The CAD/CAM workflow has transformed what you manufacture. But it has not transformed how you coordinate with the clinic to manufacture it. Here we break down both processes: the one that already works and the one that still breaks.
Three digital phases that replaced decades of manual wax-ups, casting and hand-finishing. But they left the weakest link in the chain untouched.
The intraoral or desktop scanner captures the patient geometry into an STL or PLY file. This is the digital entry point: without a good scan, everything downstream inherits the error.
The technician imports the scan into CAD software and models the restoration: anatomy, occlusal contacts, minimum thicknesses, margins. This is the phase where the most critical clinical decisions are made.
The design is translated into machine instructions: toolpaths for milling, layers for 3D printing. The physical piece is born here, with micrometer tolerances.
Before CAD/CAM, a crown went through manual wax-up, investing, casting in molten metal, grinding and polishing. Each step introduced human variability. The CAD/CAM workflow compresses all of that into three digital stages with tolerances a manual process cannot match.
But there is a critical nuance the industry tends to omit: the CAD/CAM workflow begins after the clinic has sent the case to the lab. And that submission — the prescription, instructions, shade photos, patient preferences — is still analog in most labs. The complete digital workflow includes that earlier phase, not just design and manufacturing.
Each layer has its own standards, formats and manufacturers. Interoperability is the factor that determines whether your workflow is smooth or you waste hours converting files.
The scanner captures the patient or physical model geometry and generates a 3D file (typically STL, PLY or OBJ).
Where the technician models the restoration on the scan. The three dominant ecosystems:
The design is translated into a physical piece through subtractive milling or additive 3D printing.
Each material has an optimal manufacturing method, distinct mechanical properties and specific use cases. Choosing correctly here determines the restoration's longevity.
| Material | Method | Strength (MPa) | Main indications | Considerations |
|---|---|---|---|---|
| Zirconia (3Y-TZP) | Milling + sintering | 900-1.200 | Crowns, bridges, abutments, implant-supported structures | Requires sintering furnace. Improved translucency in multilayer. |
| Disilicato de litio (e.max) | Milling + crystallization | 360-400 | Anterior crowns, veneers, inlays/onlays | Better esthetics than zirconia. Not indicated for long-span bridges. |
| PMMA | Milling or 3D printing | 80-120 | Provisionals, temporary prosthetics, prototypes | Fast and affordable. Not definitive. Ideal for validating design before manufacturing. |
| Titanio (Grado 5) | Milling (5-axis) | 860-1.100 | Implant bars, custom abutments, frameworks | Biocompatible. Requires 5-axis mill with coolant. |
| Cromo-cobalto (CoCr) | Milling or laser sintering | 650-850 | Removable partial denture frameworks, bridges | More economical alternative to titanium. May cause sensitivity in some patients. |
| Castable wax | Milling or 3D printing | N/A | Casting patterns, digital wax-up try-ins | Not a final restoration: it burns out in the traditional casting process. |
Material selection is not just a lab technical decision. It depends on the doctor's prescription: tooth location, expected occlusal force, required esthetics, patient budget. This information must reach the lab before design begins. When the digital prescription includes these parameters in a structured way, the technician can select the optimal material and manufacturing method without calling the clinic to confirm.
A common mistake: milling in zirconia a restoration whose design was approved in provisional PMMA. The material properties change minimum thicknesses, convergence angles and cement space. The CAD design must be made for the final material, not adapted afterward.
Design is digital. Manufacturing is digital. But coordination between clinic and lab is still WhatsApp, email and phone calls. That's where the errors are born.
The analog link in a supposedly digital workflow
A lab can have the most precise mill on the market and the most advanced CAD software. But if the doctor's prescription arrives as a WhatsApp voice note, the STL file via WeTransfer with a generic name, and shade photos by email with no case reference, the digital workflow breaks before it starts.
These are the most common failure points:
The result: remakes do not come from CAD/CAM, they come from what happens before. A 2024 study in the European dental sector estimated that 60-70% of remakes originate in the communication phase, not the manufacturing phase.
The missing piece is not another design software. It's a system that connects design with everything around it: prescription, files, approvals and traceability.
TrazaLab is not CAD/CAM software. It does not compete with exocad or 3Shape. It's the coordination layer that connects your CAD/CAM workflow with the rest of the clinical process. What it does:
The clinic uploads the STL, photos and prescription to a single case. The lab opens the case and has everything together, without searching emails or downloads.
See file managementInstead of voice notes, the clinic fills out a digital prescription with specific fields: material, shade, restoration type, urgency. No ambiguity, no interpretation.
See digital RxThe technician uploads the CAD design to the case. The doctor approves it (or requests changes) within the platform. A versioned history is kept with date, time and author of each decision.
See approval workflowNot all labs need the same stack. Smart investment depends on your volume, your clinics and your business model.
The priority is not buying all the equipment. It's deciding what to do in-house and what to outsource. Many small labs design in exocad but send milling to a production center. The investment focuses on the scanner and software.
Here the problem is not technology but coordination between people and processes. Con multiples tecnicos disenando, varias fresadoras en paralelo y decenas de clinicas enviando casos, el cuello de botella es la gestion, no la fabricacion.
What already works, what is maturing and what is still more marketing than reality.
Both 3Shape and exocad integrate algorithms that propose an initial anatomy based on the antagonist scan and adjacent teeth. The technician adjusts instead of building from scratch. Reduces routine design time by 30-50% for single crowns. Does not replace clinical judgment in complex cases.
Software automatically organizes multiple restorations within a zirconia disc or print platform to maximize material usage and minimize waste. Previously manual and operator-dependent. Now algorithmic, optimizing for tool time and residual material.
La clinica escanea, el laboratorio disena y fresa, y el paciente recibe la corona en una sola cita. Funciona para coronas unitarias en zirconia con perfiles de sinterizado rapido (90-120 minutos). Requiere proximidad fisica o un flujo digital ultrarapido entre clinica y laboratorio. Aun no es viable para casos complejos.
Impresoras que combinan dos o mas resinas en una sola pieza: por ejemplo, una base opaca con una capa translucida. Permite crear provisionales con gradiente de color sin postprocesado manual. La tecnologia existe pero los materiales certificados para uso intraoral definitivo son limitados. En 2026, es util para provisionales y modelos, no para restauraciones definitivas.
La mayoria de los avances CAD/CAM se centran en hacer la fabricacion mas rapida y precisa. Eso esta bien. Pero la fase donde mas tiempo y dinero se pierde sigue sin recibir la misma atencion tecnologica: la coordinacion entre clinica y laboratorio. La IA puede disenar una corona en 30 segundos, pero si la prescripcion tardo tres dias en llegar porque se perdio en un hilo de WhatsApp, la velocidad de diseno es irrelevante.
El avance real de 2026 no es una fresadora mas rapida. Es conectar la fabricacion con la gestion — que el caso fluya desde la prescripcion hasta la entrega sin cambiar de canal, sin perder archivos y sin depender de la memoria de nadie. Eso es lo que TrazaLab resuelve.
CAD (Computer-Aided Design) es la fase de diseno digital: el tecnico modela la restauracion en pantalla sobre el escaneo del paciente, ajustando oclusion, contactos y anatomia. CAM (Computer-Aided Manufacturing) es la fase de fabricacion: el diseno se convierte en instrucciones para una fresadora o impresora 3D que produce la pieza fisica. Son dos procesos secuenciales pero independientes — puedes disenar en un software y fabricar en otro equipo, incluso en otro laboratorio.
El rango es amplio. Un flujo basico con escaner de sobremesa, licencia de exocad y fresadora de 4 ejes puede arrancar entre 25.000 y 40.000 euros. Un setup avanzado con escaner de alta precision, 3Shape Dental System, fresadora de 5 ejes y horno de sinterizado puede superar los 120.000 euros. Muchos laboratorios reducen la inversion externalizando el fresado inicialmente y solo disenan internamente, lo que baja el coste de entrada a 8.000-15.000 euros (escaner + software).
Depende del material y la aplicacion. El fresado es el estandar para restauraciones definitivas en zirconia, disilicato de litio y titanio porque trabaja con bloques homogeneos de propiedades certificadas. La impresion 3D domina en modelos, ferulas, guias quirurgicas y provisionales porque es mas rapida, desperdicia menos material y permite geometrias imposibles para una fresa. En 2026, la impresion 3D de ceramicas definitivas avanza pero aun no iguala la fiabilidad clinica del fresado para restauraciones de larga duracion.
Los tres dominantes son exocad DentalCAD (el mas extendido en laboratorios independientes por su modelo de licencia abierta y compatibilidad con cualquier fresadora), 3Shape Dental System (preferido en laboratorios que trabajan con clinicas que ya usan 3Shape TRIOS), y Zirkonzahn (popular en laboratorios que priorizan control vertical con hardware y software del mismo fabricante). La eleccion depende mas del ecosistema de tus clinicas que de las funciones del software en si.
Porque el flujo CAD/CAM solo digitaliza el diseno y la fabricacion, no la comunicacion. La prescripcion del doctor, las instrucciones de tono, las preferencias del paciente y las aprobaciones de diseno siguen viajando por WhatsApp, email o llamadas telefonicas. Ahi es donde se pierden datos, se malinterpretan instrucciones y se fabrican piezas que no corresponden a lo que el doctor pidio. La cadena digital completa incluye la coordinacion, no solo la fabricacion.
Si, y es uno de los avances mas relevantes de 2026. Plataformas como TrazaLab permiten vincular los archivos STL del escaner directamente al caso clinico, de modo que el diseno CAD se asocia automaticamente a la prescripcion, las fotos de tono y el historial de comunicacion con la clinica. Esto elimina la necesidad de descargar archivos de emails, renombrar STLs manualmente o buscar instrucciones en conversaciones de WhatsApp. El flujo CAD/CAM se convierte en un paso dentro de un proceso trazable, no en un silo independiente.
TrazaLab connects digital design with the prescription, files and approvals. 14-day free trial, no credit card, no contracts.