AG Motion 2 For Dentures

[CanadaDenturist]

Hello. This is my first post here and just looking for some overall feedback.

I'm a denturist looking at getting into the world of digital dentures and the Amann Girrbach system appeals to me the most, mainly because of the fact that with the Motion 2 mill you can mill the basal and occlusal surfaces of Vita(and other) teeth using the DD Frame. To my knowledge AG is the only system in which you can do this. Or am I possibly missing something?

Since I'm a denturist and will only be using the mill for dentures and related products(milled implant substructures, partial frameworks etc) I don't want to get a mill where I don't have the ability to make single dentures against an opposing natural dentition. Making a single denture against an opposing dentition would require alteration of the occlusal surface of the teeth which I don't believe any other mills/systems can do at this time. Is this correct or are there any others that can mill the basal and occlusal surfaces of the teeth? Alternatively, does anyone know if the exclusivity of AG being able to mill the basal and occlusal surfaces of Vita teeth will be ending and will be available on other platforms in the future?

Does anybody here currently use the Motion 2 to mill both the denture base and teeth? If so, what are your thoughts of the results and process? Also, has your Motion 2 been consistantly reliable? I know AG sends out their own people to do repairs(apparently you have to pay their travel and accommodations as well) and the possible down time is a big consideration in my mind in going digital since they come from the US and I am in Canada. If you do have service needed to your mill how long is your typical down time?

I know there are much less expensive mills available which I could use to mill a denture base and use the Vita Vigo teeth, but then the mill can't alter the occlusal surface of the teeth. I know I could 3D print denture bases and teeth but I've never seen any great looking 3D printed dentures. I offer premium and high quality teeth and I feel using 3D printing would be taking a step backwards.

Your input is appreciated.

 

[2thm8kr]

Even though you're from Canada I'll toss in a few thoughts.
I'll add that I am not an acrylic/removable tech by any competent means so make sure you have a grain of salt handy.
If you want to use carded pre-manufactured teeth, AG was probably the first. I have seen some dentures made this way and they are as good or better than 'average' analog dentures.
The limit to this are the teeth available for this process. I'm sure there are more now, but several years ago there was only 2-3 companies. Typical pre-manufactured tooth molds are not consistent enough for a predictable digital work flow so you will want to use teeth made specifically for the digital process.
With generic exocad it is possible to make a single arch denture opposing a natural arch or other starting with Plovdiv CADApp version. This does not provide a 'turn key' solution for milling pre-manufactured teeth occlusal and basal sides using a holder similar to AG. That's not to say it couldn't be made to happen if you were the tinkering DIY type. If it is a patent protected process it may be coming to and end soon unless it were worth renewing/enforcing the protection. If it is an agreement between exocad and AG then who knows?? Right now there are a lot of prosthetic tooth libraries available in generic exocad. Several different branded manufacturers are represented. Some of these libraries are locked and by that I mean the teeth aren't scalable in size and the morphology can't readily be changed by moving a cusp tip or changing a buccal contour. Some or all of these libraries have cards available by the manufacturer. They could be put into a milled wax base and processed or possibly milled similar to the ones available in the AG version if a card stock holder was made or is available for the CAM software.
Many of the other libraries are unlocked and can be scaled, free formed, etc and milled like any other stl design file, occlusal and basal surfaces from your choice of materials.
My experience with milling dentures as temps for implant and other cases is pretty good for the most part. I don't use carded teeth and just mill the teeth from shaded multi layer PMMA and the base gingival shaded disks. For temporary solutions to what I'm solving and not having to get involved with a full blown acrylic lab set up. Not to mention my lack of practical experience with analog acrylic methods, it's been pretty solid.
Being able to print monolithic denture setups as prototype trials, scan appliances, custom trays, etc from the CAD designs and then mill amended two part designs is a huge plus.
My thoughts are AG will not have this process of milling carded teeth exclusively in perpetude, but they have been doing it longer, so the technical support and process should be pretty solid regarding that technique. I can't speak of their overall support since I've never dealt with them personally. I do have experience with proprietary and closed systems and will say that you will do it their way or you won't do it with that system. So keep that in mind! As you learn the process and start to think of solutions with digital tools, you may find a closed 'turn key' system to be very limiting in how you want to do it.
Branded versions of exocad have pluses and minuses, (read limitations) some more than others, not necessarily negative depending on your needs or how far you look down rabbit holes.
Be sure to ask every question you can think of regarding software design limitations or CAM process limitations from whichever company you decide to purchase from. Double check what they say as best as you can. Double check that the teeth you want to use are manufactured to specs compatible with the digital process.
Printed dentures are not there yet unless you're setting up a denture vending booth. Materials are lacking and not easily repairable.
Hopefully you find some useful info among all this yammering.

 

[CoolHandLuke]

AG's denture thing is the Baltic system.

forget that nonsense. design your own.

 

[Ikon Dental]

Maybe printed to get all undercuts etc.?

 

[Ikon Dental]

 

[2thm8kr]

AG's denture thing is the Baltic system.

forget that nonsense. design your own.

They may have a system for Baltic dentures, but this is what the OP is referring to.

 

[lowercased]

The denture system is a total load of crap that should never have been released. No one supplies the carded teeth and no one supports the systems. #2cents

 

[npdynamite]

I don't have experience with the specific process that you are asking about, but I do have experience with the AG motion 2 and milling in general. I would just say to be very thorough in your research because the motion 2, while maybe a fine enough mill, isn't very flexible, meaning, if you aren't happy with that specific product, you might find that anything else you want to mill, you would be better off with a different mill and have more material options.

I am of the opinion that the digital denture market is still developing and many of the systems being used today will disappear in the next 2 years. I am sure a couple will still exist but in a modified form. For that reason, if I was looking at something for digital dentures, I would think about maximum compatibility with other systems. So I would be looking for a mill with a 98mm disc holder, or I would look at 3d printers that work with resins made by other companies (I would probably want a printer that keystone was developing materials for, for instance)

 

[sirmorty]

I'm not sure milled will be the way with Dentures.
I think you would be better off looking at 3d Printers.

 

[npdynamite]

I'm not sure milled will be the way with Dentures.
I think you would be better off looking at 3d Printers.

I agree, I don't think milling dentures makes much sense

 

[bigj1972]

While milling is as good as you can get to analog in DD, it never made sense to use and wear out a 50k+ mill with an acrylic puck when you can get so much more profit per hour out of a Zr puck, and feel it was an addendum sales pitch to those that already wrote the first check to mill C&B.

Analog is just so cheap to make from a material cost stand point, the ROI doesn't make sense to me.

 

[lowercased]

Forget about milling the denture base, if nothing else it just takes too damn long. Design it digitally with blender4dental, blue sky bio, or exocad. Print it either monolithically or as the base then the teeth separately. If you want hybrid analog process, then take your digitally designed and monolithically printed denture and use the anaxdent verticulator/flask with your choice of materials. You can buy the software, two 3d printers, all the anaxdent kit, and 10 years of consumables for the cost of the mill by itself.

 

[CanadaDenturist]

Forget about milling the denture base, if nothing else it just takes too damn long. Design it digitally with blender4dental, blue sky bio, or exocad. Print it either monolithically or as the base then the teeth separately. If you want hybrid analog process, then take your digitally designed and monolithically printed denture and use the anaxdent verticulator/flask with your choice of materials. You can buy the software, two 3d printers, all the anaxdent kit, and 10 years of consumables for the cost of the mill by itself.

My issue with 3D printed dentures is that I've never seen a good one in comparison to a denture made with high quality carded teeth. Also, the issue of being able to repair or reline a 3D printed denture base or tooth worries me. I've never heard of anybody with long term success when relining a 3D printed base. As far as repairs go I've had a couple of reps tell me "just print them a new denture if it breaks" which doesn't seem like a great option.

 

[lowercased]

The 3D printed resin is just resin, so repairs aren't that different from regular denture acrylic repairs. As for breaking, you can reinforce the dentures with fiber or pretty much any of the regular denture reinforcement techniques and in general don't push the envelope with material thickness. If you want to use materials you're more familiar/comfortable with, then use a process like this or it's equivalent (https://multimedia.getresponse.com/646/377646/documents/1369209.pdf)

 

[bigj1972]

Already doing that without 3d printer.

 

[ztech]

My issue with 3D printed dentures is that I've never seen a good one in comparison to a denture made with high quality carded teeth. Also, the issue of being able to repair or reline a 3D printed denture base or tooth worries me. I've never heard of anybody with long term success when relining a 3D printed base. As far as repairs go I've had a couple of reps tell me "just print them a new denture if it breaks" which doesn't seem like a great option.

I agree with you on this one. I have yet to see a printed denture that I would actually put my reputation behind. Looks......like shizza. Still not as strong as the acrylic teeth and base. The AG system would be the only system that I would use if I was still doing dentures. You are working with a really strong denture tooth and the base is processed in regular acrylic, so it is as strong as any denture made today. It also gives you the opportunity to modify the denture base internally in the process for the highly natural look. Problem is, it's a lot of money to save the time of setup and waxing of the denture base. Also, not enough digital labs want to incorporate a hybrid system into their digital world to make sure the AG product is supported long term.

As far as the machine itself. You will have repairs that are required as with all mills. Axis motors, sensors, and maybe a spindle if you use it long enough. The minimum charge that I have incurred was $2,500. I do have the option of a local repair shop that is trained by AG to repair the equipment but they are about the same price. That was travel and repair cost. Wait time was about one week and the technician stays until it's complete and during this time my AG distributor milled my production items. Although I do primarily fixed restorations if you need more info, message me.

 

[CanadaDenturist]

I agree with you on this one. I have yet to see a printed denture that I would actually put my reputation behind. Looks......like shizza. Still not as strong as the acrylic teeth and base. The AG system would be the only system that I would use if I was still doing dentures. You are working with a really strong denture tooth and the base is processed in regular acrylic, so it is as strong as any denture made today. It also gives you the opportunity to modify the denture base internally in the process for the highly natural look. Problem is, it's a lot of money to save the time of setup and waxing of the denture base. Also, not enough digital labs want to incorporate a hybrid system into their digital world to make sure the AG product is supported long term.

As far as the machine itself. You will have repairs that are required as with all mills. Axis motors, sensors, and maybe a spindle if you use it long enough. The minimum charge that I have incurred was $2,500. I do have the option of a local repair shop that is trained by AG to repair the equipment but they are about the same price. That was travel and repair cost. Wait time was about one week and the technician stays until it's complete and during this time my AG distributor milled my production items. Although I do primarily fixed restorations if you need more info, message me.

Your points regarding the AG system are pretty much in line with mine; It's the closest replica in product to an analog denture, however, it comes at a high cost of roughly $200,000CAD by the time I acquire all of the pieces of equipment required to make dentures from start to finish(scanner, mill, 3d printer, curing/cleaning unit, fume hood, computer, software etc). Is this worth it to save the time of setup, wax up and investing? I believe the time spent investing a case will be swapped for the time it now takes to bond the teeth to the denture base and fill in any small crevices between the teeth and the milled base though, so not much time saved there.

Thanks for letting me know the minimum repair cost and down time. That's a consideration for sure.

 

[CanadaDenturist]

While milling is as good as you can get to analog in DD, it never made sense to use and wear out a 50k+ mill with an acrylic puck when you can get so much more profit per hour out of a Zr puck, and feel it was an addendum sales pitch to those that already wrote the first check to mill C&B.

Analog is just so cheap to make from a material cost stand point, the ROI doesn't make sense to me.

The ROI of the AG system is really the only thing holding me back. It's a lot of money to basically save the time of having to setup and wax up the case yourself. I've been making dentures for over 25 years now so I can setup and wax up a case in a reasonably short amount of time, I'm not seeing a huge time savings there vs. designing on the computer. Also, half the time I have my lab tech wax up my dentures(I always do my own setups),so there's even less of my time involved for half my cases.

 

[CanadaDenturist]

I'm not sure milled will be the way with Dentures.
I think you would be better off looking at 3d Printers.

My issue is that I've never seen a good looking 3D printed denture. Even the reps I talk to say they look like $#!+ in comparison to a denture made of carded teeth. I'd be taking a huge step backwards in the quality I'm offering my patients if I were to start to solely 3D print my dentures. I think 3D printing would be a great option for transitional dentures though.

 

[CanadaDenturist]

I don't have experience with the specific process that you are asking about, but I do have experience with the AG motion 2 and milling in general. I would just say to be very thorough in your research because the motion 2, while maybe a fine enough mill, isn't very flexible, meaning, if you aren't happy with that specific product, you might find that anything else you want to mill, you would be better off with a different mill and have more material options.

I am of the opinion that the digital denture market is still developing and many of the systems being used today will disappear in the next 2 years. I am sure a couple will still exist but in a modified form. For that reason, if I was looking at something for digital dentures, I would think about maximum compatibility with other systems. So I would be looking for a mill with a 98mm disc holder, or I would look at 3d printers that work with resins made by other companies (I would probably want a printer that keystone was developing materials for, for instance)

Thanks