Titanium

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molarmaker

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My Drs. want me to research Titanium PFM's, who does the milling, what kind of porcelain, cost, would I have to get a scanner, we do about 150 PFM's a month, what are the insurance codes, does tilite from Tallidium count as titanium,searched already in here but still unsure, also health risk to tech,patient some one said something about cross contamination in lab, is this viable as a HN. replacement, some real life numbers would go a long way inputting a serious investment
 
doug

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Mark Jackson at Precision Ceramics in Ca. has as much knowledge as anyone and he's opposed to casting it...oxide layer problems and just plain nasty. Milled seems to work for some. Al Tassi in Chicago does a lot of it. He'd be a great resource. If it were really viable I'd think Jim Glidewell would be all over it. He seems to be more interested in milling Titanium implant abutments than copings. I guess there's no bonding issues with an abutment.
 
kcdt

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You should contact someone like Mark Jackson at Precision ceramics. He has researched this fairly extensively and knows a lot of the pitfalls of working with Ti.

My feeling, from what I've been able to glean when the conversation comes up is that its not really ready for primetime.
Casting Ti is nearly impossible in a predictable, profitable manner.
There is the Cad Cam option, yes, but then we go over to the ceramics themselves, and I have not heard that you'll get any results that you'd want to write home to mom about.
Add to that the fact that you'll need an argon atmosphere in your oven, and most likely a dedicated loop... and, well.
I'd also be VERY concerned about the market for the product. If this is all out of one account with no real guarantee of volume or interest beyond feelers...
As a younger tech I've been too willing to expand into a product line only to find it be the once in a decade request, and you're stuck with the investment and no return.
But if you want hard info. I'd talk to Mark or go on IDF, as this has been gone over there a few times.
 
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molarmaker

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Thanks Doug and KCDT, will call Mark tomorow, will search their web site today for more of the answers of my questions, Drs want answers now, got to strike when fire is hot ,so proned to cooling off on these tangents, gold bill intirely to high, now that ins co.'s are classifing Ti. as HN. something has changed in the process to change this.
Stan
 
doug

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Molar, You'll probably have to wait to speak with Mark. I think he just left for another trip to Africa. Ask for Jason, he seems to know quite a lot about the processes they have in place there and past experiences.
 
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trimmerman

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My Drs. want me to research Titanium PFM's, who does the milling, what kind of porcelain, cost, would I have to get a scanner, we do about 150 PFM's a month, what are the insurance codes, does tilite from Tallidium count as titanium,searched already in here but still unsure, also health risk to tech,patient some one said something about cross contamination in lab, is this viable as a HN. replacement, some real life numbers would go a long way inputting a serious investment

I work at B&D Dental we mill Noble Titan Titanium a grade 5 Titanium for copings and full contour restorations on our Origin mills everyday. This grade of Titanium is the same that they use for implants it is an 85% which makes it stronger than the more pure stuff. There have been way to many delamination problems in the past with cast Titanium. This is due to the metal always being overheated when it is cast. Titanium is overheated when heated above 880 degrees Celcius. this causes the metal to go through a chemical reaction which changes the metal. This is one thing that causes the porcelain to delaminate. By milling Titanium this problem has been overcome. We also use a great porcelain called Triceram it is manufactured in Germany by the company Dentaurum. Triceram is a low fusing synthetic porcelain that is easy to handle and looks great. We have been using it for about a year now with out any issues like bubbles, cracks, delamination etc.
the only difference in using milled Titanium compared to Traditional PFMs are that you do not have a degas firing. but you do have a powder or paste bonder fired on before you opaque so number of firing cycles are the same. you also process the metal a little differently. instead of going directly to the degas or opaque after sandblasting and cleaning the copings you let the copings sit in the open air on the counter top for 10-30 minutes to create and oxide layer. This layer is not visible to the naked eye, but doing this step helps to create the necessary bond strength with the porcelain. Now if you let the clean copings sit out longer than 30 min you will need to sandblast and clean them again with a steamer then let them sit again for 10 minutes in the open air. The porcelain is very reasonalbly priced at $31.50 for a 15g bottle $74.50 for a 40g bottle. We sell the coping for $25 a unit if you send us a file from your open arch scanner (STL File) or $45 a unit if you send models for us to scan, design and mill.
The Titanium insurance code from the ADA is D2794. the ADA classifies Titanium between noble and high noble alloy as long as it is contains at least85% Titanium which allows the dentists to use the above code for billing. Many insurance companies will pay HN rates for Titanium and others pay just higher than Noble rates.

Tilite from Talladium does not count as Titanium it is a non precious (Base metal) alloy but it is a great one at that.

We have swithed all of our PFMs over to PFTs or PFZs.

We do separate all the Titanium finshing burs from the other material like zirconia or all porcelain CAD material burs just like you should for the differnent materials that you use in your lab. although we do use the same porcelain ovens interchangeably with different materials without any issues. If you do decide to use one porcelain oven dedicated to Titanium you should make sure that you run a high degree cycle one or twice a week to burn out any contaminates. contaminates will build up if you only use low fusing cycles all the time. but as long as you use a higher temp cycle every now and again your oven will be fine. Oh and you don't need to worry about having and inert atmosphere when firing the porcelain on Titanium that is only necessary when casting Titanium.

I hope this helps
 
JohnWilson

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Very good post, very informative.

Since you are relatively new from what I read in the post ( 1 year) has there been any additional issues intra orally? Margins turning dark? Porc fractures?

With what it costs to do EMAX these days its very hard to even consider something else but I would like to have additional solutions for clients that don't fit into the EMAX mold.
 
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trimmerman

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yes margins may turn dark just like other PFMS unless you do a porcelain margin on the crowns. we have not had any remakes due to porcelain fractures.
when you have your own in-house Origin milling system it only cost $8 per unit for the material and bur costs to mill Titanium. How does that compare to emax
 
aidihra

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Nice info timmerman. Have you made any long span bridges with the titanium or only single units? I do find it odd that leaving a sandblasted unit out for 15-30 minutes is required to have the desired effect on the final product.
 
mert_k

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I work at B&D Dental we mill Noble Titan Titanium a grade 5 Titanium for copings and full contour restorations on our Origin mills everyday. This grade of Titanium is the same that they use for implants it is an 85% which makes it stronger than the more pure stuff. There have been way to many delamination problems in the past with cast Titanium. This is due to the metal always being overheated when it is cast. Titanium is overheated when heated above 880 degrees Celcius. this causes the metal to go through a chemical reaction which changes the metal. This is one thing that causes the porcelain to delaminate. By milling Titanium this problem has been overcome. We also use a great porcelain called Triceram it is manufactured in Germany by the company Dentaurum. Triceram is a low fusing synthetic porcelain that is easy to handle and looks great. We have been using it for about a year now with out any issues like bubbles, cracks, delamination etc.
the only difference in using milled Titanium compared to Traditional PFMs are that you do not have a degas firing. but you do have a powder or paste bonder fired on before you opaque so number of firing cycles are the same. you also process the metal a little differently. instead of going directly to the degas or opaque after sandblasting and cleaning the copings you let the copings sit in the open air on the counter top for 10-30 minutes to create and oxide layer. This layer is not visible to the naked eye, but doing this step helps to create the necessary bond strength with the porcelain. Now if you let the clean copings sit out longer than 30 min you will need to sandblast and clean them again with a steamer then let them sit again for 10 minutes in the open air. The porcelain is very reasonalbly priced at $31.50 for a 15g bottle $74.50 for a 40g bottle. We sell the coping for $25 a unit if you send us a file from your open arch scanner (STL File) or $45 a unit if you send models for us to scan, design and mill.
The Titanium insurance code from the ADA is D2794. the ADA classifies Titanium between noble and high noble alloy as long as it is contains at least85% Titanium which allows the dentists to use the above code for billing. Many insurance companies will pay HN rates for Titanium and others pay just higher than Noble rates.

Tilite from Talladium does not count as Titanium it is a non precious (Base metal) alloy but it is a great one at that.

We have swithed all of our PFMs over to PFTs or PFZs.

We do separate all the Titanium finshing burs from the other material like zirconia or all porcelain CAD material burs just like you should for the differnent materials that you use in your lab. although we do use the same porcelain ovens interchangeably with different materials without any issues. If you do decide to use one porcelain oven dedicated to Titanium you should make sure that you run a high degree cycle one or twice a week to burn out any contaminates. contaminates will build up if you only use low fusing cycles all the time. but as long as you use a higher temp cycle every now and again your oven will be fine. Oh and you don't need to worry about having and inert atmosphere when firing the porcelain on Titanium that is only necessary when casting Titanium.

I hope this helps
Dear Trimmerman,
I have read your comments and advices regarding fusing ceramic over titanium with interest. We are also working in our laboratory to produce titanium-ceramic crowns. We mill the titanium (grade 5) on our milling machines avamill chrome, and use GC ceramic material for Titanium frameworks, with kerasmart 200 furnace from Manfredi-Italy, which has an Argon inlet availability.
We have just started working on the issue, so it is rather early to talk about the results, but as fas as I can see from your message, argon is not a big necessity when we consider the "milled" ti framework.

Regards,

Mert
 
k2 Ceramic Studio

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Dear Trimmerman,
I have read your comments and advices regarding fusing ceramic over titanium with interest. We are also working in our laboratory to produce titanium-ceramic crowns. We mill the titanium (grade 5) on our milling machines avamill chrome, and use GC ceramic material for Titanium frameworks, with kerasmart 200 furnace from Manfredi-Italy, which has an Argon inlet availability.
We have just started working on the issue, so it is rather early to talk about the results, but as fas as I can see from your message, argon is not a big necessity when we consider the "milled" ti framework.

Regards,

Mert

Hi guys nice thred, and nice to see more and more people using Ti, we have been milling it for over 6 years now using GC Initial and have had great results, our remake % is less than our pfm crowns, in fact I cant remember the last time one did fail.
You do not need to use argon in your furnace at all as the top temp is 820'c so the oxide is stable and does not change so no argon is required. 15 to 30 min sound a long time to me for bench resting as we try to stick to the recommended 5min but not sure if that is because you guys are using grade 5, I was told that even though that stuff is stronger it also has a darker oxide than the grade 2 pure Ti that we use, is that true? What made you go for grade 5?

Have done a number of large bridges with no problems at all and mill a couple of all on 4 implant bars every day. This stuff is great and still not sure why so many people are hesitant to use it, any way have fun.
 
Vazone

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Why Titanium?
- Biocompatibility
- Strength
- weight
...
what else ?
 
Mark Jackson

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Why Titanium?
Biocompatibility: YES-

Strength: Maybe-

Weight: Maybe...

what else ?

I suppose cost is the major driving factor for most people to consider this, but it does open a whole can of worms in the case of technical difficulties. I'm sure there are people who are having success with it, but I still talk to people all the time who aren't. Mainly those who read these forums, try it, then call me asking for help to sort out the problems, which of course I can't do.

There is a reason that titanium porcelain sales are not even registering on the radar for the big companies, and no big production labs, including the Chinese are doing it.

Frankly, I have all my bets on monolithic restorations of the YZ, LDS and CR varieties, and the faster we get away from layering the better. Especially layering on something that is so sensitive!

I'll watch with amusement to see how fast this takes off. Since the post is already a couple years old, and most of the people who were curious way back then are STILL curious tells me a lot.
.
 
Mark Jackson

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I do find it odd that leaving a sandblasted unit out for 15-30 minutes is required to have the desired effect on the final product.

Titanium alpha coat is a science all unto itself. There are people who make a living off just that, and nothing else. You'll not find many people who can plate or layer titanium with ANYTHING, let alone low-tech dental porcelain.

If I were to do them at all, it would be as a full cast crowns or abutments/bars, in a number of pretty, anodized colors.

That's about it.
 
k2 Ceramic Studio

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Why Titanium?
- Biocompatibility
- Strength
- weight
...
what else ?

Hi guys

STRENGTH, Yes, we have done a lot of Ti bridges big and small, and have never had one break, Why would they, Tensile strength 90 000 100 000 N/mm2 (should be a really small 2 sorry)

WEIGHT, this stuff is fantastic as far as weight goes, I would say that you can dramatically reduce the weight of a dental appliance using Ti,

TASTE, Titanium has a neutral taste, so no strange tastes in the mouth for the patient.

CONDUCTIVITY, Titanium is a poor conductor of heat, so no oversensitivity due to hot or cold food

BIOCOMPATIBLE. Medical Grade 2 Titanium is a biocompatible material

RADIOLUCENT, This one will surprise most people. Titanium is the only metal in the world that is radiolucent.( Radiolucent: Anything that permits the penetration and passage of X-rays)

Oh yeh, it looks great with GC porcelain layered on it. :)

All the best Pete
 
Tom Moore

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There are better ways to put ceramic on Ti other than a hot furnace.
 
Tom Moore

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I was just kidding it can't be done.

mumble, mumble, what in the world came over me?:dontknow:
 
TheLabGuy

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The new insurance code puts the reimbursement of Titanium metal between noble and high noble PFM's. Milled Titanium should be the answer to everyone who hates base metals, doesn't want to use base metals, and is sick of putting crap metal in people's mouths.
 
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Why use another alloy that will eventually leave a black line at the margins, and maybe even darker lines ?
Some doctors are switching to all ceramic to get away from future black margin and seeing opaque on day one.....and looking for cheaper fixed prices
So, my question is......Why go there with another pfm alloy on your menu.... unless your accounts are asking for titanium....
 

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