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We have always been very concious of production standards, time in motion and scheduling timelines, but recently took a step further, and redesigned our lab to use Lean Manufacturing Practices. We have attempted to break things down into syncronized movements, limited numbers of tools and reducing work in progress. Of course there are all kinds of books on the subject, so it's pointless to try and cover it here, but so far, we have seen improvements in quality and consistency, more on-time delivery and fewer errors.
Eliezer Ganon · CTO at DTG
dtg is the publisher of Technology and VentureBeat a 3d oral health care multimedia online digital magazine, publication, blog and collaboration platform being launched by 1st quarter 2013.
As you are aware, dtg is in the process of assembling a global team of world-renowned clinicians, lab technicians and engineers such as Prof. Francois Duret the "father" and innovator of the 3d digital cad/cam,
dtg will be conducting market research and clinical studies in the 3d cad/cam, additive and subtractive restitution systems, 3d intra oral scanners, 3d desktop scanners, 3d cbct scanners,...See more oral care informatics systems - electronic health record, practice management, lab management, bio-informatics systems - pacs/ris, shade scanners, light curing devices, orthodontics appliances and brackets, sleep apnea appliances, etc.
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Think it's okay to mix and match materials? Think it's okay to not have your FDA GMP's in place? Think it's okay to use FDA controlled materials in a manner that is contraindicated?
The problem as I see it Laura, is that the information is almost obsolete as soon as it's finished. I don't think CAD CAM should be a specialty unto itself, but rather a method by which a technician like myself could take the C&B practical for example.
We have a Lava ST white light scanner, and it is currently sitting in our electrical room gathering dust. There is no doubt white light is more accurate than laser, but it's not anywhere as easy to use, calibrate or maintain as a 3Shape. In my eyes, it's just not worth the hassle.
Is the added accuracy really worth it? Accuracy is a cumulative thing. One scanner is +_10um more than another. Then the mill is +_ 10um more than another. before you know it, you're up to 50um or more difference between another combination. Therefore, I prefer to use a system (or combination of systems) that is fast,...See more easy, well supported, popular and common.
At a more basic level, 110um you can see with the unaided eye, 90um you cant. The tip of a dental probe is 80um. Its will pick up a margin at 90um but not at 70um. The use of a 3Shape scanner, combined with some of our 5 axis mills are capable of 20um accuracy, and that's good enough for MY mouth!
I'm no expert, so hopefully some other people will chime in.
Aaron Hoffman · Co-Owner (I'd rather be in the trenches than a suit) at Sunflower Dental Studio
Lots of new faces on the bridge and it's always great to see the familiar ones as well! I'm sorry to myself for have been missing out. A ton of experienced people with a ton of great conversations, and I'll be trying to go back and read as much of them as possible. I hope my absence has not left me out of the matching tattoos we were thinking about getting. (some reason I couldn't tag you Dan;) — tagged 4 members
Daniel J. O'Rourke, CDT · Owner/President at O'Rourke Dental Studio
Thanks for the CBCT poster. What a game changing tool for the world of dentistry. I mainly use it to read ceph's to determine skeletal discrepancies, and air way volumes and the effect we could have when changing the VDO in a case. It has changed the way I diagnose cases that come into my lab.
Age Discrimination suit. Dental technology is called a "Gray Haired" industry as we have very few young people coming into the field. I think that's going to swing back the other way with all the new technology, and our ability to compete better with off shore labs, and bring the work back stateside. I still think we are going to see more suits like this, and it's prudent to be careful about jokes and fun in the lab. It's all fun and games until some calls a lawyer.
Here is an old article I did for a magazine way back in 2000. It shares parts of our 1998 business plan. Many, many things have changed, and i kind of laughed at what I did 14 years ago, but it gives you a basic idea of who I look at business plans. Hope this helps.
âIf you donât know where you are going, you will probably end up somewhere else.â
Define the task with a business plan.
Too many dental laboratories make business plans only when they have to. Unless a bank or investors want to look at a business plan, there isnât likely to be a plan written at all. How much time...See more do you spend putting out fires? Thatâs a subject that might come up when you sit down and start your business plan.
A business plan will look at where you are, where you have been, where you want to go, and what youâll need to do to get there (including installing fire sprinklers if those fires are keeping you from reaching your goals).
The content and detail of a business plan is largely dependent on the audience for whom the document is prepared, and what you expect them to do. If the plan is primarily for your own use as a means to get a better handle on your laboratory, you can keep things fairly simple. Obviously things will be much more complicated and detailed if your goal is immediate capital from a bank or other institution.
The bibliography at the end of this program will give you some suggestions for help in preparing a number of different business plans depending on the purpose of the plan. For example, you may want a business plan for an existing company, business plan for a new company not yet started, or a regular plan for business review and course direction.
If you canât measure, you canât manage
Once youâve defined your goal, broken it down into manageable pieces, and established a time line for accomplishing them, youâll need measurement tools. A carefully prepared business plan will not only define your objectives, but map out a time line for measuring your progress in reaching those goals.
Following is a copy of my labs 1998 business plan. This is an example of an informal plan used as a business review and for course direction. This document was prepared for internal use, but was also given to a number of respected professionals for their opinions. At the time this document was prepared in November 1997, we were facing a number of challenges for the coming year, however we had an aggressive plan representing 32% growth for 1998. Note how the spreadsheet gave us mileposts to measure our progress, and how the sale objectives reflected typical seasonal fluctuations.
PRECISION CERAMICS 1998 MARKETING PLAN
Established in 1981, Precision Ceramics is a full service dental laboratory dedicated to providing quality products and unmatched customer support to dentists and dental laboratories across the US, and abroad.
Precision Ceramics has suffered from a number of significant events during the past five years. In 1992 our laboratory in Denmark was closed in an abrupt and unexpected manner when we entered into litigation with the Danish labor union and the US Department of commerce. With close to a 50% reduction in business we were forced to implement a number of âlifesavingâ changes, some of which affected morale, profitability and quality.
The departure of one of the founders in 1994 dealt another blow, resulting in further losses of business and profitability. Quality suffered, and sales dropped by another 50% while the remaining owner tended to another business entity. During the period from 1994 through mid 1997 very little was done in the way of marketing or sales, and no price increases were implemented.
With the return of the departed founder in mid 1997, we face the coming year with real leadership and renewed optimism. The past several weeks have been spent remodeling the lab, replacing and repairing equipment and establishing quality standards and procedure manuals. We have readjusted our operating budgets to reflect continued improvements in quality and training, and investments in new technology.
New products to be added next year will be priced at cost, plus 20%, and all new accounts will be brought on board with a price list reflecting a similar philosophy for ALL other products.
Among dentist customers, our strengths are customer service, communication and strong technical support. We are a one-stop dental laboratory providing most of the popular dental products and services, or are in the process of adding them. Our lifetime guaranty is a popular attraction, as are our implant services. Among dentist customers, our weaknesses include average or only slightly above average anterior cosmetics. Consistent quality from our denture department is a problem. Additional training (or more drastic approaches) is planned for these areas.
Among laboratory customers, our strengths are customer service, communication and strong technical support. Additionally, for those laboratory customers interested in our assistance we offer the best marketing and sales support of any business to business laboratory in the country. Good relationships with our vendors, and articles published in journals reinforce our quality and technological position. Our weaknesses include a lack of a second shift to accelerate turn around time which is important to laboratory customers, and managing the wild fluctuations lab work seems to produce. We will be researching ways to improve throughput such as splitting shifts, automation or copy milling.
1998 Sales Goal
Add $343,960 in additional sales by December 31, 1998.
1. Price Increase
2. Add new products (IPS Empress, Targis, possible others)
3. Retain existing clients
4. Acquire and retain new customers
At $67 per unit, our prices are well below market levels in the areas where our clients are concentrated, and in the areas we will be marketing to. Since we have not had a price increase in several years, I believe a well orchestrated increase could add 3.5% (based on a 5% gross increase, some clients excluded) to next years sales without any appreciable loss of current business. ($85,000 per mo +3.5% =$87,975. Difference of $4150 x 12 = $35,700 added to next years sales.) We will also implement a completely new price structure for all new customers, moving us to $90 plus gold and shipping for Ceramco, and $139 for Omega 900 porcelain.
Add New Products
IPS Empress and Targis should bring in the remaining $49,300 by adding just 2.1 units per day (at $90 per unit avg.) to our unit count. This could be work our current customers may be sending out to another laboratory, or bring back customers we may have lost because we are not offering these items. Incremental new business should also follow.
As of the summer 1997 there are NO other laboratories offering IPS Empress or Targis on a sub-contracting basis (according to competitive ads in LMT).
Retain Existing Clients
Efforts to retain existing customers will include regular activity from our sales and service representatives, three issues of our newsletter, Occlusal Concepts, and special holiday gifts and cards.
Our ongoing quality control improvements will be an integral part of our customer retention and satisfaction program.
Add New Clients
We will need to pick up the balance of additional sales ($255,015) through new clients. Having this forecast in mind, we can calculate the number of new customers we will need to reach our sales goal. We used conservative numbers, such as an average account size of $750 per month to come up with this number. In reality, the top 20% of our customers average more than $2000 per month. (Since the list we purchased from D&B is based on the profile of our top customers, we could expect them to have similar sales.)
Based on information gathered from Dun &Bradstreetâs business services group, and through other research, we can expect a .5% response to a single mailing to a prospect list. This return jumps to 3% by the third mailing, and can pull as high as 5% when combined with telemarketing. We have purchased 6678 names and addresses of highly qualified leads in desirable market areas.
Our plan is based on a rotation of the mailing list whereby we send one half of the list a direct mail piece with an integral reply card. Each half of the list will receive the same piece three times, and then receive a second, different piece three times. Additionally, they will each receive a copy of our newsletter three times during the year. Each prospect will be hit a total of nine times.
A five percent return on 6678 would give us 333.9 new leads. If half of these try us out, and half of them "stick", we have more than our 68 new accounts for necessary growth. The results of a campaign probably will not take affect until Q2, however a price increase and some new products will produce some immediate sales. Please note that the PCDL Sales Analysis reflects a very slow growth curve in Q1, with no new customer activity until the beginning of Q2.
ï£ 2000 Mark Jackson
NADL Meets with U.S. Food and Drug Administration.
On May 1st, a contingent of eight representatives from the dental laboratory industry (appointed by NADL) met with fourteen officials and staff from the U.S. Food and Drug Administration (FDA) at their headquarters in Silver Spring, Maryland.
This meeting was the result of interaction that has taken place between the NADL and FDA since January of this year relative to a number of issues in terms of new technology (materials and equipment), process changes in the industry and enforcement.
The FDA brought personnel from different...See more divisions of the agency to the meeting including key staff from the Office of Device Evaluation; Dental Devices Branch;Division of Anesthesiology, General Hospital, Infection Control and Dental Devices; Office of Chief Counsel and Office of Regulatory Affairs and Compliance/Enforcement Division.
Effectively, the FDA is evaluating current aspects of how dental laboratories manufacture dental devices. As the dental laboratory industry evolves in terms of using new materials and equipment, the agencyâs perspective on what elements of federal regulations apply to our constituents is changing.
A number of topics rose to the top in terms of potential FDA action:
The FDA has questions/concerns on what tasks dental laboratories are actually performing related to implant abutments (both the design element and milling). The key concern is what protocols are in place when a dental laboratory can ask an implant manufacturer for an override on built in software thresholds for angulation.
There are a couple of options for FDA to consider. One is to look at whether or not dental laboratories would have to have a pre market 510k approval for conducting such processes or two, provide some specific guidance on how these tasks should be performed. Itâs more likely that a guidance document would be released rather than requiring dental laboratories to seek 510 approval. That would be an expensive proposition for most dental laboratories to undergo and it was mutually agreed that for an industry of our size and make up that this option would be overkill and not necessary.
FDA is reviewing the âbrandedâ products that dental laboratories market to dentists. When a dental laboratory brands a product such as âXYZ Crownâ or âABC nightguardsâ technically, a laboratory should register this product with FDA under its name since by branding it under the laboratoryâs name could be considered that the device is adulterated if the device is manufactured based on a manufacturers 510k market approval.
NADL and FDA held considerable discussion on enforcement both in terms of inspections and un-registered activity or mislabeling. Both parties came to some agreement on the best way for the agency to enforce existing regulations rather than seek additional oversight authority. FDA is interested in exerting its authority on dental laboratories that are not following registration and listing and labeling requirements when they are importing dental restorations.
On another element of enforcement, NADL will be developing some tutorial documents for the FDA so that they can use these resources to assist agency inspectors when they visit dental laboratories so the inspector knows what types of dental devices and processes are present in a laboratory. In many cases, those dental laboratories that have had inspections from FDA in the past, have vastly different experiences. For example, some inspectors go beyond what is required based on a dental laboratory environment, thinking they are a raw material or equipment manufacturer.
In terms of enforcement, NADL stressed that dental offices that have in house laboratories, under the federal regulations are defined in the same manner as a commercial dental laboratory. The fact that a dentist is on site should have no impact, as dental devices are being manufactured in both settings.
NADLâs Board of Directors will be reviewing next steps to best serve its memberâs interests on this important subject. FDA is seeking further input from NADL during the summer so that it can outline an action plan for any future guidance it may deem necessary to publish.
Â© Copyright 2012, National Association of Dental Laboratories, NADL
Driving traffic to The Bridge....
I wish we saw more faces here on this forum. It's a fantastic resource, but not enough people post. I feel like the loud mouth at the party. I used to go to DentalTown a lot, but the forum moderators edit posts and pick and choose what they want people to say, and the place is overrun with Cerec doctors who are "passive aggressive lab haters'". Dental Lab Network is full of posts about how to re-press used emax ingots, crack (hack) dongles and cheat the manufacturers out of money. I just can't support a community that allows and condones that. I suppose it's better...See more to NOT moderate that stuff like DentalTown would, but nobody speaks up against this activity either (except me). Illegal, immoral or what have you, it's terrible. Let's spread the word to our friends and see if we can't get The Bridge more active.
Dental Lab in the News. Little stories like this are great for public awareness. Call your local paper and see if they'd be interested in doing a story about you. You may end up with a nice bit of coverage and some new business to boot!