Milled Titanium Framework

[Tayebdental]

I usually don't bite on these type of threads, but here's my $0.02 FWIW:
The fact is, as long you are in the "lab" role, you'll be always running in circles... facing all the challenges mentioned here, trying to stay afloat and be profitable. When the only thing you gotta do, is just think outside the box.
I going to share my latest business model with you:
Setup shop at a lesser developed, non regulated, but booming location... there's zero competition, but plenty of costumers w/ mucho $$$. See the opportunity ? Offer cutting edge dental services w/ an inhouse lab, and the only full digital workflow in a 100 mi radius, if not more. Assemble a good team of professionals with plenty of know how, and some experts who can be flown in to get the job done and have a mini vacation at the same time. Win, win...
Now bring the local hospitality industry on board for their support and advertising, since we will be servicing dental tourism as well. Easy-peasy, since I am involved with the local, fast growing medical tourism already. The only thing I need to worry is supplies (being remote) and how to manage my team to keep the customers happy, nothing more. Opening in three weeks... word got out, and we're booking for July already... yeah, I got my arm twisted, but somebody has to do it So much for being retired... it only lasted for a year, fml

Old technicians never die, they simply fade away
It sounds good, but I don’t know what is means

 

[John in Canada]

Well, I asked. I got a whole lotta info totally off topic. Pizza Hut drivers, working out of my garage, so called technicians, digital, analog, ai, etc.
All I was looking for was a honest discussion on an appropriate percentage mark up on an out sourced titanium bar. (Or anything else outsourced could have been relevant) Thank you for the few that were closer on topic. And to be clear, all discussions on this forum are good discussions…. Well most, lol. Communication is key. I’ve never been the guy to cover or shadow my work or my business. Perhaps if more people were straight forward honest about the effort it takes to get to being successful, less people would strike out on their own and offer such deep undercuts, which does nothing except create slaves, and underpaid employees, and no margins. I could go on but won’t. We know the drill.

Now, an update. The bar went out marked up 100%. So $1200 went to 2400. Add in a SBOR, teeth, set up 2 times, injection processing, recovery, remount, polish, shipping (for the original scan work to be done). I spent over 2 hours on the phone with the milling center to get the frame designed the way we wanted. They charged me twice and had to deal with that-another 20 minutes or so. An hour total of time reviewing their designs on computer for approval, and more. The case went out today a shade over $3200. Delivered, doctor and patient ecstatic.

 

[Andrew Priddy]

sorry, fully guilty as charged.
are you happy with the bill out? aside from the obvious initial stress involved?

 

[John in Canada]

I am happy with what I billed out. But, to me, it’s not a question of am I happy with what I invoiced. Am I being fair to myself? I don’t want to gouge, I’m not greedy. Is the invoiced price fair, and correct for the service/work completed. You get what you pay for. That’s more of what I’m sparring with. Just because I’m happy, and it’s fair to me, doesn’t mean it’s the right price. If the doctor is charging 30K, and I billed out 3K, am I right? With these numbers I still feel I’m low, but where do I justify more?
I do 3 or 4 of these a year. They’re a lot of fun when you’re working with the right doctor.

 

[Yourgoes]

Cost of crowns is a good analogy. Lab bills went down, cost to patient went up.

So when you see 30k to the clinician, your 3 seems unfair when you look at the work involved from both parties. To position yourself to charge more and be seen as worth it, you have to become a more integral part of the team. Be more valuable and harder to replace. Implants start at planning, not surgery. Involve yourself at that stage to ensure a good prosthetic outcome.

We would be involved at the planning stage and recommend implant sites that would be best for the prosthetic, not being surgeons ourselves, we go back and forth with the clinician until we have a good plan. Then we prepare the surgical guides and prosthetic components.

If old school free-handing I had a doc who would ask me about every site, if I liked the site and the angle. Not everyone will do that so we would fabricate what we called 'dummy' guides that we would sell to the surgeons as 'semi-guided'. They looked like a denture or a copy of the new prosthetic with flanges. We make horizontal slots on the flange to define the bone reduction, and open up the ridge area while leaving the facial and buccal walls of the teeth so that the surgeon has an idea of where the teeth will be in the final to have good screw emergence. Not perfect but it prevented the most common surgical errors we saw; insufficient bone reduction and bad implant angulations.

As John W said, to feel comfortable doing these, you have to invest in yourself. Join study clubs, go to the courses, observe a colleague in action, do anything build up your 10,000 hours.

 

[John in Canada]

Cost of crowns is a good analogy. Lab bills went down, cost to patient went up.

So when you see 30k to the clinician, your 3 seems unfair when you look at the work involved from both parties. To position yourself to charge more and be seen as worth it, you have to become a more integral part of the team. Be more valuable and harder to replace. Implants start at planning, not surgery. Involve yourself at that stage to ensure a good prosthetic outcome.

We would be involved at the planning stage and recommend implant sites that would be best for the prosthetic, not being surgeons ourselves, we go back and forth with the clinician until we have a good plan. Then we prepare the surgical guides and prosthetic components.

If old school free-handing I had a doc who would ask me about every site, if I liked the site and the angle. Not everyone will do that so we would fabricate what we called 'dummy' guides that we would sell to the surgeons as 'semi-guided'. They looked like a denture or a copy of the new prosthetic with flanges. We make horizontal slots on the flange to define the bone reduction, and open up the ridge area while leaving the facial and buccal walls of the teeth so that the surgeon has an idea of where the teeth will be in the final to have good screw emergence. Not perfect but it prevented the most common surgical errors we saw; insufficient bone reduction and bad implant angulations.

As John W said, to feel comfortable doing these, you have to invest in yourself. Join study clubs, go to the courses, observe a colleague in action, do anything build up your 10,000 hours.

I’d say I’m integral and involved-especially when I was at the university. I’ve consulted with docs many times, made scores of surgical and radiological guides, mock ups, sliced and diced countless models for oral surgeon’s splints, been to the morgue a dozen times to take different types of impressions-I’m active and known. Most everyone gets squirmy when it comes to brass tacks-I don’t. I have the same issues when I do maxillofacial work and surgical obturators. A lot of what I do is complex and well outside the run of the mill fare. Maybe that’s part of the problem….
On the other hand, I’m fine without the digital technology. I’m 57. I LOVE what I do and it’s provided well for me and my family. If business dries up because I’m not digital, then I retire. I don’t need the lab. I keep doing what I’m doing because my accounts keep sending me work. I retired in 2015. So I thought…..
Thank you for speaking up. I do appreciate your POV!

 

[lcmlabforum]

yes, that's how that works. advances make people obsolete.


as i have mentioned several times now, it is always easier to make a convenient process higher quality than it is to make a quality process more convenient. eg it is always easier to make milling quality better than it is to make layering porcelain easier. the mill is the convenience, the hand work is the quality process that can't easily be reduced to automatable tasks.

luxury marks like Rolex and Rolls Royce don't have advertizing. they don't need it. they don't want it. they do not want to be cheapened to influence more people to purchase their products through mass appeal. this is the whole essence of being a luxury brand. you don't mass produce.

look at the value of the rolex company though. today acording to google its nearly 8 Billion dollars.

compare with the value of 3shape https://www.zoominfo.com/c/3shape-inc/348241950 q1-q2 revenue 2021 says it earned 360million

theres nothing luxury about our products, i don't care what lab you are.

one of two ways porcelain will be eliminated from the dental world: 1. material sciences will find a material that is printable, or 2, someone will invent a dual arm layering robot. neither idea is far fetched in 2022. in 2012 this was a dream.

to John In Canada: heavily invest in your capacity to mill, get hyperdent's template generator. go to courses on cnc manufacturing. watch youtube if need be. you can easily mill bars with the smallest of effort. many providers already have solutions in place too.

Thanks for sharing - found a video and Nowak as reseller for Hyperdent - text on YouTube seem foreign - it is a company in Turkey or something
like that?
LCM

 

[lcmlabforum]

Thanks for sharing - found a video and Nowak as reseller for Hyperdent - text on YouTube seem foreign - it is a company in Turkey or something
like that?
LCM

Found it:

TMS Control and Technology Management Systems Ltd. Şti.

a:2:{s:2:

www.tms.gen.tr

Turkey most likely after all.
LCM

 

[CoolHandLuke]

Thanks for sharing - found a video and Nowak as reseller for Hyperdent - text on YouTube seem foreign - it is a company in Turkey or something
like that?
LCM

thanks for the link to the company, but why are you linking it? what was the youtube video?

 

[lcmlabforum]

Just so glad we have both John Wilson and Andrew Priddy sharing personal experiences and perspective.
Almost want to say you are both like the apex predators in the field, except you are not predatory but
have reached your own pinnacle in a realm with multiple mountain ranges.
The key is always looking to make things better, in what we do, and the people's life and at the end of the
day just knowing we are already doing what we can without sacrificing our own personal and mental health.
!
LCM

 

[lcmlabforum]

thanks for the link to the company, but why are you linking it? what was the youtube video?

I just thought I shared what I found for those like me with OCD and need to know . . .
Sorry for posting unnecessary info, and here was the video I found - most likely
from the company itself, more unncessary info.

!
LCM

 

[CoolHandLuke]

if you aren't interested in honing or crafting your own templates for hyperdent then this video isn't helpful to you.

as to the turkish region, i have no idea why a company wouldn't list Dental support on their website but what may be instead, theres identically named company with a different focus.

the TMS company you linked doesn't show dental in any of their applications. it must be a different TMS.