TrueDef IOS

[rkm rdt]

I think we have so much fun here on DLN that everybody and their brother want to be dental techs just like us!arty:

 

[boyan]

First I’d like to say I wont argue with anyone but I’ll show you my business plan. I welcome any criticism and I wont get offended … actually I think it will be a great learning experience:

ROI plan:

Currently:
250 FCZ crowns/year at $99 = 24,750
20 implant crowns/ year at $190 = 3,800
TOTAL: $28,550

Future:
I have quotes on zirconia 98*/14mm discs for $130 (local guy so no shipping) and I can mill about 25-30 crowns on average. This makes a crown cost $5.20 plus an additional $3.00 for tools, electricity and other so total $8.20.

250 FCZ x $8.20 = $2,050
20 implants x $8.20 = $164
Labor: $0 – I guess I’ll spend less time on facebook. Staff is already on the payroll. And yes design takes 10-12min – I timed myself today. And for those critics I’ll post a pic of a milled crown in wax. Milling takes 15-20min. Staining is tricky – staff will learn it though – I’m not concerned. And after all I’ll be doing posterior teeth only…. so besides me and my hygienist no one will see back there. And from experience let me tell you – unless we are talking about 6 though 11 patients DO NOT CARE how their molar looks like! But thats only for as long as it is not black!
Unforeseen issues: $1000/year
TOTAL: $3,214

Total savings: $28,550 – $3,214 = $25,336/year

Further more – now when I can make inlays and onlays and deliver them the same day (lava ultimate or other materials) I’ll have much more things to offer and increase production. I wont include this in the calculations though!

Total investment:
ezMill: $31,000
oven: $14,000
exocad: $5000 – I chose this because there are no yearly fees.
PC and zirconia staining: $1400
Other things along the way: $600

Total Investment: $52,000

So break even point: 2 years. Have in mind I will definitely increase production through inlays/onlays, and I can become a provider of more ins. since profit margin is better now.

Someone also asked about the scanner – why iTero and not 3M’s true definition or Trios. Well the reason is because iTero was FREE!!! I got it from the old doctor who sold me the practice.

OK guys its your turn … hit me hard!

 

[boyan]

Are you and your colleges willing to pay more for your anterior work then?
Your lab will have to make up for the lost revenue somehow?

I am willing to pay more for a nice restoration but "more" becomes tricky! As i said for posterior teeth patients do not care. They just want to be out of the chair. For 6 - 11 they care a lot. But again what is "more" for a crown. If you come and tell me "I'll make you the BEST looking #8 you have ever seen and I'll charge you $250" yet I know it costs you $10 to make it I'll say "he must be greedy" and I wont buy it. On the other hand if the guy next door can make me something nice and can make it match well for $150 I'll probably buy from him. It all depends on my experience. Currently I pay 130 for emax anterior teeth and I am very happy. I've had 1 or maybe 2 returns in 3 years. Fit is always perfect (thx to iTero) and shade is 90% right on. Why change?

 

[Labwa]

I bet you shop around too...call labs and ask them to match prices from china? I'll give you the big tip no one can make a crown for 10 dollars...except you apparently. I envision seeing patients walking out of your office with anterior FCZ in a couple of weeks. Think of all that money mate!

 

[martintay]

I'm not sure it is entirely through ignorance John. Pressure to lower our fees is coming from all angles. We have outsourceing , we have implant companies,we even have other techs coming on here, looking for the average fee everyone charges only to turn around and drop it by 10 %.

We even have cad/cam which facilitates the lowering of fees through labour savings.I think you mentioned this as one of your plans for 2013.

I'm not sure we can put the genie back in the bottle.

Are prices being driven down everwhere, because they are here at all levels ! But i don`t see dentists charging less !!

 

[rkm rdt]

I am willing to pay more for a nice restoration but "more" becomes tricky! As i said for posterior teeth patients do not care. They just want to be out of the chair. For 6 - 11 they care a lot. But again what is "more" for a crown. If you come and tell me "I'll make you the BEST looking #8 you have ever seen and I'll charge you $250" yet I know it costs you $10 to make it I'll say "he must be greedy" and I wont buy it. On the other hand if the guy next door can make me something nice and can make it match well for $150 I'll probably buy from him. It all depends on my experience. Currently I pay 130 for emax anterior teeth and I am very happy. I've had 1 or maybe 2 returns in 3 years. Fit is always perfect (thx to iTero) and shade is 90% right on. Why change?

It would cost me a heck of a lot more than $10 to make. I have overhead too .

I find your use of the word "greedy" to be a tad ironic.

 

[rkm rdt]

Are prices being driven down everwhere, because they are here at all levels ! But i don`t see dentists charging less !!

We have the same pressures but fortunately the lab fee is separate from the dentist's fee here.That eliminates the dentist from finding a lab that melts down car bumpers to make pfms so he can save $10.

 

[martintay]

Personaly i think cad- cam will kill many of us in time , as work is rapidly becoming a cheap commodity.High skills will no longer be such a factor , and machines will be able to cover most of the market. I may be wrong but i forsee less and less technicians and labs competing on cad prices ! We have all helped manufactures develop this equipment by being short term guinee-pigs, and now they are ready to sell direct to dentists !!Any thoughts from you wise men and women ???

 

[martintay]

We have the same pressures but fortunately the lab fee is separate from the dentist's fee here.That eliminates the dentist from finding a lab that melts down car bumpers to make pfms so he can save $10.

Nice, i`m on my way to Canada ! In England there was supposed to be a lab fee element for health service work but it ignored !!

 

[NicelyMKV]

Luckily for the patients, I care about what their posterior crowns look like...


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[ceram1]

Luckily for the patients, I care about what their posterior crowns look like...


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As well as how they function. Think about how many cad crowns most of us made before we were actually getting truly outstanding results. How many zr crowns are in our drawers for reject just on shade or chipping alone. $600 for unforeseen expenses, I don't think this guy is for real. ROI in 2 years at 500 units. Someone has got to be just messing with us. Can a doc even access stl files directly from an Itero, I don't have any Itero accounts, I thought there was some sort of fee. Maybe only on model option? I think we are getting our chains jerked, this generally is just not plug and play especially at a micro volume with no dental tech. Background.

 

[araucaria]

Extract

Labor: $0.
Staff is already on the payroll.

so if the staff have time to do these tasks, they're currently doing nothing, or shouldnt be on the staff?
stafftime is the most valuable part of the process, it must be valued surely?

 

[Hary]

First I’d like to say I wont argue with anyone but I’ll show you my business plan. I welcome any criticism and I wont get offended … actually I think it will be a great learning experience:

ROI plan:

Currently:
250 FCZ crowns/year at $99 = 24,750
20 implant crowns/ year at $190 = 3,800
TOTAL: $28,550

Future:
I have quotes on zirconia 98*/14mm discs for $130 (local guy so no shipping) and I can mill about 25-30 crowns on average. This makes a crown cost $5.20 plus an additional $3.00 for tools, electricity and other so total $8.20.

250 FCZ x $8.20 = $2,050
20 implants x $8.20 = $164
Labor: $0 – I guess I’ll spend less time on facebook. Staff is already on the payroll. And yes design takes 10-12min – I timed myself today. And for those critics I’ll post a pic of a milled crown in wax. Milling takes 15-20min. Staining is tricky – staff will learn it though – I’m not concerned. And after all I’ll be doing posterior teeth only…. so besides me and my hygienist no one will see back there. And from experience let me tell you – unless we are talking about 6 though 11 patients DO NOT CARE how their molar looks like! But thats only for as long as it is not black!
Unforeseen issues: $1000/year
TOTAL: $3,214

Total savings: $28,550 – $3,214 = $25,336/year

Further more – now when I can make inlays and onlays and deliver them the same day (lava ultimate or other materials) I’ll have much more things to offer and increase production. I wont include this in the calculations though!

Total investment:
ezMill: $31,000
oven: $14,000
exocad: $5000 – I chose this because there are no yearly fees.
PC and zirconia staining: $1400
Other things along the way: $600

Total Investment: $52,000

So break even point: 2 years. Have in mind I will definitely increase production through inlays/onlays, and I can become a provider of more ins. since profit margin is better now.

Someone also asked about the scanner – why iTero and not 3M’s true definition or Trios. Well the reason is because iTero was FREE!!! I got it from the old doctor who sold me the practice.

OK guys its your turn … hit me hard!

I know dentists think they are on top of the food chain. But if we (TECHS ) fall down You ( Dentists ) are next to fall. What i mean by that if your thinking this, there are other dentists thinking the same so welcome to the price lowering club. Next thing you know your next door dentist is charging 100$ a crown to the PATIENT.

 

[Labwa]

Id like to be a fly on the wall when this guy is yelling at his nurse for not glazing those 15 crowns in between patients.

 

[CoolHandLuke]

the investment of such money in a homebrew lab probably will even off in 2 years, however there is a faster and better method which i will describe in a bit of detail.

i've been working on this "concept" since 2007.

it basically consists of an investment in 5 very basic things with two optional components.

1. a small portable air compressor.
2. roland dwx50
5. (three, sir) right! 3. 3shape premium software package (or whichever the user actually prefers to use including outsourced design from another lab)
4. an undisclosed induction heating device of my own brew.
5. stain kit of your choice.

optionally you can opt for a small portable 3dprinter, also you can opt to not purchase the stain kit if you already do staining of crowns chairside.

what this package will allow a single technician to do is to be flexible; make PMMA temporaries if that is all that is requested. surely not, however, as this setup allows the designer to immediately do 2 things: print try-in jigs for implant frameworks, and mill immediate crowns. but with an added value.

see the beauty of this setup is in the induction heater of my own design. its still undergoing some tweaks and development but it will be able to fully sinter zirconia faster than 2hrs normally done with traditional sintering crucibles and heaters. this is non-contact heating so its far more safe and economical. in a pinch it can be used to bake stains too.

this is a much bigger initial investment however.

this when paired with Intraoral scanning is essentially a cerec unit, but a hellofa lot better. with good designers on the software you can have a full 14 unit roundhouse (sorry bob) Izir bridge complete with try-in jig in under 2 hours (tryin jig of that size in under half an hour) made at the dentist office. no more shipping, no more overnight pressing or burnouts. in a "lab" that fits in a refrigerator box with room for a sixpack.

a person who owns one of these "labs" can sell himself to the highest bidder. never have to sit in one place more than a day if he chooses. can service a whole medical building if required. hell, if i build it right he can operate out of the back of a chevy astro.

edited to add: the time you spend remaking a lot of your zirconia (which you will do a fair amount of) costs you in units per puck and time lost redesigning and re milling. you MUST double the amount you have factored for this investment because i can guarantee some units will be chipped, fractured or broken even before they get sintered. my experience has been for every unit milled we've lost about 2 units worth in miscellaneous errors and just everyday screw ups. with big production comes big screw ups, and you are estimating a rather size-able amount of possible screw ups.

 

[boyan]

Hi Everyone,
I see my idea was not well accepted. And thats ok ... I understand. I would probably feel the same way if someone came up with a "cavity vaccine" But they have not yet.... so you can say anything you want and you can be as unhappy and you want and can tell me as many times as you want that this is not going to work (which I was told many times about dental school aka that I can never do it) but here is the bottom line: there is a lab right now right here in the US that is going to suffer a 25K less in production in 2013 just because of me. PERIOD! So good luck to all of you. I was just trying to be helpful to the once who can see through all this ... and the short sighted once ... well have fun ... Take care ...

 

[rkm rdt]

I think an arrogance vaccine would be more welcome around here!

 

[Al.]

Hi Everyone,
I see my idea was not well accepted. And thats ok ... I understand. I would probably feel the same way if someone came up with a "cavity vaccine" But they have not yet.... so you can say anything you want and you can be as unhappy and you want and can tell me as many times as you want that this is not going to work (which I was told many times about dental school aka that I can never do it) but here is the bottom line: there is a lab right now right here in the US that is going to suffer a 25K less in production in 2013 just because of me. PERIOD! So good luck to all of you. I was just trying to be helpful to the once who can see through all this ... and the short sighted once ... well have fun ... Take care ...

I would love to see you post some of your seated anterior cases here in the "Case Presentation" section or in the "Cosmetic Section" on Dental Towne for pier review.

My bet is your $130 anterior Emax crown seats will take some hits.
Don't know where you came up with the $10 a unit number but it costs $25 alone just for the ingot to press a crown. Not including other materials and equipment and labor.

I also bet you will NEVER make any of your anterior cases public for pier review.

I make a good living replacing crappy, esthetically marginal and failing dentistry done by Drs that look at the bottom line first rather than quality.

You have to prove your quality everyday not talk about it.

Lets see some pics of that acceptable anterior work.
I want to go WOW that's nice when I see your work!

 

[Hary]

Hi Everyone,
I see my idea was not well accepted. And thats ok ... I understand. I would probably feel the same way if someone came up with a "cavity vaccine" But they have not yet.... so you can say anything you want and you can be as unhappy and you want and can tell me as many times as you want that this is not going to work (which I was told many times about dental school aka that I can never do it) but here is the bottom line: there is a lab right now right here in the US that is going to suffer a 25K less in production in 2013 just because of me. PERIOD! So good luck to all of you. I was just trying to be helpful to the once who can see through all this ... and the short sighted once ... well have fun ... Take care ...

By the way, what your saying its not comparable with cavity vaccine. Cad cam system is a tool like any other tool in my lab it will never replace a dental tech. it will maybe reduce and facilitate some steps. In my 23 years i have seen dentists that wanted to cut their lab fee by buying all sorts of equipment
to do the job them self but in the end 2 things happen. They gave up all together or hired some techs. to do their job in their clinics.
We are all aware that our profession is evolving very fast, the importance is to adapt. I have some dentist use to outsource even to over sea's and their back with me again, i have another dentist that i have lost to the cerec system about 5 years ago know his fed up with the upgrades and the fees he said ( last year only he spent 40 k on cerec ) He is sending cases again.
Sorry Boyan if i offended you in any way but this is the reality what i have seen in my years in this business, i hope you will succeed in yours.

 

[Al.]

First I’d like to say I wont argue with anyone but I’ll show you my business plan. I welcome any criticism and I wont get offended

Currently:
250 FCZ crowns/year at $99 = 24,750
20 implant crowns/ year at $190 = 3,800

patients DO NOT CARE

OK guys its your turn … hit me hard!

This is a public forum not only do dental professionals read this but patients also.

Not a good business attitude to publicly say your patients dont care, about anything you put in their mouth and show that you are putting in the lowest and cheapest restorations made on the planet.

If you are going to bottom feed for the cheapest medical devices you can put in patients mouth and let that be your business model keep it private.

Hey you said "hit me hard". Thats just the way I see it.

I get tons of work from dentists that send me crowns for their assistants and family and gladly pay $250 a unit and they photo the cases and use them to market. Then they put in cheap $99 stuff in their patients mouths.

LOL thats called Bait and Switch.