educate me please

[labdude]

Been in ortho so long, I don't have a clue what is a fair price for PFM etc.
Mainly the abbreviated descriptions of things made. As in PFM and such,Porcelin fused to metal.
It would be nice for a list of these things so us underlings can follow the talk easier.
Also, when I price an appliance, I base that price on 70.00 per hour gross. Net is obviously less for overhead. Make it easy for me to know closely what the day will bring in at a glance.

So, I get 30.00 for a hawley with adams clasps. Less for "C" clasps or ball.

Also I wonder, the amount of gold used to make lets say, a coping, is quite small in a way. Does the price of gold fluctuate enough to really be a problem??

 

[Travis]

I have seen crowns marketed from 49.00 up to 450.00 for a single restoration. I have heard of labs in California that make even more than this. It might be a rumor I don't know. As far as a fair price my thoughts would be 150.00 and metal would be an additional fee based on the weight. These high volume labs don't use the correct support for porcelain when they do the wax for the metal framework(dip and cast). If you want the porcelain to last a lifetime the metal has to be there to support it.

Crowns will have more metal if there is a metal occlusion, or a metal collar, ext. Gold is right now at 850.00 an once(31 grams) If the minimum gold copping weighed 1.5, you could get 20 copings.

20 copings = 850.00
42.00 a coping

Total labor for one crown?
I guess 3 to 8 hours

95.00 pmf crown with gold included
95.00-42.00=53.00 not including any materials

Lets say 3 hours to make it, you would make 17.66 a hour
Lets say 8 hours to make it, you would make 6.62 a hour

150..00 metal not included

Lets say 3 hours to make it, you would make 50.00 a hour
Lets say 8 hours to make it, you would make 18.75 a hour

Time I figured is for model work, waxing, metal work, porcelain, returning case.

This is only my opinion, don't take anything I said too seriously. If it makes you feel any better it takes me 10 hours to do a crown.

 

[labdude]

My huorly thing is based on and from being at it for so many years. When I get some new design, I have to factor in the fact that I will not be very fast and accept $4.00 an hour once in a while. Pay off for that is learning and perfecting the manufactuer of something new.
What is the fastest a quality PFM crown can be made?? Keep the quality as high as you can. Based on using the best machinery and materials available?
I've found this point where I just keep repeating to myself "It takes what it takes, it can't go any faster". I do continually look for little goodies of info and machinery that can help. That is another thingf this site just might be good for. Problem is,getting people to share their hard earned knowledge.
A few years ago I paid $800.00 for a PFM to my lower left first molar.
My experience with porcelain is from seeing crowns on the work models I get. All metal seems to wear more than the opposing tooth. Porcelain seems to wear down tooth enamel. I mean it seems to be a harder material as I have noticed wear on the opposing models caused by the crown or bridge.

 

[mzrdmd]

Hi, labdude !

Yes, porcelain is harder than enamel.

As far as quality taking a certain amount of time, sometimes my patients will as why such-and-such takes so long to get done. I tell them "I can do it fast, or I can do it right. Which one do you want ?" No one has EVER picked fast !

Mike

 

[JEmirzian]

Mike Katrina and I charge $150 for a High Noble posterior PFM which includes 1 penny weight of metal. We are trying to stay low in price and high in quality because we are a new lab.

 

[JEmirzian]

Mike (mzrdmd).....Lower fusing porcelains will be easier on opposing dentition. But....your right, still harder then enamel.

 

[labdude]

Dr. Mike,
Fast isn't always low quality. I always try to keep my focus on my work and produce as well as possible, in both quality and speed. I could go faster than I do, simple story, then quality fails.
Every now and then I find a new product or machine that increases productivity by maybe 10 minutes to an hour a week. It's all I have left anymore. Things can only go so fast. They take what they take, I keep telling myself as I work. Keeps me settled.
Still curious about more abbreviations for crown and bridge work. Or are there not that many?? Ones like PFM. I know what that is but have seen a couple of others here I don't get.

 

[TheLabGuy]

Hi, labdude !

Yes, porcelain is harder than enamel.

As far as quality taking a certain amount of time, sometimes my patients will as why such-and-such takes so long to get done. I tell them "I can do it fast, or I can do it right. Which one do you want ?" No one has EVER picked fast !

Mike

However, Some porcelain's are much softer than others, especially some of your low fusing (almost identical to natural enamel wear).

 

[TheLabGuy]

The Dental Lab's conundrum..........Work faster, lose quality......however, I have seen many CB god's work up a masterpiece in no time.

 

[labdude]

Hey Labguy,
Sometimes a job just flows, sometimes....not. Most times now it is a cruise.
I like to think about my product this way, if I wouldn't put it in my mouth, I won't send it out.
Not saying I put everything in my mouth prior to shipping however. Some people wouldn't appreciate the flavor of what I had for lunch.
Like in another thread, you hit it on the head. Quality and Communication. I got ine guy that I have to force to communicate. He is fun in that way.

 

[Byron]

I just want to post a quick response to our pricing. I know most labs are in the fear factor mode, if I charge to much the work will not be here. Lets look at this from a business and profitability point of view. First we are in business to be profitable, if we fail at this then all we have is nothing. Second you must know what your hourly rate "minus supplies" must be to maintain profitability. This will vary between labs but this will be the baseline for your fee structure. Third and most important come up with a teared fee schedule. I have Dr's that want simple and easy restorations to make and others that I must use a lot of labor and knowledge to produce their work. Trust me there are a lot of Dr's that want quality lab work and they will pay a fair price for this, not a cheap price! So please do not under charge for your work. This will bring down the industry and it will make it more difficult for you and the of rest of us to survive.

 

[Tony Atkins]

hardness of ceramic

Ever so sorry that my first post is a contradiction to some of the statemnets made on this thread,
when we talk of dental ceramics abraiding natural dentition, it is not because of a ceramics hardness, it is caused by it's abrasivness, higher fuseing feltspatic porcelain's generally have much larger and more irreguar particle size's, Thus creating a more abrasive surface, even when glazed and polished, this is why the general trend is now moving toward lithium disilicate
and other synthetic varietie's of porcelain. These porcelains inherently have much more uniform particle shapes and size's therefore giving a much more homoginous surface, Hardness is in dental cermics = brittleness but all ceramics work harden over a period of time this factor made worse by uneven thickness's of ceramic caused by lack of support in framework designs.
In terms of structuring prices, This is a difficult thing to quantify and is surely dependent on what our overheads and markets dictate we charge. I have a very small business in London where the overheads are massive, But when I initially set up I looked at the principle of the pyrimid. (cost in one corner,Turnaround time in the other and quality in the other) As I understand it a business cannot operate in more than two corners of the pyrimid, For example if cost is low turn around times must speed up so therefore quality goes down but this rule may only be dependent on how many staff you have look forward to speaking to you all very soon
best wishes
Tony Atkins
visit laboratory site it is still under construction but I think you'll get the general idea
www.tonyatkins.ourocean.co.uk

 

[labdude]

Hi Tony,
Interesting info. Abrasiveness as opposed to hardness wearing down a natural tooth. Dr. states that porcelain is harder than a natural tooth. Put the both together, and you get serious wear. I noticed a lot of this on the work modes I get.
Yeah prices...depends on a lot of factors. Now, all prices will increase due to the increase in fuel costs. I hope it settles out by next summer. Price of a Big Mac, or Bubbles and Squeak will climb for a while.
Thanks for the input Tony.
Mike.

 

[Tony Atkins]

hardness of ceramic

Being invloved in ceramic research (UK) I have studdied this area in great depth over the last eight years. When we talk of hardness I assume we are talking about flexural strength, In terms of the science of materials the minerals that make up a natural tooth are the (hardest) structure in the human body hence the reason we have periodontal ligements to stop us smashing our teeth when we masticate, It is very difficult to carry out a vickers hardness test on a natural tooth due to apperatus that are used to measure these figures, So quotes vary considerably anything from 400-900mpa, the average phelspatic porcelain is around 120-180mpa although some of the latest lithium disicate ceramics measure readings around 400mpa (But because these are synthetic porcelains particle formations are genreally encapsualted within quartz therefore giving a superior surface finish to the porcelain ie non abrassive) this figure aguably increases when enamel bonding an allceramic restoration as the bond to enamel is far greater than dentine bonding, This is due to the fact that when bonding to dentine you are reliant on mechanical adhession as oppose to chemical (mpa is the measurement for hardness Mega pascals) I hope this gives a lttle more insight if anyone has any further questions on this topic I will be more than happy to discuss it further,
I once remember reading the research on a variety of porcelain that was based on hydroxy appetite the foundation mineral of a natural tooth it was apparently amaizing the only side affect was that restorations would suffer from tooth decay
Kind regards
Tony

 

[TheLabGuy]

I gotta chime in here,
The abrasion of opposing dentition has been well documented for a very long time. I was waiting for someone from removable to respond but they didn't. When a denture is made today, it's made using plastic teeth or some form of resin based tooth. Back in the day, and some of you dinosaurs...oops, i mean dynamo's.....remember dentures use to be made using porcelain teeth. The problem was that the porcelain teeth would just abrade the hell out of the natural dentition, that's why they went to what they have now.

As for the hypoxy apetite restorations, that was very interesting, they made a restoration so close to natural dentition that it was acceptable to tooth decay....wowzer, how cool is that....lol

Lastly, Low-fusing porcelain has a lower abrasion rate, that's what needed to be stated.

 

[labdude]

Dynosaur here....
That shows my focus intensity. Last I heard of, procelain was the thing for dentures.
Now... back to being old.