6 ms·

why aren't teeth implants and crowns getting cheaper because of 3D Printers crowns and teeth implants should be a lot easier than other organs or bones

maxerickson 9y ago
Because a 3d printer isn't going to be vastly better than a milling machine. https://www.usatoday.com/story/news/nation/2014/04/06/dentist-digital-crowns/6267717/ https://www.usatoday.com/story/news/nation/2014/04/06/dentis... (especially for such a small amount of material, material with a lot of requirements, bio-compatibility, durability, etc)
- sjg007 9y ago
  Not much competition I would imagine as well as "installation" costs
ShannonAlther 9y ago
In addition to maxerickson's point, a lot of the bill goes into paying the dental professionals who do the implanting. It's a (minor) surgical procedure.
- chiph 9y ago
  My dentist has a jar in his waiting room full of the stems left over from all the crowns he's placed (he uses the CEREC system). No idea why he thinks people would be interested in seeing them while they wait, but I observe that each one represents about $1800 in billing revenue. And there's hundreds of them in there. The material is interesting - it starts off as a lavender color, but after curing in the oven you get a shade which is a close match to your natural tooth color (they have charts/samples to pick a match before the milling is done). https://en.wikipedia.org/wiki/CEREC https://en.wikipedia.org/wiki/CEREC
  - kwhitefoot 9y ago
    > each one represents about $1800 in billing revenue. Do you mean that it costs a patient USD1800 to get a crown? I have two crowns both made and installed at the same dental practice in Drammen, Norway, using, I think, the CEREC system. At one time he had a screen mounted above the couch so that you could see it being shaped while you waited. Including the initial consultation, the crown itself, and the fitting I paid about NOK5000 each. That's about USD580 at today's exchange rate, about USD750 at the rate that was in force when I had them done.
    - dsp1234 9y ago
      It's important to note that in the US (not sure about Norway), the revenue from a procedure, and the out of pocket cost that a person pays is not the same due to insurance. A procedure could cost a very small amount out of pocket, but still provide significant revenue to a doctor if is insurance is paying for a large portion of the procedure.
    - systems 9y ago
      i guess the 1800 per crown also include the root canal treatment i think it is usually around 600-800 USD for the root canal treatment and around 1000 for the crown
      - kwhitefoot 9y ago
        Ah, perhaps we are talking about different things here. My crowns are just that, quite a lot of the original tooth is still there. But it still seems to me that you are being seriously ripped off in the US.
        maxerickson 9y ago
        What's a crown worth though? Dentists have been successful in limiting the number of dentists, so decent ones can charge good money. The terrifying thing is that they tend to do a lot more out of pocket business than doctors/hospitals and so the prices for dental care are generally lower than the prices for similar healthcare (they often do first appointment x-rays for free, or for cheap; hospitals will charge $200+ just for something that needs 2 or 3 x-rays).
yourapostasy 9y ago
I spoke about this with my dentist, and according to him the research and money is going to ever-greater precision and bio-compatibility. Scanning and imaging the tooth to replace is still part-art and not fully-automated yet. The scanning processes out on the market has not perfected discriminating the tooth from the surrounding tissue, so there is some manual work the dentist performs to shape the replica; there are weird artifacts here and there they shave away and/or re-shape. Bio-compatibility sounds like it is is very close: the latest materials outlast human lifespans, and is tougher than enamel, with very small populations that adversely react to the materials.
- komali2 9y ago
  Heh, Outlast humans lifetimes for now.
- dbcurtis 9y ago
  The part-art comment is certainly true. I have a 3D milled ceramic crown that was done years ago during the early days of the technology. It is absolutely great in every way, and has been since day 1. My wife went to the same dentist a few months later, another 3D milled ceramic crown. Same guy, same machine. The crown had an awful fit, was never right, and she had it replaced with a different technology within 6 months. Getting to three-9's reliability is hard for all of us.
- killjoywashere 9y ago
  Gold amalgams outlasted the human lifespan too. As usual, the problem is the interface: eventually, a bacterium will slip its way in between, ferment some lactose, and drop the pH, eventually dissolving away enough of the native enamel for a friend to join, and away the positive feedback loop goes.
nsxwolf 9y ago
According to my dentist, implants are getting cheaper or are about to get cheaper, because several important patents have expired and dentists are training to do in-office implants with generic screws.
ptero 9y ago
Cost of an implant, at least in the US, is a small part of the total procedure cost (dentist's fees, malpractice insurance, etc.). Total implant price tag (shared between patient and his insurance), might be $5k for a single tooth. This is prohibitive for many people. I wonder if advances in robotics can be coupled with lower implant costs to provide a significantly lower cost alternative. Robotics can help lower dentist fees (lower skill level) and also limit or eliminate malpractice risks by limiting human's role. Not everyone would want the robot-driven implant from just out of dental school nurse, but I think it can be a decent option for many patients.
scythe 9y ago
A 3D Printer cannot print a material which will crumble, melt or break during the printing process. This excludes a lot of materials due to the pressure/temperature required in order to achieve cohesion. Natural teeth are made of a nanostructured material (dense hydroxyapatite nanorods in a less dense hydroxyapatite matrix) which is the sort of thing that cannot be 3D-printed.
bluedino 9y ago
Some dentists have an in house cnc/cmm type machine and make your crowns on-site (takes two weeks but are better quality). Mine still sends them out, costs me about $400 out of pocket, insurance covers the other 50%.

maxerickson 9y ago

Because a 3d printer isn't going to be vastly better than a milling machine. https://www.usatoday.com/story/news/nation/2014/04/06/dentist-digital-crowns/6267717/ https://www.usatoday.com/story/news/nation/2014/04/06/dentis... (especially for such a small amount of material, material with a lot of requirements, bio-compatibility, durability, etc)

sjg007 9y ago
Not much competition I would imagine as well as "installation" costs

ShannonAlther 9y ago

In addition to maxerickson's point, a lot of the bill goes into paying the dental professionals who do the implanting. It's a (minor) surgical procedure.

chiph 9y ago
My dentist has a jar in his waiting room full of the stems left over from all the crowns he's placed (he uses the CEREC system). No idea why he thinks people would be interested in seeing them while they wait, but I observe that each one represents about $1800 in billing revenue. And there's hundreds of them in there. The material is interesting - it starts off as a lavender color, but after curing in the oven you get a shade which is a close match to your natural tooth color (they have charts/samples to pick a match before the milling is done). https://en.wikipedia.org/wiki/CEREC https://en.wikipedia.org/wiki/CEREC
- kwhitefoot 9y ago
  > each one represents about $1800 in billing revenue. Do you mean that it costs a patient USD1800 to get a crown? I have two crowns both made and installed at the same dental practice in Drammen, Norway, using, I think, the CEREC system. At one time he had a screen mounted above the couch so that you could see it being shaped while you waited. Including the initial consultation, the crown itself, and the fitting I paid about NOK5000 each. That's about USD580 at today's exchange rate, about USD750 at the rate that was in force when I had them done.
  - dsp1234 9y ago
    It's important to note that in the US (not sure about Norway), the revenue from a procedure, and the out of pocket cost that a person pays is not the same due to insurance. A procedure could cost a very small amount out of pocket, but still provide significant revenue to a doctor if is insurance is paying for a large portion of the procedure.
  - systems 9y ago
    i guess the 1800 per crown also include the root canal treatment i think it is usually around 600-800 USD for the root canal treatment and around 1000 for the crown
    - kwhitefoot 9y ago
      Ah, perhaps we are talking about different things here. My crowns are just that, quite a lot of the original tooth is still there. But it still seems to me that you are being seriously ripped off in the US.
      - maxerickson 9y ago
        What's a crown worth though? Dentists have been successful in limiting the number of dentists, so decent ones can charge good money. The terrifying thing is that they tend to do a lot more out of pocket business than doctors/hospitals and so the prices for dental care are generally lower than the prices for similar healthcare (they often do first appointment x-rays for free, or for cheap; hospitals will charge $200+ just for something that needs 2 or 3 x-rays).

yourapostasy 9y ago

I spoke about this with my dentist, and according to him the research and money is going to ever-greater precision and bio-compatibility. Scanning and imaging the tooth to replace is still part-art and not fully-automated yet. The scanning processes out on the market has not perfected discriminating the tooth from the surrounding tissue, so there is some manual work the dentist performs to shape the replica; there are weird artifacts here and there they shave away and/or re-shape. Bio-compatibility sounds like it is is very close: the latest materials outlast human lifespans, and is tougher than enamel, with very small populations that adversely react to the materials.

komali2 9y ago
Heh, Outlast humans lifetimes for now.
dbcurtis 9y ago
The part-art comment is certainly true. I have a 3D milled ceramic crown that was done years ago during the early days of the technology. It is absolutely great in every way, and has been since day 1. My wife went to the same dentist a few months later, another 3D milled ceramic crown. Same guy, same machine. The crown had an awful fit, was never right, and she had it replaced with a different technology within 6 months. Getting to three-9's reliability is hard for all of us.
killjoywashere 9y ago
Gold amalgams outlasted the human lifespan too. As usual, the problem is the interface: eventually, a bacterium will slip its way in between, ferment some lactose, and drop the pH, eventually dissolving away enough of the native enamel for a friend to join, and away the positive feedback loop goes.

nsxwolf 9y ago

According to my dentist, implants are getting cheaper or are about to get cheaper, because several important patents have expired and dentists are training to do in-office implants with generic screws.

ptero 9y ago

Cost of an implant, at least in the US, is a small part of the total procedure cost (dentist's fees, malpractice insurance, etc.). Total implant price tag (shared between patient and his insurance), might be $5k for a single tooth. This is prohibitive for many people. I wonder if advances in robotics can be coupled with lower implant costs to provide a significantly lower cost alternative. Robotics can help lower dentist fees (lower skill level) and also limit or eliminate malpractice risks by limiting human's role. Not everyone would want the robot-driven implant from just out of dental school nurse, but I think it can be a decent option for many patients.

scythe 9y ago

A 3D Printer cannot print a material which will crumble, melt or break during the printing process. This excludes a lot of materials due to the pressure/temperature required in order to achieve cohesion. Natural teeth are made of a nanostructured material (dense hydroxyapatite nanorods in a less dense hydroxyapatite matrix) which is the sort of thing that cannot be 3D-printed.

bluedino 9y ago

Some dentists have an in house cnc/cmm type machine and make your crowns on-site (takes two weeks but are better quality). Mine still sends them out, costs me about $400 out of pocket, insurance covers the other 50%.