Designing with concrete is no different than designing with aluminum. You create a protrusion and go. The only reason designing with concrete may be different is because you do not have a homogeneous-throughout material. There is a lot of cement with various sizes of aggregate. If I were to machine concrete, I have to know my speeds and feeds for cement, large stone aggregate, small stone aggregate, and where exactly those materials lie in relation to my cutting surface so I can adjust the mill or lathe as necessary.
Take it one step further, how do I easily model concrete with rebar? That is the same problem as doing a long fiber material in an epoxy matrix. If I need to easily place aggregate particles in a cement binder arbitrarily in a confined space, how is that different than placing atoms at specific location of a crystalline structure? Sure, the scale changes because of their relative sizes, but MCAD doesn't really care about size. Just zoom in and out of your screen to know what I mean. Change the units of a model to know what I mean. The same techniques will be used to model either, just the dimensions will change.
To give you a personal example of solid/binder stuff.
I have a warhead (my day job) filled with Octol. Octol is made of TNT (a wax) and HMX (a crystal). At varying concentrations of each, what dispersion of HMX crystals (solid) do I have in the TNT (binder)?
Sure, there are mathematical models out there for me to assume a average spherical size for the crystaline HMX and determine the number of crystals are within a certain volume based on a particular packing efficiency, but it would sure be nice to visualize that.