Monday, November 5, 2012

Changing Seasons

Fall is upon us. It is the season of change. Everything changes, leaves change, temperatures change, clothing changes and it's good in a way because it reminds us that we have to adapt to changing paradigms. The same is true in dentistry. There was a time when restorations were pretty much porcelain fused to gold, or full cast gold crowns, but change is upon us. If you haven’t noticed gold is hovering around $1700.00 per ounce and the economy...well it is just hovering. Gold as a component of crowns increases the cost of restorations as it goes up. Gold is not the only volatile component either. Palladium, which is frequently alloyed with gold is three times the cost it was in 2009. The challenge then becomes twofold, how to offer a product at the highest quality level and making it cost effective in a weak economy.

This is where we take a look at the new materials that are available and see if they fill a need. Full contour Zirconia for example as a replacement for some gold crowns is a great option. Extremely strong, tooth colored and less than half the cost could help patients afford a restoration. New alloys that are noble but with less cost and less price volatility give great results at a reduced fee. CAD-CAM technology has allowed us to control costs and offer better material choices.

The point is that change is good because it forces us to find alternatives and sometimes in the alternatives, we actually find a better way. Now is the time to discuss materials with your lab and see if you are taking advantage of all that is available today. These combined with our standard restorative products can give a range of great options for every situation.

So enjoy the fall and if you haven’t already done so…break out the sweaters!

Wednesday, September 12, 2012

Welcome to our new blog at Mountain Dental Lab. We are excited to have this opportunity to share some exciting things that are going on in dentistry and have a little fun as well. We hope you will enjoy and participate.

I started in the dental lab field in 1979. We had basically two material choices, Ceramco or full cast crowns. Restorations were not always pretty and you had to work very hard to get a result that was pleasing. Manufacturers were constantly trying to give us a great result by refining their porcelain systems. The major complaints of those days were the grey discoloration at the gingival and the overall dead look of porcelain. Strength of the restoration was an issue as well.

The 1980's brought some interesting products to try, to hopefully address these issues. One of the first was Cerestore, which was porcelain fused to a ceramic core. They were beautiful, but one of the problems in these early days was cementation. Bonding was not well developed yet and the cement of choice was zinc phosphate, which did not add any strength to the restoration. Many of these restorations failed. Dicor was a joint venture of Dentsply and Corning (famous glass makers). The idea here was a lost wax casting made in corning glass and externally shaded, this solved the translucency problem, but boy were they translucent! Time also showed that the external stain wore off leaving the glass so we were back to grey. Each one of these products had its problems but, with each one, we learned how to build a better material. Props to the manufacturers (and clinicians) who put in the time and investment to bring us where we are today.

The late 1980's brought two significant changes. The first was the innovations in cementation. Bonding brought the ability to seal and give some strength to an all ceramic restoration. The biggest change was the esthetic revolution that came with Empress by Ivoclar. Empress changed everything because it gave us a material that was strong and beautiful. The color was internal and the grain structure had light scattering properties to mimic the natural tooth. This was a material that could be placed with confidence and it had a "wow" factor for patient acceptance. Empress has been used with a high level of success for the past 25 years and that success has led to an explosion of all ceramic materials. Indeed this is absolutely the best time for esthetic dentistry. Given the materials and techniques available today we can achieve dramatic results. Products like E.max and full contour zirconia combined with CAD-CAM technology are giving us a way to create the most natural looking restorations ever!

The challenge today is information. We need knowledge of these materials, as well as their particular protocols for prescribing and cementing. We need to know how the materials fit the overall goals of the case. Labs and dentists working together, sharing information, can make these cases win. We can create the "wow" factor.

In the coming weeks we will share information about materials and techniques through this blog. The goal is to start a conversation that leads to great results. Thanks for reading.


Friday, September 7, 2012


Welcome to Mountain Dental Lab's new blog! We're a full service dental lab in Asheville, NC. We are excited about connecting with you as we journey through the latest dental technology, tried and true methods, and many other aspects of the dental community. Thanks for stopping by today, check back soon for our first article!