Milling's Relevance in the Era of 3D Printing Hype
In the ever-evolving digital dentistry landscape, milling technology is seen as the gold standard for final restorations despite the burgeoning enthusiasm for 3D printing.
In our recent episode of the Digital Dentistry Decoded podcast featuring Nicolas Rhode, Chief Strategy Officer at VHF, we discuss why milling continues to dominate the restoration space and how the technology is evolving to meet modern demands.
Listen to the Podcast on Spotify Below
Here is a recap of everything we spoke about:
The Evolution of a Milling Powerhouse
VHF's journey exemplifies the transformation of digital dentistry itself. What began as a software startup for CNC milling machines 35 years ago has metamorphosed into a dental technology juggernaut, with 90% of its business now dedicated to dentistry.
"VHF was founded 35 years ago as a little startup in a garage," explains Nicolas hohde. "Dental was just added about 15 years ago and has overtaken the whole company."
This pivot proved prescient. Today, VHF stands among the leaders of dental milling machine manufacturers, specializing in tabletop mills that help democratize access to precision manufacturing.
Their product line includes the entry-level E-Series machines to sophisticated units with extensive automation capabilities, all while maintaining their foundational philosophy.
"We stayed true to that conviction that a machine should be small, and you should be able to place it everywhere in your lab, in your clinic," Nicolas Rhode emphasizes.
Software: The New Frontier of Innovation
While hardware improvements continue incrementally, VHF has pivoted its innovation focus toward the software experience.
At the recent International Dental Show (IDS), they unveiled Dental Cam 9, a completely revamped CAM software package designed to simplify the milling workflow through automation.
"There's a lot of automation included for nesting and pinning," notes Nicolas Rhode. "Why is automation important? Because we want to make it super easy to run a milling machine."
This user-centric approach extends to their new customer portal, "my VHF", which offers remote monitoring capabilities and utilization insights. The focus on software accessibility reflects a mature understanding of the market, particularly the needs of dental clinicians who may lack extensive technical training.
The Milling vs. Printing Debate: A Matter of Material Science
Perhaps the most provocative aspect of VHF's recent messaging is its IDS slogan: "We love milling because perfection cannot be printed." This statement cuts to the heart of the ongoing debate between subtractive (milling) and additive (printing) manufacturing in dentistry.
Nicolas Rhode articulates the material science underpinning this position: "If you compare the flexural strength of printing materials, even the ones that are now approved as final restorations... around 150 Megapascals. If you compare that to Emax, it's 530 Megapascals, and then zirconia goes up to 1200 Megapascals. So it's a completely different league."
Beyond mere strength metrics, Nicolas Rhode highlights the aesthetic limitations and potential toxicity concerns associated with printable resins. He references research from LMU Munich suggesting that even properly cured printed pieces remain "moderately to severely cytotoxic," raising critical clinical considerations.
"For everything that stays long-term in the patient's mouth... I would personally not want to do it [with printed materials], and I would not recommend it to a loved one," Nicolas Rhode states candidly.
Complementary Technologies, Not Competitors
Despite his stance on printed restorations, Nicolas Rhode views the technologies as complementary rather than competitive.
He acknowledges the clear advantages of 3D printing for specific applications like models and surgical guides, where the economics and efficiency decisively favor additive manufacturing.
"For certain indications, it has a clear advantage over milling," he said. "No one would mill a model anymore. This is much better, faster, and less expensive to print."
This perspective suggests digital dental practices and labs are best to leverage both technologies appropriately - printing for models, guides, and perhaps short-term appliances, while reserving milling for final restorations where material properties are paramount.
The Clinical Adoption Curve
While laboratory adoption of milling technology approaches saturation at 80-90%, clinical implementation lags significantly at just 15-20%. This disparity represents both a challenge and an opportunity for companies like VHF.
The entry barrier continues to lower, with Nicolas Rhode noting that basic VHF milling units start around $20,000 USD. While this exceeds the cost of entry-level 3D printers, the material capabilities and restoration durability offer compelling justification for the investment.
Interestingly, Nicolas Rhode observes that 3D printing often serves as a gateway technology for dental practices. As one dentist told him, "printing was the gateway drug for milling." Once clinicians experience digital production, they naturally seek to expand their material options and restoration longevity.
The Path Forward for Digital Dentists
For clinicians contemplating their digital journey, Nicolas Rhode recommends a methodical approach:
- Start with intraoral scanning to master digital impressions
- Add design capabilities (either through AI services or lab partnerships)
- Begin production with simple cases like single molar crowns
- Gradually expand to more complex restorations
This incremental strategy mitigates the learning curve while building confidence and expertise. It also acknowledges the shifting industry focus from individual products to comprehensive workflow solutions.
The New Standard in Dentistry
Perhaps Nicolas Rhode's most significant observation from his IDS experience is that digital dentistry has transcended its niche status. "Digital has really become the new standard," he remarks. "It's not something progressive anymore."
This normalization signals the maturation of digital workflows from cutting-edge novelty to everyday practice. The industry's evolution now centers on integration, automation, and accessibility, making advanced technologies more intuitive for the average practitioner.
As we navigate this digital landscape, the complementary nature of various technologies becomes increasingly apparent. The future belongs not to a single modality but to thoughtfully integrated workflows that leverage each technology's strengths to deliver optimal patient outcomes.
For dental professionals evaluating their technology investments, the message is clear: consider the complete workflow, the material requirements, and the specific applications before choosing between milling and printing. In many cases, the answer may well be both.
Take Your Digital Dentistry Journey to the Next Level
Ready to elevate your practice with digital dentistry? The Institute of Digital Dentistry offers comprehensive courses to guide you through every implementation step—from your first scanner to complete in-house production.
Join our community of forward-thinking dentists today:
- Explore our online courses covering the complete digital workflow
- Subscribe to the Digital Dentistry Decoded podcast for regular insights from industry leaders
- Register for hands-on workshops to master both milling and printing technologies
- Get personalized guidance on equipment selection based on your practice needs and goals
Don't let technological complexity prevent you from delivering superior patient care and enhancing your practice efficiency. Visit instituteofdigitaldentistry.com today to begin or advance your digital transformation journey.
