The Complete Guide to Chairside Milling

Researching ways to increase your profitability as a practice?

Bringing more production in-house may be on your mind!

Practices just like yours are increasingly adopting chairside milling to streamline workflows, reduce lab costs, and enhance patient satisfaction. By bringing restorative fabrication in-house, clinicians can deliver same-day crowns, inlays, onlays, veneers, and more—without compromising on quality or precision.

This guide will walk you through everything you need to know about chairside milling: what it is, how it works, the benefits, equipment required, and best practices for implementation in your dental office.

What Is Chairside Milling?

Let's jump back to the basics.

Chairside milling refers to the process of designing and fabricating dental restorations—such as crowns or bridges—directly within the dental office, using CAD/CAM (computer-aided design and manufacturing) technology. It eliminates the need to outsource restorations to a dental lab, allowing for same-day treatment.

How Chairside Milling Works: Step-by-Step Workflow

1. Digital Impression
   Use an intraoral scanner (e.g., 3Shape TRIOS, Medit, Alliedstar, iTero) to capture a digital scan of the patient’s dentition. This replaces traditional impressions and provides a fast, accurate 3D image.

2. CAD Design
   The scan is imported into CAD software to design the restoration. Many systems offer AI-assisted tools for margin detection, occlusal adjustments, and anatomy customization.

3. Material Selection
   Choose a block or disc of milling material (e.g., zirconia, lithium disilicate, composite resin, PMMA) based on the case requirements.

4. Milling
   The restoration is sent to a chairside milling machine (e.g., Roland DGSHAPE, vhf, Planmeca PlanMill, or CEREC), which mills the restoration in 10–30 minutes.

5. Finishing & Sintering
   Depending on the material, the restoration may require sintering, glazing, or polishing before delivery. Some materials can be polished and cemented chairside immediately.

6. Placement
   The completed restoration is fitted, adjusted, and cemented—all in one visit.

Benefits of Chairside Milling

✅ Same-Day Restorations
Patients receive high-quality crowns or veneers in a single visit—no temporaries, no second appointments.

✅ Practice Efficiency
Reduces lab turnaround times and enhances scheduling flexibility.

✅ Lower Lab Costs
By producing restorations in-house, you cut out the middleman and save on recurring lab expenses.

✅ Digital Precision
Improved fit, margins, and esthetics with fewer remakes or adjustments.

✅ Patient Satisfaction
Convenience and same-day delivery lead to higher case acceptance and better reviews.

Essential Equipment for Chairside Milling

To implement chairside milling, you'll need the following digital tools:

Choosing the Right Milling Machine for Your Practice

When selecting a chairside mill, consider:

• Wet vs. Dry Milling:

  • Wet mills are preferred for glass ceramics and composites.

  • Dry mills are ideal for zirconia but require dust control systems.

• Material Compatibility:
  Ensure the machine supports your preferred materials.

• Speed and Accuracy:
  Faster mills increase efficiency, but make sure they maintain precision.

• Ease of Use:
  Look for intuitive interfaces and open system compatibility with your scanner.

• Support and Training:
  Choose a vendor with reliable support and onboarding.

Best Practices for Chairside Milling

1. Start Simple
   Begin with single-unit posterior crowns before moving into anterior esthetics or bridges.

2. Train Your Team
   Invest in hands-on training for scanning, designing, and finishing restorations.

3. Standardize Protocols
   Create clear workflows for scanning, file prep, milling, and post-processing.

4. Maintain Your Equipment
   Clean the milling chamber regularly and replace burs as needed to ensure accuracy.

5. Communicate with Patients
   Market same-day dentistry as a premium service to attract patients and differentiate your practice.

Common Applications

Chairside milling is ideal for:

• Crowns (posterior and anterior)

• Inlays and onlays

• Veneers

• Temporary bridges

• Implant abutments (with compatible CAM systems)

• Nightguards and provisional prosthetics (with printable materials)

Cost Considerations