It's become something of an annual ritual for me and Rune Fisker to sit down and discuss where digital dentistry is headed. We've done this since 2024, and honestly, I can't think of anyone better to have this conversation with.
For those who don't know, Rune spent 25 years at 3Shape, starting on September 4th, 2000, in an apartment and helping build the company to over 2,500 employees. I actually showed him our first-ever TRIOS 3, which we purchased back in 2016. That scanner was one of the first TRIOS scanners in NZ, and I have to thank Rune for everything he's done for digital dentistry.
He's now transitioned to an Executive Advisor role with a contract through the end of May, and before you ask, no, he's not retiring.
"I have too much energy, too many ideas, and am far too young to go on pensions," Rune told me. "I love dentistry. I love teeth. I will definitely stay in digital dentistry."
He also hinted at diversification, noting that 3Shape has invested in a clear aligner company in Jordan. "Stay tuned for more," he said. "We will continue to expand our portfolio over time when the right opportunities are there."
So what does someone with that depth of experience see coming in 2026?
Let's get into it.
A Quick Look Back at 2025
Before diving into the trends, it's worth reflecting on what stood out last year.
The most significant factor for me was the push toward horizontal scanbody systems. Almost every competing scanner company now requires a full-arch implant workflow to be built in. 3Shape partnered with TruAbutment, and we're seeing basically major companies create these horizontal titanium scanbodies. This will exert significant market pressure on traditional photogrammetry companies.
We also saw extreme price competition. Shining 3D released the ELF late last year, with aggressive pricing that's going to impact every other company this year. How the market responds will be fascinating to watch.
And then there's the iPad compatibility trend. Medit took their i900 and created the i900 Mobility, a total iPad platform. I think it's a really cool move. TruAbutment announced photogrammetry on an iPad. Face scanners can run on iPads. I genuinely think the future of intraoral scanning might be iPads. When everything moves to a single device, that workstation becomes capable of much more than a laptop.
Rune's a bit more skeptical. "I don't feel an iPad is a clinical tool. To me, it's just a screen, whether the screen is Windows-powered, iPad-powered, or Android-powered." I respectfully disagree, but time will tell. Will be interesting to look back at the end of 2026 on who called it correctly.
Now, onto the five trends.
1. AI Agents Will Finally Enter the Dental Clinic
We've all heard about ChatGPT and generative AI. But the next big shift isn't chatbots. It's AI agents, or what Rune calls "digital coworkers," that connect different actions together.
The most obvious example? AI voice assistants for dental practices.
"There are at least 10, if not 20, companies now doing voice recognition specifically for dental," Rune explained. "Both for the receptionist, but actually also for note-taking, for updating the charts."
I've tested a bunch of these tools myself. The technology is impressive, but I still have hesitations about mass adoption. The cost is one thing. Dentists don't love subscriptions. And there's still this uncanny valley with AI receptionists, where patients can tell they're speaking with a bot.
Rune's take? The real barrier is integration.
"If there's no PMS integration, so you can, for instance, book a time or take other actions, then it has no worth, then it has no value."
He shared an interesting case study. One of 3Shape's KOLs built his own AI receptionist system and has now handled more than 3,000 calls with really positive results. Even elderly patients are able to sit and talk for 15 minutes, discussing treatment options.
Pricing is coming down as well. Heidi, which just raised $65 million in Series B funding, charges $99 per month. And with competition intensifying across industries, expect prices to decline further.
"This is gonna be extremely competitive," Rune said. "Competition is always great. It moves a product forward, innovation forward, and it gives better prices for customers."
My suggestion for practices hesitant to go all-in? Start with a backup system. Have your AI bot handle missed calls. There are a lot of calls missed every day in a dental office. That's basically lost revenue.
2. Generative AI Is Changing Daily Clinical Workflows
This is where AI is already making a real impact. Not tomorrow. Today.
Let me give you some numbers form Rune - 3Shape Automate is now designing more than 12,000 crowns a day. That's not hype. That's happening right now. And it's booming, partly because the pricing model changed. If you pay for your lab subscription, you get the whole AI for free.
On the diagnostic side, we're seeing AI tools for X-ray analysis gain serious traction. Pearl, Overjet, and others have been around for years, but adoption is picking up. The key, as Rune pointed out, is frictionless integration.
"I was visiting a clinic where they had Pearl fully integrated into the imaging system," he said. "They took the X-ray, then almost looked at the patient and said something, and then it was overlaid. That's where you get impact."
If you need to log in somewhere, upload files, and wait around, it's never going to fly. I feel diagnostic AI will really take off when it's totally integrated with your X-ray software. You take an X-ray, the readings are there, the findings are there, and the report is there automatically. No logging into a cloud, no uploading to a browser.
What really excites me is CBCT diagnostics. It takes time. AI can provide instant clinical value here because the task is genuinely difficult for humans.
"Especially when we come to CBCT, it's, in my opinion, instantly clinical value because it's so hard to do it manually," Rune agreed.
I recently saw research in the medical field comparing AI, AI-human teams, and humans alone for reading X-rays. It basically proved that AI is more accurate than humans when diagnosing x-rays.
Make no mistake, every X-ray will eventually be read by AI. It's just a matter of time.
AI Planning Is the Next Frontier
One area Rune flagged that we haven't seen much of yet is AI planning. Once you have diagnostic data, generating treatment plans or options isn't that hard.
"I would say planning proposals or options afterwards, I think, will be a trend," he said. "We'll see more unfold here this year. It comes so easily after diagnosis."
Patient Engagement Is Getting Wild
Here's something that genuinely impressed me this year. AI can now take a standard photo after smile design and generate videos in which the patient's hair is blowing or the patient is speaking.
Rune saw a demo where AI took a retractor out of the mouth, and the patient started talking. Smile Cloud was the first to demonstrate this capability, and Align Technology has already incorporated a similar capability into iTero's outcome simulator.
"It is insane," Rune said. "That's gonna be a big blur between what is real and what is not real in the future. Almost a little bit scary."
Of course, you need to be able to deliver afterwards. Don't oversell.
3Shape has also launched the Dental Health App for sharing scans and diagnostic results with patients. The feedback has been extremely positive, particularly from practices that have adopted AI diagnostics.
"I think there are huge opportunities to change the whole way we interact with patients," Rune said. "If you look at the checkup, it looks the same as when we were kids."
3. Intraoral Scanning Is Becoming the Undisputed Standard of Care
This shouldn't surprise anyone following the industry. But the numbers are still striking.
Many leading countries are now surpassing 60% IOS penetration. And yet, globally, we're still only at about 35% adoption.
"I really don't believe you can run a modern clinic without an intraoral scanner," Rune said.
He shared a story about a dentist whose scanner was down for 24 hours. "He had to find impression material. He could hardly remember how to do it. It was not a pleasant experience. It was a good reminder going back."
I think the new generation will accelerate adoption further. Every new grad I know wants to work with an intraoral scanner. They get it. The challenge is that many dental schools are still not properly digital.
I graduated 10 years ago and was still doing amalgam and impressions. My dental school now has an agreement with Dentsply to install CEREC, but the undergraduate clinic has only one scanner. That needs to change.
"It's honestly almost sad and highly concerning," Rune said. "Some schools are very progressive, but it's more the exception than the rule. Please go and push your own dental school. Reach out to companies like 3Shape and others. They should be motivated to get it out there."
Beyond Digital Impressions
Still, 70-80% of all TRIOS cases are digital impression cases. Rune believes we'll see more practices scanning not just for impressions, but for diagnostics and patient communication.
"I really believe and hope we're seeing signs that people are scanning not just for the impression, but actually start to use it for diagnostics, where there are now so many opportunities coming with AI diagnostics."
The challenge has always been creating enough value to make additional scanning worthwhile. And the workflow needs to be easy. That's why the hygienist should be scanning, not the dentist.
Speaking of which, Rune mentioned he had a cleaning scheduled that afternoon. "I'm actually excited to see if he's gonna scan me or not."
I told him if they don't, he'd be very sad.
4. The Rapid Rise of 3D Printing in Dentistry
Full credit to SprintRay here. What they've done with the Midas printer has genuinely shifted the market. That espresso machine concept, where you drop in a capsule, and a crown comes out, resonated with dentists in a way previous printers didn't.
"I really think there has been motion in the market this year and real excitement," Rune said. "A lot of people now have an intraoral scanner, are getting very accustomed to that, and then it is kind of the next natural step to buy a printer."
At ADF in Paris recently, there were crowds around the printer booths. Not just SprintRay, but Formlabs, Asiga, and others. The interest is real.
Rune also praised the Asiga Pod concept. "You can combine printing models and print guides with a very affordable crown. I'm actually a great fan of it."
But here's the thing. This isn't a printer game. It's a material game.
The Printed Crown Question
On printed crowns specifically? I have to be honest with you. I remain skeptical about final restorations.
Rune quoted Marcus Heinz, CEO of Ivoclar, saying, "A ceramic crown will always be better than what you can print, a full ceramic crown, but you can also make a good crown. Maybe not yet."
The question becomes: do you want the best possible crown, or a good enough crown?
"In full transparency, I don't see many people that I consider serious putting finals in," Rune admitted. "People are putting temps in big time. But finals, I don't believe they're there yet. Neither from material property for longevity, and also from aesthetics."
He did mention talking to dentists in Ukraine and Romania who are putting in printed crowns every day. But in what he called the "western mass market," adoption of printed finals is minimal.
Justin from Asiga has a great framing: "We're only one innovation away." But we're not there yet.
I've used SprintRay's Crown HT on the Midas. It's pretty nice. Much better than first-generation resins that were opaque and ugly. But would I put a printed crown in as a final restoration? Not yet.
The comparison Rune made to early full zirconia is apt. First-generation full zirconia was terrible. One dentist called it "a snowball in the mouth." Look where we are now. Printed materials will improve. But we're not there yet.
One thing that's interesting about Midas? The economics. Rune pointed out that many printers can produce a crown for about $2. Midas? About $20 per capsule.
"No one talks about that anymore," he said. "The cartridge really changed the marketing here."
Milling vs Printing: The Verdict
I'm ready to declare victory for printing over milling for chairside applications. Printers have already surpassed mills in install base. But utilization is different. People who buy mills tend to actually use them for restorations. Many printers sit there doing a few models and splints.
The usage breakdown Rune cited? About 70% models, 10% guides, and 10% splints. Then some temps and a little bit of everything else.
"If printed crowns get good, the labs will print them tomorrow," Rune said. But they don't. Why? "When you look at the hardcore zirconia cost, if you are a big lab, your unit cost is very, very low. And you already have the machines."
Both milling and printing face the same adoption problem: workflow change.
"Why should I put pressure on myself?" is what many dentists ask. "I can earn more money treating patients." That's why no DSO has really implemented classical mill chairside in the last 10 years. The business case is wrong.
As Rune put it, "I literally spent 10 years of my life trying to get chairside milling off the ground, and I might have succeeded in many other things, but here I didn't succeed."
A Note on AI CAD Design
If you're interested in where AI design software stands right now, check out my recent review. Rune recommended it, noting it shows "there's still a way to go. You need to know what you're doing."
Some of the AI designs are good. Some are not so good. You still need to understand CAD design to evaluate what the AI proposes. If you just click next, next, next without knowing what you're looking at, you're going to have issues.
5. The Unconnected Ecosystem Problem Is Holding Us Back
This might be the most frustrating trend on the list. Not because it's new, but because it's been a problem for years, and progress is glacial.
Look at general technology. Your car connects to traffic lights. Your phone connects to everything. In some places, if you're in an Uber, you can see the lights changing as you approach because everything's connected to the cloud.
Then look at dentistry. Almost nothing is connected.
"The PMS is connected to the X-ray, but that's more or less it," Rune said. "It is probably the thing that holds digitalization most back."
All these AI tools flooding the market are actually making things worse in some ways. More digital tools mean more silos. The world is actually more unconnected than it was just a few years ago.
"If you don't get connected, then the digital future will be slow-moving because no one wants to sit and upload and download files," Rune explained.
My Personal Frustration
Let me be honest with you. I'm supposed to be the digital guy. I run a practice with over 20,000 patients across multiple locations with more than 40 dental chairs. And I'm still on one of the most ancient PMS systems available.
Why? Because it's so difficult to migrate. I've talked to every cloud provider in Australia and New Zealand. None of them can properly transfer all our data. It's maddening.
I've had enough of using Chrome Remote Desktop to access a local PMS. I want to move to a cloud solution. But I physically can't do it right now.
Why Nothing Changes
Rune shared something interesting. 3Shape has looked multiple times at building a PMS. They always conclude the same thing.
"When we look at the market data, no one is moving. Companies have burned over $100 million on this and ended up with 2,000 users."
The legacy PMS companies are sitting on a gold mine. They charge per seat, per X-ray machine. They have no incentive to make switching easy.
"It's a fantastic business if you are there," Rune said. "But they're not helping you. That is really a significant barrier."
Signs of Progress
The good news? There is motion. Cloud-based systems are making integration easier from a technology standpoint.
If you want to see something interesting, go look at Dentrix Integration Partners. Dentrix is the biggest PMS in the world, and they now have a surprising number of integrations, including close to 10 voice AI tools.
Some Danish cloud-based PMS systems are building really cool APIs and doing impressive integrations. 3Shape has open APIs. DS Core lets you get API access in a few hours with a few clicks on the homepage.
"I would say there's more motion than there's ever been before," Rune said. "But it's still slowing the whole progress and innovation down."
Let's hope the PMS systems are listening.
What's Coming in 2026
Looking ahead, I think AI diagnostics will see meaningful clinical adoption beyond early adopters. 3D printing will continue its momentum, though final crown materials still need work. And the PMS bottleneck will remain frustrating, but might finally start to crack.
One thing's for certain: digital dentistry isn't slowing down. If you're still on the fence about adopting these technologies, the window to be an early adopter is closing. Soon it'll just be standard care.
And for Rune, we're all watching to see what his next chapter looks like. Twenty-five years at one company is remarkable. Whatever comes next, I'm sure it'll push the industry forward.
"I'm certainly not leaving," he said. "Stay tuned."
Thanks for reading. If you want to hear the full conversation, check out the podcast episode. And as always, let me know your thoughts in the comments.
This article is based on the Digital Dentistry Decoded podcast featuring Dr. Ahmad Al-Hassiny and Rune Fisker. For more insights on digital dentistry trends, courses, and reviews, visit the instituteofdigitaldentistry.com
