Cerec Doctors

Surgical guide made three different ways: Costs and time

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CG2, Milled first version, sent to Frankie at AA Dental Design for conversion and design. Printed with Moonray S and also with a  new in the market filament printer.

All three: Cerec scan,CBCT scan, design of implant placement. Lets say 1/2 hour assuming a simple case, adequate bone, etc.

CG2 Milled: 10 minutes design time, 55 minutes milling time. Allows for change to carbide burs and clean up of milling chamber. Cost $60 block.

CG2 DLP/SLA Printed in office: About a day turn around from InLab user, Frankie did rush this for me, so got it back in the afternoon, but realistically 24 hours on a routine basis, 47 minute print, 45 minutes post processing. Cost $20.00 lab fee, $4.00 in resin another $4 in alcohol, gauze, gloves, etc.

CG2 FDM ( Filament) Printed in office: Same time from Frankie, 50 minute print, 5 minutes post processing.Lab cost $20.00 material cost Less than $1.00.

Summary:

Milled took about an hour, cost me $60, minimal learning curve, and no additional equipment.

High quality print with other possible in office applications, took about 26 hours, cost $28, moderate learning curve, $4000 in new equipment

Acceptable quality print with no other real in office application, took about 25 hours, cost $21.00, moderate learning curve, $1500 in new equipment (FDM printer I used was about $180, but it is unproven and glitchy at the moment)

 

I did this comparison so that those of you thinking about this have some basis for decisions. As Skramy has mentioned in the past, there are some fiddly softwares that you need to learn to get here. You also need to add in additional equipment, or trade off wear and tear on your mill. Time is also a factor here if you are trying to knock out a same day implant. There are other workflows available which can reduce time and cost by eliminating the lab conversion, but I was trying to look at staying within the Sirona workflow. Another factor to consider is that there is excess capacity in labs and other sources to get guides printed or milled, typical cost $35-$100. Also to be considered is potential disruption or smoothing of workflow, failed prints are a PITA and a definite reality, but DIY can be efficient and fast when you start to consider higher volumes of models/ guides.


Great post!


Great comparison Marc. I would argue that there are other hidden costs not mentioned, such as milling burs and resin tanks that need to be replaced, but overall a fair comparison. Like anything else we buy, the question is always "what are you going to use it for?"  If you are going to only print single hole surgical guides and that's it, I would say buying a printer and learning the software makes no sense.  If on the other hand you want multiple hole surgical guides, the math changes pretty quickly. Add on printing models for clear aligners (can't use filament printer for this), articulated models and implant analog models and now you create a procedure that can't be done practically with milling.

I still believe the only practical same day guided implant workflow is using a milled CG2. This may change in the future, but with file conversion, multiple software platforms and processing of prints and print time, it's not a same day procedure.  


Awesome resource Marc and Dan!

Mark


Marc when you go to the 3D class, you'll learn how to save your ipa


On 8/7/2017 at 11:22 am, David Honey said...

Marc when you go to the 3D class, you'll learn how to save your ipa

Pretty sure I saw David drinking it during happy hour.


All of that is true, but as a Surgeon with no mill, The 3D printer is by far the most affordable way in comparison to a Sicat produced guide.

And don't forget the $60,000+ mill as a cost.


No right or wrong answers here, just wanted to get more information out there for people to begin to see about this technology and to begin seeing costs. I actually held off on purchasing a printer for about a year and a half because of the excess capacity in the market. I think it may still make sense for a lot of docs to design and have fabricated elsewhere, and for others to fabricate themselves. Frankly, even with a mill in house, if not needed same day outside manufacture of a surgical guide may be more cost effective. Not sure how Doug is handling this, but I believe Farhad has a lab tech in house fabricating milled and printed guides.

I do like the Moonray unit so far, build time is fast compared to form2, but software is not nearly as smooth, yet. 


Dan... You found me out.  It's way cheaper than the bars :P
 

Marc bring up a great discussion on the whole cost thing With the moonray you are looking at a cost of $250 per liter as opposed to $400 for the form 2 per liter.   150 bucks over time if you are making a lot of guides can add up.  Then there is the cost of the vat (resin tank)   Moonray's FEP is supposed to last a lot longer than form.  There are FEP's that have lasted a year. While if you print a lot on the Form, you are looking at a few L then having to change the Vat or do a DIY PDMS layer.   
BUT if you are not printing a lot, then these can almost be mute points.


So Marc do you mill more or print more?


Will be moving towards printing. As noted above it will depend on complexity of case and timeline. Geeked out so heavily on this over the past couple weeks I had to take a break for a couple days. 


Great post, Marc!


On 8/7/2017 at 5:24 pm, Gene Messenger said...

So Marc do you mill more or print more?

It's a great question, Gene. I see printing guides on a $4000 3D printer as a better solution for many than milling guides on a $70,000 milling unit. If there's a problem with either of my 3D printers, it's unfortunate, but doesn't mess with a daily production.  If there's a problem with either of my milling units, that hurts my bottom line.