My experience using open software in a closed system

April 5, 2022

Dr. Kunal Lal could be described as an exocad superuser. The New York City-based prosthodontist employs DentalCAD, ChairsideCAD and exoplan with impressive dexterity in his dental practice. But the Columbia University-trained doctor and researcher wasn’t always able to include CAD software solutions in his workflow. “I was stuck in a closed system for a few years,” Kunal says. “I kept getting frustrated and running into walls. That's when I thought to expand and broaden my horizons with other software. Once I started using exocad, it was a no-brainer. It was so intuitive, and I was able to adopt it and implement it in a short timeframe.”

Kunal took a few minutes before starting the day at his busy NYC practice to share thoughts on how to create stress-free digital workflows.

Q: You’ve worked in the dental field for more than two decades. How have you seen the industry change within that time? Especially regarding technology?

A: My master's thesis at Columbia University in 1999 was on using stereolithographic surgical guides for implant placement. We did our first case at Columbia in 2000 where we used rapid prototyping and additive manufacturing. Right now, everyone's talking about it. But in 1999, it was groundbreaking. Over the years, it's been a real treat for me to watch the field evolve. I really feel passionate about it, and I don't consider it work. Every day, I'm eager to go and learn something new and do better.

Q: What excites you about the technical capabilities in dentistry?

A: The goal ultimately is to have the best patient experience and to deliver the highest standard of dental care to my patients. Advanced software and CAM systems have allowed me to do that. I can say very clearly that we've evolved so much from where we started to where we are right now. The quality of the crowns, bridges, and implants is just so much better from the perspective of fit, esthetics and function.

Q: What exocad products would you say that you're using the most right now?

A: I use DentalCAD 3.0 Galway, exoplan 3.0 Galway and I'm starting to also use ChairsideCAD 3.0 Galway. Those are primarily the three that I use. I got the DentalCAD Ultimate Bundle, so I can do dentures, nightguards and incorporate facial scans. I'm excited to learn about jaw motion files and how this will improve function. I still have a way to go, but I'm plugging away at educating myself. With exocad, I've also become more familiar with dentalshare, and I love it. It allows me to work with master technicians all over the world.

Q: Do you involve patients in the planning? Do they see what you’re doing with the software or is it more behind the scenes?

A: It varies. Some patients, they say, ‘just tell me when it's over,’ and then some are very interested. I am a very visual person. So even when I'm in the operatory, I have large screen monitors all around me. As I'm scanning their mouths and manipulating the data, the patients can see it, and they're interested. The reactions vary from ‘my teeth look like toes’ to ‘wow, that's what my teeth really look like?’

Q: Can you explain a bit more about how you’re using exocad within closed systems? I think that’s something a lot of people would be interested in learning about. And you’re running a course on that too, right?

A: I'm doing a two-day course at my office in New York City. Both days will offer the same curriculum that reviews my workflow where I incorporate a lot of different hardware and software. I was struggling with the software that I was using. By incorporating exocad into what I already have, it’s really been a game changer for me. The first step is data acquisition. I use a Primescan, which is one of the best scanners on the market. Then I use that data and bring it into exocad, and I do all my designs there. I then bring the design files back into my Sirona MC XL and MC X5, which is a five-axis mill, and I manufacture the exocad designs on those machines. It took me a while to figure out how to do all that. I'm sure that there are people with the same hardware that I have who are dealing with those same initial frustrations. I want to provide an opportunity for those people to learn how I figured things out and to see if it works for them.

Dr. Lal’s five tips to get started in digital:

  • Keep an open mind. Don't get locked into just one company’s system. Doctors usually get their first exposure to software and hardware at conventions, and a lot of the people that are showing them are working for companies that focus on just one kind of system. The doctor then signs up and is kind of stuck with it.
  • Get educated. Go to as many seminars as possible and don't restrict yourself to one source of education. Listen to everyone and then make your own decision on which way you want to proceed.
  • Open is key. Choose systems that allow you to interact with different software, different hardware.
  • Start with software. After data acquisition, software is the next critical piece of the digital puzzle. The software should allow the user to design even difficult cases with intuitive ease.
  • Take it one day at a time. Don’t try to become a master from day one. Start out with the basic software. Learn how to do the easy stuff. Then add modules as you get more comfortable and expand your capabilities.

Q: Now I've got some fun questions for you. Flossing morning or evening?

A: I will typically floss after every meal, but I advise patients to floss at least twice a day.

Q: Do you have a favorite tooth?

A: Central incisor. Maxillary.

Q: Favorite one-day getaway?

A: Coney Island in the summer.

Q: If you could give advice to your younger self, what would it be?

A: I would encourage myself to be less tentative about doing certain things and take the leap. I tend to think things through for a while before I make decisions. In some ways, that helped me, and in some ways, it slowed me down. If you believe in something, just go for it.

Q: If you could describe exocad in one word, what would that be?  

A: Game changer.

Dr. Kunal Lal graduated from dental school in 1996, followed by his master’s degree in Prosthodontics from Columbia University in 2002. Upon graduation, he continued to teach at Columbia University Medical Center. After becoming a Diplomate of the American Board of Prosthodontics, Dr. Lal was appointed the Program Director for Post Graduate Prosthodontics at Columbia University College of Dental Medicine.  As part of that position, Dr. Lal served on numerous administrative committees at the School and University level.  He supervised a team of over 20 dentists working and teaching in the division of prosthodontics. He has authored articles on the use of computer-generated surgical templates for prosthodontic and surgical implant planning and placement. He has extensive experience in the treatment of partially and completely edentulous patients using dental implants. He has lectured Nationally on implant, esthetic and reconstructive dentistry with a primary focus on computer-guided implant surgery combined with various immediate loading protocols.

by Caitlan Reeg
Writer at exocad

Caitlan Reeg spends her days telling the world about the innovations her colleagues create. She’s passionate about healthcare, technology, and the ways the two interact to improve our lives. A former journalist, Caitlan has worked on staff at Dow Jones Newswires in Frankfurt and at the national public radio program Marketplace in Los Angeles.