When 3D printing "collides" with the new intelligent manufacturing of oral cavity, what kind of new species in the industry will be born?
In May last year, Thales, a domestic dental digital intelligent manufacturing company, obtained the Class III certificate for additive manufacturing zirconia restorations approved by the NMPA with its disruptive inkjet custom technology (Advance Customized Jetting, referred to as ACJ), which attracted widespread attention as the industry's first certificate for dental zirconia 3D printing.
First of all, this is not only the first approval in China, but also the first technology in the world, which enhances the competitiveness of domestic dental products in the world; Second, Thales' product process innovation not only helps to improve the diagnosis and treatment effect of downstream clinical ends, but also breaks through the bottleneck of mass production of personalized products, bringing new possibilities to the industry.
The industry's rare huge investment in R&D funds has tackled the weakest link in dental digitalization...... Where does Thales' innovation DNA come from? Where does the future hold?
On June 9, on the occasion of the 2024 Sino-Dental Beijing International Dental Exhibition, Medical Trends® interviewed Ye Yueheng, Executive Director of Thales, and Zhou Xiaojian, R&D Director of Thales.
01. The only one in the industry, the "wall breaker" of the dental industry chain
The cross-domain application of technology is a wonderful thing, such as the invention of microwave technology, which was originally used as a radar system, and the VR technology, which was originally used for military training, is now widely used in games, education, medical and other daily life scenarios.
Thales' core technology, Custom Inkjet Technology, has evolved from aerospace technology applications.
"With the rapid development of Continental Aviation Technology, traditional castings and forgings can no longer meet the machining accuracy requirements of alloy materials. It is in this bottleneck period that Thales entered the field, striving to promote international and domestic technical cooperation, investing hundreds of millions of yuan independently, and successfully developing ACJ through nearly ten years of research and development, which has become an important technical way for the manufacture of high-performance complex components in aviation. Ye Yueheng, executive director of Thales, told Medical Trends.
In 2011, the early founding team of Thales began to conduct pre-research on inkjet principle technology; In 2019, ACJ was successfully developed and began to explore the direction of industry application; In 2021, Thales was established and began to focus on the dental track to incubate medical-grade applications; In May 2023, it obtained the industry's first registration certificate for Class III oral restoration products, and then launched Zrcoop®, a professional dental cinema aesthetic restoration brand, and began to commercialize it.
▲Conceptual diagram of ACJ inkjet custom process
To put it simply, ACJ's technical principle is similar to that of inkjet printers used in the office, with Thales replacing the cartridges with two materials: liquid zirconia and support. At the same time, the two materials are sprayed with hundreds of millions of drops of ink per second through more than 10,000 nozzles to the platform for micron-level precision printing, and the heat lamp heats the ejected materials, and then sinters and shapes, so as to restore the oral scan data 1:1 and reconstruct the restorations of the original teeth (including veneers, crowns, inlays, bridges, etc.).
"ACJ is known as the fifth largest ceramic process, and Thales is the only company in the industry that has overcome the technical difficulties of 3D printing liquid zirconia materials." Ye Yueheng said.
3D printing is an intelligent manufacturing technology that superimposes layers of materials, and ACJ's three major clinical solutions have realized the transformation of oral materials from "cutting to fit" to "tailoring".
First, the industry's first precision, the thickness of each layer of material is 2-10μm, about one-fortieth of a hair; Second, it can realize personalized customization and make arbitrary and complex products; Third, to achieve the fastest industrialization system in the ceramic 3D printing industry, the production capacity can reach 1000 pieces/production line/day.
Just as no two leaves are exactly the same, there are no two teeth in the world that are exactly the same. Nowadays, Thales' technology platform integrating "material + equipment + process + algorithm + product" has made it possible for personalization and standardization to coexist with personalization and standardization. The innovation of means of production is driven by innovation, and the transformation of production relations and productivity has been realized in the dental industry.
▲Thales Global Intelligent Manufacturing Center Headquarters 10,000m² intelligent manufacturing production line. It is reported that this is the world's largest ceramic 3D printing center, each production line can produce more than 1,000 pieces of customized dental restoration products per day, and the whole process can be completed by only two people.
02. Three major solutions are born for clinical needs
After overcoming difficulties such as material process research and development, customized mass production, etc., in order to meet the unfinished clinical needs, three solutions came into being.
▲Thales' three exclusive clinical solutions
"Thales' starting point is to address clinical needs and target unique clinical value." Zhou Xiaojian, R&D director of Thales, said that our goal is to provide clinicians with a powerful diagnosis and treatment "weapon".
First of all, the accuracy breaks through the limitation and restores the design data 1:1.
There is a famous saying in the dental industry: precision is the soul of restoration.
The oral environment is delicate, and the slightest difference cannot withstand long-term wear and tear. However, due to the limitations of the traditional subtractive manufacturing (cutting) process, the bur processing that the traditional prosthodontic technology relies on has a diameter of more than 0.6mm, which has a large error, resulting in problems such as unsealing of the restoration, micro-leakage at the edges and secondary caries. In addition, there is a wear rate of burs, and there is a difference in accuracy between the 1st and 100th cylinders, which cannot be fully standardized, and there are various problems such as edge/internal misfit in clinical practice.
Through 3D printing technology, Thales stacks one-time molded products layer by layer, achieving ultra-high precision of 2-10μm printing layer thickness, meeting the accuracy requirements of oral restoration (within 30μm), and can quickly complete the manufacture of complex and fine structures, completely solving the above problems.
Especially for clinical cases of complex structures, higher material accuracy is a must. According to Zhou Xiaojian, in an actual case of short abutment teeth, after using different brands of zirconia and glass-ceramic restorations, there were four consecutive crown fractures, due to the traditional cutting process to expand the cutting range, the design should have a crown with a thickness of 0.62mm, but the actual measurement was only 0.5mm thickness, resulting in insufficient strength and fragmentation after repeated bites of the patient. When doctors and patients had nothing to do, they chose the Zrcoop® restoration, and the thickness of the designed crown reached 0.68mm, and the thickness of the adhesive also left 0.08mm of space for aesthetic design, and there were no problems since wearing it in June 2023.
▲Recently, Peking University Stomatology published an article in the Journal of Prosthetic Dentistry, the top international journal in the field of prosthodontics, and commented that compared with the use of cutting SM or light-curing printing process, ACJ technology has more advantages in reducing secondary caries, avoiding wear on the jaw teeth, and restoring the original tooth morphology, and has higher potential application value in the clinical scope.
Secondly, the adhesive technology was innovated to make the shedding of restorations a thing of the past.
The repeated shedding of restorations is one of the biggest distresses faced by patients with prosthodontics, and it is also one of the main reasons for the clinical failure of zirconia materials.
Due to the limitations of traditional manufacturing processes, such as the smooth surface inside the restoration and the limited bonding area, the restoration is prone to "slipping" and eventually cracking under extreme chewing conditions like climbing a snowy mountain in flat shoes.
To this end, Thales has taken advantage of the advantages of 3D printing personalization to design an adhesive surface with an exclusive metasurface microstructure, which significantly increases the mechanical mating force and the stability of the tooth retention. According to the report "Evaluation and Optimization of Adhesion Performance of Zirconia Slurry Additive Manufacturing Products" by West China School of Stomatology, Sichuan University, this innovative design has increased the immediate bond strength by 60% and the aging bond strength by 100%. It greatly reduces the loss of adhesion of clinical zirconia, which is equivalent to creating a pair of "professional hiking shoes" for the restoration body.
▲On the left, only a small amount of adhesive is attached to the traditional shedding crown, and on the right, the surface microstructure is added to the 3D printed crown to enhance the bonding. It is reported that the microporous structure of Thales simplifies the traditional glass-ceramic restoration bonding process, without the need to go through the cumbersome steps such as sandblasting, acid etching, and silane coupling required for traditional bonding, saving doctors 10-15 minutes of tooth wearing time, alleviating patients' fear, and completely solving the industry pain point of poor bonding of zirconia restorations.
Third, the perfect integration of hardness and aesthetics to meet the aesthetic needs of the public.
After nearly 20 years of development, with the improvement of public aesthetic demand, the research and development direction of zirconia materials has undergone a significant change: from a single pursuit of hardness indicators to the search for a perfect balance between hardness and aesthetics.
It is reported that the Zrcoop® restoration has considered the color shielding ability at the beginning of the research and development, and for the clinical problems of heterochromatic teeth (tetracycline teeth, fluorosis teeth, dead pulp teeth, metal piles, etc.), Thales zirconia material can cover the basal tooth color of ND9 with a 0.3mm inner crown, achieving an extremely thin color shielding effect, and significantly reducing the amount of tooth preparation.
This kind of product that meets the needs of strength, is thin and has good color hiding performance, which is rare in the current oral restoration material market.
Three innovative solutions create the possibility of win-win for all parties in the industry: for clinics and private medical institutions, they can help them generate income; For the highly competitive and marginally marginal processing industry, Thales brings new value opportunities and directions.
It is reported that although it has just been introduced to the market, Zrcoop® has been warmly welcomed by doctors. Mauro Bazzoli, Honorary Life Member of the European Society of Cosmetic Dentistry and Founding Member of the Italian Society of Implant Prosthodontics, spoke highly of the company's technology and expressed his willingness to use Zrcoop® products during his visit to Thales.
03. Combine vertically and horizontally to seize the digital advantageous ecological niche
At the end of 2023, the Thales Global Intelligent Manufacturing Center will be launched in Hangzhou. In 2024, in the first year of commercialization, Thales chose a three-legged strategy of sales expansion, diversified cooperation, and digital center promotion.
Among them, the digital hub is a key focus for Thales.
Dental digitalization is a systematic project, and it cannot be completed alone. Nowadays, Thales is actively cooperating with industry peers to feed the whole process of dental digitalization with digital intelligence.
In January this year, the first "model house" built by Thales, the 3D digital center certified by Zrcoop®, was launched, which was cooperated with Hangzhou Qingshang high-end dental chain institutions; On May 8, Hangzhou Xingzhi Dental & Zrcoop®3D Digital Center was signed and listed. The successful collaboration between the two institutions marks a solid first step in Thales' digital hub strategy.
▲Conceptual art of the Zrcoop®3D Digital Center. Thales' digital territory is developed with the "Taiyun" cloud platform, and it is currently actively opening up all aspects of dental care such as clinic institutions, design ends, and intelligent manufacturing centers, so as to realize the whole process of digital intelligent manufacturing, data analysis, instant communication, auxiliary diagnosis and treatment, integrated marketing, etc., before, during and after diagnosis.
It is worth noting that under the trend of more and more accurate, efficient and integrated requirements for dental digitalization in the industry, as a manufacturer of end products, it is theoretically the place where all the data of the industrial chain are gathered, and Thales has a natural niche advantage.
In addition, for the "new domestic products" with their own innovative technologies, the ambition of commercialization has long been not limited to China, but a broader sea of stars.
"Since its inception, Thales has been actively deploying its globalization strategy. In April this year, Thales received CE certification and expects to receive FDA 510k certification in the near future. In addition, as our global strategic partner, Songbai Dental Group will carry out strategic cooperation with Thales and extend it to global promotion. With the blessing of hard-core technology, Ye Yueheng is full of confidence in the commercialization prospects of Thales.
04. From point to surface, lead the new era of flexible dental manufacturing
With the improvement of aesthetic awareness and the acceleration of aging, theoretically everyone will face the demand for tooth damage and aging, and the dental 3D printing market can be expected in the future.
According to the comprehensive industry consulting report, just looking at the scale of the national denture restoration market, it will exceed 40 billion yuan in 2020. Based on the average number of missing teeth in the population over the age of 50 is 11, there are about 2.64 billion missing teeth in China that need to be repaired.
In addition, as an integral part of dental implant treatment, dental crowns and restoration materials account for about 20%-25% of the total cost.
From the perspective of domestic substitution, since 2021, 3D printing technology has been frequently named by the national industrial policy, and at the same time, due to the convergence of starting time at home and abroad, the technology generation difference is not significant, especially in the field of medical additive manufacturing, through the R&D momentum accumulated by manufacturers such as Thales, from import substitution to export overseas, it is expected to bring tens of billions of economic pull effects.
Under the favorable conditions of multiple industries, Thales believes that the era of "flexible and intelligent dental manufacturing" has quietly come.
How to understand?
"Thales' innovation is based on a technology platform composed of five elements: materials, equipment, processes, algorithms, and products, each of which can be extended infinitely. For example, in terms of materials, on the basis of the current zirconia, titanium alloys, stainless steel, etc. can be launched in the future; In terms of process, the cloud can digitally allocate production capacity and industrialize production in batches around the clock. The same is true at the device, algorithm, and product levels. ”
In this way, flexible manufacturing is equivalent to a combination of "Lego" bricks, which can be customized according to user needs, providing flexible solutions at multiple levels and realizing the infinite possibilities of material technology.
The point is turned into a bead, the bead is turned into a chain, and the chain is turned into a surface. Thales has a longer-term development plan.
It is reported that starting from dentistry, Thales plans to expand to other medical fields such as orthopedics and ophthalmology in the future, integrate different medical resources through digital transformation, and take the lead in building a comprehensive and collaborative ecosystem in the medical industry. The long-term goal is to expand into more application fields, break the concept of traditional industry classification, and become the world's leading full-category digital intelligent manufacturing enterprise.
That is, starting from 3D printing, ending with ecological construction, and empowering new quality productivity in an all-round way.
We are in the trend of the times of scientific and technological intelligent manufacturing, which is an unstoppable trend.
Among the young companies, Thales chooses to stand firmly on the pulse of this era - leveraging the power of trends, embracing technological development, and insisting on innovation-driven. Throughout the 100-year history of business, these are the essential attributes of pioneers, and they are the ones who have led the industry forward.