1. Technological Foundation
Digital dentistry has advanced continuously since the 1990s and has fundamentally changed workflows in dental practices as well as patient care. One of the most important milestones was the introduction of computer-assisted impression and manufacturing techniques, which enabled a fully digital process chain for the first time (Baroudi & Ibraheem, 2015).
From Conventional Impressions to Intraoral Scanning
Traditionally, impressions were taken using materials such as silicone or alginate. This method was not only uncomfortable for many patients but also prone to error, as distortions or bubbles could affect restoration accuracy. The intraoral scanner has revolutionized 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 usability. Color scanning, soft-tissue representation, and direct interfaces to CAD software are now standard features. This not only facilitates the dentist’s work but also improves patient communication by allowing patients to visualize their oral situation directly on screen (Nulty et al., 2021).
Chairside CAD/CAM Systems
Parallel to scanner technology, chairside CAD/CAM systems have also evolved significantly. They typically consist of three components:
From Scan to Final Restoration
By 2025, the chairside workflow is an established treatment method. Dentists can perform all steps—from digital impression to design and placement of a definitive crown—within a single visit. This makes chairside CAD/CAM a key factor for modern, efficient practice management (Reich & Schierz, 2013; Blatz & Conejo, 2019).
2. Practical Applications Scenarios
The strengths of intraoral scanners and chairside CAD/CAM systems are particularly evident in everyday practice. They fundamentally change workflows and enable more patient-oriented care.
Digital Workflow in the Practice
The typical workflow begins with a digital impression taken by an intraoral scanner. The data is transferred directly into CAD software, where the dentist or a trained team member designs the restoration. Fabrication is then carried out 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 especially suitable for single-tooth restorations, such as:
Complex cases such as multi-unit bridges or implant prosthetics still typically require cooperation with a dental laboratory (Fasbinder, 2012).
Integration into Everyday Practice
Digital workflows simplify not only restoration fabrication but also communication with patients and laboratories. Patients can view 3D models of their teeth on-screen, increasing transparency and acceptance. Digital data can also be shared easily with laboratories via cloud platforms—particularly useful when a restoration is not fabricated chairside (Zimmermann et al., 2015).
Chairside vs. Laboratory Fabrication
A key consideration is deciding which cases to produce in-house and which to outsource. Chairside systems are ideal for time-sensitive, straightforward restorations, while laboratories remain indispensable for more complex prosthetic work. A hybrid model—combining both options flexibly—has proven especially effective in daily practice (Reich & Schierz, 2013).
3. Benefits for Dentists
The use of intraoral scanners and chairside CAD/CAM systems provides a wide range of advantages for dentists, significantly improving practice workflows and patient satisfaction.
Increased Efficiency
A major benefit is the reduced treatment time. Being able to design and insert restorations in a single visit eliminates follow-up appointments and provisional restorations, leading to more efficient scheduling and better practice utilization (Reich & Schierz, 2013).
Greater Patient Comfort and Trust
Patients benefit from greater comfort because traditional impressions are no longer needed and restorations can often be placed immediately. The ability to visualize the treatment process on-screen also increases transparency and trust (Zimmermann et al., 2015).
Economic Advantages
Chairside systems enable dentists to bring part of the value chain—traditionally handled by laboratories—into the practice itself. This can increase revenue over time. At the same time, costs for laboratory services decrease for standard restorations, improving overall profitability (Fasbinder, 2012).
Competitive Advantage Through Innovation
Practices that adopt digital technologies position themselves as innovative providers of modern dentistry. This strengthens patient loyalty and helps differentiate the practice in an increasingly competitive market.
4. Challenges and Limitations
Despite their many advantages, intraoral scanners and chairside CAD/CAM systems also present challenges that must be considered before implementation.
Investment Costs
Purchasing intraoral scanners and chairside production units represents a significant financial investment. Additional costs include software licenses, service contracts, and materials. A detailed ROI analysis is essential to ensure economic viability (Fasbinder, 2012).
Training Requirements and Learning Curve
Operating scanners, CAD software, and milling machines requires practice and training. Both dentists and dental staff must be trained to use the systems efficiently. Inexperience can lead to longer treatment times or suboptimal outcomes (Reich & Schierz, 2013).
Indication Limits
Chairside systems are mainly suitable for single-tooth restorations. For complex indications such as multi-unit bridges, extensive implant prosthetics, or highly esthetic anterior restorations, laboratories remain essential (Zimmermann et al., 2015).
Material Versatility and System Openness
Not all chairside systems allow the use of a wide range of materials. Closed systems can limit flexibility and increase dependence on a single supplier. Practices should look for systems with broad material compatibility to remain flexible long-term.
Practice Workflow and Team Acceptance
Integrating digital systems changes existing workflows. Some team members may initially be skeptical. Clear communication, targeted training, and gradual implementation are necessary to build acceptance and routine.
5. Market Outlook and Future Perspectives
The increasing adoption of intraoral scanners and chairside CAD/CAM systems demonstrates that these technologies are no longer niche solutions. They are becoming fundamental components of modern dental practices and will strongly influence future patient care.
Technological Development
The coming years will bring AI-enhanced software solutions that automate restoration design and support clinical decision-making. Cloud-based platforms will further accelerate data exchange between practices and laboratories, making hybrid workflows even easier to implement (Nulty et al., 2021).
Expanding Indications
While chairside CAD/CAM has been predominantly used for single-tooth restorations, advancements are emerging in more complex applications. Improved materials and more powerful milling units may extend use to implant prosthetics and larger bridges (Reich & Schierz, 2013).
Patient Comfort as a Growth Driver
Growing patient expectations for comfortable, fast, and esthetically pleasing treatments will continue to increase demand for digital workflows. Dentists who adopt intraoral scanners and chairside systems gain a strong competitive advantage.
Market Forecast
Experts expect the penetration rate of intraoral scanners in dental practices to increase significantly over the next five years. Chairside systems may become standard in medium-sized and specialized practices, while smaller practices are likely to rely more on hybrid models—scanning in-house and fabricating through laboratories or milling centers.
Sustainability and Efficiency
Another emerging trend is sustainability. Eliminating physical impressions reduces material consumption, transportation, and storage needs. Digital workflows are therefore 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 major milestone in the development of modern dental practices. Dentists benefit from improved efficiency, increased value creation, and greater patient satisfaction. At the same time, these technologies enable more precise and comfortable treatments.
However, it remains important to consider the economic, technical, and organizational challenges. Investment costs, training needs, and indication limits require a strategic approach.
Recommendations for Dentists
In summary, dentists who invest early in digital technologies improve their treatment quality and efficiency while positioning themselves as innovative providers in an increasingly competitive market.
7. 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 complex indications such as multi-unit bridges or implant-supported restorations, cooperation with a dental laboratory is typically required (Fasbinder, 2012).
2. How long does it take to fabricate a chairside crown?
From digital impression to placement, fabrication typically takes between 60 and 120 minutes, depending on case complexity, material selection, and the practice team’s experience (Reich & Schierz, 2013).
3. What investment costs should be expected?
Costs vary by manufacturer and system. Intraoral scanners generally cost between €15,000 and €30,000, while complete chairside systems with scanner, CAD software, and milling unit range from €50,000 to €120,000 (Fasbinder, 2012).
4. How does the precision compare with laboratory restorations?
Current studies show that digital impressions with intraoral scanners offer comparable or even higher accuracy than traditional impressions. Chairside-fabricated crowns achieve clinically reliable results equivalent to laboratory-made restorations (Zimmermann et al., 2015; Giuliodori et al., 2023).
5. What benefits do patients experience?
Patients benefit from greater comfort (no impression materials), shorter treatment times, and often a definitive restoration in a single session. This increases patient satisfaction and strengthens loyalty to the practice (Reich & Schierz, 2013).
