iTero Design Suite: The Missing Link for In-House Milling & 3D Printing

For many dentists, the iTero® scanner is already a cornerstone of their digital workflow. But what far fewer clinicians realize is that hidden inside the iTero ecosystem is a powerful design tool that can fundamentally change how you approach in-house restorations.

In this deep dive, Phil from Voxel Dental walks through the iTero Design Suite—a fully integrated, exocad-powered design platform that comes free with iTero Lumina scanners. For practices exploring or already invested in in-house milling and 3D printing, this software may be the missing link that finally connects scanning, design, and fabrication into one cohesive workflow.

Watch the video or continue reading to get the recap.

A Best-Kept Secret in Digital Dentistry

If you already own an iTero—or are evaluating scanners—you likely associate iTero primarily with Invisalign workflows or lab-based restorations. What often goes overlooked is that Align Technology exocad, the same company who owns and operates the Invisalign® and iTero® brands, also owns exocad, allowing them to embed a streamlined version of exocad directly inside the iTero software.

The result is the iTero Design Suite:

• Integrated directly into the iTero platform

• Powered by exocad

• Included at no additional cost

• Designed to support in-house fabrication

Understanding what this software can (and cannot) do is critical, especially if your long-term vision includes chairside or same-day dentistry.

What Exactly Is the iTero Design Suite?

At its core, the iTero Design Suite is a condensed, integrated version of exocad’s core CAD software. While it is not a replacement for a full exocad lab license, it delivers an impressive amount of functionality—especially considering it is free.

To put this into perspective, a traditional exocad setup requires:

• A core license

• Optional add-on modules as workflows expand

• Either a perpetual license or a subscription (Flex) model

That core exocad license typically includes:

• Crowns

• Inlays and onlays

• Veneers

• Night guards / bite splints

• Digital wax-ups

• Basic restorative design tools

The iTero Design Suite mirrors much of this core functionality, making it ideal for practices that want to design restorations internally without investing in a standalone CAD license right away.

What Can You Design with iTero Design Suite?

Within the Design Suite, clinicians can design:

• Crowns

• Inlays & onlays

• Night guards / bite splints

• Smile mockups

• Digital restorations using a virtual articulator

This makes it a powerful tool for general dentists, cosmetic dentists, and practices moving toward same-day or next-day restorations.

Why This Matters for In-House Fabrication

The real power of iTero Design Suite lies in how it connects scanning to fabrication.

Once designs are completed, they can be exported and fabricated using:

• 3D printers (such as SprintRay systems producing restorations in minutes)

• Chairside mills (such as Perfit OVIS)

Whether you’re printing high ceramic-content resins or milling pre-sintered zirconia, the Design Suite allows you to:

• Control your designs

• Reduce lab dependency

• Increase speed and profitability

• Offer more modern, aesthetic solutions to patients

How the Workflow Actually Works

Sending iTero Scans for Design

Design does not happen directly on the iTero cart. Instead:

1. Scans are captured on the iTero

2. Instead of sending the case to a lab, it’s sent to MyiTero.com

3. The clinician logs into MyiTero on any desktop or laptop

4. Cases become accessible for in-house design using the Design Suite

This flexibility allows design to happen anywhere—operatories, offices, or even remotely.

Crown Design: A Step-by-Step Overview

Margin Marking

The workflow begins with margin identification:

• Automatic detection can be used for clear, supragingival margins

• Manual draw and correction tools are available for less ideal cases

• Margins can be fine-tuned node by node for precision

Path of Insertion

The software calculates a path of insertion, which can:

• Be adjusted manually

• Highlight undercuts

• Be reset based on clinician preference

This step is critical for proper seating and long-term success.

Initial Proposal & Pre-Prep Comparison

One of the most powerful features is the ability to:

• Overlay pre-prep scans

• Compare proposed restorations to original tooth anatomy

• Scale, rotate, and refine designs based on real reference data

This allows restorations to remain conservative, aesthetic, and anatomically correct.

Fine-Tuning the Restoration

Design tools allow clinicians to:

• Move the entire tooth bodily

• Adjust specific cusps or surfaces

• Modify mesial, distal, occlusal, or axial contours

• Select from multiple tooth libraries with different characteristics

Once the general shape is approved, finishing tools allow:

• Margin adaptation

• Occlusal refinement

• Contact smoothing

• Occlusion visualization using color mapping

Light blue contact indicators help ensure uniform, balanced occlusion before fabrication.

Exporting for Milling or Printing

Once finalized:

• The restoration is exported as a file

• Sent to a shared folder or network

• Imported directly into a mill or 3D printer

From design to fabrication, the workflow is efficient, repeatable, and fully controlled by the practice.

Night Guard Design Workflow

The video also walks through a full night guard / bite splint workflow.

Tooth Segmentation

• The software guides clinicians through identifying teeth

• Missing teeth are automatically skipped

• Segmentation allows the software to define margins accurately

Automatic Margin Detection

• Margins are detected based on segmentation

• A basic night guard is generated automatically

• Additional tools allow for advanced customization

Using the Virtual Articulator

One standout feature is the virtual articulator, which allows clinicians to:

• Open the bite digitally

• Simulate mandibular movement

• Design splints based on a therapeutic bite position

This is especially useful when:

• Bite records were captured in occlusion

• Leaf gauges or CR records are desired

• Excessive opposing intrusion needs to be corrected

Adjustments can be made in millimeters, and the occlusion updates in real time.

Clinical Customization & Finishing

As with crowns, night guards can be refined by:

• Adding or removing material

• Flattening or smoothing occlusal surfaces

• Adjusting tool strength and brush size

• Customizing for patient-specific functional needs

This transforms the design from a basic appliance into a more clinical, intentional solution.

Why iTero Design Suite Is a Strategic Advantage

The iTero Design Suite isn’t just software—it’s a strategic tool for practices planning their digital future.

It allows clinicians to:

• Start designing in-house without upfront CAD costs

• Learn digital design workflows at their own pace

• Seamlessly integrate scanning, design, and fabrication

• Scale into more advanced systems over time

For practices considering in-house milling or printing—or already there—this software removes a major barrier to entry.

Final Thoughts

As showcased today, the iTero Design Suite is a powerful, often underutilized capability within the iTero ecosystem. By combining a high-quality scanner with built-in, exocad-powered design tools, clinicians gain unprecedented control over restorative workflows—without additional software costs.

As Phil demonstrates, this integrated solution empowers practices to stay modern, efficient, and profitable while delivering high-quality restorations and appliances in-house.

For any practice using—or considering—iTero and in-house fabrication, understanding and leveraging this workflow is no longer optional. It’s the missing link.