Not a Simple Answer
When our clinic started looking at digital workflows seriously, the first question wasn't about CBCT scanners or intraoral scanners. It was: Do we buy into one ecosystem, or do we piece things together?
The easy answer—buying everything from Dentsply Sirona—felt too expensive on paper. The harder answer—mixing brands for 'better' specs—felt risky. My job was to figure out which gut feeling was wrong.
This isn't a review. It's a breakdown of costs I tracked over 18 months, covering about 40 equipment orders for our mid-sized clinic. If your situation is different (say, a single-chair startup or a large DSO), your numbers will shift. That's fine. I'll help you figure out where you fit.
Scenario A: The All-in Ecosystem (Dentsply Sirona)
This is the path we almost didn't take. The quote from our Dentsply Sirona rep was higher than the mixed-vendor alternatives we pieced together from 3Shape, Planmeca, and a local distributor. Higher by about 22% on sticker price.
But here's what almost got me: the hidden costs of NOT going all-in.
The Value of DS Core Interoperability
We have a Primescan intraoral scanner, a Cercon milling machine, and a Sirona CBCT. The DS Core cloud platform is the glue. When a scan goes from the Primescan to the milling unit, it just works. There's no file conversion, no 'this file is too large' error, no waiting for a technician to resize or re-export. That 'just works' factor isn't cheap on paper, but it's brutally expensive when it's missing.
I compared our workflow to a colleague's who uses a 3Shape scanner with a Roland mill, managed through a third-party platform. On a good day, their turnaround was 4 hours faster. On a bad day (about 30% of the time), they'd spend an extra 2 hours troubleshooting compatibility issues.
The difference? For us, a single crown from scan to mill takes about 45 minutes of active chairside and lab time. For them, it averages 1.5 hours. That's 45 minutes of billable time lost per case. At 15 cases a week, that's 11 hours of lost productivity. At $150/hour, that's $1,650 a week. That 'cheaper' setup was costing them $85,800 annually in lost time.
(Note to self: This assumes the cases are simple. Complex implant cases are a different story entirely, and I'll cover that next.)
When the All-in Option Wins
- High-volume clinics where minutes matter
- Clinics with existing Sirona equipment (the upgrade path is smoother)
- Teams that want a single point of support when something breaks
Scenario B: The Best-of-Breed Mix
This is the route I was leaning toward for the first six months of our planning. On paper, you can get a 'better' intraoral scanner (like Primescan meets Medit), a 'better' CBCT (like Planmeca), and pair it with a Dentsply Sirona milling unit. You get the best hardware specs, arguably.
Real Costs I Tracked
The Dentsply Sirona quote for a package (Primescan + CBCT + milling + DS Core) was $245,000 delivered. The mixed-vendor quote (Medit scanner + Planmeca CBCT + Cercon mill + third-party software) was $198,000. I was ready to sign for the $198K until I calculated total cost of ownership (TCO).
Year 1: Mixed vendor saved $47K upfront. But we spent $6,000 on third-party software licenses, $4,500 on integration consulting to get the scanner and CBCT talking to the mill, and had two service calls ($1,200 total) due to incompatibility issues. Net savings: ~$35K.
Year 2: The third-party software platform increased its annual fee by 20%. The Dentsply Sirona ecosystem had zero unexpected fees. The mixed setup also required a different technician for the CBCT vs. the scanner vs. the mill. That meant scheduling headaches. The all-in setup had one support number.
By year 3, the mixed setup had cost us more in time and support than the upfront savings.
When Mixing Works
- Specialized labs that need specific hardware (e.g., 5-axis mills not offered by Dentsply Sirona)
- Clinics with existing equipment from a specific vendor (building around that is cheaper than replacing)
- Teams with in-house IT support to manage integrations
Scenario C: The Hybrid Approach (My Recommendation)
After our experience, I'd recommend this: go all-in with Dentsply Sirona for your core clinical workflow (scanner, mill, CBCT, DS Core). For peripheral items—dental chairs, handpieces, infection control—you can mix and match more freely. The cost savings there are real, and the risk of incompatibility is low.
For example, we kept our old A-dec chairs and bought new Sirona handpieces (because the ergonomics were better). The chairs had no impact on the digital workflow. We saved about $18,000 by not replacing them.
But we absolutely did not mix the scanner and CBCT with a different software platform. The DS Core integration is not just a 'nice to have'—it's the thing that makes the upfront investment pay off. (I really should write a separate post on DS Core's billing model; it's complex but fair.)
How to Decide Which Scenario You're In
Ask yourself these three questions:
- How many scanners/units do you process per week? Above 20, go ecosystem. Below 10, you can mix without much pain.
- Do you have in-house IT? Yes? Mixing is more viable. No? Go all-in—support calls are simpler.
- What's your growth plan? If you're expanding to multiple chairs or a second location, ecosystem standardization saves thousands in training and troubleshooting. If you're a single-chair clinic staying that way, mixing might give you better specs for less.
There's no perfect answer. But there is a wrong one—and it's usually the one that ignores the time your team spends fighting with interoperability. That time is a cost. A real one. Don't ignore it.
