Laboratory owners like Ragle have used their experiences with digital integration as an opportunity to repurpose experienced hands-on technicians into digital technologists. “The biggest learning challenge to move from what I call an ‘analog’ to a ‘digital’ system, is getting your staff to embrace technology so this can work,” he said.

Ragle acknowledges that with new systems, it’s sometime more comfortable to rely on old methodologies because it’s often easier and quicker at first...but the perseverance pays off. “We’ve crossed that bridge, and we now have two or three people who come upstairs and design work on the inLab system. We didn’t plan it that way, but they just started to show an interest, and we ran with it,” he added.

Or, will it be the next generation who lead the technological evolution of the dental laboratory? The Generation-Y “Millennials” born between 1981 and 2000 have entered the workforce, some now with college education and advanced degrees. They have grown up in a world where digital technologies are commonplace and nothing particularly new, much like television was to their Baby Boomers parents. Tina Chemini, DLP’s “Employee Management” columnist (see page 76), said Gen-Ys are technologically savvy and quick to learn, which makes them ideal to handle tasks in a virtual environment.

“When we go to employ people,” Stroh said, “we find applicants with very good minds” but who may not have the hands-on skills traditionally required for working at the lab bench. “With this kind of technology, that’s a lot less important. So your labor pool is much larger and much better.”

Screen Smarts Technicians at Ragle Dental Lab are just as likely to work at a computer workstation with digital systems such as Sirona’s CAD/CAM design software (left) or Cadent’s iTero (below) digital impressions as they are to perform manual work at the bench.

He believes that the proliferation of digital technology minimizes the need to dip into that pool for staff growth. “Today, we create a lot of things with computers that we never dreamed of just a few short years ago,” said Stroh, who estimates that 95% of his crown and bridge substructures are produced via CAD/CAM. “If you think about it, there’s very little hands-on work for technicians to do between trimming a die and applying incisal powders. These technologies are of really high quality and produce more consistent results than we can achieve by hand. I’m a 22-technician lab. As I grow and these new technologies are going to come in, I’m not going to have to hire more people because the people that I have can be more productive on computers than they have ever been before.”

Ragle also likes the ability to hire from a technologically educated labor force. “They find lab work quite challenging, so they stay interested. You’re able to start them at a reasonable salary, and you get a very productive technician quite rapidly: a digital technician, not a hands-on type of technician,” he said. “They don’t even need to know how to wax a crown anymore.”

Girard-Sebestyen said the technician of the future will be a creative designer, skilled more in computer arts than in hands-on craftsmanship. “Digital, virtual models generated by a chairside oral scanner or from the scan of a model will become the technician’s new canvas.”

Ragle looks at the next generation of younger, more tech-savvy dentists as a driving force in the adoption of digital technologies in the office and in the lab. They may still be working in practices as junior associates, under the direction of the senior practitioner and business owner.

“Once they reach a level where they can go out and buy their own equipment,” Ragle said, “then we’ll begin to see a real change.” He then added that laboratories need to be knowledgeable and comfortable with the latest technologies to attract this next wave of tech-saavy dentists.

The range of different digital technologies also may play a role in the concept of a future independent dental laboratory.

Dr. DiTolla said he imagines the development of dental practices located in a large metropolitan area with 15 to 20 dentists sharing a common laboratory, all in a single building. The clinicians would be equipped with a digital impression system and digital camera to send tooth prep data and shade information to the technician, who then designs and mills the full-contour crown on a CAD/CAM system. The crown is shaded and glazed to match the digital patient images, then the finished restoration is delivered by hand to the dentist for seating, all in one patient visit.

“You have the best of both worlds. You have something that’s available in one day, but it also has the artistry of a dental technician,” he said. “That might be where the future of laboratories is.”

Another creative business model brings the same idea of a one-day, single-unit restoration, but brings the digital laboratory to the digital doctor (see “A new twist in the road for dental technology,” on page 28).

The centrally located laboratory or “laboratory on wheels” approaches help retain a certain personal approach that may fade from the dental laboratory . Computer-based communications, like e-mail and digital images as well as electronic transmission of digital impressions and CAD/CAM manufacturing, help streamline the workflow of any laboratory but make the production-type laboratory all that much more appealing. Dentists generally place an emphasis on the bottom line, while still looking for quality.

Digital preparation, design, and manufacturing systems allow labs to produce a quality restoration—matching or surpassing the level achieved through hand-crafted means—but at a more consistent and desired price base. Laboratory owners who depend on the traditional methods of hands-on fabrication may not be able to compete against the high volume of production labs.

“You’re going to see a large number of labs cease to exist over the next 10 or 15 years,” Stroh said. “If you’re ready to close your laboratory in the next five years, you can survive that long and go out happy. But beyond that, you’re going to have to invest. You’re going to have to step into a digital world.”