Showing posts with label implant dentistry. Show all posts
Showing posts with label implant dentistry. Show all posts

Tuesday, January 12, 2016

Top 5 Requirements to Expect When Seeking a Quality-Oriented Dental Lab

Although there are many dental laboratories in the U.S., not all can deliver the quality that many patients today would expect from their dentist. The dental lab that dental professionals choose may impact their business and quality of care they provide. Due to patients high expectations, it’s important to find a quality-oriented lab that can fabricate prosthetics with high esthetics and the proper mechanical properties needed for long-lasting restorations.

Finding a dental lab that cares about the quality they provide is essential for your practice to thrive and succeed throughout the years. Listed here are the top 5 requirements you and your dental team should anticipate when choosing a quality-oriented dental laboratory.

1.    Use genuine manufacturer parts and hardware for implant restorations

Using genuine implant manufacturing parts is important for the long-term success of implant restorations. The number of imitative implant manufacturers has increased greatly in recent years, and while some may make decent parts, others compromise quality for cheap, low-quality alternatives. According to Steve Pigliacelli, CDT, “It is not uncommon for labs to use plastic imitation components and pass them off as genuine…you must question how a lab can offer any implant restoration at such a low cost”. This can be a “serious offense,” he goes on to explain, “if you ask for a genuine Nobel Biocare™ bridge and the lab uses a knockoff.” Not only is this unethical but the manufacturer’s warranty is voided and if the implant fails, then the surgeon or periodontist will be responsible for replacing the implant.

Furthermore, using genuine implant components—screw, abutment and implant—from the same manufacturer minimizes complications such as implant or restoration fracture, screw loosening and fracturing; as well as minimizing biological complications such as bone loss or bacteria penetration. Pigliacelli recommends if you want to save money on parts, “get your own account, buy your own parts, and supply them to the lab to use.”

2.    Use ADA-approved materials for their dental lab products

It is recommended to be sure the dental materials that your lab uses are manufactured by reputable companies and are ADA-Approved1. The American Dental Association’s Approved products go through a stringent, scientific-based investigation that assesses the manufacturing standards that assure purity and uniformity in dental materials. Not only is using dental materials that are manufactured by reputable companies better for the oral health of the patient, but it is also a more ethical decision that you would expect from a quality-oriented dental lab. Some labs will pass off cheaper alternative materials for brand name ones. To ensure your getting quality ADA-approved materials, request manufacturer information from your lab. This is important to fabricating quality restorations that will give your patient the longevity and proper mechanical properties that they expect from your dental expertise.

3.    Provides reliable technical advising services

Technical Advising is one the most important services a dental lab should excel at. “Prosthodontics is a discipline that requires a synergy between the dentist and dental technician in order to fabricate intraoral prostheses with acceptable fit, function and aesthetics,” reported by Berry et al.. This “synergy” requires collaborative teamwork between the lab’s technical advisor and the restorative dentist to achieve the best outcome for restoring the patient’s oral health. Whether it be planning a case, dealing with a challenging patient, working with new materials, developing a digital workflow, or implementing CAD/CAM technologies within their practice—the clinician should be able to rely on their dental laboratory for knowledgeable solutions.

One of the more important aspects of technical advising is supporting the clinician with complex cases—relying on them for the right shades and knowledge of subtle nuances, teeth position, materials and restorative options. From treatment planning to placement of the prosthetic, reliable technical advising and collaborative teamwork between both parties achieves a better outcome for the patient. Some quality-oriented labs will send their CDT implant specialists to aid in surgery, further minimizing complications and showing the patient that the dentist has a team to create the smile that’s customized just for them.

4.    Lab should not send dental work offshore, use “gray-market” or counterfeit products

Outsourcing dental work to a foreign lab runs the risk of substandard quality and little (if any) governmental regulation of material safety and of the manufacturing processes. Some domestic labs will outsource their dental work to foreign labs and pass it off as their own, compromising the quality you would want from a domestic dental lab.

Dental material manufacturers sell their dental products either directly to the laboratory or through their authorized distributors. When the lab purchases products from a specific distributor, the source must be authorized by the manufacturer or they will run the risk of receiving gray-market and counterfeit products that may be passed down to you.

According to Dr. Christensen, gray-market products “include branded goods intended by the brand owner for one national market that instead are diverted and resold by unauthorized distributors to another market.” Counterfeit products pass off fake materials under a legitimate brand name. The main concerns for “gray-market” and counterfeit dental products are they may not comply with FDA regulation requirements, the quality and material safety may be compromised, and a false negative brand perception among clinicians3. Ordering only from “known, authorized retailers will ensure that the products are legitimate and from respected manufacturers”3. Therefore, when choosing a lab you can trust be sure to ask the lab where they purchase their products and if their vender is an authorized distributor.

5.    Lab facility should be clean, equipped with the latest dental technologies and dental materials

CAD/CAM technology has transformed and revolutionized the way dental laboratories design and manufacture restorations. CAD/CAM technology has streamlined the lab’s workflow, increasing productivity and predictability within their fabrication processes. The dental lab you choose should not only be up to clinical standards, but they also should be up-to-date with the latest dental technologies and materials to provide you with the best quality available on the market. As well as to stay competitive with other dental labs and industry pricing. 

Pigliacelli recommends taking a tour of the your prospective lab—meeting the lab owner, quality control manager, and technical advisors. He questions, “Is it clean?…Why would you accept a dirty, pumice-covered, disheveled mess of a dental lab instead of a professional-looking establishment?…Are the work desks neat?…Do the technicians take care of the equipment and respect their tools?” When a lab is well-organized and clean, its shows the company commits to high standards and holds their employees to those same standards.

To put briefly, it’s imperative to find a dental lab that you can trust because you as the dentist is reliant on your dental lab to consistently provide your patients with the best dental lab products available on the market. Quite often the patient sees a failed restoration as the clinician’s mistake and rarely blames the dental lab; so when clinicians choose a low-quality or offshore dental lab they run the risk of unhappy patients.

Dental professionals need to have strict requirements when choosing the best dental lab to fabricate their patients’ restorations. The lab’s mission should align with your mission: find the best solution for restoring the patient’s oral health.

About the company

Since 1991, Iverson Dental laboratories has provided their clinicians with high quality dental lab products and excellent dental lab services to ensure their clinicians’ patients are completely satisfied with their customized restoration. 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 believes in using high-quality certified materials and authentic manufacturing components to fabricate their dental restorations. Iverson also has a knowledgeable team of certified dental technicians because clinical evidence has shown adequate skills of the technician are important for the long-term success of a restoration.

Sources:

1. Pigliacelli, S. (n.d.). Top 5 questions you should ask a dental lab before you send them a case. Retrieved January 12, 2016, from http://www.perioimplantadvisory.com/articles/2011/4/top-5-questions-you-should-ask-a-dental-lab-before-you-send-them-a-case.html

2. 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.


3. Christensen, G. J. (2010). Are You Using “Gray-Market” or Counterfeit Dental Products? The Journal of the American Dental Association, 141(6), 712-715.

Tuesday, October 6, 2015

Advantages of CAD/CAM Custom Abutments in Implant Dentistry

The use of CAD/CAM (computer-aided design/computer-aided manufacturing) technology to design and manufacture custom implant abutments is a highly predictable and reliable fabrication process; demonstrating survival rates comparable to conventionally fabricated abutments2. The latest generation of CAD/CAM techniques allows the “clinician or technician to fully customize the abutment contour to match carefully the clinical situation after tissue customization with provisional restorations”1.

Benefits of CAD/CAM Custom abutments

·         Precisely configures abutment for ideal anatomic contours1
·         Optimal design for esthetic emergence profile1
·         Highly predictable manufacturing process2
·         Availability of angulation correction1    
·         100% survival rates reported up to a 6-year period2
·         No technical complications reported up to a 6-year period2
·         Cheaper than gold cast abutments1

Over the last 10 years, dental CAD/CAM digital systems have been gaining increased use in implant dentistry because of the accurate and calculable nature of CAD/CAM technology. For instances, some studies found the fit of “CAD/CAM implant frameworks to be statistically superior to that of conventional cast frameworks”1. It also has improved productivity and efficiency of prosthetic manufacturing processes within the dental lab. Continuous improvements to CAD/CAM technology have started to challenge the technique of fabricating dental implants and abutments using conventional methods.

Implant abutments should be made from biocompatible materials with adequate mechanical properties to meet the functional, biological and esthetic demands1. Furthermore, they should “accurately and passively fit on their mating implants to prevent complications, such as screw loosening, bone loss and abutment fractures during function”1. To achieve optimal mucogingival esthetics, dental implant abutments require the appropriate emergence profile needed to support the surrounding soft tissue, especially for esthetically driven patients1.

Implant abutments can be either stock, cast custom or CAD/CAM custom abutments. The main advantage of stock abutments is their lower initial cost, but a major disadvantage is the ideal anatomic contour and emergence profile cannot be achieved. Cast custom abutments have similar tough mechanical properties to CAD/CAM custom abutments; however, the complicated fabrication process of investing, casting and finishing could be prone to manufacturing errors1. Whereas, the use of CAD/CAM technology to design and manufacture custom abutments has been clinically proven to be extremely accurate due to the predictable nature of computer-aided manufacturing2.

In a 2014 systematic review by Harvard School of Dental Medicine, researchers found CAD/CAM technology is able to provide results that are comparable to that of conventional techniques for implant survival, abutment survival, technical and biological complications2. In the study, a total of 101 patients were treated with a total of 138 CAD/CAM implant abutments with the same patient group seen at 12, 36, and 67 months. Three different major CAD/CAM systems were used to fabricate the dental implant abutments: Procera (Nobel Biocare), Straumann Cares, and Zirconzahn. Amazingly, they found the CAD/CAM abutment survival rate is 100% and no complications were reported, including screw loosening or fracturing of the abutment2.

In sum, CAD/CAM custom abutments have demonstrated survival rates comparable to conventionally fabricated abutments and have several advantages over other fabrication methods, allowing the technique to be a viable option for manufacturing custom implant abutments.  

About the Company

Since 1991, Iverson Dental laboratory has provided dentists with high quality dental lab products and excellent dental lab services to ensure dental patients are completely satisfied with their restoration outcome. Iverson dental labs strongly believes in using high quality certified materials and authentic manufacturing components to fabricate their dental prosthetics given that material quality influences longevity of the restoration. Iverson Labs values their skilled team of certified dental technicians because clinical evidence has shown adequate skills of the technician are important for the long-term success of a restoration. Iverson dental labs strive to be a great dental resource for dental professionals by offering training on digital dentistry and new dental implant techniques at their cutting edge on-site operatory and training facility.

To inquire more about CAD/CAM custom implant abutments, please visit http://www.iversondental-labs.com or call us at (800) 334-2057.

Reference:

1. Kim, E., & Shin, S. (n.d.). Influence of the implant abutment types and the dynamic loading on initial screw loosening. The Journal of Advanced Prosthodontics J Adv Prosthodont, 21-21.


2. Kapos, T., & Evans, C. (n.d.). CAD/CAM Technology for Implant Abutments, Crowns, and Superstructures. The International Journal of Oral & Maxillofacial Implants Int J Oral Maxillofac Implants, 117-136.