In order to meet dental patients’ high expectations for
long-lasting and highly esthetic dental restorations, its essential for
dentists to find a dental laboratory they can trust and rely on for quality dental lab products to ultimately provide optimal patient care
services. The
long-term success of modern dental restorations depends on a number of factors
that dentists must take into consideration when choosing the best dental
laboratory to fabricate their patients’ dental prosthetics. Such factors
include the lab’s ability to employ skilled dental lab technicians to adequately
fabricate high quality dental lab products, and the lab’s ability to preserve
the strength and esthetics of dental materials for restorations by executing
proper lab techniques and procedures.
The success or failure of a dental restoration is also determined
by how effective the dental lab’s communication methods are, prompting dentists
to find a dental lab they can depend on
for effective communication. Finding a dental lab that a dentist can
trust to consistently deliver first-rate dental lab products and dental lab
services can be taxing, but the alternative can lead to unsatisfied patients
and be damaging to a dentist’s reputation.
Clinical evidence has shown the “skills of the clinician and
technician are important for the long-term success of a restoration,” therefore
dental laboratories must ensure their lab technicians have
the skills and knowledge necessary to manufacture high quality prostheses on
a consistent basis [1]. For instances, fabricating
porcelain crowns and bridges is a highly sensitive technique and requires adequate skills of lab technicians
because “minor laboratory faults may result in clinically unacceptable surface
layers” [1]. One major fault is the formation of porosities that in
turn may negatively affect the surface roughness, texture and shade of the
restoration. Common reasons for the formation of porosities in dental porcelain
as described by Rashid are “laboratory faults during condensation,
in-appropriate powder/liquid mixing ratio and due to variations in firing time
and temperature.”
The long-term clinical success of modern
dental restorations greatly depends on “the physical properties of the
material, the laboratory fabrication process, the laboratory fabrication
technique and clinical procedures that may damage these brittle [ceramic]
materials” [1]. The surface roughness and
microstructure of dental materials, particularly dental ceramics, are also
factors that influence the strength and long-term success of a restoration. During laboratory processes—such as powder compaction, process of forming, firing and shaping—can cause flaws in dental ceramics when the procedure is not performed correctly.
Rashid explains during lab processes, flaws may become inherited in the surface
and/or microstructure of dental ceramics that can compromise the strength and
esthetics of a restoration. Surface roughness will “lead to a non-uniform
stress distribution and concentrate locally an applied stress due to the shape
differences in the surface layer… developed cracks cannot propagate randomly
but occur or propagate at points with higher stress,” causing fractures at
these points of high stress [1]. In other words, laboratory
processes can influence the existence of micro cracks and residual stresses
that affects the longevity of the material, and therefore should be executed
competently with the correct dental lab procedures and techniques by capable
lab techs.
Along with the ability to adequately manufacture ceramics
and other dental materials with acceptable mechanical properties, the lab technician
must also have the ability to recreate esthetic details that will match the
patient’s natural tooth shape, texture and shade characteristics. Dr. Markus
Blatz, restorative dentistry’s leading researcher at the
University of
Pennsylvania School of Dental Medicine, states the goal of restorative
intervention is “to mimic nature as closely as possible” and the dental
materials used should “depend on the patient’s needs”
[6]. Recreating esthetic details that mimic the patient’s natural teeth
is crucial when “subtle details in texture, anatomy, and contours keep the
ceramic restoration from looking contrived and can provide the element of
‘prefect imperfection’ that natural teeth exhibit”
[4]. In
The Penn Dental Journal for the
University of Pennylvania School of Dental Medicine, Dr. Blatz explains how he
relies on the artistic skills of his dental technicians to first plan and
design the substructures using CAD/CAM systems, and then build “the individual
teeth by hand and applying the layers of ceramic on top of the copings and
frameworks”
[7]. He further adds, “Despite all technical
advancements, machines are not able to recreate the intricate and subtle
esthetic features of a natural tooth. That’s why [the lab technician’s] artistic
expertise is so important"
[7].
Restorative dentistry also requires effective communication between the
dental lab and dental practice to achieve the restorative goals set by the
patient and dentist. With the development of software programs and
effective web applications, dental labs can now use web content management
systems (WCMS) to communicate to the dental office and manage laboratory cases
at a faster and more accurate rate. As stated by Alshiddi, “Laboratory case
management is a teamwork that should involve good communications between not
only the dentist and the dental technician, but also other staff in the dental
office (e.g., dental assistant and receptionist) and dental laboratory (e.g.,
laboratory owner, receptionist and delivery person)” [2]. When
managing a large number of dental lab cases, the lab must implement an effective content management system
that will manage all of the dental cases coming from multiple forms of
communication methods (e.g., hand-written lab authorization forms, telephone,
email, photographs, electronic STL files, etc.). Equally important is the lab’s
understanding of individual software requirements and design of the software
that will essentially, if implicated correctly, improve communication and will
ensure long term relationships between the dental office and dental laboratory [2].
Providing excellent
dental lab services will lead
to “well-designed prostheses, satisfied clinician and comfortable professional
relationship between the clinician and dental technician/laboratory”
[2].
The dental laboratory must provide great customer service for dentists and their
dental office personnel, so all parties can work effectively together in the
interest of the patient’s oral health.
Collaborative
technical advice on routine or complex dental cases is a very important
service that dental laboratories should exceed at every time. The lab needs to
have a strong management team to implement and oversee quality control processes
on every dental case. They must also have an effective logistic team to ensure
dental cases are fabricated and delivered in time for the patient’s scheduled
appointment. Offering in-house custom shade appointments should be available
for doctors and their patients, making sure the lab facility is up to
professional standards in appearance and services they provide.
As stated in General Dental Council’s (GDC) policy document
Principles of dental team working,
“members of the dental team will work effectively together” and members have to
“communicate clearly and effectively with other team members and colleagues in
the interest of patients”
[3]. Given these points, choose a dental lab that employs a knowledgeable
team of certified dental technicians that can consistently fabricate high quality dental lab
products. Also, finding a lab that can effectively
communicate with the dentist and dental office personnel is essential for the
overall success of a dental practice.
About the Company
Since 1991,
Iverson
Dental laboratories has provided dentists with high quality
dental lab products and excellent dental
lab services to ensure dental patients are completely satisfied with
their restorative outcome. Iverson dental labs offer training on
digital dentistry
and new
dental implant techniques
at their high-tech operatory and training facility. Iverson dental labs strongly believes in using high
quality certified materials and authentic manufacturing components to fabricate
their dental restorations. Iverson also strongly believes in having a dedicated,
knowledgeable team of certified dental technicians because clinical evidence
has shown the skills of the lab technician are critical for the long-term
success of a restoration. They serve dentists from all over North America with
a strong following in Pennsylvania (PA), Texas (TX), and California (CA), where
they are leading the way in providing professional dental lab services and
products to ultimately improve patient care in restorative dentistry.
Reference:
1. Rashid, H. (n.d.). The effect of surface roughness on
ceramics used in dentistry: A review of literature. European Journal of Dentistry Eur J Dent, 571-571.
2. Alshiddi,
I. Communication Between Dental Office and Dental Laboratory: From Paper-based
to Web-based. Pakistan Oral & Dental Journal, Vol. 34 Issue 3, p555.
3. Berry,
J., Nesbit, M., Saberi, S., & Petridis, H. (2014). Communication methods
and production techniques in fixed prosthesis fabrication: A UK based survey.
Part 1: Communication methods. BDJ Br Dent J.
4. Weston,
J., & Haupt, E. (n.d.). Creating Aesthetic Success Through Proper Clinician
and Laboratory Technical Communication. Dental Clinics of North America,
371-382.
5. Miyazaki, T., Nakamura,
T., Matsumura, H., Ban, S., & Kobayashi, T. (n.d.). Current status of
zirconia restoration. Journal of
Prosthodontic Research, 236-261.
6. Blatz,
M. (2013, January 1). Prosthetic parameters and materials for anterior implant
esthetics. Lecture.
https://www.for.org/en/video-insights/markus-blatz-prosthetic-parameters-and-materials-anterior-implant-esthetics?rate=KDjDad61ETC0oRsYOyMxaye7jTkb3qvyTEpMruuj9qM
7. Bonett,
J. (2009). Bringing Da Vinci to Dentistry. Penn Dental Journal, 5(2), 2-5.
Retrieved August 31, 2015, from
http://www.dental.upenn.edu/pdf/penn-dental-journal/pdj_spring09.pdf
