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Since their introduction in the 1950s, PFM restorations have been the bread-and-butter of C&B and most full service laboratories. In fact, as recently as 2005, only 17% of C&B workloads were metal-free. However, with the proliferation of metal-free materials and technologies, we’re nearing the tipping point: 45% of C&B workloads are now comprised of metal-free restorations, according to LMT’s 2013 Porcelain Survey.
Foreign Dental Work Put to Test, an investigative report about lead found in restorations made in China was the talk of the industry when it aired in February 2008 on Ohio’s WBNS 10TV. The story covered an Ohio woman who had experienced pain and infection in her jaw after her dentist placed an ill-fitting, three-unit PFM bridge the previous year. After learning the bridge was made in China, she had the bridge removed and tested for hazardous materials, and lead (160ppm) was found in the restoration.
In addition, the TV station ordered eight PFM crowns from four labs in China and also had...
Invented by Dr. Itzhak Shoher and Aharon Whiteman, CDT, first-generation Captek™ was introduced to the international dental community in 1993. The unique capillary technology took the PFM world by storm because it produced a high noble metal coping right on the refractory die without casting. Dentists and technicians alike were taken by its resulting thin, gold-colored copings and ability to maximize soft tissue health; Captek remains an ideal option for patients with any type of predisposition to caries or perio concerns.
In 2007, Captek Nano™—stronger and thinner than the original...
Although PFMs were still considered by many to be the esthetic standard for clinical longevity, pressable ceramics—starting with IPS Empress and Optimal Pressable Glass (OPC)—began to drive the metal-free dentistry movement in the late 1980s. The improved esthetics and biocompatibility—coupled with soaring precious metal prices—quickly made the pressable technique a successful and cost-effective way to fabricate metal-free restorations. Later, the technique was adapted to create press-to-metal and press-to-zirconia restorations.
Visit LMTmag.com on Monday for another LMT Memorable Moment.
LMT took six impressions of the same prep and anonymously sent them to six different laboratories along with prescriptions for non-precious PFM crowns; one was made in the Philippines. In this ground-breaking experiment in 1985—with LMT Publisher Judy Fishman as the patient—we wanted to know: could a dentist tell the difference between the $35 crown and the $75 crown?
Among our panel of dentists, no one crown was rated head and shoulders above the rest. Although not uniform in their assessments, the dentists could not discern which was the most expensive and which was the least; in...
- November 2013
Last year, Bob Iuliano, CDT, invested about $80,000 in CAD/CAM equipment—and he hasnât looked back since.
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. Crystal Diamond was chosen for its excellent translucency and strength, ideal for highly esthetic anterior and posterior metal-free restorations.
FABRICATION PROCESS: The case was scanned using a 3Shape D710 scanner and milled using Delcam software on a DentMill...
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 of Glidewell Laboratories' new BruxZir™ Shaded material, which offers complete color penetration all the way through the restoration for greater shade consistency. The new material also prevents shade changes or white "show-through" after occlusal adjustment....
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 of the bridge. The patient's occlusal planes were also uneven, and she had another large-span anterior bridge on teeth #6 through #11 that was starting to show signs of decay at the margins.
TREATMENT PLAN: The team opted to remove both bridges and the remaining...
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 and esthetics were a priority, a Zirlux FC2 full contour zirconia crown was chosen. The laboratory prefers to use Zirlux FC2 because of its flexural strength and low wear against opposing dentition. The Zirlux FC2 system consists of five pre-shaded...
- September 2013
Thanks to the advent of digital technology, many laboratory owners and managers are discovering new business models and finding ways to reinvent their businesses and reinvigorate their careers. Here are the stories of three lab owners/managers who have done so using Sirona Dental, Inc.'s CEREC Acquistion Centers, Sirona Connect.
- August 2013
Lately, Iâd noticed some pain when chewing, but I wasnât sure whether it was coming from that tooth or the opposing PFM crown. Though #19 had a root canal [the one from LMTâs second crown experiment, 1987], there was a chance that the tooth had cracked.
The following week, the prosthodontist confirmed that, indeed, the next step would be the crown lengthening procedure followed by six weeks of healing time before he would insert a post to further support the crown. And, as Bill Mrazek, CDT, recommended, the best restoration in this case, would be a PFM. He and his office are the cat's meow when it comes to professionalism and patient care and I'm fortunate to become their patient.
The periodontist he recommended was the same one I'd already called so that added to my feeling of being in the right hands. I've since had the crown lengthening procedure....
- April 2013
All-ceramics, implants, profit erosion and other hot topics inspired dialogue during the biggest weekend of the year.
Shofu demonstrated its next-generation ceramic, One Shot Unilayer Porcelain, that enables you to match all VITA shades and achieve the esthetics of a multi-powder buildup with a single powder. "They said it couldn't be done but we did it. One Shot powder is an incisal, body and dentin all in one bottle. It's an enormous time and money saver," said Lynne Calliott, Vice President of Marketing, Americas.
An extension to the Vintage MP and ZR product lines, One Shot's densely packed homogenous material yields reduced shrinking versus multiple firing-cycle techniques while allowing one powder to build...
- March 2013
Restoring the smile of a dentistâs relative can be particularly challenging. Here, Luke Kahng shares how he transformed the smile of a clientâs mother-in-law with two PFM bridges and one PFM crown.
The growing popularity of all-ceramic restorations continues to erode the PFM market. The percentage of metal-free work being done—45%—is up 15% in just three years, and 20% since 2008.
Sixty-eight percent of the larger laboratory respondents to LMTâs latest Howâs Business? survey are optimistic about this year, compared to only 42% of labs with five or fewer employees.
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- February 2013
LMT's February 2013 issue features our 2013 Dentist Survey conducted with Dental Economics. Our dentist-respondents speak out on...
...Why They Switch Labs
• Quality wasn't consistent.
• Cases returned with open margins.
• Crowns had high occlusion and open contacts.
• Inconvenient to work with due to the distance from my practice.
• I have switched from PFM crowns to PFZ or full zirconia crowns. My previous lab was not yet offering this service. Meanwhile, I was noticing that I was taking too much time to adjust my PFM crowns and was becoming increasingly frustrated....
- January 2013
From new ways to digitize workflows to product launches and enhanced equipment and software, the DLOACâs CAD/CAM Expo and Symposium was the place to be to learn about the latest in digital technology.
- November 2012
As a kid, James Grady never envisioned working at his father's laboratory; he wanted to "do his own thing." But then he grew up.
"It was when I was in college that I realized the opportunity I'd be passing up. How many people can graduate and get involved in an established business at the level I would be able to?" says James. So, after earning a BS in public relations from East Carolina University, he went back to school to earn another degree in dental technology so he could have the complete picture of the business.
In 2001, he joined the laboratory his father, Arey, had founded 25 years...
- September 2012
The Argen Corp. announces the expansion of its Argen Digital Center that provides laboratories with low-price, quality digital PFM substructures. The Center now offers the industry's only noble Selective Laser Melted (SLM) substructures, non-precious SLM substructures and precious metal substructures fabricated with additional manufacturing technologies.
Depending on the material chosen, a variety of substructures are available, from single-unit copings up to six-unit bridges. The most popular material offerings are Argedent EURO high noble substructures and Argenco Y+, a 2% full gold crown....
- April 2012
The 200 attendees* at How to Control the Future Before the Future Controls You, co-sponsored by Vident and Nobel Biocare, received a digital, handheld device so they could provide instant feedback to questions posed by Moderator Mark Murphy, DDS, FAGD. Their answers were immediately displayed on a large screen at the front of the room.
One striking statistic: 87% of attendees said an undue amount of pressure is keeping them from raising their fees. Given the price erosion trend in our field, this number didn't surprise panelist Richard Harrell, Vice President, DSG. "There is significant pressure...
The rumors of my demise have been greatly exaggerated.
Mark Twain's words—repeated by Dentsply's Chris Clark—appropriately describe the gist of the Cal-Lab Group's 86th annual meeting in Chicago. Or, to use Clark's own words, "The lab market is here to stay.
"There's been a lot of gloom and doom of late, with some saying laboratories are headed for extinction. But this market is viable and strategic, and you provide the dentist with services, partnership, education, technical expertise and a knowledge base that can't be duplicated," said Clark, President and COO of Dentsply, to more...