Lab Tribune Middle East & Africa No. 1, 2014
More flexibility in the lab / The necessity of (Dental Technician-Patient) interaction for a successful esthetic material selection / Interview: “One cannot just replace a technician with a machine”
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[1] =>
Dental Tribune Middle East & Africa Edition | November-December 2014
lab tribune 1D
More flexibility in the lab
By Ivoclar Vivadent
S
CHAAN,
Liechtenstein:
The extended product
range of the IPS InLine metal-ceramic system from Ivoclar
Vivadent offers dental professionals an even greater choice of
application options.
It is often the small things that
render the daily lab work more
comfortable and flexible. This
also applies to the IPS InLine
System Powder Opaquer which
makes alternative application
techniques accessible.
The IPS InLine System includes
a manageable number of components and an extensive range
of applications according to the
respective prosthetic situation.
The system is suitable for every
processing technique – from the
easy one-layer and the conventional multi-layer to the presson-metal technique. The new
IPS InLine Powder Opaquer
meets this high level of flexibility as it is compatible with all system components.
Furthermore, users benefit from
many economic and technological advantages: The Powder
Opaquer is equally suitable for
the conventional application
with a brush or application instrument as well as for the sprayon technique. What is more, the
same IPS InLine System Powder
Opaquer Liquid is used irrespective of the application technique.
(IPS InLine System Powder Opaquer & Liquid.jpg)
Fig: The new Powder Opaquer and the corresponding Powder
Opaquer Liquid
Fast veneering of all CAD/
CAM-fabricated and cast metal frameworks
The homogeneous structure of
the new Powder Opaquer with
optimized grain size distribution
ensures a high application and
firing stability.
Thanks to the optimally coordinated opacity and colour
saturation, the desired shade is
easily achieved with the Powder
Opaquer. Frameworks, fabricated with either conventional
casting methods or digital processes, are quickly masked even
with only thin layers due to the
material’s excellent masking
strength.
IPS InLine® is a registered
trademark of Ivoclar Vivadent
AG.
Contact Information
For additional information,
please contact:
Ivoclar Vivadent AG
Bendererstr. 2
FL-9494 Schaan
Phone: +423 235 35 35
Fax: +423 235 33 60
E-mail:
info@ivoclarvivadent.com
www.ivoclarvivadent.com
[2] =>
2D lab tribune
Dental Tribune Middle East & Africa Edition | November-December 2014
The necessity of (Dental Technician-Patient) interaction
for a successful esthetic material selection
Extreme white
By Aiham Farah, Syria
M
ore important than the
indications of a certain
case, (especially when
the need behind the treatment
plan is the bleach-esthetic part
in the first place), is to understand the patient’s needs and
expectations.
As a dental technician, you have
to give your insights about a possible solutions from the technical standpoint, and whether
these solutions can be done to
the extent of the patient’s esthetic visualization, or if they will
compromise another functional
or phonetics parameters.
Bright Decent
Finding out more about the
patient’s personality and what
needs to be expressed with his/
her smile, will add a lot of judgment on our decision as to what
to choose of restorative esthetic
material. Like how bright the
color should be? Is it a concern
of how natural the outcome
looks? Or on the contrary, what
matters is how prominent and
visible to everyone it is?
This can be done only if we allow the dental technician to interact with the patient’s personality that is hidden behind his
replica plaster-working model!
Therefor; I divide the esthetic-
Back to Natural
seeking people, who show up
to the dental studios asking for
a change in their smiles (based
on the intensity of bleach color
required, and the concern of
how life-like those ceramic teeth
should look like) to a three categories:
Back to Natural – Bright decent
– extreme white. Then I relate
that to the most used esthetic restorative material system in the
world, the IPS e.max system.
So The dental team can easily
rely on certain factors in choosing:
1st. their restorative ingots ac-
Back to Natural
cording to a scale of bright-dark
shades and transparent-opacity
range.
technique is recommended,
(MO0 & LT BL1) ingots are recommended.
2nd. the working technique to
be carried out.
Never to forget that the above
mentioned is always relative to
the thickness of the material.
For (Back to Natural) patients.
The Layering working technique is a must, (Value & LT &
MO1) ingots are recommended.
For (Bright decent) Patients
Either the Cut-back working
technique Or layering, (LT BL2,
BL3 & MO0) ingots are recommended.
For (extreme White) Patients
Full press & Staining working
Contact Information
Aiham Farah. CDT
Technical Training Consultant
Near East & Orient
IvoclarVivadent
Email:
aiham.farah@ivoclarvivadent.com
Interview: “One cannot just replace a technician
with a machine”
Interview with the Agnini brothers, dentists and prominent specialists in fixed prosthetics,
periodontology, and implantology
By John Battersby, Singapore
B
rothers Dr Andrea Mastrorosa Agnini and Dr Alessandro Agnini presented
a series of lectures on digital
dentistry and mastering the fully
digital workflow at IDEM Singapore 2014 in April. The doctors
were two of the star speakers at
the Dental Technician Forum
introduced for the first time at
this year’s IDEM Singapore. Between their packed schedule of
lectures and open panel discussions, the brothers took time out
to answer some questions on
their experiences in Asia, the
current state of digital dentistry,
CAD/CAM, and 3-D printing,
and the direction in which they
see these technologies developing in the future.
John Battersby: Have you observed any difference between
Asian and European techni-
cians when it comes to their
familiarity with and adoption
of the latest digital dentistry
technology?
Dr Andrea Mastrorosa Agnini:
We have not really had the opportunity to work closely with
any Asian technicians yet, so we
do not know with which technologies they are familiar or which
technologies have already been
widely adopted in Asia. What we
have seen is that there is massive and growing interest in all
> Page 3D
[3] =>
Dental Tribune Middle East & Africa Edition | November-December 2014
lab tribune 3D
< Page 2D
Figs. 2 & 3. Digital workf low by Drs Agnini
Fig. 1. Drs Allesandro Agnini and Andrea Mastrorosa Agnini
“... one still needs a dental technician who
is well trained in using all these
new digital technologies...”
aspects of digital dentistry, not
only among technicians but also
among all members of the modern dental team.
Dr Alessandro Agnini: Yes, this
is why there are more events like
the Dental Technician Forum at
IDEM Singapore and other similar events around Asia, just like
one sees in Europe and the US.
We were here in Singapore last
November for the CAD/CAM
conference and we will be back
again later this year for another.
How did you find your Asian
audiences at IDEM Singapore? We (Asians) have a reputation for being very shy when
it comes to asking questions;
did you have many questions
or much feedback?”
Dr A. Agnini: Actually, we had
quite a few questions from the
floor and via the SMS system
they used for the Dental Technician Forum. The audience can
text any questions they have to
a number and we can answer
them after the presentation during the Q & A session.
Dr A.M. Agnini: “The SMS system worked really well because
people could ask us anything
and often they asked us about
something we had not had time
to cover in the presentation or
had not included because we
were not sure whether it would
interest people. With such questions, we thus could cover such
topics too.”.
in using all these new digital
technologies; it is not easy for
anyone to use these new digital
technologies for the first time.
One needs a great deal of training to fabricate a final restoration that is precise, predictable
and of the same quality as that
achieved via traditional protocols and craftsmen technicians.
Software can help the clinician,
the technician and the patient,
but on its own cannot solve the
problem; one still needs a skilled
person behind the machines to
tell them what to do.
Dr A. Agnini: The machine
does not know what to do; it
cannot look at a restoration and
see where we need more support, or whether a molar needs
to be done this way or another
way. We need a person with the
skills, knowledge and training to
decide how to shape this framework if we are to achieve the
outcome of long-term predictable restorations.
But now, a well-trained and
knowledgeable technician using CAD/CAM can dramatically improve his or her productivity.
It has been suggested that Asia
might not be as quick to adopt
digital technologies as Europe
and the US because skilled labour costs here are still comparatively low, so there are
not the same savings to be
made by giving some of the
technicians’ jobs to machines.
Do you think that is true?
Dr A. Agnini: That is true, one
advantage of CAD/CAM is one
can speed up production. Another advantage for the dental technician is that one can reduce the
variables without reducing the
quality. The third advantage is
that it can level the playing field
between technicians and make
standards more homogeneous.
Before, especially for large restorations, the technicians’ skill
with their hands was crucial in
producing high-quality restorations, but with new technologies
perhaps technicians who are
less skilled in traditional manual
manufacturing techniques can
produce high-quality restorations.
Dr A.M. Agnini: One cannot just
replace a technician with a machine. In Europe or anywhere
else, one still needs a dental
technician who is well trained
While everyone agrees that
digital dentistry is the way of
the future, there does seem to
be one area where not everyone agrees. Everyone agrees
that the first two steps of the
process, that is the acquisition
of data via some form of scanning and CAD, are essential,
but when it comes to the CAM
component, there seems to be
a divergence of opinions.
One of the other speakers
at IDEM Singapore, Mr Rik
Jacobs, seems to think that
3-D printing can already cope
with most laboratory manufacturing and, once the latest biologically compatible
materials currently being developed have been tested and
approved, 3-D printing will be
able to do everything, including implants. Do you see that
happening or do you think
precision milling will be with
us for many years to come?
Dr A. Agnini: We do not have
much experience with 3-D
printing machines. For sure,
they will one day revolutionise
the future of dentistry, but right
now I do not think they can
match the precision achieved by
milling machines. For the time
being, I think milling machines
are a gold standard that will be
difficult to surpass.
As scanning and CAD/CAM
technologies, and especially
the software that links the
three stages, improve, do you
think more dentists or at least
the larger dental practices will
start to do more manufacturing in-house rather than using
external laboratories? And if
that is the case, what can laboratories and technicians do
to retain their customers?
Dr A.M. Agnini: The in-house
milling process is a hot topic
nowadays in dentistry. Everything has to begin and end with
the quality of the final restoration in mind, and that will always have to be the deciding
factor. Today, the clinician has
the option of organising his or
her work as he or she prefers,
but doing everything by himself or herself is, in our opinion,
something that is not convenient
or practical.
It is a different matter if the clinician has in his or her clinic a
well-trained dental team who
can manage the digital workflow
Fig. 4. Surgical guide made with 3-D printer (Objet Eden260V,
Stratasys) on the model.
Fig. 5. Surgical guide made with 3-D printer (Objet Eden260V,
Stratasys) in patients mouth.
“One needs a great deal of training to fabricate a
final restoration that is precise...”
from beginning to end. Such
a team would have to include
an expert dental technician devoted to studying and mastering
all of the latest digital possibilities. Only this way can this quality be achieved and the clinician
be satisfied from a business and
economic standpoint.
if the dental laboratories want
to keep themselves in business,
they have to incorporate the latest digital solutions into their
practice, understand and invest
in them, and work out how to
make the most of them. It is the
only way dental laboratories will
survive this digital dentistry era.
Another solution is to team up
with an external expert laboratory that can design, customise
and produce the prosthetic elements. This way, one does not
have to invest in the initial startup costs involved in setting up a
dental laboratory.
“The buzzwords at this year’s
IDEM Singapore were definitely “CAD/CAM” and “3-D
printing”, but what do you
predict the buzzwords will be
in 2018?”
In summary, on the one hand,
the craftsmanship of the dental
technician cannot be replaced
by digital dentistry; it will still be
necessary to work with someone
in-house or externally who is
capable and up-to-date with the
technology. On the other hand,
Dr A. Agnini: I think in 2018
the buzzword will be “full
digital workflow”, meaning a
completely predictable digital
process, and “full-arch rehabilitation”. Today, it is still too early
to manage complex cases with
the intra-oral scanner; the average error is still too large.
[4] =>
Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in
identifying quality providers of continuing dental education. ADA CERP does not approve
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by boards of dentistry.
CAD/CAM & DIGITAL DENTISTRY INTERNATIONAL CONFERENCE
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08 - 09 MAY, 2015
06-10 MAY, 2015: HANDS-ON COURSES
JUMEIRAH BEACH HOTEL
DUBAI, UAE
14 CME HOURS
th
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DENTAL TECHNICIANS INTERNATIONAL MEETING 2015
Part of the
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International Conference
08 - 09 MAY, 2015
JUMEIRAH BEACH HOTEL
DUBAI, UAE
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