Where Digital Helps — and Where It Stops
We use digital tools where they make a real clinical difference: intraoral scanning, digital smile design, virtual case planning, digital bridge and crown design, and digital occlusion analysis — integrated into a single case file the doctors and our in-house master ceramists work from together. For cases that require 3D CBCT imaging, we coordinate scanning through our trusted surgical specialist partners; for full-arch implant cases, those same specialists perform the surgical placement before the case returns to us for the prosthetic and laboratory work.
The point is not the technology itself. The point is what it lets us decide before any tooth is prepared: preview your final result, design a bridge to your exact bite and lip line, and review every margin and contour digitally with you in the room. By the time we make the first prep, the case has already been finished on a screen.
After that, the digital workflow stops. The actual restorations — the veneers, crowns, inlays, onlays, and bridges — are not milled by a machine and they are not 3D-printed. They are hand-pressed in GC LiSi Press lithium disilicate or hand-cast in high-noble gold, hand-stained, and hand-glazed by our in-house ceramists. That is a deliberate choice, not a limitation. Pressed lithium disilicate and cast gold, finished by an experienced human hand, still hold up better and look better than what current milling and printing can produce.
Arch Scanning for Design and Provisionals
We scan your arches — your full upper and lower teeth — with an intraoral scanner to design the case digitally and to fabricate provisional restorations. The scan captures your existing dentition in three dimensions in a few minutes, without trays, putty, or the gag reflex traditional impressions cause. From those scans we design your future smile, mock it up against your photographs and video, and produce the provisional restorations you wear during treatment.
Final crown and veneer preps are not scanned. Once the case is approved and we prepare your teeth for their final restorations, those preparations are captured with conventional precision impressions for our in-house lab. Pressed lithium disilicate and hand-cast high-noble gold are still finished to a microscopic fit by an experienced ceramist — and the impression workflow that fits a hand-finished restoration that way has not been improved on. Digital where it sharpens the design. Conventional where it produces a final restoration that fits and lasts longer.
3D CBCT — Coordinated Through Surgical Specialists
When a case requires 3D CBCT (cone-beam CT) imaging — most often for full-arch implant work and complex implant planning — we coordinate the scan and the surgical placement through our trusted surgical specialist partners. They own the imaging, perform the diagnosis, and place the implants. Our role on those cases is what we are best at: prosthetic planning, digital smile design, provisional restorations from your arch scan, and the final hand-pressed or hand-cast restorations from our in-house lab once the implants have integrated.
This is a deliberate division of labor. The specialists we work with have invested in CBCT and surgical practice the way we have invested in ceramic and prosthetic mastery — and the patient benefits from both rooms working at the level they each work at.
Digital Smile Design
Digital smile design (DSD) is the process of designing your future smile on a screen — using your photographs, video of you speaking and smiling, and a 3D scan of your teeth — before any physical work begins. We can adjust tooth shape, length, proportion, and arrangement and show you the result against your own face. You see, refine, and approve the design before we commit to it in porcelain.
For cosmetic veneers, smile makeovers, and full-mouth reconstructions, this preview-and-refine step is the difference between a finished case you are happy with and a finished case you wish you had pushed harder on. We do not start clinical work on a cosmetic case until you have signed off on the digital design.
Digital Design, Hand-Pressed Ceramics, Hand-Cast Gold
Most digital dental practices end the case on a milling machine or a 3D printer. We do not. Once the design is finalized digitally and signed off, the file goes to our in-house ceramists — not to a mill. Pressed lithium disilicate (GC LiSi Press) and hand-cast high-noble gold are the two restorative materials we use for single-unit cases, and they are still finished by hand. GC LiSi Press is the press ingot we have settled on for every ceramic case — Dr. Brumm is a long-standing Key Opinion Leader for GC America, and the optical depth, edge strength, and shade stability of LiSi Press are what we trust against natural enamel.
Pressed porcelain restorations are produced by hand-waxing the case at full contour, investing it, and pressing molten ceramic into the mold under heat and pressure — the same technique used in the highest-end laboratories in the world. Gold restorations are hand-cast the same way: hand-waxed, invested, cast in high-noble alloy, and hand-finished. Each restoration is then layered, stained, and glazed by an experienced ceramist looking at it under a microscope, against shade tabs, against your photographs, against the adjacent teeth.
Digital design lets us decide what should be made. Hand-pressed ceramics and hand-cast gold are how we still make it. Approximately 3% of dental practices have an in-house lab. None of those practices, anywhere, also have two AACD Accredited Fellows.
Frequently Asked Questions
- Do you scan or take traditional impressions?
- Both, deliberately. We scan your arches with an intraoral scanner to design the case digitally and to fabricate the provisional restorations you wear during treatment. We do not scan your final crown or veneer preparations — those are captured with conventional precision impressions for our in-house lab. Pressed lithium disilicate and hand-cast high-noble gold restorations, finished by an experienced ceramist to a microscopic fit, still produce a better-fitting and longer-lasting final result when made from a conventional impression of the prepared tooth.
- What is digital smile design, and how is it different from a regular consultation?
- Digital smile design overlays a proposed final smile onto photographs and video of you speaking, smiling, and at rest — so you see what your actual face will look like with the new smile before any work begins. It is the difference between describing a result and previewing it. For cosmetic veneers and smile makeovers, we do not begin preparation until you have approved the digital design.
- Do you have a CBCT in your office?
- No — we do not have a CBCT or panoramic X-ray in-house, by choice. When a case requires 3D imaging — most often for full-arch implant work and complex implant planning — we coordinate the CBCT scan and the surgical placement through our trusted surgical specialist partners. They own the imaging and perform the diagnosis and surgery; we handle the prosthetic planning, digital smile design, provisional restorations, and the final hand-built restorations from our in-house lab. The patient gets specialist-level surgery and AACD Fellow-level prosthetics — neither room compromises to do the other's work.
- Is digital dentistry just a marketing label?
- It can be — many practices use one digital tool and call themselves a 'digital dental practice.' Strupp & Brumm uses digital where it sharpens the design: arch scanning, digital smile design, virtual case planning, and digital occlusion analysis are integrated into one case file before any tooth is prepared. After the design is approved, the restorations themselves are still hand-pressed in GC LiSi Press lithium disilicate or hand-cast in high-noble gold — finished, stained, and glazed under a microscope by our in-house ceramists. Digital where it sharpens the decision. Handcrafted where it determines how the work looks and how long it lasts.
- Are your veneers and crowns milled by a machine or 3D-printed?
- No. Our veneers, crowns, inlays, onlays, and bridges are hand-pressed in porcelain or hand-cast in high-noble gold by our in-house master ceramists. Milled and 3D-printed restorations are convenient and fast, but pressed ceramics and cast gold — finished by an experienced human hand — still hold their fit, their margin integrity, and their appearance over decades better than what current milling or printing produces. We use digital tools where they make the design better; we keep the fabrication in human hands because that is where the longevity comes from.