Thursday, October 12, 2017
Wednesday, August 2, 2017
A New Generation of Dental Ceramics
The year was 1988 when dental laboratories first heard about an "Aesthetic Revolution". Up until that time, we had limited materials to work with, and doing cosmetic cases was challenging - to say the least. Porcelain was heavy-grained and metal framework had to be masked, making it difficult to refract light and produce natural-looking dental restorations. So, dental technicians settled for something that resembled glow-in-the-dark Chiclets. We all wished for something that was strong and translucent. There were many products that tried to hit this mark, but somehow, all missed due to their compromises in either strength or beauty.
Fast-forward to today. The science of dental materials has brought some tantalizing options to the table. We have Full Contour Zirconia (Zirconium Oxide), which definitely gives strength enough to eliminate metal frameworks, but doesn't always deliver aesthetically. Dental technicians also have Lithium Di-Silicate that has been the aesthetic standard for years, but it also has some limitations when it comes to multiple splinted units. Now, a new player in dental ceramics has taken the field! Celtra Press (Zirconia-Reinforced Lithium Silicate) from Dentsply Sirona has achieved all of the expectations dental labs, dentists, and patients, have been hoping for. It combines strength and beauty into one product that is versatile and translucent. We have been using Celtra in our lab for the past year, and have noticed several positive improvements that we believe have benefits for the clinician.
- Strength of 500 MPA: Fracture resistance at 500 MPA opens up possibilities for not only anterior, but posterior, bridgework, and implant restorations. All this without the dense, glow-in-the-dark look of other high-strength ceramics.
- High-Translucent Index: This material refracts light in a way that is similar to enamel rods found in natural teeth..The main reason for this is that the crystal particle size is smaller, so it not only looks more lively, but it blends well with the surrounding dentition, giving it a chameleon effect. This is especially beneficial for restorations that have high-translucency and a dark shade.
- Magical Margins: Celtra has a better resistance to chipping in thinner areas such as margins around implants, which allows us to use this material in areas where we once had to choose a less-aesthetic material in the past.
In summary, we are excited about this new tool for the toolkit of aesthetic options, and how it can bring a "wow" factor to your dental practice. If you would like more information on Celtra, we have printed guides available for your office, or we will come to your office for a lunch and learn presentation at your convenience. Thanks for your time.
George Zoller, CDT
Wednesday, June 14, 2017
In an Expedient Era, What You Don't Know Can Delay You
Today, dental implants are a standard part of a dental practice. They are reliable, predictable, and when designed properly, the restoration seats easily. Dentists have the option to use a stock abutment, or a custom abutment designed specifically for the patient in question. Custom abutments designed via CAD/CAM (Computer-aided Design/Computer-aided Manufacturing) further enhance the process by providing a custom solution for each case with the final restoration in mind, giving proper tissue emergence and strength for the desired material choice. Before any of that is decided upon, however, the impression coping and implant replica must be considered.
The challenge for dental labs doing implant restorations is lack of information. There are approximately 15 recognized implant companies in the U.S., and almost 200 companies worldwide making some type of dental implant. Many of these companies have their own connection type and parts, and many of these parts look alike. It is understandable that there would be some confusion when attempting to locate the correct driver or screw, or trying to determine which implant system it is just by looking at an impression post. Ordering the wrong part, or trying to find out which implant system it is can cost time and money for both parties.
Here are some practical steps that will insure success with every implant case:
- Always communicate the type of implant system in its entirety. Many implant manufacturers have sub-categories. For example, Nobel Biocare Active vs. Nobel Biocare Replace. The surgeon who placed the implant will have this information in writing, which can be copied and sent with the prescription for the implant case to the lab.
- Verify the platform size. Implant systems usually have three main measurements; the length, the implant size, and the platform size. The lab needs the platform size more than all other measurements. For example, an implant might be listed as a 3.8, when in fact the platform size is a 3.0.
- When ordering an impression post, also order the coinciding implant replica/analog at the same time. This saves the dental practice money, and it saves the lab time.
- For implant cases covering 4 or more units, include a study model or a diagnostic wax-up to ensure the lab achieves proper restoration placement.
- Allow a minimum of 3 weeks for the lab to return the finished case. Implant cases take more time to process, as more steps are required.
These are suggestions for making implant restorations a reliable part of the dental practice. Parts can be challenging, given the number of systems available. Mountain Dental Lab, Inc. has short implant lunch and learns that can help you and your staff with identifying and ordering the proper parts. We would be happy to schedule one of these for you - just give us a call at 828-665-2257 or email me at MountainDentalLab@gmail.com. Our goal is to support you in what you do, because
"We Love Being Part of Your Practice"
Thank you for your time.
George Zoller, CDT
Wednesday, February 15, 2017
Selecting a Shade
Top: Ivoclar Vivadent Shade Guide
Bottom: Ivoclar Vivadent Prep Shade Guide
Selecting the appropriate shade for a patient's crown or bridge can sometimes by trying. There are many factors that contribute to the way a patient's teeth look, which can result in varied outcomes. To assist with obtaining an objective shade, take into consideration the following factors:
- Color & Temperature
- Surrounding Objects
- Operatory Walls
- Clothing of Patient
- 2nd Opinion from Staff Member
- Digital Camera
- Shade Tabs
- Prep Shade
- Shade Tabs
Ensure the source of light is directed relative to the patient as they would normally be seen (i.e. have the patient sit up in the chair, and use passive light from above). When possible, use natural light, or use color-corrected bulbs.
If a patient is wearing a red shirt and pink lipstick in a room with yellow walls, the light will reflect off of these objects and onto the teeth, presenting a skewed shade.
Everyone's eyes interpret color differently. It never hurts to ask a second opinion.
When taking a shade photo to send to your dental lab, include the shade tabs in the photo, holding them up as they would read on adjacent teeth (match Gingival to Gingival, etc.).
If an all-porcelain crown is requested, providing a stump/prep shade is extremely helpful to the dental lab technician in determining the material shade. Most all-porcelain materials are translucent, allowing light to shine through, reflect off the prepped tooth, and transmit it's shade back through the porcelain material.
Part 3 - Understanding Color & Shade Selection" Crest® Oral-B®
at dentalcare.com Continuing Education Course, Revised October 27, 2011