What Type Of Ceramics In 2011

[charles007]

For those of you in the loop of Cad/Cam and materials, what type of all ceramic crown do you see being done now and even more in the near future?

We are already seeing the bruxzir being used more because of the high cost of gold, and gold is really to high to use in these days and times of the economy.
Emax is busting loose at the seams, and prices dropping with the big labs. Palladium is creeping up in price.

More and more labs will buy scanners next year so they can design zirconia correctly and not having the chipping issue. It will allow them to do full contour zirconia, zir coping, full contour & cutback for emax and wax frames and save on cost to compete with the big labs.

I think we will see a ceramic milled top for zirconia like 3M's DVS crown that's to expensive to buy from a Lava lab at for $99. Maybe a ceramic top or lithium disilicate or both. This seems to be an under -cover topic that no ones knows much about.....
When this comes out, it will be a big labor saving crown for the cad/cam labs.

I predict for 2011, zirconia will be used more with a partially full contoured zirconia being used, with the buccal or facial being layered, or more. I think this will have a big influence next year and for years to come.
What say you ?

Charles

 

[rkm rdt]

I did my first porcelain to Zirconia crown for this year.
I am doing more pfms and emax than ever.
Gold is still the material of choice for longevity not zirconia.

 

[TheLabGuy]

I'm redoing my fee schedule as we speak and adding
E.max MT - assuming it's coming out sometime (was suppose to be out this past summer)
I'm still on the fence about adding BruZir or some type of full contour zirconia. I know it's getting more and more popular but the clinical studies are still being done and it may be a couple years yet before we fully know the abrasive nature and wear patterns on natural and restorative dentition. Spoke with a highly regarded Prosthodontist recently who said he is still doing Empress and won't touch E.max until their is more research conducted and seen it in the mouth clinically over time. We all run a business, so it's always better to offer services someone is willing to purchase, but I wonder if we aren't moving too fast and setting ourselves up again for another art glass incident. Are we?

 

[JohnWilson]

CAD/CAM is the future and the future is here. Embrace it or die trying to compete.

Materials are constantly evolving and with that we have improved the products we make. Sadly as the quality of our restorations improve the compensation for them has not. Eliminating or reducing tech labor will be the only way to stay competitive with pricing. There will always be niche markets, but the broad marketplace will be looking for $100 restorations as I see it. Not because the economy sucks but because the marketplace has the ability NOW to produce a very decent restoration at this price point and still generate the industry standard as it relates to profit margin on such a restoration.

The quality of milled glass will meet or exceed the expectations of most clients. The Clients that can cut a great prep and take a perfect impression and expect all the things we artists want to put into a single unit is not even close to a 10th of the marketplace. So how do we stay competitive and still make our desired profit margin? Control direct labor is how. If the computer can minimize our hands on time on a product that is acceptable to a broader range of the market at a price that is attractive. Why wouldn't we embrace it? Is it the struggling artist in us that tells us that we can make a better looking restoration by using 15 powders and 3 times the time to make it? Is it the fear of change? Is it the cost to invest in technology that changes so fast that we may not see ROI? I think its a bit of all of these things, but even with these rational fears its something the small to mid size lab MUST not hide their heads from.

Things are evolving so fast. Things we were doing on the computer 1.5 years ago now seem ridiculous compared to the software thats out there today. Wait till we see whats unveiled at Midwinter this year.

Technology and how we embrace it will definitely define our future. I urge you to educate yourself to the point that you are more than just AWARE of whats out there. Grab hold of the future make your mark!

 

[charles007]

John I whole heartily agree with you. More and more average doctors will be looking to buy a $100. crown . I think a lot of HN alloy crowns will fall to the way side to some form of all ceramic crown that is made through cad/cam.

When Ivoclar adds eMax MT, this may kick start the emax thrill all over again and take away some of our pfms.

I see the small boutique labs really having to sharpen their skills to keep there high prices for the dwindling number of doctors that will want their services. These types of labs will always be in demand, but they will also have to bring in cad/cam into their lab whether it's just a scanner, or with a milling machine at a later time.
There is already a $25k Roland miller that will probably become very popular in the months to come. Other cheaper milling machines that smaller labs can afford may hit the market as early as next year.

To stay in business for the near future, we really need to be ahead of the curve, and not just think that making pfms will keep your business afloat .

 

[rkm rdt]

I coudn't disagree more.

I see the smaller labs evolving into extensions of the dentist's practice.More patient oriented with more involvement with treatment planning.

I tend to outsource more time consuming tasks to the manufacturing labs.I look for the best quality to enhance my service to the dentist who has no time to "shop around".

 

[JeffT]

Hi All, I too run a small lab, and can provide any product the big labs can. I don't even own a scanner yet and see no need for one at the moment. I could probably convince myself that I could use one in my lab but at the moment I see no gain. When intraoral scanners become main stream than I will have to act. As stated in previous post, we must stay tuned in to the current and emerging tech and roll with what works based our own goals and business aspirations. We are not factory workers churning out MP3 players or LCD TV'S by the millions. We recreate nature, and for me that is with my hands.

Don't get me wrong I love tech as much as anybody but I didn't devote a third of my life to a trade to end up pushing a mouse around all day. If that time comes then hopefully my house will be paid off and I will probably go buy a lawn mower round.

just my two cents
jeff
"Here for a good time not a long time"

 

[DMC]

lithium on top of zirconia digital. From scanned model, or scanned mouth.

BIG Ultra-sonic mill to cut costs of tools and to mill much faster.

Just like a Roeders or DMG w/ultrasonic transducer on the spindle.

Mike Gerrard is heading this project I believe w/Ivo ..I heard this around three years ago. Still in the worx and people are excited.


Scott

 

[TheLabGuy]

CAD/CAM is the future and the future is here. Embrace it or die trying to compete.

Yep and All-Ceramic was suppose to replace all PFM's too. How many times do we have to hear the same mantra over and over again......you better get cad/cam or your going to die. As Jeff stated, cad/cam is a tool, nothing more, nothing less, we make our living with our hands. Most of us here are small labs that have NO need to invest in a scanner or milling/printing/additive technology. Should we know what's out there, absolutely, just as we should know what type of porcelain or acrylic is on the market. That's why I think Scott (***) and yourself John will do great servicing the smaller labs and the smaller labs will still continue to thrive as well.

 

[charles007]

Earlier this year I had 2 companies to say there will be cheaper portable intraoral scanners that might be released next year, and cheaper models for the near future. Will that change small labs thinking, or just the progressive lab?
I'm buying my ticket now for the digital train that already here.

 

[paulg100]

"This seems to be an under -cover topic that no ones knows much about....."

Hey charles, not so sure about under cover, its available now and i have the blocks in the lab. Just got the software update for milling but havnt had time to try a bridge out yet.

Only major problem at the mo is you get a zirconia colar around the cervical of the abutments as our milling unit cant mill knife edge margins, so i dont see this concept going anywhere fast with our system for the time being.

Yeah you could dip the frame so you get a coloured colar then stain but still a let down. I dont see it being a lower aesthetic cheap option either as the material costs are not cheap. around £90 in materials for a 3 unit bridge.

The emax MT or Emax Opal as its actually called i believe, is not quite what i expected. It will only be available in a few limited colours to start in the press format and as i understand it is not quite designed to sit between the LT and HT blocks. Its an opalescent shade that is designed for full contour anterior work.

 

[dmonwaxa]

So Paulg100, what kinda markup/return should one expect since the materials cost alone is £90, and haven't factored in overhead, labor and profit. And its still not an esthetic solution.

 

[sixonice]

i think your going to be very pleased with the new e.max ingots. the whole idea with these i have heard is giving us a value based system similair to the original empress esthetic organization. you could consider them a medium translucent alternative for certain (and yes, i agree they will be especially used in anterior cases but can also be perfectly fine for posteriors). from what i have researched they will organized something like this:
Value 1 = Lowest Value (most like TC1)
Value 2 = Medium Value
Value 3 = Highest Value (whitest shade)
Opal 1 = Highest Translucency
Opal 2 = Lowest Translucency

they can be done monolithic style & stained or internally stained & layered with enamels. im excited about these.

 

[charles007]

All of my doctors are telling me emax looks so much better than pfms. To me any improvements over LT''s would be a big improvement. This puts us emax users another step away from pfms and dirty metal finishing, and another nail in empress, maybe ?
The more alternatives we have in all ceramic materials, the less reasons to use metal....
Yes I'm a metal hater... so what

 

[PGguy]

i think your going to be very pleased with the new e.max ingots. the whole idea with these i have heard is giving us a value based system similair to the original empress esthetic organization. you could consider them a medium translucent alternative for certain (and yes, i agree they will be especially used in anterior cases but can also be perfectly fine for posteriors). from what i have researched they will organized something like this:
Value 1 = Lowest Value (most like TC1)
Value 2 = Medium Value
Value 3 = Highest Value (whitest shade)
Opal 1 = Highest Translucency
Opal 2 = Lowest Translucency

they can be done monolithic style & stained or internally stained & layered with enamels. im excited about these.

In your opinion, do you think we will be able to achieve beautiful full contour stain/glaze anteriors with these?

 

[paulg100]

demonwaxa - yeah exactly, its about as appealing as LAVA DVS at the moment! ie totally cost prohibitive. WHEN i get a chance, hopefully over the next few days, ill get a bridge milled and stain/glazed and post some pics.

Yeah im looking forward to the Emax Opal too. The monolithic results from emax CAD LT are real nice so if it at least compares to this then we will also have a great press alternative for all the crappy prep designs that i cant mill!

As for great results for anteriors with a stain technique, im not so sure. Its still a single colour/opacity solution. You really need a multi layered solution like the empress CAD multi blocks that have a transition from chroma/opacity to translucency to get a good base for staining in my opinion, but we shall see.

I have the VITA real like blocks in the lab also, im just waiting for a suitable case to come in to test and ill post some pics of how that turns out too.

Yep i hate metal too.

Exciting times for sure popcorn

 

[disturbed]

'm still on the fence about adding BruZir or some type of full contour zirconia. I know it's getting more and more popular but the clinical studies are still being done and it may be a couple years yet before we fully know the abrasive nature and wear patterns on natural and restorative dentition. Spoke with a highly regarded Prosthodontist recently who said he is still doing Empress and won't touch E.max until their is more research conducted and seen it in the mouth clinically over time. We all run a business, so it's always better to offer services someone is willing to purchase, but I wonder if we aren't moving too fast and setting ourselves up again for another art glass incident. Are we?

LOLOLOLOLOL!!!!!:bolt:

 

[labmanmike]

Cerastore, Dicor, Artglass,Concept along with the Forte I ate. m. Whats next

 

[DMC]

Earlier this year I had 2 companies to say there will be cheaper portable intraoral scanners that might be released next year, and cheaper models for the near future. Will that change small labs thinking, or just the progressive lab?
I'm buying my ticket now for the digital train that already here.

One Year later.....


Digital Train Wreck,.... All Aboard! Chooochoooo......

 

[disturbed]

Cerastore, Dicor, Artglass,Concept along with the Forte I ate. m. Whats next

full contour zirconium. history repeats itself..anyone remember full contour stainless steel crowns? how they beat the 5hit out of opposing dentition? how when they opposed themselves the root and bone was lost? 1950-60's I was told..can anyone verify? HEY OLD GUYS!! any 70-80 year old techs still around or did they all die from overworking?