them, they love using them, they want a second one if they have the volume, because it just works. The other nice part about it is it’s a fully integrated solution. So we have our NextDent 5100. And we have our NextDent resins. And the nice part is you know, use the machine, you just you know, it’s going to work because we’ve tested we’ve developed it on it, we know that our materials work with our printer, and you don’t have to worry about and I have a problem with the printer or I have a problem with a print do I call the printer manufacturer? Do I call the software company? Do I call the materials company. With us, you know, we know it all works together? Because we built the integrated platform there.

Alison Werner
And then in terms of the software because you talked about the materials. So the other aspect of this would be the software. How does that fit in with the printer.

Chuck Stapleton
So there’s I mean, there’s two aspects of the software. One is the CAD software in which you go and design whatever it is you’re going to be making, right whether it’s an aligner or bonding tray. But then there’s also the software that runs the printer itself. And the software that we have it’s called 3D Sprint. It’s a 3D Systems software and has a lot of great tools built into it allows for automatic nesting, it allows for stacked printing, so you can print a whole set of models at one time in series. And it’s something that you really don’t get with some of the other printers that are on the market. Right they’re very manual. There’s a lot of trial and error to make sure that you get what you need. One thing I also forgot to mention was due to the printing technology, the supports so anytime you print, you have to add little supports to the print so that it can stay up. With the 5100 and that oxygen membrane of the supports can literally just wipe off with your thumb, right? There’s no sitting there, clipping it with pliers and having to grind it down. They’re very light supports that come off very, very easy.

Alison Werner
So can you talk a little bit about the workflow for practice incorporating this? What kind of time or just staffing are we talking about to get from that inputting the intraoral scan into the software to printing and moving on to thermoforming?

Chuck Stapleton
Yeah absolutely. So if a practice already has an intraoral scanner, it’s not adding any additional time to that process, right, just like they would send it to a lab. Now they’re just going to take the file and utilize it themselves. Also, if they’re if they’re pouring up impressions with, you know, alginate, or PVS. And having an assistant pour up the models, this probably will save them some time, because now you don’t have to sit there and mix all the model material and do all that the CAD software can generate models or appliances very easily, there are AI systems out there that generate the appliances as well. So that nobody has to sit there and design anything, and then loading it into the 3D Sprint software, to then run a printer, like the 5100, you just drop the file in, it’ll add the supports for you. And you click go. Now that there’s always post processing, when it comes to printing, so that means you’re going to have to take the part out and clean it and go through that. But versus traditional method, you’re going to be on par or faster. And then the nice part is you, you know, you have the digital record too. So like if the patient calls and says, Hey, I, you know, I lost my retainer, okay, fine, I’m going to go ahead and print another model, do a thermoform of retainer, and you can come pick it up tomorrow, you don’t have to go through that whole process. So there’s, there’s quite a few advantages aside from just the in office processing time.

Alison Werner
Can you talk a little bit about how many you know, how many models can you print on a run? Or aligners?

Chuck Stapleton
So it particularly I’ll speak to our machine with the NextDent 5100, we have a stacked printing mode that essentially lets you print a full set of models. I believe it’s somewhere around 20 models in one run, and it prints them all vertically in a very, pretty high stacked print but that does take some time to print. Right, I would recommend you run that overnight. But if you’re just looking for something, hey, I want to get something done quickly for the patient. You can design a very thin model load it on the printer, probably take 10 to 20 minutes to print, and then it’d be ready to go. And so that’s yeah, so in terms of cycle time, you’re not sitting there waiting hours for something that come out, it’d be on the order of yeah, let’s say 15 minutes.

Alison Werner
Okay. What is maybe the timeframe for getting that direct metal printing to the orthodontic practice?

Chuck Stapleton
Oh, that’s  a really good question. So, because of the nature of the technology, and you’re dealing with, you know, metal particles as well, making that compact enough for the orthodontic office, that’s probably a longer term thing to come to fruition and, you know, trying to think of the advantages necessarily, I guess for a space maintainer, it would, it would kind of make sense or bands and things like that, but yeah, miniaturizing that technology that is a tough one. Now, given the size of the orthodontic practice, yes, somebody I’m sure could find space for a machine like that. I mean, if they’ve got a copier, theoretically, maybe a little bit bigger than that. But it has to be a pretty big copier to say like, yeah, they’re equivalent. So yeah, that one, that one is a little bit a little bit further off.

Alison Werner
So where should an orthodontist start if they’re interested in bringing 3D printing into their practice?

Chuck Stapleton
My recommendation is just talk to somebody you know, that’s using one and get their feedback on it, right? Like they’re going to actually have gone through all the trial and error of trying to utilize whatever machine they purchased. If you talk to somebody and this might be a little self deprecating here, talk to somebody that works for a company or a salesperson, you’re always going to hear the best stuff. But I would say talk to someone that’s actually using the machine. And then once you’ve decided on which machine to purchase, definitely make sure the support is there, right, you’re getting into something new, you haven’t done it before. Even if you’ve done 3D printing before with let’s say FDM machines or things at home, there are going to be things that you haven’t run into or that you’re going to need help with and the support is the most critical part of that. There’s a lot of companies out there that will sell you a printer and it will be really cheap too probably and then they’ll run away and you’re left figuring out everything on your own. So some people like that they’d like to tinker around. But I think a lot of us just want, I just want it to work and not have to worry about it. So the support part is a critical piece of it. And then you find out from others, what they’re what they’re using. Going to trade shows is another way you can kind of see what machines are out there. But you know, that kind of evaluation, you’re really only looking at it from an aesthetic standpoint, like, oh, it looks cool. But then does it actually accomplish what you need?

Alison Werner
Yeah. Let’s go back a bit. In terms of the resins, can you talk a little bit about how important that is to this whole process? Because I think a lot of focus is on the printers.

Chuck Stapleton

The resins are critical to the process and making sure it works with the printer that you’re utilizing. You know, I’ve heard like, oh, you know, I can go online and find, you know, resin, extremely cheap. And I’m like, yeah, but you know, how long is that going to last year was going to look like when it prints. And that’s just for things like, you know, indirect things that aren’t coming in contact with the patient. When you start dealing with things that come in contact with the patient, you definitely want to work with a reputable company. There’s, you know, for instance, we have a whole regulatory team that’s dedicated to making sure that all of our products are safe. We have quality management systems, we’ve been doing products for the dental space for over 30 years, right? So 3D Systems acquired a company that was doing this already. So there’s a track record there of kind of what we produce. But yeah, I would say anything that that’s going to be coming in contact with a patient or will be coming in contact with something that eventually goes in the patient’s mouth. Make sure it’s from a reputable brand. And you know, check everything, make sure they have their FDA clearance. Make sure that you know if you’re in Europe that they have their CE clearance, because that’s, that’s critically important. You don’t want somebody to have a bad reaction to something and then that comes back on you.

Alison Werner
Yeah exactly. What does the next decade look like for dental 3D printing?

Chuck Stapleton
The next decade? I think it’s going to be heavily around materials development. So just things getting faster, better, stronger. I believe there’s going to be applications that come out that maybe we’ve never seen before, right things that you can do stuff with new materials that we’re like, wow, it creates a whole new way to handle things in orthodontics or dentistry in general, I believe on the printer side, you know, things will get smaller, and we’ll start seeing more automation. So it’ll be less handwork, which will be great for the orthodontist offices, but also for large manufacturers. And, you know, I’ve heard people say like, oh, well, everything’s going to move chairside. Right. And you know, the labs won’t be relevant anymore. But I don’t see that happening. I see some stuff moving into the office. But I still see the manufacturing side being very relevant as we go forward just because of the efficiency that you get from it and the scale that that comes with that.

Alison Werner
Well, Chuck, thank you so much for joining me today. It’s been really a pleasure getting your insight into this. Thank you.

Chuck Stapleton
Yeah. Thanks for having me. Appreciate it.

Alison Werner
As always, thank you for joining us. Be sure to subscribe to the Orthodontic Products podcast to keep up with the latest episodes. And be sure to check out orthodonticproductsonline.com to keep up with the latest industry news. Until next time, take care.