Although there are thousands of dental laboratories worldwide,
not all of them communicate effectively and provide their dentists with high quality
dental lab products that exhibit longevity and lifelike esthetics. The long-term success of modern dental
restorations depends on a number of factors that dentists must take into
account to ultimately provide their patients with the best dental care services
available on the market. Such factors include adequate skills of laboratory
technicians, proficient dental laboratory processes, and effective
communication methods between the dental lab and dentist.
In order for a dental restoration to
have a successful outcome, proper manufacturing procedures and techniques must
be followed to ensure the patient’s high demand for durable and esthetically
pleasing prostheses are met. According to Rashid, long-term clinical success of
modern dental restorations greatly depends on “lab fabrication techniques and
clinical procedures that may damage these brittle materials,” along with
physical properties of the material and adequate skills of dental lab
technicians. 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 “faults
during condensation, in-appropriate powder/liquid mixing ratio and due to
variations in firing tine and temperature.”
As a matter of fact, major faults have
been indentified when lab technicians do not adequately finish the surface of
dental ceramics. For instances, if the surface of the dental material is rough
it will “abrade the opposing dentition or restoration,” and Rashid highly
recommends the lab technician finish and/or polish the surface appropriately [1].
Considering recent studies on wear of antagonist enamel, Miyazaki et
al. confirmed that adequate surface finish of all-ceramic restoratives resulted
in least wear of antagonist enamel and suggests that the “antagonist
enamel wear is significantly affected by the degree of surface finish.” For
that reason, it is very important lab technicians have adequate skills and
tools required to achieve an extremely smooth surface for least wear of
opposing enamel.
Furthermore, the surface quality and composition
of a dental restorative material determines the initial bacterial adhesion, and clinical studies have shown a rough surface
will accumulate more plaque [1]. The oral cavity is “constantly
contaminated by a complex diversity of microbial species that have a strong
tendency to colonize surfaces” and if the “roughness were sub-gingival, the
retention of the microorganisms would be more” [1]. Increased
amounts of plaque on rough surfaces of ceramics and enamel is the major cause
of dental caries and also a harmful influence on periodontal tissue [1].
The surface roughness and microstructure
of dental materials, particularly dental ceramics, is also a factor that influences
the strength 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 executed correctly. According to
Rashid, 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” [1]. More simply
put, laboratory processes can influence the existence of micro cracks and
residual stresses, and therefore should be executed competently by lab
technicians.
Additionally, Rashid argues other lab
processes are can be factors that influence the microstructure and thus the
strength of the restoration. Specifically, damage to restorations can be “caused
during grinding; pull-out caused during polishing, micro-porosity present on
the subsurface and the introduction of large pores by technicians during
restoration manufacture are common technical laboratory flaws “ [1].
Consequently, clinical success of a dental restoration is largely determined by
the skills and knowledge of the dental lab and their technicians, along with effective
communication between the dentist and dental lab to successfully collaborate on
a dental case.
Accordingly, restorative dentistry
requires effective communication
“between the dentist and dental technician in order to fabricate intraoral
prostheses with acceptable fit, function and aesthetics” [3]. 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]. Collaborative
technical advice on routine and complex dental cases is an important service
that dental laboratories should provide. Finding a dental laboratory that can
effectively communicate with their dentist is essential to the clinical success
of a dental restoration. Also, time is money. Dental Labs need to have an
efficient logistics team to assure dental cases are fabricated in time for the
patient’s scheduled appointment.
Given these points, choose a dental lab that
employs a knowledgeable team of certified dental technicians that can
adequately fabricate high quality dental lab
products. Also, finding a lab that can effectively
communicate with the dentist on a consistent basis is essential for the overall
success of a dental practice; ultimately to provide their dental patients with
the best dental care services available on the market.
About the Company:
Since 1991, Iverson
Dental laboratory has provided dentists with high quality dental lab products and excellent
dental lab services to ensure their dental patients are completely
satisfied with the restoration outcome. Iverson dental labs strives to be a
great dental resource for dentists by offering training on digital dentistry
and new dental implant techniques
at their high-tech operatory and training facility. Iverson dental labs strongly believe in using high
quality certified materials and authentic manufacturing components to fabricate
their dental restorations. Iverson also strongly believes in having a knowledgeable
team of certified dental technicians because clinical evidence has shown the
“skills of the clinician and technician are important for the long-term success
of a restoration” [1].
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. Miyazaki, T.,
Nakamura, T., Matsumura, H., Ban, S., & Kobayashi, T. (n.d.). Current
status of zirconia restoration. Journal
of Prosthodontic Research, 236-261.
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