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The female patient was previously restored with less than ideal esthetic and functional results. In pre-planning the case, Dr. Jim Fondriest, Lake Forest, IL, and I intended to use IPS e.max lithium disilicate restorations. But when the old restorations were removed, we found the canine preps to be very dark so we switched to zirconia-based restorations on teeth #6 and #11 to cover the dark color and used HT e.max for the rest of the teeth.
To maximize strength, I used a full contour design with very thin enamel layering ceramic on the facial surface only. Fortunately, the...
- November 2013
DENTAL TEAM: Scott Atkin, Creative Dental Laboratory and Dr. Michael Foley, both in Scottsdale, AZ
RESTORATIVE PROBLEM: A 79-year-old male patient with an existing PFM full mouth rehab needed a classic A3 shade replacement bridge for teeth #11 through #15.
TREATMENT PLAN: A five-unit Crystal Diamond full contour bridge was prescribed....
DENTAL TEAM: Ken Upright, Oxford Crown & Bridge, LLC and Dr. Shelley Olson, DDS, FICD, Granville Family Dentistry, both in Oxford, NC
RESTORATIVE PROBLEM: A female patient fractured the entire facial surface and buccal cusp of tooth #4, which had an old MOD amalgam restoration. Due to a 2mm diastema, the entire mesial aspect of the crown...
DENTAL TEAM: Gyu Cho, CDT, 3D BioCAD Milling Center, Renton, WA and Dr. Ronald Bryant, Seattle
RESTORATIVE PROBLEM: The patient presented with severe occlusal wear on his natural teeth; the lower anterior teeth were also very crooked and discolored. The existing crowns also exhibited wear, tissue retraction, dark margins and uneven shades...
DENTAL TEAM: Cindy Vuong and Dr. Michael DiTolla, both of Glidewell Laboratories, Newport Beach, CA
RESTORATIVE PROBLEM: The patient presented with a pre-existing discolored PFM restoration on tooth #8.
TREATMENT PLAN: Dr. DiTolla prescribed a full contour BruxZir® crown, and decided to take the opportunity to test the translucency...
DENTAL TEAM: Manfred Pörnbacher and Clemens Schwerin, Dentallabor Steger, Brunico, Italy and Dr. Lyndon Cooper, Professor and Chair at the University of North Carolina, School of Dentistry, Department of Prosthodontics
RESTORATIVE PROBLEM: A young female patient lost teeth #7 through #14 in a car accident and was already wearing a provisional...
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DENTAL TEAM: Dr. William Roddy and in-house technician Steve Coles, Flow Laboratory, Fort Worth, TX
RESTORATIVE PROBLEM: A 62-year-old female presented with implants on teeth #3, #4 and #5 and a PFM bridge placed by another dentist. The implants had been placed too far buccally and the patient was unhappy with the esthetics and thickness...
DENTAL TEAM: Scott Gallacher, Precision Milling Center, West Valley City, UT, and Steven Barker, DDS, Salt Lake City, UT
RESTORATIVE PROBLEM: The patient was missing a second bicuspid (#12), didn't want an implant crown and was also concerned about the reduction of the adjacent healthy teeth.
TREATMENT PLAN: To address the patient's desire...
DENTAL TEAM: Sven Jesse, Jesse & Frichtel Dental Labs and Dr. Edward Narcisi, DMD, both of Pittsburgh, PA
RESTORATIVE PROBLEM: The patient—the wife of one of the laboratory owners--had an existing all-ceramic restoration on tooth #30 that cracked (she had previously had a PFM crown that also chipped).
TREATMENT PLAN: Since functionality...
DENTAL TEAM: Janet Jones, CDT, Technical Consultant, Ivoclar Vivadent and Jenny Sy-Munoz, DDS, MSD, University at Buffalo, Buffalo, NY
RESTORATIVE PROBLEM: A 36-year-old patient presented with a request to have teeth #30 and #31 restored as recommended by his general dentist. These molars had existing large pin-retained amalgam buildups that...
DENTAL TEAM: Kazunobu Yamada, RDT, Cusp Dental Supply Co., Ltd., Nagoya, Japan and Dr. Yoshihiko Mutobe, Mutobe Dental Clinic, Osaka, Japan
RESTORATIVE PROBLEM: The patient had a full cast crown on tooth #30 but wanted a more esthetic appearance.
TREATMENT PLAN: The dental team opted for a full contour zirconia restoration using the new...
- June 2012
In the early to mid-90s, enrollment in the dental technology department at Kirkwood Community College (KCC) was so low there was talk of shutting its doors. Today, those doors are still open and stay open even later thanks to growing enrollment numbers.
KCC —one of only 19 ADA-accredited programs left in the country — had always limited the program to 15 students due to lack of space but, three years ago, the program's waiting list grew to the point where the school could justify adding an evening program. Currently, there are 24 full-time students: 15 during the day and nine in the...
- April 2012
The CAD/CAM software, equipment and materials market continues to flourish and several new players were first-time exhibitors at LAB DAY, including:
Creo Dental System launched the Arum5X Milling Machine. This five-axis wet milling unit is compatible with any scanner and features a nine-unit revolving dispenser, a tool breakage sensor and...
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- March 2012
"You can't survive by doing the same thing you did five years ago. In this industry, we're in a time of change. Things are moving extremely quickly and a lot of factors are hitting us at the same time. There are challenges, but also opportunities," said Tais Clausen, 3Shape's CTO and Co-Founder, during his presentation, Vision of the U.S. Laboratory Market, at the NADL's Vision 21 meeting last month in Las Vegas.
What are the challenges in today's market? You know them all too well: a depressed economy, keeping pace with new technology, dentist-clients who are business driven rather than loyal...
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- February 2012
- LMT Communications, Inc. · Faster, Smarter, Better: 36 Strategies to Boost Your Business · Digital Dentistry · Feb 2012
Problem: I'd like to purchase a complete CAD/CAM system, but I've heard a lot of lab owners get burned by high material costs.
Strategy: When doing your research, find out if there's a set number of units you can mill from one block or if you can "nest" units, allowing you to optimize the number of units you can fabricate from one block, reducing your material costs.
Also find out if the manufacturer allows you to buy materials from any source; this can help keep material costs down. For example, when David Nunnally, Owner of Derby Dental Lab in Louisville, KY, switched from a system that required...
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- April 2011
Once you've selected a CAD/CAM scanner or milling system, phase two is implementing the equipment into production and training your technicians.
When an experienced technician is handling scanning and design and you're working with ideal preps, introducing a stand-alone scanner can be fairly straightforward. Manufacturers have made improvements to their software, decreasing training time, and a technician can usually master simple copings within a few days, while more complex cases like bridges or Hader bars take longer. The key is to select a technician who is computer oriented and can visualize...
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The advent of CAD/CAM technology and other significant advances continue to boost confidence in implant restorations among dental professionals.
"Implants are no longer 'smoke and mirror' technology. They've proven themselves and, for the last five years or so, many technicians and dentists consider them to be the standard of care for qualified patients," says Chris Morris, owner of ADL Dental Laboratory, Louisville, Kentucky.
Once skeptical of the complexity and long-term viability of implants, restorative dentists have become more comfortable prescribing implants as the first choice in...
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