Are Pfms Disappearing, and Increasing your Profits ?

[charles007]

Just curious if your seeing fewer pfms come into your lab in the last 6-12 months with Emax and FCZ growing so fast. And more importantly, has your bottom line dropped or increased because of that ? For the labs looking to buy a scanner, and or plus a mill, it does change your business and opens up a new world for your business to grow, or fail with the high payment cost.
Would also like to hear the pro's and con's stories of how the all ceramic business with and without a scanner has changed your lab. Are you working + or - hours per week, new accounts, hiring/ firing. Are milling bills eating up your profits. Do you think the cad/cam restoration will ruin the average small lab in the future with big box labs spitting out more units by the year at lower prices.. Will this drive the average lab out of business....
Will the obvious decline of pfms doom the small labs of the present and future ? Are techs being laid off now because of cad/cam being a must have, and with businesses being so slow because of the economy?
Are Cad/Cam restorations Doom or Gloom for the future-younger dental lab tech/techie.....Are we going to see a evolution also with the down fall of pfms......did I say that. lol
And you say ?

Charles

 

[paulg100]

like i posted before, spoke to a chap from roland that sat a recent talk from Jim Glidewell. He was predicting 70% of techs would be unemployed within 3 years, due to cad/cam automation and other pressures.

that probably covers alot of the questions there i guess.

im having a hard time seeing any future for middle of the road labs anymore.

Either invest in cad/cam and pump out the numbers at the cheapest price or go higher end where cad/cam cant compete.

so many techs seem to be rushing to commoditize themselves now and sign away there worth, its sad to see.
once you become a price, your essentially worthless. Makes it nice and easy for the big boys to step in and hoover your clients up.

 

[cheadlemick]

Out of 6000 techs there will only be about 1800 techs left in this country within 3 years?

 

[Tom Moore]

I think because of downward price pressures and technology making products less labor intensive we will see a consolidation of the work in larger and larger labs. The PFM is still a big deal in this industry but it will be market demand and wider acceptance from the insurance companies that will fuel the change from the PFM.

I think Jim is on track but I think it will take a decade. The old guard is on its way out and the startup costs with the new technology will make startups very hard. Most people working for GM are not even dreaming about owning a car company and I see the same down the road for those working on the production line in a dental lab. Not happy about it but that is what I see coming.

 

[cheadlemick]

Tom i think your analogy using GM is flawed,and i know the comparisons between the UK and the US dont always work but i agree it will take at least a decade probably two! Think how quickly the last twenty years have gone!

 

[charles007]

Dental insurance is paying less, so this changes everything for the average dentist, and puts more incentive to look for cheaper lab prices. I would think with lab prices falling/leveling out, and milled crowns becoming the norm, its going to be a very hard road to hoe for all of us within the next 5 years. Not sure if the small or middle size lab has a better chance of staying in business or not.. The way I see it, the scanner is a great tool in the hands of a more experienced tech and can take the place of several techs with monolithic crowns/ which is becoming the norm. The less experience you have, the more average your restorations become. Even at this time the scanner/cad software can do more than we can extract out of the software... I say that because the learning curve is so great, and so many techs can't use the full potential of the software.. Don't know what's on the horizon with the cad, I just think cad has no limits and will greatly improve faster than we can learn how to use the software..Teaching cad could become a new business in our field..

 

[paulg100]

yep, i think 3 years is a bit alarmist to, but its coming, theres no doubt about it.

Seeing the invisilign prodution set up on youtube was another eye opener. To think most of that automated product line was being done by techs only a few years ago is another wake up call for anyone in denial.

 

[cheadlemick]

I dont think people are in denial! To be fair Paul using invisalign is not a good comparison! I think the future of Dental Technology is under threat in the future but my experience is my clients love the idea that i can talk to them and their patients about the work.Most of my new clients are young dentists who want to work closely with the tech, mass production only works to a point.

 

[cheadlemick]

Where cad cam is concerned at the moment the software isn't designed by people who can wax,build, shape etc so dont have an understanding of what we really need! Btw im no Luddite! technology is good when used correctly and you dont have to buy all the gear there are plenty of labs (in the over subscribed UK) who are cutting prices to labs for substructures like crazy at the moment!

 

[BobCDT]

Hi,
Here is how we see it at CAP.
First of all, the future advancement of CAD will likely mean fewer clicks to get to a superior design. To be a CUaD operator will become easier as time move forward.
CAD CAM absolutely reduces the gap of quality of all dental labs.
We do not see dentists turning to huge companies to obtain prosthetics. The needed conversations and close relashonships between knowledgable dental tecks and dentists will likely remain for quite some time. As a result, it's critical for small (and all) labs to maintain great relashonships with there dentist customers. And, CAD CAM will provide additional time to do so.
Monolithic, is here to stay. Materials science will continue to get better and we will see significant improvment in all of the essential properties of new materials.
CAD CAM is not necessarily a must for small labs to stay in business. But, all lab owners should look at the ROI's often and make educated decisions.
PFM's are no longer the first choice by dentists for crowns in the US. I am not up on foreign markets. I think PFM's will continue to shrink in numbers. PFM's were the standard for about 40 years. It's been a great run. But, a new age has arrived.
Bob

 

[TheLabGuy]

Nope, still see at least 50% of my work being PFM's. Sure, I've seen the E.max replace a few of my clients but the rest will retire before they stop doing PFM's...lucky me huh? joy joy

 

[charles007]

Nope, still see at least 50% of my work being PFM's. Sure, I've seen the E.max replace a few of my clients but the rest will retire before they stop doing PFM's...lucky me huh? joy joy

Three years ago your pfms were almost 100% alone with your fcg....right ?
Your getting there..

 

[Gru]

In the last 3 years we've made a push to educate and encourage our accounts to use monolithic. Our workload has inverted and we are now >85% monolithic, primarily emax. Even the doctors approaching retirement age have made the switch for the most part. Not one has requested pfm for their own mouth when having us do personal work for them or their family members. That said, the pfm's are always used where indications do not allow for emax, and few wish to pay the premium for zirconia. Perhaps Charles007 is right on the insurance reimbursement aspect of this.

 

[CatamountRob]

This is a great thread and it's got me wondering about something. For those of you who have encouraged your accounts to switch to mostly monolithic, either e.max or zirc.

How differant are your restorations from everyone else's? What sets your work apart from that done at any other lab?

I guess my fear is that if I push monolithic alternatives, sooner or later, dentists will realize that they can get a strong, great fitting, but average looking crown anywhere.

 

[NicelyMKV]

This is a great thread and it's got me wondering about something. For those of you who have encouraged your accounts to switch to mostly monolithic, either e.max or zirc.

How differant are your restorations from everyone else's? What sets your work apart from that done at any other lab?

I guess my fear is that if I push monolithic alternatives, sooner or later, dentists will realize that they can get a strong, great fitting, but average looking crown anywhere.

You can still set yourself apart with correct ingot selection, superior staining and the normal fit, form nd function. I have seen a lot of monolithic Emax from cheap labs that were way over contoured, shaped like a wad of chewing gum and not only monolithic, but monochromatic. You can still greatly separate yourself in those ways.

P.........F.........M? What is that?






Sent from my iPad using Tapatalk HD

 

[Gru]

Nicely said! (pun intended!) They already can get average crowns from any average lab. MicelyMKV is dead on. As observed by my #1 account- a high end office, e.max looks very average no matter who does it unless the contour, surface texture and stain are expertly done. IMO anteriors still must have layering to look great. I do see the price differential between PFM's and metal free gradually shrinking to the point of disappearing. Not really a surprise, since many doctors claim to know it's "less work" to do monolithic crowns. They don't seem to realize the product costs are much higher though. And as always you get what you pay for.

 

[molarmaker]

why Drs.don't want to change from pfm's
they hate to adjust any mono Emax or Zirc. If they learn the process you won't be able to give a pfm away.
with overhead' labor,and this new mandatory healthcare, survivability for us, not so good

 

[TheLabGuy]

Three years ago your pfms were almost 100% alone with your fcg....right ?
Your getting there..

You know, come to think of it, you're right!!! I guess I am doing that much more e.max....I'll look at the numbers but I wouldn't be surprised if it was 60% PFM still.

 

[BobCDT]

At ADT We have been pushing all ceramics for years. Knowing it has a superior bottom line. It wasn't until gold prices cranked up that we finally got a BIG product shift. Today we are about 70/30 all ceramics. And, 60/40 e.mx to FZ. We were also concerned about the monolithic restorations all looking alike. But, we try to provide crowns that requie no chair side adjustment and have all the essential ingreadience of a great crown. Except for multilayering. We also priced posterior and anterior differently. We get about $100 more per unit for anteriors. This has kept us some what competitive with the posterior market and very profitable for anterior work. We do layer all anterior e.max restorations.
Bottom line, I believe the move to monolithic should help us reduce labor and be just (if not more) profitable. Not to mention keeping is a little more competitive with China.
Bob

 

[Gru]

Bob, is it your opinion then that domestic labs can, with automation produces monolithic crowns at a price competitive with China? I envision a future where our turn times will be as good or better because of shorter delivery distances, but can we hope to compete on price??? What's more, do we want to? And does that truly spell the end of small labs?