It's that time of year to start planning your year end equipment purchases John Wilson: Hello, my friends, John Wilson here and I have a question for you. Are you ready to finish this year strong? Well, hey, it's that time of year to start planning your year end equipment purchases. And I'm here to tell you that Ivaclare has really stepped up their game and is offering some of the most incredible deals on mills and furnaces here at Sunrise. We've certainly been impressed with ivaclair's quality, but more importantly, how they've been a true partner to me and my laboratory. When you can invest in reliable technology and say, well, it's a no brainer, right? So if you've been thinking about your first mill or an upgrade, I certainly encourage you to reach out to them today. Elvis: And of course, we appreciate Ivaclar for their continued support. Welcome to Voices from the Bench, a dental laboratory podcast. Send us an email@infovoicesfromthebench.com and follow us on Facebook and Instagram. Barbara: I'm surprised you're not here in Indianapolis this weekend Greetings and welcome to episode 345 of Voices from the Bench. My name is Elvis. Barbara: My name's Barbara. Elvis: What's happening, Barb? How are you? Barbara: I'm hanging in there. That's about all I got. Elvis: That's not good work related. Barbara: No, it's just been rough. You know that. Elvis: Yeah. Barbara: I just got to take it one day at a time and that's what I'm trying to do. Kamil Zabrowski: But yeah, I actually. Elvis: I'm surprised you're not here in Indianapolis this weekend. Your BFF is here ending her tour. John Wilson: I know. Barbara: and that's the last US stop and it's in your city, so she'd be impressed with that. Yes. Elvis: Why does she choose Indianapolis? I have no idea. Barbara: Probably because she's going to. She's going to Canada next, so it's probably as north. That's my thought anyways. Elvis: Nobody wants to end in Detroit, so it's us. Barbara: no. You know that's where I was born. Elvis: Oh, I know. That's why I said it. It's nuts how crazy this town has gone. It's just. It's nuts. I mean, there's huge stickers on sides of buildings and just roads are shut down and they're expecting 200,000 people into the city with a stadium that only seats 70,000, so. Barbara: Oh, yeah, I know. It's wicked fun though, I tell you. Elvis: Yeah. You actually saw her, right? Barbara: Yeah, it was like two years ago. I was her first stop, believe it or not. Elvis: Really. Barbara: Tampa. Yeah. Was her first show. And then in your city is her last show. Like, that's Crazy. Elvis: Do you think she did that because of the podcast? Do you think she listens? Barbara: Probably. Elvis: And realize, I know she knows who I am. Barbara: Thank you, Taylor. Elvis: There you go. Good luck. It's crazy. We're just going to avoid the downtown area for three days and. Barbara: Oh, hell, yeah, I know. I would do the same thing. If you want to be a guest on our podcast, it's easy So what's up? Elvis: Well, actually, I want to kind of talk about next year. So we're. We're wrapping up 2024, which is kind of hard to believe. I mean, here we are in November. Barbara: Yep. Elvis: But we want to make sure that we get to, people in our industry in 2025. I mean, with this podcast, most guests, you know, they either reach out to us to see if we're interested, or I find you on social media and start bugging you. But I just want everyone to know that if you want to be a guest or you know, of a good candidate to be on the podcast, it's okay to reach out to us. We want to hear from you. All you got to do is send us an email at, ah, infovoicesfromthebench.com or just send us a message on Facebook or Instagram. It's really that easy. I just don't want to miss people just because I don't know about you on social media. I feel bad. Barbara: So don't be shy. Come on and tell us your story 100%. If you don't think you want a whole hour to yourself, then come join us in Chicago or Germany. You know, you want to say at. Elvis: ID at IDs early next year. Barbara: Yeah, right on. Thank you. Xoced, of course. Elvis: Because a lot of the times a whole hour can be daunting to people. I get it. I get it. It's a long time to have a conversation. So some of these live shows, we do a little shorter conversations. So that's a great way to get on the podcast, but either way, we want to hear from you, so please reach out. Barbara: Right. Camille Zabrowski was first to bring photogrammetry into dental practice Elvis: So this week, Barb, I got to talk to the very first person to bring photogrammetry into a dental practice in the US Kamil Zabrowski. Barbara: Nice name. Polish boy. Polish. Elvis: There you go. So I don't know what you were doing. I think it was hurricane related. Yeah, I think it fell right in, like, that weekend that, you were getting hit with. Either the first one or second one. I can't keep your hurricane straight. Barbara: Yeah, I know. Elvis: You were missed, but you missed a great conversation. So, Camille, he grew up in a lab and really didn't get interested until later, when he actually almost went to dental school. But this was right around the time when digital started entering the industry. And it was that technology that kept him on the lab side. And eventually he started consulting and his own small, fixed lab. But without doing dentures, there was a barrier to get into full arch cases, because back then, you know, we were all converting dentures. Barbara: Yep. Elvis: for full arch, that is when he learned about the PIC photogrammetry unit, and he actually brought the first two to the United States. Barbara: Nice. Elvis: It's pretty cool. Since his first case, that workflow worked, and he was sold. Now Camille runs WTI Dental Concepts, where he helps other labs and dental offices get into digital. He talks about the early days of photogrammetry, what makes it work, why it works, perfecting the workflow, and how to decide if you want to get into photogrammetry and where to even start. Barbara: Nice. Elvis: So join us as we chat with Camille Zabrowski. Voices from the bench. The interview. Camille Zabowski was one of the first people to introduce photogrammetry I am super excited today to welcome a gentleman that I have been told by inside sources was one of the first people to bring photogrammetry into dental in the U.S. am I even saying that right, sir? Kamil Zabrowski: absolutely, Elvis. Yeah. Elvis: That's awesome. Awesome. Well, we welcome Camille Zabowski to the podcast. How are you, sir? Kamil Zabrowski: Doing great. Doing great. Excited. Big fan of the. Of the podcast and everything. You do Elvis with Barbara. So, yeah, it's a. It's a big one to be on. Thank you so much for the invite. Elvis: Yeah, no, absolutely. I think it was Pete from Ottawa that connected us. I've known him for years, and he said, you're the guy that's responsible for all this. It added a whole new level to do full arch cases that we were never able to achieve before. So tell us, obviously, you just didn't fall into photogrammetry one day. How did you get into this? Kamil Zabrowski: I guess it's been a long road, right? I come from a laboratory family, so. Elvis: Oh, nice. Kamil Zabrowski: Grandfather had done a lab in Connecticut for. Geez, Ever in a day. I have an uncle on the west coast, has a big laboratory in San Diego. I kind of grew up in lab laboratories. I was actually kind of dubbed as the first dentist in the family. And, you know, for whatever reason, it didn't jive with me. I really liked the technology that was coming into the dental lab field in the early 2000s, and I started working in CAC CAM with the first lava system way back when. So it's maybe dating myself a little bit. And, you know, my interest always gravitated towards implants. And so there's this long road of, you know, starting WTI Dental Concepts, which is our, company. It was a consulting company for laboratories at that time going into digital because a lot of people didn't know where to go. Yeah, you know, a lot of people. Elvis: Still don't know where to go. Kamil Zabrowski: Yeah, absolutely. Ah, it's, it's wild, right? But it was, you know, 2014, 13, 14, 15, it was that kind of big rush into cat cam with dental labs. And so that's kind of where we started at. And honestly, it's through a friend of mine in Europe. In kind of 2016, I got a call about a camera that is extra oral and it takes full arch impressions of implants in the mouth. And you can imagine never hearing about photogrammetry. That sounds crazy, right? Elvis: The first time I heard it, I was like, what's the point? I mean, you're outside the mouth, but yet you're trying to capture records of inside. How the hell does that work? I mean, what's my initial thought? Kamil Zabrowski: I had the same thought. I was like, this cannot work. Right. And so I was interested. I recently actually, at that time, started a little crown and bridge lab and, to go along with wti. And I was just like, you know what? I'm trying to break into the full arch sector. And how do I do it? I don't have any experience with church side conversions. I didn't do dentures at that time, nor did I have a denture tech involved. So, I was kind of on the outside looking in, right. And so then when I kind of sat back and I'm like, well, you know, if this device works right, we can technically not need those services in house. We can design these stuff digitally and send out the camera with the technician to capture the scans, bring them back in and still do immediate load, temporaries, which, you know, if you're a crown and bridge lab, that's kind of like your barrier to entry, right? Your comfort level. Elvis: Because you don't want to set teeth. Sure. Back in those days. Kamil Zabrowski: Yeah, yeah, set teeth. But even just, you know, the chairside manner, right. I think retrofitting, Chairside for immediate low dentures, I mean, that's an art form in itself, right. And it takes a lot of skill and it takes, a lot of knowledge to get that number one done and then. And have it done nicely. Speaker E: Right. Kamil Zabrowski: So it's pleasing. So in any case, I ended up calling up the owner of PIC Dental, right. Adrian Hernandez back then, and had him out to San Diego. We did some cases with California implant institute, Dr. Farage out here. And after doing the first couple cases, and at that time 3D printing wasn't what it is today, we had to mill our temporaries. So is a little bit different of a flow than what we have today. Kamil Zabrowski: But after seeing it and after being able to capture impressions, digitally in the mouth, going back to the lab, designing everything, milling everything, coming back the next day with a perfectly fitting temporary, my mind was blown. Speaker E: Right. Kamil Zabrowski: I could not understand why this isn't the gold standard in full arch dentistry. And you know, it was just kind of a. Got lucky with timing and the connection, took a chance and out came this thing called photogrammetry today, which has really kind of taken over the full arch market from a restorative approach concept. Speaker E: Right. Elvis: Yeah. So you grew up in a lab. Did you go as a kid So I want to back up a little bit. I know you're jumping right into this and we're going to get into all of this photogrammetry stuff, but. So you grew up in a lab. I mean, did you go as a kid? Were you exposed from that early age? Kamil Zabrowski: Absolutely. I mean, yeah. You know, anybody that's a lab person. Speaker E: Right. Kamil Zabrowski: You know that lab is just going to swallow you. Speaker E: Right. Kamil Zabrowski: I joke around like once you get in the lab business, you just can never leave. Elvis: oh, when people do, I'm like, you got out. It's an option. Kamil Zabrowski: It's so true. You know, it's almost like a life quest. and yeah, I mean, I remember spending, you know, after school, afternoons at the lab and being around the techs and you know, trying to stay out of the guy's casting medal and. Yeah, and all the, all the fun stuff. Elvis: Did you work there as a kid? I mean, did you do all the jobs and poor models and all? Kamil Zabrowski: You know, honestly, no. I was kind of around the lab, in the lab at all times when I was younger. Well, really young. And then, kind of when I got to college and I was looking at going pre dental, I started taking the lab a little bit more serious. Speaker E: Right. Kamil Zabrowski: And so at that point worked at the lab. But I quickly got, onto the Lava system and you know, kind of the cat cam journey started from there. Speaker E: Right. Elvis: What were you designing on back then? Is that three Shape? Kamil Zabrowski: No, no, no, this is well before three Shave. This was the, Yeah, this was one of the first, design softwares from 3M Lava. I mean it was a big thing when we started doing Bridges because, you know, as first just. Right. Five, ten scopings. And then, yeah, we got into some bridges. And eventually I think we had a, you know, the big update was that we got a block that could mill like a six unit, kind of quadrant style bridge. Speaker E: Right. Kamil Zabrowski: Sure. Wasn't, quite big enough for a full arch. But, yeah, we could, we could have some fun with it. Elvis: Yeah. Not many labs had lava machines. I mean, I know they were expensive and heavy. Kamil Zabrowski: Absolutely. They were huge behemoths and they definitely. One thing though, they, they got automation down early. That thing legitimately could mill, 24 hours without attendance. You come in, everything's milled perfectly and everything. But it was a different time in the industry. Right. At that point. I remember a lava crown being like 350. Speaker E: Right. Kamil Zabrowski: Layered porcelain. I think we were selling copings to laboratories for $200 at first. Elvis: Wow. Kamil Zabrowski: So, yeah, maybe the golden age of the dental lab industry at that point. Elvis: Who knew we'd all be doing $70 cramp? Kamil Zabrowski: No, it seems like that's the going rate. Speaker E: Right. Photogrammetry came into dental field well in advance of CAD CAM systems Elvis: So what, did you go to dental school? Did you graduate? Kamil Zabrowski: Nope. Pre, dental. Speaker E: Ah. Kamil Zabrowski: At San Diego State. Elvis: Yep. Kamil Zabrowski: I remember, getting through all of my, o chems and kind of sitting there going, you know what, this is just not where my interest is. Speaker E: Right. Kamil Zabrowski: Like, yeah, at that point I was really, really deep into, the interest level with implants. Early on, Lava at some point allowed, us to do hybrid abutments. Speaker E: Right. Kamil Zabrowski: With a, hole down the middle. And you know, that was mind blowing with a long time ago. You know, Cat cam just kind of grabbed onto me and I looked around, I'm like, okay, well what can we do with CAD cam? That's the most interesting. And it was implants. And so then it was just kind of a quest of how far can we get with that combination CAD CAM and implants. And, yeah, photogrammetry just kind of got pegged in there and sure glad. Elvis: You figured that out before you went to dental school, you know what I mean? Kamil Zabrowski: Yeah. Elvis: When you learned about photogrammetry, you said it was over in Europe. Was it pretty regular over there? Kamil Zabrowski: Or. Elvis: I mean, were a lot of people using it in Europe? Kamil Zabrowski: I guess I should ask, honestly. No, you know, I think photogrammetry came into the dental field well in advance of our CAD CAM systems. Speaker E: Right. Elvis: Really? Kamil Zabrowski: Yeah. You know what it could provide. So going back to the kind of the beginning of photogrammetry in dental, that would be 2010 in Spain. And then, you know, we didn't officially bring IT to the US till 2017, so they were functioning in Europe for about 7 years. Elvis: Interesting. Using it the same way we're using it today. No, Kind of like a, Kamil Zabrowski: Okay, yeah, no, no. And this was probably the reason why it didn't grow faster earlier is because, you know, we were. Even when we got it in 2017, we had to use Geomagix, for example, to manipulate the data. Geomagix is a kind of an industrial CAD software. And we had to prepare a lot of the components to be able to then design in Geomagix. And, you know, for anybody today, learning blender for dental, for example. Kamil Zabrowski: Which is a big jump kind of from our standard dental cads, like 3 shape and exocad. Geomagix was, you know, that times 5 on difficulty. Right. And so it wasn't a very commercial way to grow in the market. Elvis: Yeah, it wasn't easy. Kamil Zabrowski: It wasn't easy. And look, in the US we do like easy, right. We need things to be streamlined. and eventually Exocad provided that platform. And, you know, I would probably say that we eventually got some users on board, which really kind of carried the torch as well early on and, put it on the map. Speaker E: Right. Elvis: And Pick was the first one. Kamil Zabrowski: Pick was. Pick gets the credit for starting the craze. At that time, it was the only game in town and, it worked very well. Elvis: Yeah. You said the first case you did worked. Kamil Zabrowski: Yeah, I mean, right out of the bat is quite amazing. Speaker E: Right. Kamil Zabrowski: In those early days. And in fact, in 2017, you know, we picked up the first two cameras in North America, and that was pick 26 and 27 in the world. Speaker E: Right. Kamil Zabrowski: So. Elvis: Ever made? Kamil Zabrowski: Wow. Yeah, it was still the infancy of that, whole process. Elvis: Were they crazy expensive? Because it was so new. Kamil Zabrowski: It was. It was. I mean, yeah. I can only imagine, you know, initially you're running about $50,000 for a camera investment. that eventually kind of dipped down, as ICAM came out. But, you know, we had a fantastically crazy Covid period, as you know, and, that did all kinds of crazy stuff with technology supply and technology prices. So, it was a little bit of a ride there through those Covid years and shortly after. But I would say, like, right now is probably the golden age of photogrammetry. Speaker E: Right. Kamil Zabrowski: You're starting to see a huge expansion period. Speaker E: Right. Kamil Zabrowski: Not only with, you know, kind of competition between different cameras, but a changing of the flavors. Speaker E: Right. Kamil Zabrowski: Pick an iCam. They started this whole thing, as I mentioned, and they're a standalone handheld camera and. Hey, Elvis, I, just realized, Elvis: Yeah. Kamil Zabrowski: People might not even know what photogrammetry is. Elvis: Well, you know, we should. I was going to touch upon that. I mean, it's brought up a lot on the podcast. I think a lot of people are aware of it and kind of like what it does. But the nuts and bolts and why it works, I think we probably need to talk about it. What exactly is photogrammetry? It's a fairly simple technology Speaker E: Okay. Elvis: What exactly is photogrammetry? Kamil Zabrowski: It's honestly a fairly simple technology. ah, from the outside looking in. And it's been used, you know, it's not a technology that was developed for, for dental, for example. We've used photogrammetry in industry for decades and decades. and it was primarily used to measure, large objects. Speaker E: Right. Kamil Zabrowski: for the most part, photogrammetry systems consist of a couple of things. Well, number one, you need a camera. Usually that camera has multiple cameras in its system. Speaker E: Right. Kamil Zabrowski: Pic, for example, has two cameras. iCam has four cameras. Topel 3D has two cameras. So you can see that you need multiple cameras. Elvis: Is more cameras better? Kamil Zabrowski: There is that debate out there. But the reality is, you know, it just gives you more views. But there's different ways to go about the whole subject, right? Kamil Zabrowski: And you know, I guess maybe this will be a long winded explanation, but the number one thing is you need cameras and you need to know the distance and angle in between them so that angle is fixed. Speaker E: Right. Elvis: Okay, gotcha. Yeah. Kamil Zabrowski: These Cameras will take 2D images, okay. During the scan. And they're taking 2D images of some known markers. Right. So pic had flags. ICAM4D has their ICAM bodies. Tupel, 3D has dot posts and. Elvis: Each cam the dominoes. Kamil Zabrowski: Yeah, so called the dominoes. Usually, usually it's a, it's a black marker with white dots. Speaker E: Right. Kamil Zabrowski: To highlight contrast in between the colors and be, able to, in the picture for the system to be able to pick it up easily. Speaker E: Right? Kamil Zabrowski: And so you have the camera, you have your markers, then you need a software then that will essentially calculate the vectors or the distances in between implants, in the patient's mouth. Speaker E: Right. Kamil Zabrowski: And the reason that this all works very well is because the camera sees the dominoes or the markers in one shot. Speaker E: Right. Kamil Zabrowski: The full field of view. And as it's measuring, it takes into consideration the full arch or the full view of the patient's mouth. And it can get in a single shot, very high accuracy. Elvis: So it's looking at all these dots, each implant m flag or scan body, let's say, has multiple dots. So it's measuring the distance between each dot on each scan body compared to where the dots are on other scan bodies. Am I understanding that right? Kamil Zabrowski: Yeah, sort of. I mean, you could look at the dots as a fingerprint. Speaker E: Right. Kamil Zabrowski: So in, in most cases, for example, the dot post. Right. The, the scan body from Tepel 3D, that's, that's a round one, a round cylinder and it's normally fabricated. Then, it's coated and the dots are placed on there, with a laser. After that's produced, it goes to get measured and a calibration file is created for a set. Speaker E: Right? Elvis: Yep. Kamil Zabrowski: And so each calibration file is essentially the fingerprint for each dot post or scan body, which the system then can recognize and utilize for, you know, spatial measurement. Elvis: And then you have these measurements between all the dots. How the hell does that work? How does that, how does that help somebody when they're creating a full arch? You just have the position of the dots. Kamil Zabrowski: Yeah. So I think here we're kind of getting to a very important point. Speaker E: Right. Elvis: do it, do it. I want it. Kamil Zabrowski: Photogrammetry is, is simply a measurement of implant position in space. Speaker E: Right? Elvis: Yeah. Kamil Zabrowski: And that really doesn't do everything for us to have a successful case with a good occlusion, well fitting and fully digital, you know, outcome. Speaker E: Right. Elvis: Yeah. Because I've seen like the screenshots or what you get, and it's just basically four dots. If it's an all on four type thing, just floating. Kamil Zabrowski: Yeah, absolutely. Elvis: There's like no reference to anything else in most cases. Speaker E: Right. Kamil Zabrowski: And there, there is one exception that just entered, so we'll probably touch on that in a little bit. But in most cases, what you get out of a photogrammetry system is an XYZ coordinate. Speaker E: Right. Kamil Zabrowski: And then on top of that coordinate, we'll add a healing cap. A healing cap for a multi unit abutment or, a scan body that will be exported from our photogrammetry system. And then that has to be married with some impression of the patient's tissue. Speaker E: Right. Kamil Zabrowski: And the key factor there, what you need to make sure you have, is that you're using a healing cap in the patient's mouth for that impression. It doesn't matter if it's a traditional impression or an intraoral impression. Elvis: Yeah. Kamil Zabrowski: What matters is that that healing cap is also in your photogrammetry system and, is also in your design software. So you have to make sure. That you're using the same part in all three pieces, because that's how you layer this data together. Elvis: That makes sense. I didn't realize the photogrammetry companies provided the intraoral scanning part heart. Kamil Zabrowski: So just to be clear, right. How does photogrammetry make the process in exocad better they don't provide the intraoral scanning piece. Speaker E: Right. Elvis: They don't provide the healing abutment, you said. Kamil Zabrowski: No, because, we can take any healing abutment in the world and put it into your workflow. Speaker E: Right. Kamil Zabrowski: So if Elvis creates a healing abutment for the, you know, standard 4.8 MUA, and, you start getting people to use it, we could get a STL file from you, and we could put it into the photogrammetry system, and then we can add it to, a library that we've created for the design portion, which kind of facilitates different screws and different, connections for the actual prosthetic. And off you go. Elvis: Just like having the parts DME and exocad, you gotta have it in the photogrammetry. Kamil Zabrowski: Yes. You have to have the same part across the three spectrums. Elvis: And it can be any part. Yeah. Got it. Kamil Zabrowski: Yeah, it could be any part. you know, and a lot of people utilize healing cap from their implant manufacturer. A lot of people like some scan body, you know, and, it doesn't matter, as long as you keep it consistent between the physical, the photogrammetry system and your CAD system. Elvis: Yep. Makes perfect sense. Yeah. How does the software and, like, exocad that we know might not be perfect? Because if we knew if it was perfect, we wouldn't need photogrammetry. Does it correct it to fit the photogrammetry? Is this question even making sense? Kamil Zabrowski: yes. so essentially, I think what you're asking is, how does photogrammetry, make the process in exocad better? Elvis: Yeah. How does it make it correct? Because that's why we're using it. Kamil Zabrowski: So imagine we have that healing cap we just discussed, and whatever healing cap it is, and we have it in the patient's mouth. We take an intraoral scan of it in the patient's mouth. That scan we understand that is, it's not 100% the shape of the healing cap as it was designed. Speaker E: Right. Kamil Zabrowski: It's gonna be plus, minus, I don't know, whatever. How, however many microns. Elvis: Sure. Kamil Zabrowski: But we actually have the real STL of that scan body. Speaker E: Right. Kamil Zabrowski: And that STL is exactly what it should be or what it was manufactured to be. Speaker E: Right. Elvis: Uh-huh. Kamil Zabrowski: And so as we take a photogrammetry measurement of implant Position and we export that stl. If we're doing an all on four now, we're going to have that exact scan body STL or healing cap STL in each position over the implants. And that's fixed. Those can't be altered. We can't pull those apart. They are fixed to the measurement coordinates. Speaker E: Right? Elvis: Yeah. Yeah. Kamil Zabrowski: And when we go to exocad to design, when we go into our implant library and we select, you know, the implant library, inside the implant library we have a selection of our healing caps or healing abutments. We select the one that we're using. It's the exact match to the export. Speaker E: Right. Kamil Zabrowski: So when we do best fit match for every single alignment of library to our marker file. Speaker E: Right. Kamil Zabrowski: Marker file is what Exocad calls the scan body file. Speaker E: Right. Kamil Zabrowski: It's a one to one match. They are exact copies of each other. So there is no introduction of error for the implant site. Speaker E: Right? Elvis: Yeah. Kamil Zabrowski: And when we do that on each one, we don't have any introduction in error based on best fit matching. If you take a, standard approach, if you take a, let's say you have a model, and you scan it with scan bodies, you will have some alignment error and it could be very small. Speaker E: Right. Kamil Zabrowski: But it's no longer the same piece. When you do, your scan to your library alignment. Does that make sense? Elvis: It does. I mean, we know it's not super accurate, but it's the photogrammetry that makes it super accurate. Kamil Zabrowski: Right, right. It's the fact that in photogrammetry we're not using a service scan to align to the library stl. We're using the STL in a coordinate position to align to itself. Elvis: Got it. And you can use photogrammetry off of a model. Would that help? Kamil Zabrowski: You know, yes. If you had it, you could. Absolutely. If you had a case, for example, that you know, came into the laboratory as a traditional, impression, you could use, you know, it's, it's just a tough way to do it, but. Elvis: Yeah, yeah. Kamil Zabrowski: you could use photogrammetry to scan the model. But one of the things that photogrammetry alleviates is a lot of error introduction through the process. Speaker E: Right. Kamil Zabrowski: So if you have it, ideally you would end up just converting that case to photogrammetry by, if it's time for the final, just make an appointment with the dentist and say, hey, we're going to take all of your records digitally. We'll do a intraoral impression of the temporaries. We'll take those off. We'll take, a impression, intraoral impression of the healed soft tissue with the healing caps. And then we'll take a photogrammetry measurement of the implant position. Hey, we'll capture some photos and maybe a face scan, and we'll knock this one out of the park. Speaker E: Right? Elvis: Yeah. Kamil Zabrowski: So really take advantage. Elvis: There's a photogrammetry also scan the face. I mean, you're already outside of it shooting pictures. Photogrammetry has a lot of benefits over the entire treatment of a case Kamil Zabrowski: Not today. I wish that it did, because it would save us on some of the. Some of the equipment that we. Sure, that is available today. Speaker E: Right. Kamil Zabrowski: But no, today, all of the main options for photogrammetry, they're all strictly measurement devices for the implant positions. Elvis: Yeah. And this works both after integration and like, right after surgery. So when patients flapped and you got all that blood and everything, ideally, photogrammetry is the best way to grab it. Right? Kamil Zabrowski: Absolutely. Speaker E: Right. Kamil Zabrowski: Like, a lot of people think that with photogrammetry, we, we aim to be faster than the perfect conversion. that's not necessarily the case. Photogrammetry and immediate loading through printing is not necessarily the fastest, you could complete the case, but it will set you up with all of the records to come back and do a prototype in the next phase. and you'll have everything for it. Speaker E: Right? Elvis: Yeah. Kamil Zabrowski: So it has a lot of benefits, not just in that immediate load appointment, but over the full treatment of that case. Speaker E: Right. Kamil Zabrowski: And, you know, it's. For example, you'll have, a ready made file to remake or, remill or reprint at any time if that patient decides to eat a chicken bone or whatever, or bite an apple when they're not supposed to. And they. And they break because temporaries break. All temporaries will break at some point. Speaker E: Right. Kamil Zabrowski: And so now it's like, how fast can we remake it? and, how much, you know, headache is that? And yeah, with a photogrammetry LED workflow, I mean, that can really be done kind of on the spot. Elvis: I do quite a few conversions, I do a few prints, but we don't use photogrammetry. We use, what's that called? The Opti Splint. Kamil Zabrowski: Opti splint, exactly. Yeah. Elvis: Opti splints. Yeah, it works pretty well. But I'll tell you, it's not about speed. It's about lack of stress, man. Doing conversions. I mean, I know there's a lot of people in our industry that are just fantastic at it, but I sweat bullets during that time because I feel like I'm rushed. I'm always worried I'M gonna break the thing. Picking up in the mouth with acrylic is just, you know, you hope you pick. Pick everything up. It's just all that is gone. Kamil Zabrowski: Absolutely. And it's way more predictable. Elvis: I can only imagine with photogrammetry, I. Kamil Zabrowski: I mean, with just a digital workflow. Speaker E: Right. Kamil Zabrowski: Even with Optisplant, you still produce a temporary that fits directly to a patient. Speaker E: Right. Kamil Zabrowski: So you're not trying to pick something up, right? In most cases, yeah, yeah, yeah, 100%. So, yeah. Like when we can alleviate the need for that. Sure. Side conversion and go into photogrammetry, we alleviate stress, but we also open up a lot of opportunities to grow the business because you can only be in one place at a time, right? Elvis: Oh, yeah. Kamil Zabrowski: But if you have four or five clinics that are sending you, cases from their photogrammetry system, you can do a crazy amount more than you could by doing retrofitting of, dentures. Speaker E: Right? Elvis: Oh, yeah. It's not an all day event anymore. I mean, I'm probably there longer than I need to be just because I want to help. Kamil Zabrowski: And, you know, you can never time it perfectly and show up right when they're done. Speaker E: Right. Kamil Zabrowski: Like, you're always early or, m. You're always early, Right? Elvis: Yep. A lot of labs are missing out on huge photogrammetry opportunities So there's a lot of photogrammetry out now, and I know you've mentioned a few. What do you recommend if someone wants to get into photogrammetry? How do you even start to look at what you need for your workflow? Kamil Zabrowski: Number one, I'll start off by saying if you're not doing or working with photogrammetry clients today, you need to start. Speaker E: Right. Kamil Zabrowski: It is, yeah. What's interesting is, and again, I come from a traditional laboratory background. Speaker E: Right. Kamil Zabrowski: Kind of institutional laboratory. And there is a little bit of a split in the industry. Speaker E: Right. Kamil Zabrowski: Between laboratories that have embraced photogrammetry and laboratories that haven't gotten into it. And I'll tell you, there is so much photogrammetry already out there that, a lot of labs are missing out on huge opportunities. Speaker E: Right. Kamil Zabrowski: By not having that internal knowledge of, okay, how do we complete a case, how can we service these clients and everything like that? It's nice. In this, you know, call it the post Covid era of photogrammetry, we've had an expansion period. And I kind of alluded to this little earlier in our conversation. you know, when I started, the game was pic. There's some, you know, Covid supply issues. Really. ICAM grew out of that. But today you have. You still have pic and you still have icam. Elvis: Yeah. Kamil Zabrowski: But you have a kind of a newcomer which we're super excited about. Topel 3D with their MK3 camera which really kind of takes photogrammetry to a new usability because it's wireless, the dot pose for example, have a captured screw. You can screw them on and off with your finger. So really kind of increases the usability for the user and just the user experience. Elvis: What's the name of that company? Kamil Zabrowski: Tepel 3D. Elvis: Okay. Kamil Zabrowski: Yeah, we actually just launched a new website for tepel3d. that's tepel3d info. Nice on there. If you're interested in photogrammetry you can book an appointment with us and we can have a discussion with how to integrate this into your either practice or laboratory. But you know, for those that are looking for a handheld system, that's going to stand alone. That's a fantastic one because the price really has come down. I mean we have offers for that camera that are under $500 per month. So the barrier of entry is really low. On the other side for clinics that are looking to do more, you know, guided surgeries, we also have Naviden Evo which has built in Micron mapper technology. So for those that aren't familiar with Naviden Evo, it's, it's a dynamic navigation system for guided surgery. Ah, that's really a system that really belongs in a clinic for the most part but that has built in photogrammetry. So it's two in one in that sense making it interesting, pretty easy. And you know, just within the last month we've launched Shining3D's Elite Scanner which is an iOS with a built in photogrammetry function in it. So you know, the options are here and it's just about kind of getting your internal process into the laboratory and being able to service these clients. Elvis: Yeah. How does one decide which route to go for photogrammetry Okay, so back to my original question. Which one do I get? That's the problem. It's kind of like looking at what used to be 3D printers, you know, and still is kind of like there's so many out there. How does one even decide which route to go? Kamil Zabrowski: We've used kind of the gamut, right? Elvis: Yeah. Kamil Zabrowski: We've kind of chosen tepel3d to be our leader for handheld. Elvis: I love that it's new and no one knows about it I guess. I mean I didn't know about it. I guess that doesn't mean anything but sounds like it's worth looking into, you. Kamil Zabrowski: Know, the fact that it's light, the fact that it's wireless, has a built in, screen on the camera itself. So you're looking at the, the camera, the back of the camera for the scan, not, a computer that you're tethered to. Elvis: Oh, yeah. Kamil Zabrowski: You know, that really helps in a surgical environment where you don't need a cord laying on somebody and everything like that. Elvis: Yeah. Kamil Zabrowski: And it's just easy to operate. Speaker E: Right. Kamil Zabrowski: So dot posts are metal. It has field calibration. So, kind of checks all the boxes of usability function and comes at a, at a sticker price that is substantially lower than, a lot of its competitors. Elvis: Right, well, that helps. Kamil Zabrowski: Yeah, yeah, absolutely. And that's probably our go to, right now. But for those that, you know, maybe aren't doing as much photogrammetry, the Shining Elite is also a great option. Speaker E: Right. Elvis: Okay. Kamil Zabrowski: I guess the answer, Elvis, the answer to your question, it depends, right? It's that famous answer in dentistry. I think we have to qualify what you're trying to do and then we can figure out, okay. Which product is actually the best one for what you're trying to do. Speaker E: Right. Elvis: Yeah. Kamil Zabrowski: And that's the benefit, I guess, of starting off today is that you do have more options than you did in the past. Elvis: Yeah. Ah, it's a blessing and a curse, you know, now you have so many decisions to make, you're afraid to make that jump because of the price tag. But I think, you know, with what you've talked about today and some of the things we've learned, I think it's a little easier than what it was before. And, we appreciate that. Kamil Zabrowski: Today it's rinse and repeat. Speaker E: Right. Elvis: Yeah. Kamil Zabrowski: You know, the conversation, obviously there's a lot of moving parts. We've talked a lot about all of these pieces that seem foreign. But from a workflow standpoint, photogrammetry is really rinse and repeat today. Speaker E: Right. Kamil Zabrowski: M. You just need to learn the flow and it's going to be the same for every single case. And yeah, that's, that's what's fun today. Speaker E: Right. Kamil Zabrowski: When we started off, we were still trying to figure out a few things here and there, change up, you know, how we were doing the workflow today. We have all of the tools at our fingertips and we could really get, a fully digitized patient into our CAD software and a high quality design, in a pre op stage right before the patient even goes into the surgical room. So that's pretty cool. Are labs using 3D printers as a money maker rather than just workflow easer Elvis: What are you seeing mostly are labs buying these and then charging offices to use them. I mean, I know a few dentists in my area actually have these things. But are you seeing labs using it as a money maker rather than just a workflow easer? Kamil Zabrowski: Absolutely. So, so there's there's kind of the gamut. Speaker E: Right. Kamil Zabrowski: Like there are labs that provide a scan service. Speaker E: Right. Kamil Zabrowski: So they have all of the equipment, sort of like, you know, labs that did chairside conversions. They had, they would show up with everything they needed for chairside conversion. Elvis: Yeah, yeah. Kamil Zabrowski: Now you have labs that have everything they need for a full digital record of a patient at any stage. Right. So they'll have their own, iOS, they'll have their own photogrammetry system. In some cases they'll have their own facial scanner and they'll, they can walk into any clinic and take all of the records for the case. And you know, there's different models out there. Some people do kind of a all in one package where you know, you pay X and you, you get the scanning, process, you get the temporization, you get the final prosthetic. Elvis: Yeah. Kamil Zabrowski: All in a package. Some people kind of piece it out. Speaker E: Right. Kamil Zabrowski: But from my perspective, laboratories need to have at least one camera so they know how to control the clinical process. It's, it's hard I think, for a dental lab to control these cases if they don't have a photogrammetry, system and they're not in the clinic during these procedures at first. Speaker E: Right? Elvis: Yep. Kamil Zabrowski: Just like anything, there's a lot of workflows and for the workflow you need the clinic to provide the right records and everything like that. And so when you're the laboratory working with these clinics. Speaker E: Yeah. Kamil Zabrowski: You are the backbone of the whole workflow. Speaker E: Right. Kamil Zabrowski: And the case. And you have to advise on, you know, whether the vertical record is good, whether the impressions are good and everything like that. And so it's usually easiest if the laboratory gets a unit, and then facilitates this process for their clinicians. but in the long run you, as a laboratory, you want as many clients as you know you want, for example, with these cameras, right. So you have files coming in from, from all of your clinics and you're not having to have a bunch of your own cameras scanning. Speaker E: Right. Kamil Zabrowski: So it's, it's kind of the, kind of the entry point and then the long term vision for these. But the other thing is that a lot of clinics that are doing volume in full arch. yeah. They are investing in these cameras because it facilitates their process. Right. And makes things a lot easier on them. And so, again, that kind of flows into the long term vision for a lab, I think is, yeah, okay, how do we service more clinics that have their own equipment? Speaker E: Right. Kamil Zabrowski: Or how do we introduce new clinics to the process? And, you know, when they get to some point, they can pick up a camera, whether it's through the laboratory or, not. but kind of the end goal for the lab, I think, is, just to create their network of cameras that are sending information back to them. Elvis: What I'm seeing is a lot of offices and surgical doctors getting 3D printers, and they want to use those things and they don't want a traditional conversion anymore. And in order to have the lab design it and them print it, I mean, we got to get those records, right? Kamil Zabrowski: Absolutely. But I feel like we can't even. Can't blame them for that. Speaker E: Right. Kamil Zabrowski: With the temporization step. And I think this is probably true for a lot of laboratories. Immediate loads and these retrofittings, they're a loss leader, Right. They're not a huge money maker. Elvis: No, we want the final. Kamil Zabrowski: Exactly. We want the final 100%. And so when these clinics pick up a 3, D printer and now they can 3D print that temporary that the lab designed. Well, that's efficient for the laboratory. Laboratory can produce more. Speaker E: Right. Kamil Zabrowski: and it's also cost effective for the clinic because the temporary cost goes down. And hey, guess what? If and when that patient breaks a temporary, they press reprint on their printer and in 30 minutes they have a new full arch temp. They got to post, process it and whatever, but let's say in an hour and a half they can on their own do another temporary, for that emergency patient because it's always on the weekend. Speaker E: Right. Kamil Zabrowski: And somebody has a wedding and, you know, it saves headache for the laboratory. And then it's just on the laboratory to provide good service with their final. Speaker E: Right. Elvis: 100%. And offices love it, honestly, when they can print their own. And I've been stressing to labs for years that we have to get into the business of just designing and letting offices is print their own stuff. It's gonna happen no matter how much we hate it. But I got a call just today about an office wanting to print their own night guard. But they want us to design it. I get it. It's the same thing with full arch. They're gonna want to print their own. Kamil Zabrowski: Yeah, I mean, look technology evolves whether we wanted to or not, right? Elvis: Oh, yeah. You can either go with the flow or drown. Kamil Zabrowski: You gotta make it. Make it your own. Speaker E: Right. Kamil Zabrowski: And I think that's where we're at with all of this. I think, the laboratory touch is essential to high quality outcomes, and it's just a little bit different of a formula. Speaker E: Right? Elvis: Yeah. Kamil Zabrowski: But I'll tell you, we have a long list of successful laboratory outfits out there. you mentioned Pete, who is a good friend of mine from Ottawa Dental in Phoenix. jb, Stephen, Barr and Brent and the guys there. These laboratories really embraced photogrammetry early and have exploded with work These laboratories, they really embraced photogrammetry early and have exploded with work. I mean, it's hard to quantify actually their growth pattern just by embracing the technology and not being scared of it and facilitating this for their, doctors. I would say they have stronger commitments and relationships with these all in four centers because of it. And, it's beautiful to see kind of the lab and clinic find each other again. Speaker E: Right. Elvis: Yeah. Pete's definitely busy, I'll tell you that. So as we wrap up. WTI started as a consulting company for CAD cam and implants And I appreciate all the information on photogrammetry, but talk more about WTI Dental Concepts. Where did this idea come from? And it looks like you offer so much more. Kamil Zabrowski: Yeah, I appreciate the opportunity to kind of, explore that. I mean, like I mentioned, we started WTI off as a consulting company for CAD cam. And it was, I don't know, call it hijacked by photogrammetry. Speaker E: Right. Kamil Zabrowski: In a good way. And so we really have tailored what we try to, distribute with WTI to match what we're doing with the full arch niche. Speaker E: Right. Kamil Zabrowski: in 2021, we brought in, Radon technology milling machines from Turkey. And, we brought them specifically to service this growing photogrammetry market. Speaker E: Right. Kamil Zabrowski: You know, we've worked with everything in the market pretty much from the milling standpoint. Elvis: Yeah. Kamil Zabrowski: You know, through. Through the two decades, you know, Roland vhf imus and so on. And we've always had some type of a blockade in what we could produce with these systems. And when we suddenly dumped a stash of full architecture, photogrammetry users and laboratories were like, oh, shoot. Now we need really good metal milling. We need extra axis rotation for direct to MUA seating platforms, and we need longer tools and we need, seat clamps and, you know, so the list of demands on our CAM technology went through the roof, Right? Elvis: Oh, I imagine. Yeah. Kamil Zabrowski: Yeah. And so, you know, right. 2021, we were scouring kind of the world for how we're going to Solve this demand and came across Radon technology and they checked all the boxes for us. Speaker E: Right. Kamil Zabrowski: Number one, they were super collaborative. Speaker E: Right. Kamil Zabrowski: we had ideas. We're like, we feel that this is the way that we should go about, you know, xyz. They were there to, to you know, team up with us and figure out how we can do it. Speaker E: Right. Kamil Zabrowski: And, and then they provided power in all of their models. So all of the models from the entry level to our gtr, which is kind of the big board, to the best mill, which is a loader system, they all had oversized spindles. For example. The gtr, which is our metal kind of go to metal machine, has a 3.7 kilowatt spindle and servo, motors on all the drives and really kind of provides that mix of power and accuracy for you know, bars. And a lot of our bars are beefy mills. Elvis: Yeah, they're beefy mills. Yeah, sure. Kamil Zabrowski: So capability wise was really huge for us. And yeah, for kind of all of the other products that we supply, they're all kind of geared towards this niche of full arch. Right. 3D printers, Zirconia, Milbox, Exocad, all of this. if you're trying to do CAD cam and implants, our portfolio and WTI really kind of caters to that. So it became kind of a one stop shop for a laboratory trying to get into not just cat cam where we started, but cat cam and implant dentistry. Elvis: Right. Kamil Zabrowski: Whether it was custom, implant abutments or full arch, the portfolio has something for each kind of step along the way. Elvis: I am not seeing model, trimmers on here. Kamil Zabrowski: we do distribute Renfort, but I, must say I don't think we've sold a model trimmer in a long time. Elvis: Fully digital workflow. It sounds like this is a great place to start. If a lab is not into it and looking to get into it or you know, they just want to take it to that next level. It looks like you all have everything. Kamil Zabrowski: You know, what I would say is we still kind of function in a consulting type of way. Speaker E: Right. Kamil Zabrowski: So if you have questions on bringing in design or bringing in milling of a new material or expanding your milling or expanding into this world of photogrammetry, feel free to pop, onto that website I mentioned earlier, tepel3d info. Com. There's a schedule appointment button like on every page of that website. You can schedule a 30 minute chat with us and we'll be happy to kind of discuss what you're trying to do, answer some questions. If we could help, great. If not, hopefully we put you on a path to growth and, we grow this thing together. Elvis: Yeah. And what about, like, training? So if somebody said, hey, I want to get into photogrammetry, hey, I want to get my photogrammetry camera from you. Do you teach how to use it? Kamil Zabrowski: absolutely. Elvis: Yeah. Kamil Zabrowski: You could imagine when we brought PIC dental, this was a foreign topic, both from clinical and laboratory. So we've designed training processes for both sides. We have clinical training for clinics, of how to do everything from preoperative records to surgical protocols to 3D printing and so on. And the same thing for laboratories. We help laboratories understand what photogrammetry is. We have a lecture. We always start with ABCs of photogrammetry. And then we help them with their CAD library that they will use for design, which, is a custom CAD library that we've created. And we've, you know, over time, we've incorporated all of the. The hot new, screws that are in there. So, we have, you know, everything from Vortex to Powerball to the Uniprost screw, Rosen. screw in there. So. Yeah, depends on, you know, whatever school you. You come from. There's an option in the library, Elvis: For that, which is good because every doctor wants to use a different screw. It seems like. Kamil Zabrowski: Yeah, you know, people get really. We're so clan oriented and, you know, I would say in humanity. Right. So, you know, whatever clan you come from, it's okay for us. We just want to facilitate the process. Easier for you, right? Speaker E: Yeah. Elvis: I love it. That's some good stuff, man. Camille, I appreciate you coming on the podcast, talking about photogrammetry Camille, I appreciate you coming on the podcast, talking about this photogrammetry. I mean, it's talked about a lot on the podcast, but we've never really dedicated an episode to it to dive into what it is, and I appreciate it. Kamil Zabrowski: Thank you so much, Elvis. It's been great to be on here. You guys have been fantastic, I think, for the industry. So I'll send you kudos, six plus years of success. And I hope you have, many more to come. Elvis: Yeah. Do you guys have a booth in Chicago? Kamil Zabrowski: we will have a booth in Chicago, so we'll see you there. We'll be at lab, and we're probably looking at, adding a booth to McCormick as well, so stay tuned. We'll probably have that out on, social media. Ah. out there soon. Elvis: Awesome. And we'll make sure all the links to find you are on the episode show notes. So, Camille, thank you so much. Sir. Kamil Zabrowski: Thank you. I appreciate it. Elvis: Yeah, have a good one. Kamil Zabrowski: Thanks. Camille Cuts talks about photogrammetry on Voices from the Bench podcast Barbara: Thank you, Camille, for coming on our podcast to talk about such a huge hot topic in our industry. It was good to finally get to hear from somebody that not only was around in its early days, but really understands and can explain to others how it works. Now, you know me in implants, or, Elvis knows me in implants. Elvis: We all know about you. Barbara: Yeah, well, I still learned a lot from Camille during the CUT conversation. We suggest that if you are wanting to get into photogrammetry, that you reach out to Camille, as he has used most of them and can talk about the pros and the cons of all of them@wti dental.com. thank you, Camille. Elvis: All right, everybody, that's all we got for you, and we'll talk to you next week. Barbara: Have a good one. Elvis: Bye. How nice is it there right now? Barbara: Oh, it's beautiful here right now. It's probably 84. What about you? Elvis: 50? The views and opinions expressed on the Voices from the Bench podcast are those of the guest and do not necessarily reflect the official policy or position of the host or Voices from the Bench llc.