Mill temporaries only?

[Xydorf]

Hello dear Lab tech friends

I am John, a 26-year-old dentist from Sweden who has been thinking a lot about this cad/cam thing the last few years.

I have the following idea at this moment, and I would just like to hear your thoughts.

My idea is to get a Trios Scanner (it looks fantastic!),a 3shape dental system software + scanner, and the cam program. I would like to hire a lab technician to work at my office (we currently do quite a lot of units per month),to digitally design the work the way I like it, and just to order the restoration from a milling center (and sometimes finish the last parts in-house for aesthetic reasons). This way, we do not have to invest in a milling machine (which are either super-expensive or just crappy, like sirona/e4d/katana),but still enjoy many of the digital benefits. However, one problem remains... provisionals!

I hate them. Literally. You still have to take conventional impressions before you prep to make them, and they always look horrible, and have a horrible fit. They are also leaking, and they come off easily and have to be recemented with the crappy temporary cement. So, my question is:

A) Is there a small milling machine availabe just to help me produce my provisionals?

B) How do you like the idea of having the design in-house but the milling somewhere else?

Thank you in advance

Best Regards,

Dr. John Barksenius DDS Sweden

 

[DMC]

Not much market for milling temps in the US.

That about says it all IMO.

I have a disk of temp material still sitting on my desk for the past two months and many cnc mills, but not one single case has ever been sent to me.

Sure it works, but too much $$.

Learn how to make a temp faster is all I can say. My Dad and little brother (Docs) can make temps in their sleep, and I'm sure you will be able to as well in a few years.

 

[4-D]

We mill temps here. I agree that it isn't huge but we do have it requested. We probably mill a handful of temps a month. If you were going to send Zirconia to a milling center, they could probably mill temps for you too.

 

[Xydorf]

It is not that I find it difficult (I don't),it's just that the end result is not satisfactory (very few dentists I know make temporaries that look even half as good as lab-made ones),and thus makes the customer experience less satisfactory.

 

[Xydorf]

4-D: But I want the temporaries instantly, tha patient can't be without until the milling center has delivered them :-(

 

[4-D]

How quickly do you mean? like a day?

 

[Xydorf]

Like 10 minutes

 

[rkm rdt]

Have your new tech make them .

 

[IVY]

4-D: But I want the temporaries instantly, tha patient can't be without until the milling center has delivered them :-(

With 3shape you can see the patient one appointment before prep and take the intra oral pics or if you have preopmodels you can scan them. In the software you can do a conservative reduction to the tooth similiar to how we would do it on the model, then design your crown and send off for printing or milling in plastic. Patient comes in for prep when you have temp in hand. Take a new pic of prep and merge the files to copy temp except with real prep and margins.

 

[Xydorf]

Rkm: That is a good idea, but how will he/she make good temporaries without a mill? Or you mean he/she is just more aesthetic, and can thus make more with less? The dental temporary materials are horrible (luxatemp being a decent option) if you ask me... At least if u compare with what I get from the lab when they mill it

 

[IVY]

How quickly do you mean? like a day?

The 3shape website shows a work flow of this temping technique.

 

[DMC]

good luck selling that as a money maker.

Temps are suppose to be ugly. Why waste time and money on esthetics of a temp?

Dentistry is expensive enough as it is. I don't see this being popular in the Dental Office at all! Too much time to make a $3 piece of plastic that will go into the trash anyway. Manual technique is faster and cheaper and probably fits better as well. Usually the internal is made directly onto the prep.

This CAD/CAM temp idea in the office is a dream for now. Some have wasted money chasing it...others sit by and watch and laugh. It's not profitable for the Doc.

 

[harry1]

A move away from CADCAM, back to traditional techq, but I get good results for provisional's using Dentsply's Radica, with their Eclipse junior light box for nightguards and temp dentures, all with good results. Their Triad provisional materials also work well with the old Triad light box.

Friend of mine gets good results from Straumann, sometimes veneering with Shofu composite.

 

[Xydorf]

First of all: thank you all for these fantastic answers If any of you were residing in sweden, I would start sending work to you immediately

With 3shape you can see the patient one appointment before prep and take the intra oral pics or if you have preopmodels you can scan them. In the software you can do a conservative reduction to the tooth similiar to how we would do it on the model, then design your crown and send off for printing or milling in plastic. Patient comes in for prep when you have temp in hand. Take a new pic of prep and merge the files to copy temp except with real prep and margins.

Sounds like a a plan, but doesn't solve the problem when you have an emergency patient. But yes, it is a great option in general

 

[Xydorf]

good luck selling that as a money maker.

Temps are suppose to be ugly. Why waste time and money on esthetics of a temp?

Dentistry is expensive enough as it is. I don't see this being popular in the Dental Office at all! Too much time to make a $3 piece of plastic that will go into the trash anyway. Manual technique is faster and cheaper and probably fits better as well. Usually the internal is made directly onto the prep.

This CAD/CAM temp idea in the office is a dream for now. Some have wasted money chasing it...others sit by and watch and laugh. It's not profitable for the Doc.

I want to deliver the best experience possible for my patients. The normal way is not optimal. I consider it a marketing expense.

Best Regards

Dr. John

 

[tonester]

If you're going to hire a tech have them do a diagnostic wax-up and make temps with luxatemp, etc. I've seen beautiful temps from a diagnostic and luxatemp with a glaze.

I also use radica from Dentsply off my own wax-up in house. Looks great.

I do think there is too much esthetic concern on a temp without functional concern. The concern should be the final esthetics and function,phonetics, length, plane, etc. and to duplicate the approved test driven temp in the final.

 

[Xydorf]

If you're going to hire a tech have them do a diagnostic wax-up and make temps with luxatemp, etc. I've seen beautiful temps from a diagnostic and luxatemp with a glaze.

I also use radica from Dentsply off my own wax-up in house. Looks great.

I do think there is too much esthetic concern on a temp without functional concern. The concern should be the final esthetics and function,phonetics, length, plane, etc. and to duplicate the approved test driven temp in the final.

Sounds like a plan ^^

//John