Milling Teeth

Patrick Coon

Patrick Coon

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Wow, you know more than I do right now! I haven't seen anything about the training dates for the larger mills yet. I know we are training on the PM1 right now, but that is only for blocks and not disks.

When we finally release 3Shape 2017 for our customers we will follow shortly after that with the release of our Digital Denture Professional (DPP) add-on software. This will give the option to be able to mill the teeth individually, in sextants, or full arches for bonding to the milled denture base. If you don't want the option to mill the teeth, and just want to use carded tooth stock, you won't have to buy the DDP add-on (last thing I was told).

Ide alized workflow with DDP will be as follows:

1. Dentist/Denturist will take preliminary impressions and a centric tray bite registration. They will also use our UTS-CAD to take measurements for the Campers Plane and Bi-pupillary Line. These will either be scanned in the office or sent to the lab for scanning. No need to pour impressions.

2. Lab will scan (or accept scans) and design combination custom tray / bite rims. The bite rims will have an area designed into it to accept our Gnathometer CAD, for the clinician to take an intraoral tracing for determining the VDO. These get sent back

3. Clinician will border mold and take a wash impression inside the tray/bite rim. At this point they can mark the high lip line, mid-line, cuspid line. If the scanner being used has the ability to do texture scanning, this can be done in marker. If not then either a positive or negative mark must be added to see these references in the scan. The clinician will then insert the Gnathometer CAD into the bite-rim and determine the VDO and lute the upper and lower impressions with bite registration or impression material. This then gets scanned or sent to lab for scanning.

4. Final impression / Bite registration gets scanned and sent to DDP software for design. Cast analysis is done in the software, teeth are picked from all Ivoclar or Candulor molds and automatically set. Lab tech will make any changes for esthetics, characterization or function. Tissue is then designed/characterized and either a wax-tryin (actually wax and carded/milled teeth) or what is called a Monoblock (solid white denture base and denture teeth) is milled for try-in. These are sent back to the clinician for evaluation with the patient.

5. The clinician tries in the Monoblock dentures with the patient and evaluates the mid line, esthetic plane, fit, etc. If nothing needs changing, the clinician calls the lab and tells them to mill the finals. If changes are needed, then the monoblock can be added to, adjusted, marked on, or even have another wash impression taken inside it. This then can be returned to the lab for adjustments and/or rescanning.

6. If all was good the lab will mill the denture base and teeth (if milling teeth) and bond the structures together, polish the outer surfaces (no pumice really required, as the mill creates a very shiny surface already). The finished dentures are returned to the clinician for insertion.

These are the basic steps for a full U/L denture. There will be similar workflows for full upper or lower against natural dentition, and immediate dentures (removing teeth in the software). Of course some steps will be able to be skipped or modified to suit your workflows.
 
eyeloveteeth

eyeloveteeth

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Wow, you know more than I do right now! I haven't seen anything about the training dates for the larger mills yet. I know we are training on the PM1 right now, but that is only for blocks and not disks.

When we finally release 3Shape 2017 for our customers we will follow shortly after that with the release of our Digital Denture Professional (DPP) add-on software. This will give the option to be able to mill the teeth individually, in sextants, or full arches for bonding to the milled denture base. If you don't want the option to mill the teeth, and just want to use carded tooth stock, you won't have to buy the DDP add-on (last thing I was told).

Ide alized workflow with DDP will be as follows:

1. Dentist/Denturist will take preliminary impressions and a centric tray bite registration. They will also use our UTS-CAD to take measurements for the Campers Plane and Bi-pupillary Line. These will either be scanned in the office or sent to the lab for scanning. No need to pour impressions.

2. Lab will scan (or accept scans) and design combination custom tray / bite rims. The bite rims will have an area designed into it to accept our Gnathometer CAD, for the clinician to take an intraoral tracing for determining the VDO. These get sent back

3. Clinician will border mold and take a wash impression inside the tray/bite rim. At this point they can mark the high lip line, mid-line, cuspid line. If the scanner being used has the ability to do texture scanning, this can be done in marker. If not then either a positive or negative mark must be added to see these references in the scan. The clinician will then insert the Gnathometer CAD into the bite-rim and determine the VDO and lute the upper and lower impressions with bite registration or impression material. This then gets scanned or sent to lab for scanning.

4. Final impression / Bite registration gets scanned and sent to DDP software for design. Cast analysis is done in the software, teeth are picked from all Ivoclar or Candulor molds and automatically set. Lab tech will make any changes for esthetics, characterization or function. Tissue is then designed/characterized and either a wax-tryin (actually wax and carded/milled teeth) or what is called a Monoblock (solid white denture base and denture teeth) is milled for try-in. These are sent back to the clinician for evaluation with the patient.

5. The clinician tries in the Monoblock dentures with the patient and evaluates the mid line, esthetic plane, fit, etc. If nothing needs changing, the clinician calls the lab and tells them to mill the finals. If changes are needed, then the monoblock can be added to, adjusted, marked on, or even have another wash impression taken inside it. This then can be returned to the lab for adjustments and/or rescanning.

6. If all was good the lab will mill the denture base and teeth (if milling teeth) and bond the structures together, polish the outer surfaces (no pumice really required, as the mill creates a very shiny surface already). The finished dentures are returned to the clinician for insertion.

These are the basic steps for a full U/L denture. There will be similar workflows for full upper or lower against natural dentition, and immediate dentures (removing teeth in the software). Of course some steps will be able to be skipped or modified to suit your workflows.


thanks Patrick - most of these I was aware of - it's more the order form set up inside 3Shape, i don't know why it keeps only letting me pick denture tooth stock and not my regular anatomic library. I want to at least test and print some and mill some out to see what its like.

I'm so glad the PM7 locks in the Denture base so you just have to take the whole housing out to glue/bond the teeth in.

My biggest fear will be that VDO bite - because if it's not done right, how labs will charge for remakes / repairs will be very different. If the prices stay, $80 for the denture base was pretty awesome!

Aside from the denture order form design set up, I'd love to know if ALL the PM7 burs will be available immediately? It seems like you guys are doing product training EoM which tells me you have stock just not listed inventory.

If PM7 training is Aug, i guess we're looking at Mid Sept delivery?

anyway, thanks for the info, but can someone show me a 3Shape Order Form that would let me custom pick the tooth design? I select PMMA as a material, but it still only defaults to the denture tooth stock library when i get to that phase.
 
Patrick Coon

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Here are links to the clinical steps videos. I will see if I can find some videos showing a little of the lab steps, but these are still being developed.







 
Patrick Coon

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thanks Patrick - most of these I was aware of - it's more the order form set up inside 3Shape, i don't know why it keeps only letting me pick denture tooth stock and not my regular anatomic library. I want to at least test and print some and mill some out to see what its like.

I'm so glad the PM7 locks in the Denture base so you just have to take the whole housing out to glue/bond the teeth in.

My biggest fear will be that VDO bite - because if it's not done right, how labs will charge for remakes / repairs will be very different. If the prices stay, $80 for the denture base was pretty awesome!

Aside from the denture order form design set up, I'd love to know if ALL the PM7 burs will be available immediately? It seems like you guys are doing product training EoM which tells me you have stock just not listed inventory.

If PM7 training is Aug, i guess we're looking at Mid Sept delivery?

anyway, thanks for the info, but can someone show me a 3Shape Order Form that would let me custom pick the tooth design? I select PMMA as a material, but it still only defaults to the denture tooth stock library when i get to that phase.

As far as I know for the digital denture you will only be able to pick denture teeth, as the occlusal schemes (balanced, lingualized) are set to those. Now as we are able to start milling these teeth instead of using carded teeth, you will be able to morph and shape them as you want/need and any penetrations (into opposing or neighboring teeth) will be removed in the milling.
 
Patrick Coon

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Here is a video showing the design steps, unfortunately (or fortunately, depending on where you're from) it is in German, but it will give everyone a preview of the steps.

 
eyeloveteeth

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oh....that's really crummy. i was hoping we could customize it - and maybe use that as a proper segway from All on X to Zr final as well if we were to go that route.

Do you have the DME for the new teeth for us to practice on before we take delivery of the PM7?
 
Patrick Coon

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oh....that's really crummy. i was hoping we could customize it - and maybe use that as a proper segway from All on X to Zr final as well if we were to go that route.

Do you have the DME for the new teeth for us to practice on before we take delivery of the PM7?

I do not, and even if I did, wouldn't be able to give it out. That would fall on our folks at IV Troy.

As for the All on X to Zr02 conversions, I'm sure there will be some work-a-rounds for that as it gets into the market. I haven't had enough time to play yet, but have some ideas that may work. You'll just have to sign up for a course when I do. :)
 
eyeloveteeth

eyeloveteeth

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yeah, i know the PM7 training in Troy happens late July as of yesterday morning? I just think it'd be great if we could come for that too. It really helps with product planning (especially if we are going to be early adopters) - i figured i'd try running this by John Tupper or Roy Goldberg and see if Sarah would make exceptions for those that are early adopters.


Conversely, thanks for always keeping us up to date!
 
Patrick Coon

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I'm sitting next to JT right now!
 
eyeloveteeth

eyeloveteeth

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oh right he flew in yesterday!
 

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