1. Technological Background
Digital dentistry has been continuously evolving since the 1990s, fundamentally changing both the workflow in dental practices and patient care. One of the most important milestones was the introduction of computer-aided impression-taking and manufacturing processes, which enabled a fully digital process chain for the first time (Baroudi & Ibraheem, 2015).
From Conventional Impressions to Intraoral Scanning
Traditionally, impressions were taken with materials such as silicone or alginate. This method was not only uncomfortable for patients but also prone to errors, as distortions or air bubbles could compromise the fit of restorations. The intraoral scanner has fundamentally changed this process: today, digital impressions can be created with high precision, speed, and patient comfort (Zimmermann et al., 2015; Giuliodori et al., 2023).
Technological Advances in Intraoral Scanners
Modern scanners offer significantly improved accuracy, speed, and user-friendliness. Color scans, soft tissue visualization, and direct interfaces with CAD software have become standard. This not only makes the dentist’s work easier but also improves patient communication, as patients can see their oral situation directly on the screen (Nulty et al., 2021).
Chairside CAD/CAM Systems
In parallel with scanner technology, chairside CAD/CAM systems have also advanced considerably. They usually consist of three components:
From Scan to Final Restoration
By 2025, the chairside workflow is considered an established treatment method. Dentists can complete all steps — from the digital impression to the design and insertion of a definitive crown — in a single appointment. This makes chairside CAD/CAM a key factor in modern, efficient practice organization (Reich & Schierz, 2013; Blatz & Conejo, 2019).
2. Practical Applications
The benefits of intraoral scanners and chairside CAD/CAM systems become particularly evident in practical use. They fundamentally change the workflow in dental offices and open up new possibilities for patient-centered care.
Digital Workflow in Practice
The typical process begins with a digital impression using an intraoral scanner. The data is immediately transferred to the CAD software, where the dentist or a specially trained staff member designs the restoration. This is followed by fabrication via a CAM unit — usually a compact milling machine — directly in the practice. In many cases, the restoration can be placed during the same appointment (Reich & Schierz, 2013).
Suitable Indications
Chairside CAD/CAM is particularly suitable for single-tooth restorations, e.g.:
For more complex indications, such as multi-unit bridges or implant-supported restorations, collaboration with the dental lab is still often necessary (Fasbinder, 2012).
Integration into Daily Practice
The digital workflow not only simplifies the production of restorations but also improves communication with patients and laboratories. Patients can view the 3D model of their teeth on the screen, which increases transparency and acceptance. At the same time, digital data can be easily shared with labs via cloud platforms — for example, when a restoration is not produced chairside but in the lab (Zimmermann et al., 2015).
Chairside vs. Lab-Supported Production
A key aspect is deciding which cases to produce in-house and which to outsource to the lab. Chairside systems are advantageous for time-critical, simple cases, whereas the lab remains essential for more complex prosthetic work. A hybrid model — flexibly combining both options — has proven particularly efficient in daily practice (Reich & Schierz, 2013).
3. Benefits for Dentists
The use of intraoral scanners and chairside CAD/CAM systems offers numerous benefits for dentists, improving both practice organization and patient satisfaction.
Increased Efficiency
One of the main advantages is the reduction of treatment time. The ability to fabricate and place restorations in a single appointment eliminates time-consuming follow-up visits and temporary restorations. This leads to more efficient scheduling and better utilization of practice resources (Reich & Schierz, 2013).
More Comfort and Trust for Patients
Patients benefit from a more comfortable treatment experience, as traditional impressions are no longer needed and restorations can often be placed immediately. Being able to follow the process visually on screen further increases transparency and strengthens trust in the treatment (Zimmermann et al., 2015).
Economic Advantages for the Practice
Chairside systems enable dentists to bring part of the value chain — traditionally located in the lab — into their own practice. This can contribute to long-term revenue growth. At the same time, costs for external lab services for standard restorations decrease, improving profitability (Fasbinder, 2012).
Competitive Advantage through Innovation
Practices that use digital technologies position themselves as innovative providers of modern dentistry. This can be a decisive factor in patient retention and help stand out in an increasingly competitive market.
4. Challenges and Limitations
Despite the many advantages, the use of intraoral scanners and chairside CAD/CAM systems also poses challenges that dentists should consider.
Investment Costs
The acquisition costs for intraoral scanners and chairside production units remain high. Additional costs for software licenses, service contracts, and materials must also be considered. A thorough ROI analysis is therefore essential to ensure economic viability (Fasbinder, 2012).
Training and Learning Curve
Operating scanners, CAD software, and milling machines requires training. Both dentists and staff must be educated to use the systems efficiently. Lack of experience may lead to longer treatment times or suboptimal results (Reich & Schierz, 2013).
Indication Limits
Chairside systems are best suited for single-tooth restorations. For more complex indications, such as multi-unit bridges, extensive implant prosthetics, or highly aesthetic anterior restorations, the lab remains indispensable. Dentists must clearly define which cases can be treated chairside and which should be outsourced (Zimmermann et al., 2015).
Material Variety and System Openness
Not all chairside systems allow for processing a wide range of materials. Closed systems may restrict flexibility and increase dependency on a single manufacturer. Practices should therefore choose systems with broad material compatibility to stay flexible in the long term.
Practice Organization and Team Acceptance
The integration of digital systems changes existing workflows. Some practice teams may initially be skeptical about this transition. Clear communication, targeted training, and a gradual implementation strategy are necessary to achieve acceptance and routine use.
5. Market & Future Outlook
The increasing adoption of intraoral scanners and chairside CAD/CAM systems shows that these technologies are no longer niche solutions. They are becoming a permanent part of modern dental practices and will play a key role in shaping future care.
Technological Advancements
The coming years will be shaped by AI-driven software solutions that automate restoration design and support dentists in decision-making. Cloud-based platforms will also enable even faster data transfer between practices and labs, making hybrid workflows easier to implement (Nulty et al., 2021).
Expanding Indications
While chairside CAD/CAM is currently used mainly for single-tooth restorations, advances are being made in more complex indications. Improved materials and more powerful milling units could extend its application to implant prosthetics and larger bridges (Reich & Schierz, 2013).
Patient Comfort as a Growth Driver
Patients’ growing expectations for comfortable, fast, and high-quality treatments will further drive demand for digital workflows. Dentists who adopt intraoral scanners and chairside systems will gain a clear competitive advantage.
Market Forecast
Experts predict that the penetration rate of intraoral scanners in dental practices will rise significantly over the next five years. Chairside systems may become particularly common in medium-sized and specialized practices, while smaller practices are likely to use hybrid models — scanning in-house, production in a lab or milling center.
Sustainability and Efficiency
Another trend is sustainability. The elimination of physical impressions reduces material consumption, transport, and storage needs. This makes digital workflows not only more efficient but also more resource-friendly (Blatz & Conejo, 2019).
6. Conclusion & Recommendations
The combination of intraoral scanners and chairside CAD/CAM systems marks a crucial step in the evolution of modern dental practices. Dentists benefit from more efficient workflows, higher value creation, and improved patient satisfaction. At the same time, these technologies open up new opportunities for more precise and comfortable treatments.
Nevertheless, it remains important to consider the financial, technical, and organizational challenges. Investment costs, training requirements, and indication limits make a strategic approach essential.
Recommendations for Dentists:
In summary: dentists who invest early in digital technologies not only improve treatment quality and efficiency but also position themselves as innovative providers in a competitive market.
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FAQ Section
1. Which indications are suitable for chairside CAD/CAM?
Chairside systems are particularly suitable for single-tooth restorations such as inlays, onlays, veneers, and crowns. For more complex cases such as multi-unit bridges or implant-supported restorations, collaboration with a dental lab is still usually necessary (Fasbinder, 2012).
2. How long does it take to produce a chairside crown?
From digital impression to final placement, fabrication usually takes between 60 and 120 minutes, depending on case complexity, material selection, and team experience (Reich & Schierz, 2013).
3. What investment costs should be expected?
Acquisition costs vary depending on manufacturer and system. Intraoral scanners generally cost between €15,000 and €30,000, while complete chairside systems (scanner, CAD software, milling unit) range from €50,000 to €120,000 (Fasbinder, 2012).
4. How accurate are chairside restorations compared to lab work?
Current studies show that digital impressions taken with intraoral scanners offer comparable or even higher precision than conventional impressions. Chairside-fabricated crowns achieve clinically reliable results equivalent to lab-produced restorations (Zimmermann et al., 2015; Giuliodori et al., 2023).
5. What are the benefits for patients?
Patients benefit from more comfort (no impression material), shorter treatment times, and often a definitive restoration in just one visit. This increases patient satisfaction and loyalty (Reich & Schierz, 2013).
