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.
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.
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.
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.
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
Design does not happen directly on the iTero cart. Instead:
Scans are captured on the iTero
Instead of sending the case to a lab, it’s sent to MyiTero.com
The clinician logs into MyiTero on any desktop or laptop
Cases become accessible for in-house design using the Design Suite
This flexibility allows design to happen anywhere—operatories, offices, or even remotely.
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
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.
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.
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.
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.
The video also walks through a full night guard / bite splint workflow.
The software guides clinicians through identifying teeth
Missing teeth are automatically skipped
Segmentation allows the software to define margins accurately
Margins are detected based on segmentation
A basic night guard is generated automatically
Additional tools allow for advanced customization
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.
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.
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.
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.