June 28, 2010
Last Thursday, I had the pleasure of my initial consultation with Alan Barnes of the The Barnes Group which was established in 1997 as a think tank and technical consortium for independently-owned dental laboratories (I have not – I repeat – I have not sold the business!) focusing on meeting the challenges of our ever-changing industry.
As a member, we receive a host of benefits including access to exciting new techniques and products which will help our clients improve their efficiency and profitability, including Sleep Medicine Appliances; the CUP™ Technique for completing crowns under partials without having to provide the patient’s existing RPD to the laboratory, and a revolutionary digital impression system that will soon be available at a low monthly fee.
Alan and his staff will also be providing us with marketing support, financial analysis as well as short- and long-term strategic planning. Member laboratories meet three times a year to discuss industry issues where we can expect to get fresh ideas regarding the day-t0-day management of a modern dental laboratory. As I have never been much of a “joiner” – more of a lone wolf – I’m excited as to the prospects of our involvement in the Barnes Group, and hope that I can bring something to the table for the other members.
Progress updates to follow…
June 24, 2010
While attending the Cerec meeting this past weekend, it was brought up that Ivoclar has been working on a way to combine a zirconia coping with an e.Max overlay. Evidently, there are sufficient challenges to pressing lithium disilicate to zirconia that the alternative process of bonding the two substances together holds more promise. At the Cerec meeting, we were told that there was a new study coming out of Boston which indicated Ivoclar’s MultiLink Cement was capable of bonding an e.Max crown over a zirconia coping. There was also mention that Ivoclar was working on a bonder material that could be used to fuse the two materials together in a porcelain furnace, similar to the Lava DVS process.
This type of restoration would be nice to have in your armamentarium. For example, if you were completing an anterior case and one of the preps had been endodontically treated creating a dark stumpf, you could use a e.Max restoration with a thin zirconia coping to help mask the tooth structure, and then do the remaining units with unsupported e.Max. Sure, its similar to any of the Press-to-Zirconia products on the market, except that the e.Max Press material is about twice as strong as those other materials in terms of flexural strength.
If Ivoclar’s plans prove successful, I would see no reason to get involved with Lava DVS. If I hear anything definitive, I will let you know.
June 23, 2010
Here’s a link to a study done by Wieland on their brand of zirconia with regards to the wear of zirconia against opposing natural dentition. I can’t speak to any special processing that Wieland does that would make their zirconia much different from other products on the market, so I can’t say for sure that this data could be used to support all full contour zirconia restorations, like our CrownZilla. However, if its a yytrium-stablized zirconia it seems one could draw a similar conclusion…
http://www.box.net/shared/5ra6qj87pg
Seems a little polishing, and you’re good to go!
June 22, 2010
Received this email this morning (in part) -
“We are pleased to announce the availability of Atlantis™ Abutments in titanium, gold-shaded titanium and zirconia (white and shaded) for the following Dentsply Friadent implants:
- XiVE S 3.0*, 3.4, 3.8, 4.5 and 5.5
- Frialit 3.4, 3.8, 4.5, and 5.5
*not available in zirconia”
June 21, 2010
We started by reviewing the processes for using Cerec Connect for both the dentist and the laboratory. Again, I feel the use of the system is pretty straight-forward. There are a few minor idiosyncrasies related to the tracking of the order numbers, but nothing that should discourage any potential users.
Next on the agenda was a review of the lab scanning processes for both the Blue and Red Cams. Again, nothing earth-shattering. I did find it interesting that our instructor stated, unequivocally, that one should never force the stitching of the various images. In other words, if the software won’t perform the stitching automatically, there is something wrong with your scan. Its evidently a bad idea to override the software and drag the offending image into place. Whether this is common knowledge for more experienced Cerec users, I don’t know. All I can say, is no one ever previously made an issue out of it to me.
After lunch, we had our first look at the new v3.8 software with Biometrics. It was interesting, but not quite the revolutionary advancement I had been expecting. If I am correct, Biometrics replaces Dental Database and uses the surrounding dentition to create the software’s initial proposal. One can also select a particular tooth from the scanned imagery as a basis for proposal. We were shown three cases – a bicuspid, a lateral, and two centrals. The neighboring anatomy around the bicuspid was sufficiently bland that it was difficult to get a real feel for how well the software worked with respect to posterior morphology. The lateral proposal was pretty good, requiring only some minor tweaking to get a nice result. The two centrals demonstrated a new wrinkle, and a flaw that surprisingly was not addressed in this update.
As the case was scanned without a pre-op or diagnostic wax-up, the designer was reliant on the BioMetric software. He started with #8. This sequence demonstrated a weakness in the software. Because the data the software used to analyze the surrounding dentition included the prep form of #9 rather than the full contour image, the software read the mesial surface of the preparation of #9 as the mesial surface of a full contour central resulting in an overextended mesial surface for #8. Not a huge deal, as the designer could easily use the Scale tool to correct the proposal.
The flaw that I would like to see corrected is the absence of a scaled grid overlaying the scanned images. It would have been very easy to position the images of the two preparations with respect to the grid to identify the midline. Instead, the instructor used the Distance tool to measure the distance between the mesial surfaces of the laterals. He struggled a little to place the endpoints of the Distance measuring tool correctly – the grid(something available on 3Shape) would have been simple and fast.
The new wrinkle enabled by the BioMetric software is that one now has two tools available to match the proposal for #9 to that of # 8. It is still possible to use Correlation and mirror-image the likeness of #8. Or, one can simply have the BioMetric software analyze the surrounding dentition – including the proposal for #8 – and determine the appropriate contour. I like this second approach. I know about bilateral symmetry, but in my observations, its rare, -if it exists at all – in natural teeth. By allowing the software to determine the contour using input from the surrounding teeth, I think you will get subtle differences that will help create a more natural smile.
Finally, the instructors gave a very good explanation of all the parameters available to the designer, and how to go about setting them to achieve the best results for your clients. It was stressed that one can’t really simply copy parameters from someone else, as there are always differences in processes, i.e., stone expansion, degree of powdering, individual doctor’s preferences, etc…
This week is going to be busy due to vacations. I’m hopeful of using the knowledge gained to fine-tune my Cerec results in the near future, and will share the results at a later date.
