Digital Denture

Patrick Coon

Patrick Coon

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#1
Listened to an interesting episode of the new Dental Lab Podcast, Voices From The Bench, hosted by Elvis Dahl and Barbara Wodjan. Here is the link for anyone interested in listening: http://www.voicesfromthebench.com/16 . (this is only part one of the roundtable, I'm interested to see where it goes in part two next week)

What really made me think is, they were asking the question, "How many of your doctors are asking for Digital Denture?" To me this is the wrong thinking. I don't want a doctor to ask me to make a digital denture, I want to ask me to make them a denture. Just like I don't want them to ask me make them a digitally created a crown from IPS e.max CAD, I want them to ask me to make an IPS e.max crown. Let me choose my manufacturing process: hand-wax or milled wax, press or CAD/CAM. I want to do the same with the digital denture process: do I pour the impressions or do I scan them, do I do a traditional set-up or do I use my CAD/CAM process. As long as the doctor is getting the desired result, and a prosthesis of equal or better quality, my manufacturing process should be what fits my laboratory workflow the best.

What do you all think?
 
Patrick Coon

Patrick Coon

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#4
Lol, the interviewee's sound like old C & B guys in the '90s.
I was actually Richard Wills supervisor in the AF back in late 80's / early 90's.

I totally agree. They don't understand its a process, not a product. Will it make sense for everyone in the beginning, No. But before you know it, it will be mainstream. I think Rich is about correct in the 4-5 year forcast of being mainstream, not the 20 years we took with C&B.

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2thm8kr

2thm8kr

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#5
I was actually Richard Wills supervisor in the AF back in late 80's / early 90's.

I totally agree. They don't understand its a process, not a product. Will it make sense for everyone in the beginning, No. But before you know it, it will be mainstream. I think Rich is about correct in the 4-5 year forcast of being mainstream, not the 20 years we took with C&B.

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4-5 years seems like a good guess. I have seen some amazing looking dentures made digitally. I can't speak for how they function, but the appearance of the final product has moved forward greatly since the first ones I have seen.

It is only a matter of time. We have been experimenting with making duplicates of patient's current dentures, regardless of how ugly they are lol.
We use a soft reline material and then scan it and mill it from a monolithic puck. Patient's that have worn dentures for decades say it is the best fitting denture they have ever had. Elimination of the processing errors of the materials and differing techniques will be one factor that brings digital fabricated dentures to the main stream sooner than later.
 
Bryce Hiller

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#6
Listened to an interesting episode of the new Dental Lab Podcast, Voices From The Bench, hosted by Elvis Dahl and Barbara Wodjan. Here is the link for anyone interested in listening: http://www.voicesfromthebench.com/16 . (this is only part one of the roundtable, I'm interested to see where it goes in part two next week)

What really made me think is, they were asking the question, "How many of your doctors are asking for Digital Denture?" To me this is the wrong thinking. I don't want a doctor to ask me to make a digital denture, I want to ask me to make them a denture. Just like I don't want them to ask me make them a digitally created a crown from IPS e.max CAD, I want them to ask me to make an IPS e.max crown. Let me choose my manufacturing process: hand-wax or milled wax, press or CAD/CAM. I want to do the same with the digital denture process: do I pour the impressions or do I scan them, do I do a traditional set-up or do I use my CAD/CAM process. As long as the doctor is getting the desired result, and a prosthesis of equal or better quality, my manufacturing process should be what fits my laboratory workflow the best.

What do you all think?
Totally agree.
 
Bryce Hiller

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#7
We outsource all of our casting to Argen. We design digitally rather than wax up by hand. Then we send the file to argen for DPM/SLM/Milled Metal. Did we notify all of our doctors? Nope. Same product. The process/workflow is not pertinent. If they ask, we'd be more than happy to share our process, but it's just not a necessary conversation.
 
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CoolHandLuke

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#8
We outsource all of our casting to Argen. We design digitally rather than wax up by hand. Then we send the file to argen for DPM/SLM/Milled Metal. Did we notify all of our doctors? Nope. Same product. The process/workflow is not pertinent. If they ask, we'd be more than happy to share our process, but it's just not a necessary conversation.
just for sake of starting an internet fight, what if Argen sent their frames to china

would it be a necessary conversation then?

whats the difference between sending frames to china and sending frames to someone else who sends to china?
 
Patrick Coon

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#9
just for sake of starting an internet fight, what if Argen sent their frames to china

would it be a necessary conversation then?

whats the difference between sending frames to china and sending frames to someone else who sends to china?
To me this is not the same thing as a manufacturing process, as I'm not manufacturing something going off-shore.

Personally, I wouldn't outsource to a lab that sent my work off-shore. If I did though, I would disclose the country of origin for frame, crown, etc.

.
 
CoolHandLuke

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#10
does ivoclar get their Li 2Si material made into ingot and block formats at a factory in la belle chinoix? if so, why doesnt that constitute a necessary conversation, why is it taken for granted that its ok ?

if i asked ivoclar to make me an emax crown why should i not be worried you would outsource it to china?

the only point i am making is that this outsourcing and materials specificity conversation needs to be ok at every level. its either ok for the government to crack down on chinese stuff or its not. its either ok for everyone to send stuff to china or its not. it cant be ok for some people but not for others; it cant be ok for GC or zirkonzahn to tell me don't concern yourself with my product, and then turn around and face the regulations placed upon me as a lab and then say with a straight face to my regulatory body, i was told dont worry about it/

no. thats what regulatory bodies are for. either your product is above board or it isn't. either you are making what was specified or its something else. you don't get to define that. ivoclar will tell you all day long you can't call LiSi emax. they are not the same, they are two different things. its not ok to make them equivalent.

the same is true of nobel, its either authentic or its not. a knockoff is a knockoff. you have to know that, it is important.

we chastise any lab that makes FCZ without an origin sticker, why should we hold bigger companies to less standards. i specify LT Press i expect to get what i ask for, and it should matter that i am specific. it matters when you want a Bruxzir, thats a name brand process. its not ok to make a knockoff and call it a Bruxzir.

its not ok to send cases to an centre that doesnt disclose point of origin of everything. Argen discloses, Ivoclar discloses, but without specificity of making name brand things you open the doors to make anything in the category. thats got to stop.
 
Bryce Hiller

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#11
just for sake of starting an internet fight, what if Argen sent their frames to china

would it be a necessary conversation then?

whats the difference between sending frames to china and sending frames to someone else who sends to china?
I don't see a difference because I don't care within which imaginary lines something was manufactured. I care about the quality. Nothing more.
 
Bryce Hiller

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#12
does ivoclar get their Li 2Si material made into ingot and block formats at a factory in la belle chinoix? if so, why doesnt that constitute a necessary conversation, why is it taken for granted that its ok ?

if i asked ivoclar to make me an emax crown why should i not be worried you would outsource it to china?

the only point i am making is that this outsourcing and materials specificity conversation needs to be ok at every level. its either ok for the government to crack down on chinese stuff or its not. its either ok for everyone to send stuff to china or its not. it cant be ok for some people but not for others; it cant be ok for GC or zirkonzahn to tell me don't concern yourself with my product, and then turn around and face the regulations placed upon me as a lab and then say with a straight face to my regulatory body, i was told dont worry about it/

no. thats what regulatory bodies are for. either your product is above board or it isn't. either you are making what was specified or its something else. you don't get to define that. ivoclar will tell you all day long you can't call LiSi emax. they are not the same, they are two different things. its not ok to make them equivalent.

the same is true of nobel, its either authentic or its not. a knockoff is a knockoff. you have to know that, it is important.

we chastise any lab that makes FCZ without an origin sticker, why should we hold bigger companies to less standards. i specify LT Press i expect to get what i ask for, and it should matter that i am specific. it matters when you want a Bruxzir, thats a name brand process. its not ok to make a knockoff and call it a Bruxzir.

its not ok to send cases to an centre that doesnt disclose point of origin of everything. Argen discloses, Ivoclar discloses, but without specificity of making name brand things you open the doors to make anything in the category. thats got to stop.
I don't think anyone is making the argument that dentists SHOULDN't be concerned. I'd certainly care if I were a dentist. I'm making the argument that if they were concerned, they're free to ask me. And if they don't like my process, they are free to send elsewhere.
 
Bryce Hiller

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#13
why should we hold bigger companies to less standards
Hold them to whatever standard you want, but it's their company. They can do what they want with their products.

the only point i am making is that this outsourcing and materials specificity conversation needs to be ok at every level.
Who's saying it isn't??

its either ok for the government to crack down on chinese stuff or its not.
Spoiler alert: It's not.

its either ok for everyone to send stuff to china or its not.
Spoiler alert: It is.

it matters when you want a Bruxzir, thats a name brand process. its not ok to make a knockoff and call it a Bruxzir.
Now you're introducing an enitrely different scenario: fraud. Promising one brand-specific item, but providing a product from another company is lying, also known as fraud. That's a different conversation.

its not ok to send cases to an centre that doesnt disclose point of origin of everything.
 
Patrick Coon

Patrick Coon

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#14
does ivoclar get their Li 2Si material made into ingot and block formats at a factory in la belle chinoix? if so, why doesnt that constitute a necessary conversation, why is it taken for granted that its ok ?

if i asked ivoclar to make me an emax crown why should i not be worried you would outsource it to china?
All blocks and ingots in the states, and i believe world wide, are made either in Schaan, Lichtenstein or Somerset, New Jersey.

In the states we are not a lab or milling ceter (anymore),and when we did have our milling center, all restorations were made in Troy, Michigan.

As for material, of course these materials need to be regulated. The dr and i have a conversation at the beginning of our relationship about what material i use (emax, Ivobase, Vivadent teeth, etc). Now there are different methods of producing a prostheis or crown, or nightguard (etc) out of each of those materials, and it up to me as to which process I use (as long as I keep it in house, if it is produced outside my lab, that is another conversation and documentation that happens).

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Affinity

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#15
Barb was my supervisor for many years, I didnt know she had a podcast, I will have to check it out.
I plan on only doing dentures digitally starting this coming year..
 
Patrick Coon

Patrick Coon

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#16
Barb was my supervisor for many years, I didnt know she had a podcast, I will have to check it out.
I plan on only doing dentures digitally starting this coming year..
It is new, only been around a couple months. Short ~30 minute episodes. Definitely worth the listen.
 
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grantoz

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#17
the problem is Patrick that while your saying you should be able to choose the process as long as you give them what material they ask for which i agree with. Ivoclar always pushes the dentist to ask for this process or product from the lab to promote their stuff this is a classic dental company trying to sell the magic of just pushing the digital button and as Bob Marley says everything will be alright dont worry about a thing. Sirona and Ivoclar have both been documented saying you dont need a technician when you have digital dentistry welcome to our world Patrick.
 
F

FASTFNGR

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#20
Listened to an interesting episode of the new Dental Lab Podcast, Voices From The Bench, hosted by Elvis Dahl and Barbara Wodjan. Here is the link for anyone interested in listening: http://www.voicesfromthebench.com/16 . (this is only part one of the roundtable, I'm interested to see where it goes in part two next week)

What really made me think is, they were asking the question, "How many of your doctors are asking for Digital Denture?" To me this is the wrong thinking. I don't want a doctor to ask me to make a digital denture, I want to ask me to make them a denture. Just like I don't want them to ask me make them a digitally created a crown from IPS e.max CAD, I want them to ask me to make an IPS e.max crown. Let me choose my manufacturing process: hand-wax or milled wax, press or CAD/CAM. I want to do the same with the digital denture process: do I pour the impressions or do I scan them, do I do a traditional set-up or do I use my CAD/CAM process. As long as the doctor is getting the desired result, and a prosthesis of equal or better quality, my manufacturing process should be what fits my laboratory workflow the best.

What do you all think?
My question has always been why digital dentures? Well all say why digital zirconia crowns? If all remember the price of gold was $300 an once, and suddenly was $2000. This made everyone think for an alternative to the gold, and this is where E-max jumped in. But then zirconia started showing its head with a very opacious results. Gold was still $2000 oz and zirconia started getting more translucent and now no one talks about E-max. So why digital dentures? Is acrylic expensive? Is there a shortage of denture teeth or acrylic? No, it is just a hype with, as far as I know, during February Chicago meeting, there was no pink printing material approved by the ASA or the FDA. Some companies are taking chances and doing it without announcing it. So, is keeping someone’s file for future denture making? How good is that denture going to fit 2 years down the road? How much is a pink puck to mill a denture and how long it takes using a $40000 milling machine?
4hrs to mill a denture base and $100 for the puck. You still have to bond each tooth by itself tot he puck. Is this a good denture making? I say no and I have more to say about companies pushing this with no studied procedures. Peace.
 
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