Full Cast Non-Precious

[NathanH]

What do you do when a Dr. asks for a, "Full Cast, Non-Precious" crown?? We usally cast them in a noble, high silver, alloy, but today, I finished a few of them, and wanted to kill the SOB that prescribed them.

 

[TheLabGuy]

What do you do when a Dr. asks for a, "Full Cast, Non-Precious" crown?? We usally cast them in a noble, high silver, alloy, but today, I finished a few of them, and wanted to kill the SOB that prescribed them.

When I get asked to do one, I get on the horn and tell them it will cost them a thousand dollars for me to do a non precious full cast crown or roughly a little over a 100 dollars for a semi-precious (high silver) one.....the choice is pretty easy after that conversation.

 

[charles007]

I have a friend that uses a "yellow" NP alloy that's a type 3 that's been on the market for years. This tech was actually was on a panel this week at LMT and would never use a bad product. He's used it for years without any problems......
Years ago I was asked for NP full cast also, I used a Pd/Ag ceramic alloy with the doctors permission........
This past weekend Bego had a lecture I missed on a new softer ceramic NP called 260 or 280, which is the hardness #.......Most other np are over the 300 range........This alloy will probably work well for np full cast, it nickel and beryllium free.

Charles

 

[NathanH]

I found some metal at the LMT Mid-winter meeting in Chicago that I'm gonna try. It's called Ceradium V, and it's sold by Matek. It's got a hardness of 230. We will see how it goes tomorrow. We used a "yellow" NP alloy called "MS" years ago, but we haven't had any of that stuff in years. I think this is the stuff that your buddy uses, Charles. What panel was he on??

 

[charles007]

I found some metal at the LMT Mid-winter meeting in Chicago that I'm gonna try. It's called Ceradium V, and it's sold by Matek. It's got a hardness of 230. We will see how it goes tomorrow. We used a "yellow" NP alloy called "MS" years ago, but we haven't had any of that stuff in years. I think this is the stuff that your buddy uses, Charles. What panel was he on??

Whip Mix

 

[dmonwaxa]

What do you do when a Dr. asks for a, "Full Cast, Non-Precious" crown?? We usally cast them in a noble, high silver, alloy, but today, I finished a few of them, and wanted to kill the SOB that prescribed them.

I'm sure there is a good reason for requesting a FC NP. In the 2nd molar region where there is usually a lack of room. If made with Au alloys T3 or T4 may get worn through because of their softness. FC NP provides the ability to achieve a thin casting and not be concerned about perforation due to cyclic wear. The use of these new generation NP though easier to finish due to their softness may not give the durability which may be the quality the clinician is looking for.

 

[Mark Jackson]

BruxZir will do anything a full cast NP will do, and do it better. We scan and mill the wax pattern and send another copy of the same file to the BruxZir mill and make one of those too, and send it with the FCC, no charge.

We haven't done a FCC on a human in months.

Doesn't make sense.

BTW, take an ingot of that yellow NP and toss it in a test tube with a few onces of salt water. Get back to use in a week and tell us if you'd put that stuff in your mouth. Who is this tech who would never use a bad material?

I was supposed to be on that panel. I would have blew coffee out my nose if he said that with me sitting there.

 

[Joseph Haddad]

Mark is right. You don't even have to put this Yellow NP in a test tube to see the results. I had an ounce that I forgot in my drawer and it turned to a brown green colour. Imagine what it would do in the mouth and what kind of never ending taste the patient will have. Personally, I don't make NP cast crowns any more. I will offer the dentist some cheap 2% gold noble alloy instead. Why should he save money on the detriment of my time. Anyway, with these new soft NP, the only difference you will notice is when you cut the sprue.

 

[lcmlabforum]

BruxZir will do anything a full cast NP will do, and do it better. We scan and mill the wax pattern and send another copy of the same file to the BruxZir mill and make one of those too, and send it with the FCC, no charge.

We haven't done a FCC on a human in months.

Doesn't make sense.

BTW, take an ingot of that yellow NP and toss it in a test tube with a few onces of salt water. Get back to use in a week and tell us if you'd put that stuff in your mouth. Who is this tech who would never use a bad material?

I was supposed to be on that panel. I would have blew coffee out my nose if he said that with me sitting there.

This is probably just me, but the fact that you would use FCC in an animal
is telling. I am a die hard full gold person. If hardness is a concern, I don't
see why you cannot use a metal ceramic alloy instead of Type III.
I still request HN metal ceramic alloys with my lab, unless titanium/milled
indicated.
My view is that a lot of humans have hostile oral environment that equals
or surpass those challenges in an animal. Heard the saying - 'that guys'
jaws are like an animal - he just rips them up'?
What's your experience on a Bruxir for minimal occl clearance to be able
to mill down to, for those cases that really need that?
Any limitations on a partial coverage crown using that system (like a lingual
3/4 crown design)?
LCM

 

[Mark Jackson]

This is probably just me, but the fact that you would use FCC in an animal
is telling. I am a die hard full gold person. If hardness is a concern, I don't
see why you cannot use a metal ceramic alloy instead of Type III.
I still request HN metal ceramic alloys with my lab, unless titanium/milled
indicated.

The military does not play that way. There are very specific alloys that are Mil Spec, and you don't just make changes based on what you think is better.

My view is that a lot of humans have hostile oral environment that equals
or surpass those challenges in an animal. Heard the saying - 'that guys'
jaws are like an animal - he just rips them up'?

When I see a 200 pound military dog with a rock chewing habit, I don't imagine many materials will last too long. But neither do these dogs. most are retired or dead before the crown wears out.

What's your experience on a Bruxir for minimal occl clearance to be able
to mill down to, for those cases that really need that?
Any limitations on a partial coverage crown using that system (like a lingual
3/4 crown design)?

.5mm will work, though we prefer more.

LCM

.

 

[lcmlabforum]

Thanks for sharing. Would that 0.5mm mean that you mill it at 1.0 and then cut it down to 0.5mm like we used to for thin sections, or it can mill to that 0.5mm straight.
Another reason I like gold - in the case of trauma, I think any surgeon in the ER would prefer to find a piece of metal with an X-ray than zirconia. Or Titanium for that matter. I am ex-military (2 year only, long story) but in those cases, shrapnel would be all over the place and won't be the only piece of metal. Still, if something ended up in the lungs or GITract, I rather be able to find it than trying to catch a shadow of zirconia somewhere I cannot distinguish readily.
Again, only my 2 cents' worth.
There is a recent remark by someone today about Bruxir going to end up in a cycle of complications down the road and I am kind of more on the conservative side. Has anyone looked at what the Bruxir would do to the opposing tooth when they are as is, vs stained vs internally fused with the pigments?
LCM

 

[Mark Jackson]

Thanks for sharing. Would that 0.5mm mean that you mill it at 1.0 and then cut it down to 0.5mm like we used to for thin sections, or it can mill to that 0.5mm straight.
Another reason I like gold - in the case of trauma, I think any surgeon in the ER would prefer to find a piece of metal with an X-ray than zirconia. Or Titanium for that matter. I am ex-military (2 year only, long story) but in those cases, shrapnel would be all over the place and won't be the only piece of metal. Still, if something ended up in the lungs or GITract, I rather be able to find it than trying to catch a shadow of zirconia somewhere I cannot distinguish readily.
Again, only my 2 cents' worth.
There is a recent remark by someone today about Bruxir going to end up in a cycle of complications down the road and I am kind of more on the conservative side. Has anyone looked at what the Bruxir would do to the opposing tooth when they are as is, vs stained vs internally fused with the pigments?
LCM

Zirconia is Radiopaque. It will be easily seen anywhere in the body, though it's highly unlikley one will end up anywhere besides the mouth. This seems like an odd concern, but okay. Wear tests are ongoing, but they seem to be performing as well as, or in some cases much better than eMax.

If you want to know if BruxZir will continue to be popular, you might want to watch for next months DE, and their interview with Gordon Christensen

 

[DMC]

Mark, have you seen the Crystal Diamond Zirconia?

I head it is much more translucent.

Never seen it.

 

[Mark Jackson]

Mark, have you seen the Crystal Diamond Zirconia?

I head it is much more translucent.

Never seen it.

Much more translucent that the regular Crystal Zirconia? I highly doubt it. It's just a private labeled material, and NOT FDA cleared for this application. It's approved for copings only.

On top of that:

The guy who sells it has screwed everybody who bought a microwave sintering oven. The units were garbage and all broke down> then they repaired them only under the threat of lega action, but they broke again anyway.

He claims he has no obligation to honor the waranty, as that was between us and the manufacturer and he's just the middle man. The manufacturer disappeared.

Ask for copies of clinical data on Crystal. You won't get it, and whatever claims he makes are based on tests he claims were done at the University of Arizona AEROSPACE department.

He also told me he was an engineer AND a dentist. His business partner called and threatened me for calling them on their BS.

Is that the kind of company you want to do business with? What happens if there were wholesale product failures? He'll handle it just the way he did the ovens.

 

[lcmlabforum]

I already asked in another post but seems pertinent here. Where can we find a quick list of currently approved FDA dental material?
Not to disagree with Mark and I respect your work/wealth of information you share - but dentistry has seen so many cycles of popularity and complications I rather be on the cutting edge of knowledge (if I can) but late adopter clinically. Remember Empress II? I know Zirconia is radio-opaque, but in a large x-ray with lots of small parts - metal stands out readily. Again, that is just my personal take, and if fabricated well following protocol, I am sure the zirconia the likes of those on this forum will do well. The problem would be lots of other copy cats put out by novices wanting to 'try it out' on new patients and leave the clinic after a year or 2. That is why long term clinical data and reports are so important, as well as the wear tests you mention - would look forward to that data. And kudos to MJ for having the guts to stand out and 'share' bad interaction with suppliers like you did at risk of legal or other trouble.
LCM

 

[Mark Jackson]

I do a lot of lecturing. I have been at five meetings so far this year, and I have the Spring Technical in Indy next week. I NEVER EVER speak on behalf of a manufacturers sponsorship. I pay cash for everything, and that gives me the freedom to be honest and share my experiences, good and bad.

I have the security blanket of a DAMAS certification and document everything, and never mix and match.

I am in a unique position to help manufacturers who do it right, and hurt those who do it wrong. I'm sure some companies cringe when they see me place an order

 

[MasterCeramist]

Looking forward to hearing you speak next weekend. It's usually a pretty nice meeting.

 

[Darren S]

Send your full cast NP to me if you want. I'll do it, pm me for any questions. Really I enjoy burning my fingers.

 

[Bobby Orr ceramics]

Full Contour Zirconia. We do alot of Tilite PFM's and would recommend Full Zirconia over Full Tilite crown. Tooth coloured and Fixed Fee are the 2 buzz phrases to make sense to a Dr.