Sterngold - Baltic Digital Denture System

Doris A

Doris A

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If I had a dime for every time I heard the words " I know it's only a very temporary fix, but do the best you can" I would be very rich!
 
Gru

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I'm a printed denture basher, but there's a growing place for them and like any other product there is a curve. I have a hard time seeing them replace milled (sticking to the digital world). Currently the place I see for them is try-in and bite verification. It also let's the patient have a "test drive" while issues are worked through. If the majority of dentures spend more time in the drawer than the mouth, then we need better tools. Some look hideous, but some not so bad as to be unwearable for a time. So here's an effort using DIM models. Bash away, but be precise if you will.
 

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bigj1972

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Let's be clear:
If an office called you and said "Got a fractured printed denture here. Pt is from out of town just needs to get home so they can get a new one printed. They want to be unashamed when on the way home. I don't expect you can do anything permanent, just put the parts together so they look like they have teeth and I know you can't promise anything"

You'd say. "No doc, I'm not doing that."?
I would try a good job with super glue free of charge. "Have a safe trip"
 
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bigj1972

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I'm a printed denture basher, but there's a growing place for them and like any other product there is a curve. I have a hard time seeing them replace milled (sticking to the digital world). Currently the place I see for them is try-in and bite verification. It also let's the patient have a "test drive" while issues are worked through. If the majority of dentures spend more time in the drawer than the mouth, then we need better tools. Some look hideous, but some not so bad as to be unwearable for a time. So here's an effort using DIM models. Bash away, but be precise if you will.
I've been around a few decades so I'll give my opinion. That case, while brilliant, looks like a very expensive procedure for a patient. And if i had spent that much money on something that will break within 12 months, I'd be pissed. If I had to go every 10 months and be fitted with a reprint I'd be pissed.

As far as try-in, bite verification, and test drives, your either gonna get eat up with expected free reprints, or your gonna be chasing down mystery adjustments that non-cooperative dentists who won't follow workflow protocols. They start the headpiece as soon as they take it out of the bag. Then patient sticks their finger in and says "rat hur", then zip a little occlusion. Then bite wears in over time, breaks, you reprint and "it doesn't feel right". Dentist gets frustrated with patient pleasing and hour long appointments. Patient says "I can't go without my teeth, I work in the public", Your running around trying to solve the problem. And then reality sets in. There's not 1 case. There's 5, then 15, then 50 time bombs floating around. You call customer service, they say to buy new improved version printer, or new stronger resin from Denmark.
And after all the time, money, equipment, and stress, you chunk it in the closet and dig out the wax and spatula.
 
Gru

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I've been around a few decades so I'll give my opinion. That case, while brilliant, looks like a very expensive procedure for a patient. And if i had spent that much money on something that will break within 12 months, I'd be pissed. If I had to go every 10 months and be fitted with a reprint I'd be pissed.

As far as try-in, bite verification, and test drives, your either gonna get eat up with expected free reprints, or your gonna be chasing down mystery adjustments that non-cooperative dentists who won't follow workflow protocols. They start the headpiece as soon as they take it out of the bag. Then patient sticks their finger in and says "rat hur", then zip a little occlusion. Then bite wears in over time, breaks, you reprint and "it doesn't feel right". Dentist gets frustrated with patient pleasing and hour long appointments. Patient says "I can't go without my teeth, I work in the public", Your running around trying to solve the problem. And then reality sets in. There's not 1 case. There's 5, then 15, then 50 time bombs floating around. You call customer service, they say to buy new improved version printer, or new stronger resin from Denmark.
And after all the time, money, equipment, and stress, you chunk it in the closet and dig out the wax and spatula.
I appreciate all thoughtful input. I’m primarily a c&b and implant guy. This is a stretch for me.
I did note try-in. If the patient is ok with the price, then good there. This patient will not take care of anything provided regardless of cost or quality. The final is probably going to be Lucitone w/ carded teeth or Zr.
Sounds like the procedures generally used for try in of dentures are very imprecise. Also sounds like managing patient expectations is difficult.
 
JMN

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Sounds like the procedures generally used for try in of dentures are very imprecise. Also sounds like managing patient expectations is difficult.
You want to remain that ignorant of their ignorance. It's simply not really taught anymore, and even if it is the classes are like:
Ok! Today you see a patient to adjust their denture sore spots.
This afternoon we'll make a custom tray.
Tomorrow you will learn to set teeth
Next week we'll look at Wax Rims

The data is just thrown, not presented. Not even really treated as a cohesive subject.
 
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FASTFNGR

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Let's be clear:
If an office called you and said "Got a fractured printed denture here. Pt is from out of town just needs to get home so they can get a new one printed. They want to be unashamed when on the way home. I don't expect you can do anything permanent, just put the parts together so they look like they have teeth and I know you can't promise anything"

You'd say. "No doc, I'm not doing that."?
You are assuming that the Dr knows it is printed? Do they think about what material this denture is made off? What if it was Eclipse resin denture? And if he or she does not, and it is the most important probability, back to my conclusion, everyone is screwed.
 
bigj1972

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"Eclipse resin denture? "
You mean the last revolutionary denture system that was gonna save the world? "Fit at try-in means fit at delivery". Ready in 15minutes. That's really a good example. Printed dentures are really just a liquid Triad denture. You just use 1000 layers and a dipping machine instead of fingers and putty.

Now let's tell the truth.
Is the technology amazing? Yes.
Is the pictured case precision looking? Yes cleaner than by hand.
Is it easily replicated? Yes.
Does the finished product look esthetic? No.
Will it last long enough to justify the patient's cost. No.
Will the patient and client be happy after a few months? No.
Will you be left holding the bag? Yes

One of the things I don't see mentioned in these discussions is profit. We all have opinions of the work from us Purists vs the New Agers. But the most important factor of any business is profit. How is this making you more money. In a nice heat cured denture, there's around 75% profit in sale price (don't start picking). Now by my figures, you start adding printers, scanner, design software, updates, resins, and consumables including 4 quarts of Gradia Gum. At the same price, I see that profit margin shrink.
Last time I checked, a bottle of base resin was 200 to 400 dollars. And I've fooled around with enough printing to know you have misprints, leveling and adhesion problems, film and screen problems. That will drastically reduce your per hour profitably when just whipping up 50¢ of stone or self cure would fix it in 5 minutes the traditional way.

So in conclusion, it is something cool to fool around with and even make a few things if you have the extra money to play around with. But, there's a reason big money is spending their resources on aligners and bruxers. Because it's about profitably. Scan arch, print model, suck down film. No adjustment, no 15 micron precision, just throw it in a denture cup with a nice logo. Boom $89 - $250. $2500 for aligners. Dentsply just spent $1-Billion, not for R&D, not to improve dental science. No they bought another aligner company, discontinued long standing products, and moved their tooth production to Brazil.
So as those ads continue to flush your magazines and mailboxes (we used to call it marketing propaganda),and instill fear that your gonna lose your clients, be penny less, and live in the street forever. Think about it real hard before making a large investment and commitment that could wreck you, not save you. If it ain't broke, don't fix it. If it is broke, buy a good tool, not the free plastic one that comes in the kit.
 
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JMN

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You are assuming that the Dr knows it is printed? Do they think about what material this denture is made off? What if it was Eclipse resin denture? And if he or she does not, and it is the most important probability, back to my conclusion, everyone is screwed.
At this point I really cannot tell if you simply refuse to answer the question or if we're having issues communicating.
 
Gru

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You mean the last revolutionary denture system that was gonna save the world? "Fit at try-in means fit at delivery". Ready in 15minutes. That's really a good example. Printed dentures are really just a liquid Triad denture. You just use 1000 layers and a dipping machine instead of fingers and putty.

Now let's tell the truth.
Is the technology amazing? Yes.
Is the pictured case precision looking? Yes cleaner than by hand.
Is it easily replicated? Yes.
Does the finished product look esthetic? No.
Will it last long enough to justify the patient's cost. No.
Will the patient and client be happy after a few months? No.
Will you be left holding the bag? Yes

One of the things I don't see mentioned in these discussions is profit. We all have opinions of the work from us Purists vs the New Agers. But the most important factor of any business is profit. How is this making you more money. In a nice heat cured denture, there's around 75% profit in sale price (don't start picking). Now by my figures, you start adding printers, scanner, design software, updates, resins, and consumables including 4 quarts of Gradia Gum. At the same price, I see that profit margin shrink.
Last time I checked, a bottle of base resin was 200 to 400 dollars. And I've fooled around with enough printing to know you have misprints, leveling and adhesion problems, film and screen problems. That will drastically reduce your per hour profitably when just whipping up 50¢ of stone or self cure would fix it in 5 minutes the traditional way.

So in conclusion, it is something cool to fool around with and even make a few things if you have the extra money to play around with. But, there's a reason big money is spending their resources on aligners and bruxers. Because it's about profitably. Scan arch, print model, suck down film. No adjustment, no 15 micron precision, just throw it in a denture cup with a nice logo. Boom $89 - $250. $2500 for aligners. Dentsply just spent $1-Billion, not for R&D, not to improve dental science. No they bought another aligner company, discontinued long standing products, and moved their tooth production to Brazil.
So as those ads continue to flush your magazines and mailboxes (we used to call it marketing propaganda),and instill fear that your gonna lose your clients, be penny less, and live in the street forever. Think about it real hard before making a large investment and commitment that could wreck you, not save you. If it ain't broke, don't fix it. If it is broke, buy a good tool, not the free plastic one that comes in the kit.
Now let's tell the truth.
Is the technology amazing? Yes.
Is the pictured case precision looking? Yes cleaner than by hand.
Is it easily replicated? Yes.
Does the finished product look esthetic? No. That will come with practice and advancement in product. Zr was horrid a decade ago. Still could be better.
Will it last long enough to justify the patient's cost. No. Depends on the purpose and only the patient decides value for cost.
Will the patient and client be happy after a few months? No. Again, depends on the purpose and managing expectations.
Will you be left holding the bag? Yes. Yet again, depends on clarifying purpose and expectations.

As to profitability, that is always a time vs. COG equation.
 
bigj1972

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Now let's tell the truth.
Is the technology amazing? Yes.
Is the pictured case precision looking? Yes cleaner than by hand.
Is it easily replicated? Yes.
Does the finished product look esthetic? No. That will come with practice and advancement in product. Zr was horrid a decade ago. Still could be better.
Will it last long enough to justify the patient's cost. No. Depends on the purpose and only the patient decides value for cost.
Will the patient and client be happy after a few months? No. Again, depends on the purpose and managing expectations.
Will you be left holding the bag? Yes. Yet again, depends on clarifying purpose and expectations.

As to profitability, that is always a time vs. COG equation.
Which is my point. "Will comes", "depends", and "expectations" are variables. The $1,000's you spend is an immediate constant.
 
bigj1972

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I'm looking into this system currently and hoping someone on here has looked into it or is using it that can share their experience (pros/cons).
It's a milled denture with the teeth incorporated in it using Sterngolds software. The sterngold software is $1,800 and the pucks are $173 approximately.
Much like Ivoclars ivotion, except you don't have to use 3Shape and don't have to use a PM Mill which is why I didn't personally go that route. I agree Sterngolds pucks are up there, doesn't leave much meat on the bone per say for the lab but it's doable. Sterngolds info on this system CLICK HERE

Why not just print?...printed dentures still blow!!! Milling is substantially stronger and much more aesthetic pleasing. Although, traditional dentures still look even better than milling, they are no comparison to printed is why.

What say you?
Sorry to hijack OP.
Milled puck dentures are pretty much the same. Just select your base acrylic. Then decide if you want your teeth "card glued on", arch milled, or two tone puck. The Baltic System looks intriguing as the teeth are pre-set, however I've seen the technique used pre-digital, so I know there will be problems if your a perfectionist. Also would speculate a higher cost than other puck systems as well.
 
Gru

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Which is my point. "Will comes", "depends", and "expectations" are variables. The $1,000's you spend is an immediate constant.
We already use the printers and mills for other things anyway.
We manage the account and patient expectations by honest, informed consent. They know what they are buying and believe in the value.
 
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Now let's tell the truth.
Is the technology amazing? Yes.
Is the pictured case precision looking? Yes cleaner than by hand.
Is it easily replicated? Yes.
Does the finished product look esthetic? No. That will come with practice and advancement in product. Zr was horrid a decade ago. Still could be better.
Will it last long enough to justify the patient's cost. No. Depends on the purpose and only the patient decides value for cost.
Will the patient and client be happy after a few months? No. Again, depends on the purpose and managing expectations.
Will you be left holding the bag? Yes. Yet again, depends on clarifying purpose and expectations.

As to profitability, that is always a time vs. COG equation.
I agree on a lot of things you said except when you mentioned the patient. Here is my problem:
is the patient told it is a cheap denture? Non esthetic? Is it the patient decision?
Is the patient and the Dr told that by law from the ADA that it has to be replaced after 5 years max with a very selected resin? Most of them less than 2 years. Does anyone who uses these resins know that? All depends wether the answer is yes or no.
 
JMN

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We manage office expectations. It's their job to manage the patient expectations. If they don't, I cannot help it.

The medical industry (don't kid yourself, that's exactly what it is) has the most backwards, fouled up, and totally nuts ways.
The patient, no matter what letters and such are on the door, is and will continue to be the least informed and consulted person about their own treatment.

Techs trying to educate patients on all the material science is a joke. We don't have access first of all. Concern over the replacement schedule of a printed denture is not my problem. The normal ones don't get relined on schedule either. Every office if you dig some will have windows of non-compliance with best practices.

Do you go with a 3 ring binder to every denture appointment and let the patients know all about the heat cure denture materials and teeth with MSDS sheets and such? Of course not.

If you're gonna preach, I expect you'd at least follow your word once you're out of the pulpit. Do you? Are you making contact and ensureing the patient gets it relined in a timely fashion and is cleaning and caring for it properly? Of course not.

The guys clinging to their vulcanizer had really good points about differences too. Acrlyic wasn't as good when it came out as it is now.

Let the tech mature. It's really really young. Like 1990's dental mills.
Let the dentist worry about patient education.
Make as decent a product as you can of what they want and make effort to educate the office. That's what can be done.
 
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Gru

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I agree on a lot of things you said except when you mentioned the patient. Here is my problem:
is the patient told it is a cheap denture? Non esthetic? Is it the patient decision?
Is the patient and the Dr told that by law from the ADA that it has to be replaced after 5 years max with a very selected resin? Most of them less than 2 years. Does anyone who uses these resins know that? All depends wether the answer is yes or no.
As JMN said, informing the patient as to whatever the current ADA rules (doubt it's law) go with a product isn't my jurisdiction. The dentist is to be the informed decision maker as to the acceptability of a product for the purpose. The dentists wouldn't want me in their op telling the patient whatever I believe, nor do I want the liability of doing so and making an error.
 
JMN

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The dentists wouldn't want me in their op telling the patient whatever I believe, nor do I want the liability of doing so and making an error.
I got an educatoin once for agreeing with a dentist in the op. He was really cool about it afterwards, but said he didn't want me to agree or disagree as then I'm endangering myself for practicing without a license if anything goes sideways and the patient is out for blood.
 
JMN

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is the patient told it is a cheap denture? Non esthetic? Is it the patient decision?
Patients don't get that information or choice on crowns/bridges. Which are never coming out non-destructively.

I do believe patient education, labeling requirements to the patient, and such things are needing a kick in the pants.
But I can't be the kicker.

If you want to, I'd welcome an effective method of general dental knowledge increasing in the populace. Like toothbrushes are not a scam to destroy your teeth so the dentist can make money replacing/crowning them.
Let me know how to help with that.
 

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