January 5, 2010
Last week I went over some of the capabilities of our new Origin Pro Duo 5000 milling machine including its ability to mill Titanium. I was excited about the possibilities for the following reasons -
- Titanium is one of the most bio-compatible metals available (proven for implants)
- ADA classified material, Medical Grade 5 Titanium
- 10 micron knife edge margin right off the machine
- No more metal casting problems – i.e. short margin, rocking, distortion, soldering, etc
- Ideal CAD/CAM substitute for base metal and noble metal
- Single crowns to 16-unit bridges
- ADA has placed Titanium between High Noble and Noble alloys in the revised classification
because of its excellent biocompatibility
- Major insurance companies cover Titanium prosthetics at higher allowance than even noble metal
One hitch was that I had always heard that the veneering ceramics available for Titanium were not exactly aesthetically-pleasing. B&D Products was kind enough to provide us with a sample kit of their TriCeram porcelain, and a few titanium copings on which to practice. Here’s a look at our first effort -
PFT with Triceram Ceramic
This is a very simple body/incisal build-up, but it is enough to tell the shade out of the bottle is pretty good, and the ceramic stacks, fires and glazes nicely. We plan on doing some practical cases in the near future – Look for updates!
December 30, 2009
Spent yesterday with the folks from B&D Dental going over the CAM software to run the Origin ProDuo 5000 – a Wet/Dry system featuring 5-axis milling. I’m pretty jacked about the possibilities.
First, we will be able to bring our zirconia coping production in-house at significant cost savings, a significant portion of which we plan on passing along to our clients. Of course, this new capability also extends to the milling of full contour zirconia crowns, which is becoming more and more popular everyday.
Second, because the 5000 can handle alloys – Titanium (Grade 5) and Chrome Cobalt (Predominantly-base or “Non-Precious”) – we expect to begin offering PFMs featuring milled copings and frameworks in the very near future (I want to get thoroughly acquainted with the TriCeram veneering ceramic before we go into production). I also see the possibility of offering Titanium “Full Milled” Crowns, as an alternative to our fullcast restorations. The ADA classifies Titanium between Noble and High Noble alloys, and many of the top dental insurance programs recompense for Ti restorations at a higher rate than those cast with noble alloys.
Lastly, the 5000 features an innovative jig which holds up to eight e.Max CAD blocks or Vitablocs. We’ve milled these materials in the past using our Cerec InLab machine, but I was never satisfied with the results. Although the 5000 is significantly slower than the InLab when it comes to milling these materials (appx. 25m versus 12m) I believe the improved accuracy of the final mills will be worth the wait.
Give me a couple of days to get everything in order, and I will start posting reviews and pics of our results. Until then – Happy New Year!
December 24, 2009
We’re working an abbreviated schedule today, and then we are closed for the week between Christmas and New Year’s. I have meetings scheduled for Monday with two hotels regarding Dr. Bob Lamb’s April 16th seminar; and will be in the office on Tuesday and Wednesday for the installation of our Origin 5-axis Milling Machine. Given that its supposed to be vacation time, I’m not sure how excited the little woman would be if I also take time to write posts during our week off.
So… in case I can’t sneak away to post, let me wish everyone a great Holiday Season, and a Happy and Prosperous New Year. Thanks for visiting our blog!
December 23, 2009
It pains me to give up on anything. However, after much consideration, I have decided to withdraw from providing Lava COS margin marking services for other laboratories. I made the decision to focus my time and attention on other processes which offer a higher earnings potential. At an average time to mark a margin – including Downloading / Marking / Communicating with Brontes or the Doctor if something didn’t look right / Invoicing – at roughly 15-20 minutes, a fee of $8 just isn’t worth it.
Could you train someone to do this service and pay them on a piece work basis? I suppose. My problem with that scenario comes from my own experience. I’ve been doing this for 25 years, and some of the preparations and scans we received in the short time we offered this service really had me guessing. I had to send a large percentage of the files back to Brontes to be cleaned up, or email the doctor to review a scanned image. I’m not sure a trainee would have noticed some of the little nuances in the process that I picked up on (not saying I’m perfect, just experienced in spotting imperfections). That being said, I felt a high level of pressure to “get it right” - mis-marking a margin could mean a remake for the restoring laboratory. I can’t reconcile the level of responsibility and time involved with the compensation.
I would like to thank those laboratories and doctors who trusted me to provide these services for the past few months, and wish them all the best.
December 20, 2009
Last week I posted about a case we are doing on which the patient is demanding an all-ceramic solution – which I promised without seeing the case – and one of the abutment teeth was too long to be milled with Lava. As earlier noted, I called WhipMix and they stated that they could do the job.
Well, they did (Not without a couple of miscues, but they kept at it which is something you have to admire!) Here is a photo of the framework…
Great job, Guys! Thanks!
In unrelated news, I have spent the last two hours of my Sunday morning marking margins on about a dozen Lava COS cases. (Should have gotten to it on Friday (Didn’t think a 3-hour dental appointment followed by painkillers was the right kind of “warm-up” for accuracy) or Saturday (DC Area got covered up by 20″ of snow!).
All I can say is “TISSUE MANAGEMENT!”
Digital Impression Technology is not magic. If you have blood and saliva all over the place, DON’T BOTHER TAKING THE SCAN!!! The camera is not endowed with super powers that enables it to read your margins through fluids or tissue that has not been adequately retracted.
That being said, I still think, if done properly, digital impressions are better than conventional impressions. We continue to enjoy an incredibly low remake rate on COS and Cadent cases, and our doctors using those systems report a significant reduction in chairtime related to more accurate fit, proximal contacts and occlusion.
Lastly, we are just a little over a week away from installation of our Origin 5-axis milling machine. I’m excited because we will be able to bring the fabrication of our zirconia copings in-house. Plus, we’ll be able to offer a wider variety of restorative solutions. The folks at B&D Dental are providing us with a trial kit of their TriCeram porcelain which can be used on both zirconia and titanium. I have my fingers crossed. If the ceramic looks good, we will be offering porcelain-fused-to-titanium restoration early next year…
