It is okay if you do not have an intra-oral scanner or a 3D printer. The app can adapt to your workflow. 

1. If you do not have an intra-oral scanner, you can do the following. Take an impression of your patient and send it to the lab. You may ask the lab to scan the impression for you and generate an STL file extension. This file extension can be emailed to you and imported into the app. 

Side note: If you need more assistance important the IO-scan into the app, please refer to this article How Do I Upload My Intraoral Scan Into the App?

2. If you do not have a 3D printer, you can export the file to your local lab for printing. Once you have completed your design, you will be able to export it, and you can email the file to your lab so that they can print the design for you. For more assistance on how to exporting your project, please refer to this article, How to get my 3D project printed?