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How to eliminate shade-taking variables / CAD/CAM a central topic at IDS 2011 / Industry

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LAB TRIBUNE
The World’s Dental Lab Newspaper · U.S. Edition

November 2010

www.dental-tribune.com

Vol. 1, No. 6

How to eliminate
shade-taking variables
International Dental Show (IDS)
takes place in Cologne, Germany,
from March 22–26, 2011.

CAD/CAM a
central topic
at IDS 2011
Show to focus on
current developments
in technology
Digital high-technology processes
increasingly determine the day-today work in dental practice and the
laboratory. This is especially true
where the precise design and production of classic or implant-supported
dentures are concerned.
In the case of high-value fullceramic restorations, the number of
cases since the beginning of this millennium is in the high tens of millions
— undoubtedly a success for modern
CAD/CAM technology.
“Today, this scientific and technological progress incorporates all
of the disciplines of dental medicine.
The importance of digital processes
for the opportunities of the team of
dentists and dental technicians can be
characterized without exaggeration as
revolutionary,” said Dr. Martin Rickert,
chairman of the Association of German
Dental Manufacturers (VDDI).
Today, users have available digital
methods that enable the precisely fitting and economic design and manufacture of crown and bridge frameworks up to and including complex
implant-supported superstructures.
The continued development of CAD/
CAM technology has been accomplished by years of intensive research
and development work on the part of
science and the dental industry.
In the meantime, digital design
and manufacturing processes have
firmly established themselves in most
practices and laboratories and have
leant important momentum to the
disciplines of prosthetics and implantology in particular. Dentists, dental
g LT page 3D

Tech advisor: Shade matching can be difficult because everyones’
eyes perceive color, shade, hue and value slightly differently
By Kevin Kim

As a technical advisor, I see a
lot of extremes. Complicated fullmouth reconstruction cases with
huge numbers of variables and
challenges to solve aren’t uncommon to see several times a week.
By the time I see the case, I’ve
already spoken with the dentist,
planned the case, and I know what
to expect. Difficult at times, but also
fairly routine.
It’s the cases that seem extremely straight-forward and easy on the
outside that can have the tendency
to throw me for a loop. And to be
honest, if I had to choose, I’d probably choose the full-mouth reconstruction over a single unit central
incisor any day of the week.
Why? Shade.
What makes matching a shade
so difficult? It’s the one physical
property of a tooth that’s loaded
with subjectivity. The rest of the
physical properties are very objective and easier to match; length,
width, and contour are all right
there on the study model and are
plain as day.
Shade can be difficult because
everyone’s eyes perceive color,
shade, hue and value slightly differently. What looks like a perfect match to one person could
look a little “off” to another. And
with cases like single-unit central
incisors that demand vital, lifelike
esthetics, a shade match that isn’t
perfect can mean one redo after
another, and a lot of unhappy people.
This isn’t new news to most of
us, though. The majority of cases
that come in are bundled with lots
of quality information about the
case and patient, including photos to communicate shade and
other subtle details such as incisal translucency, surface texture,
craze lines, demarcation lines and
calcification. But photos can be a
double-edged sword.
If they’re taken well, a photo
can speed the shading process and
eliminate lots of guesswork. On the
other hand, a photo that doesn’t

The Canon 40-D with 100 mm macro lens and ring flash is perfect for taking shade
photos to send to our doctors. (Photo/Provided by Dave Crone)
take certain variables into consideration can put the process back at
square one and increase the chances
that the shade won’t be perfect.
Just like any other job, using the
right tools can make all the difference. And in this case, the right tools
can help eliminate many of the variables that can throw the accuracy
of a shade-matching photo off. The
toughest variable to control in this
case is light and the way it affects
your subject. The amount, type, and
temperature of light can alter the outcome of a photo. A perfect example
is a photo with subjects that have
turned a bluish hue from fluorescent
lights or an orangish hue from incandescent lights.
Here are some tips you can offer
the dentists you work with on how
to master the light and control the
subject in your office to yield the most
accurate color in your photos:
• Use color-corrected office lighting. At Keating Dental Arts, every
fluorescent light is calibrated to 6,700
degrees Kelvin. It’s very close to the
temperature of natural daylight and
helps us eliminate light as a variable
for achieving accurate shades.
• Consider your backdrop. Seafoam
green operatory walls may match the
dentist office’s color scheme, but it

can throw off the accuracy of photos.
Colored walls reflect ambient light
and can impact the color of a photo. A
room or wall with a neutral color like
white, off-white or light gray usually
generates the best results.
• Consider your patient’s clothing. Just like the surrounding walls,
brightly colored clothing can reflect
ambient light and change the quality
of your photo. Using a neutral colored
drape or smock will help minimize or
eliminate that chance.
• Calibrate your camera’s white
balance. If your camera “knows” how
absolute white should appear, then
you can be more certain that the rest
of the colors will be accurate and lifelike. Consult your user’s manual for
this step.
• Determine shade at or near the
beginning of the appointment. The
longer you and your patient are looking at and comparing shade tabs, the
more likely you are to suffer from
ocular fatigue. A tired pair of eyes has
a tougher time determining shade.
• Have your patient remove lipstick
or other makeup. This is really about
minimizing distractions and making
it easier to determine a patient’s overall tone.
g LT page 2D

[2] =>

2D Shading
f LT page 1D

• Remember the vertical plane.
Make sure that the shade tab and
the patient’s tooth are in the same
vertical plane in space relative to the
camera’s lens.
If the shade tab is in front of
or behind the tooth, the way light
reflects the two can appear slightly
different to the camera.
• Take a black-and-white photo. A
black and white photo will help show
the value of the shade tab relative to
the patient’s tooth.
• Use a macro lens. A macro lens
makes close-up photography much
easier by reducing the minimum distance you can be from your subject.
The lens your camera came with
may not be able to focus on a subject
closer than a foot from the lens, but
with a macro lens, that distance can
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Lab Tribune | November 2010
be shortened to a couple inches.
This may seem like a lot of work
just to take a few photos, but remember the idiom, “an ounce of prevention is worth a pound of cure.” By
putting in the effort at the beginning

LT About the author
Kevin Kim began in the dental lab
industry as an outside sales representative for a small lab in Anaheim,
Calif. While attending Los Angeles
City College’s dental technology program, he was taken under the wing
of the late John C. Ness, CDT, of Productivity Training Corporation. Currently, Kim works as a technical
advisor for Keating Dental Arts in
Irvine, Calif.

to eliminate as many variables as
possible, the result is getting a deadon shade match the very first time,
which is what the patient wants, what
you demand, and what your laboratory strives to achieve. LT

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The World’s Dental Lab Newspaper · U.S. Edition

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[3] =>

Events 3D

Lab Tribune | November 2010
f LT page 1D

technicians and surgery staff can optimally acquaint themselves with the
state of the art in digital technology and
receive advice from manufacturers at
the International Dental Show (IDS),
which takes place in Cologne, Germany, from March 22–26, 2011.
The CAD/CAM supported manufacture of dental restorations involves
appropriately preparing the surfaces
of the teeth involved for the materials
to be used, then digitally acquiring a
three-dimensional image of the surfaces of these teeth and possibly also
neighboring and antagonist teeth so
that the data can be processed using
computer support. This can alternatively be accomplished by means of
intra-oral digitization, in which case a
conventional impression of the clinical
situation is not required.
Over the last years, the dental industry has developed innovative optoelectronic equipment systems for the noncontact intra-oral acquisition of the
surfaces of the teeth. These systems
can combine a large number of individual measurements of spatial coordinates of the preparations or teeth taken
from different angles under the special,
particularly difficult conditions of the
oral cavity to create a complete model
dataset. Such model calculations sometimes also require corrections — due
to the individual soft-tissue status or

because of the different translucence
of the tooth surfaces — to be applied in
order to ensure the necessary measurement accuracy.
The classical route to a digitized
model via impressions taken using
high-quality materials continues, today
and in the future, to offer an alternative
to the non-contact intra-oral processes.
A master model is created extra-oral
from the impression and then optically
scanned to acquire the three-dimensional image.
Nowadays, a wide range of precision
laser scanners and purpose-developed
CAD software is available for this task.
These systems can also be optionally
linked to and expanded using new
developments in imaging processes.
Today, the practitioner has available
an entire range of powerful imaging
techniques and user-friendly software
which, thanks to the international
DICOM standard, is compatible and
interoperable between manufacturers. Computer tomography and digital volume tomography, which can
for example be used for carrying out
implant planning precisely on-screen,
are particularly worthy of mention
here. Current digital planning methods
strengthen the already close cooperation between dentist and dental technician in prosthetic or implantological
therapeutic measures.
Modern CAD programs calculate
complex clinical situation surfaces

from the digital data on tooth stumps,
implant posts or plaster models. Occlusal features of antagonists or neighboring teeth can also be created on the
computer, all the way to complete contact point patterns. Individual functions
such as an undisturbed free glide space
can be elegantly designed and implemented in crown-and-bridge frameworks by means of CAD/CAM and CNC
milling technology.
CAD/CAM technology has available a constantly growing palette of
materials including the oxide ceramics
— primarily zirconium dioxide — and
titanium and cobalt-chrome alloy, both
of which are increasingly being used
for milling frameworks. The division
of labor between the dental laboratory
that handles the design and the external industrial milling center suitable for
the technically demanding processing
of the metal materials has proven itself
in this area.
Specialized companies now even
offer the design and manufacture of
complex post- or bridge-supported
superstructures, in which case the
commissioning laboratory can then
concentrate entirely on the subsequent
finishing work in ceramic or plastic.
In addition to these subtractive, indirect processes that use CAD/CAM to
manufacture dental prostheses from
material blanks by removing material,
additive, direct processes are also used
in dental prosthetics. So-called rapid

prototyping technologies enable a cast
to be made in various ceramic, plastic
or metal materials directly from the
CAD program. Modern processes such
as laser sintering, stereolithography or
fused deposition modelling can build
up the necessary layers of material
successively and with high precision
until the final form of the restoration
has been reached without the need to
manufacture a mould in advance. Dentists and dental technicians will have a
unique opportunity to gain a comprehensive overview of the latest concepts
in dental CAD/CAM technology during
their visit to the IDS 2011.
“From March 22–26, the International Dental Show in Cologne — the
world’s largest trade fair for dental
medicine and dental technology —will
provide trade visitors from dental practices and dental laboratories an ideal
opportunity to talk to specialists from
exhibiting companies, experts and
experienced users. Here, they will be
able to address the whole spectrum
of modern CAD/CAM processes and
current developments in dental digital
technology,” said Dr. Markus Heibach,
president of the VDDI.
IDS takes place in Cologne every two
years and is organized by the Gesellschaft zur Förderung der Dental-Industrie GmbH (GFDI), the commercial
enterprise of the Association of German Dental Manufacturers (VDDI) and
staged by Koelnmesse GmbH. LT
AD

[4] =>

4D Industry

Lab Tribune | November 2010

KOMET USA offers cutters
for left-handed operators
Eight different
instruments for
working on various
laboratory materials
If you are a left-handed dental
professional searching for an instrument that will cut plaster, acrylics or
metal alloys, then KOMET USA has
the right burs for you.
KOMET USA offers eight different instruments allowing left-handed operators to ergonomically cut
material efficiently and precisely.
Standard cutters only cut efficiently
if rotating to the right.
That means only right-handed
users can work towards their body
and left-handed users must awkwardly perform the same technique
in the opposite direction.
By using KOMET’s left-handed
cutters, designed to rotate to the
left, left-handed users can now
ergonomically work toward their
body.
The left-handed instruments
available from KOMET are:
• H79SGEL.104.070 — super
coarse carbide cutter for rough trimming of plaster during model fabrication or of denture bases.
• H261EL.104.023 — carbide cutter for fine or interdental trimming
of acrylics, plaster and metal alloys
during model casting, crown-andbridge and acrylic techniques.
• H79EL.104.040 — carbide cutter for universal trimming of acrylics, plaster and metal alloys during
model casting, crown-and-bridge
and acrylic techniques, as well as
model fabrication.
• H251EL.104.060 — popular carbide cutter shape especially designed
for trimming acrylics dentures.
AD

KOMET USA offers eight instruments for left-handed operators. (Photo/Provided by KOMET USA)
• H295EL.104.023 — carbide cutter
that is mainly used for trimming of
metal surfaces during model casting
and crown-and-bridge techniques.
• H79EFL.104.040 — carbide
cutter for fine trimming of acrylics and metal alloys during model
casting and crown-and-bridge
techniques.
• 329L.104 and 305L.104 —
stainless-steel mandrels with lefthanded threads to be used with polishers.
KOMET’s left-handed cutters provide an unobstructed view of the
surface being worked on, and all
chips and dust are directed toward
the suction device at the work station.
All instruments are indentified

with the word “left” laser etched on
the shank. To use these specialty
instruments, users are instructed to
switch all handpieces to a left-hand
motion.

About KOMET USA
KOMET is a recognized worldwide
leader in the production of highly
specialized and precise dental rotary
instruments. KOMET operates in
the United States under the name
KOMET USA, and sells direct to
practitioners and dental laboratories. The company’s U.S. headquarters is located in Rock Hill, S.C.
For more information about
KOMET USA or the left-handed cutters, please call (888) 566-3887 or
visit www.komet-usa.com. LT

SensAble
launches new
lab solutions
in Germany
SensAble Technologies, a leading provider of dental restoration
design and fabrication solutions,
3-D modeling software and haptic devices, recently announced it
has appointed Antonius Koester,
GmbH & Co., KG, as its first dental reseller in Germany — and
named R+K CAD/CAM Technologie, GmbH & Co., KG, as the first
German-authorized production
center partner.
Together, they will help
SensAble expand its dental
lab presence in the Germanspeaking regions of Europe through
the sales, support and services
associated with the award winning
SensAble™ Dental Lab System, and
its new modular configurations.
These two new important partners in Germany will accelerate
SensAble’s reach into Europe, one
of the fastest-growing segments of
the worldwide dental lab market,
which is projected to grow to $14.5
billion by 20151.
“German dental technicians
demand the best, and they will
find it in SensAble,” said Antonius
Koester.
Founded in 1993, SensAble is
the leading developer of 3-D touchenabled (force feedback) solutions
and technology that allow users
to not only see and hear an onscreen computer application, but
to actually “feel” it.
“Through our partnerships with
Antonius Koester and R+K, we’ll
provide a new level of product
and services tailored specifically
to meet the needs of this technically-advanced, world-class dental
market,” said Bob Steingart, president of SensAble Dental. “We look
forward to great success in Germany.” LT

[5] =>

Industry 5D

Lab Tribune | November 2010

Sirona’s biogeneric software and inEos blue
desktop scanner receive 2010 WOW! Awards
Two new products
from Sirona Dental Systems have been named
among 2010’s most innovative tools for the dental
laboratory industry by the
Journal of Dental Technology (JDT).
Sirona’s inEos® Blue
desktop scanner and CEREC® and
inLab® Biogeneric software share the
honor as 2010 WOW! winners in the
October issue of JDT.
For the sixth annual WOW! issue,
the Journal of Dental Technology
gathered an independent panel of
laboratory technicians to help identify
the most ground-breaking products,
services and equipment available to
dental technicians. Determining factors for this year’s list were based on
products that exemplify quality and
substantially save time and money.
Panelists reviewed more than 40
nominated products to choose the
twelve winners.
Some of the winning features highlighted in the publication were the
time and money saved using Sirona’s
Biogeneric software, as the generated

restoration proposals created using
the software are usable with no or
minimal modifications. Furthermore,
the software provided a substantial
reduction in internal remakes.
In addition, the JDT panel of
judges found that by using Biogeneric software, the overall restorative quality is improved by the software’s ability to replace subjective
occlusal anatomy design with objective, scientifically proven anatomy
design methods.
The WOW! factor was defined
as the software’s efficient approach
to clinically and functionally viable
mass-customization of individualized
restorative occlusal surface anatomy.
The inEos Blue desktop scanner
was placed on the winning list for
its time- and money-saving aspects.

According to the
JDT panel of judges, using the inEos
Blue saves time by
producing
more
units daily than is
possible with the
standard method.
Moreover,
the
accuracy of the scans makes the dental technician more efficient, thus
cutting down on labor costs and providing improved overall quality of the
restoration.
The WOW! factor of the inEos Blue
is stated as follows: “As the demand
for CAD/CAM restorations increases,
you can be confident in providing
high-end restorations at twice the
level of productivity.”
The original WOW! nomination
reflects JDT’s statement by remarking: “I have scanned over 600 units
with the new inEos Blue and have
had margin issues on two units. The
real “WOW” factor is that as my
demand for CAD/CAM restorations
increases, I will be confident in providing my accounts with high-end
restorations while at the same time

being twice as productive as the old
conventional methods.”
“Sirona is extremely pleased that
two of our latest solutions for dental
professionals have been featured by
JDT and embraced by the dental
industry,” said Roddy MacLeod, vice
president CAD/CAM. “Since 2005,
Sirona has won five WOW! awards
and we plan to continue to WOW! the
industry with innovative services and
products that surpass the market’s
expectations.”
Past WOW! honors for Sirona
include a 2005 win for the inEos® Dental Digitizer. In 2006 Sirona received
a WOW! award for its revolutionary
infiniDent service, and in 2008 Sirona
shared the honor with Ivoclar Vivadent for IPS e-max® CAD restorations
through CEREC® Connect.
To view a full list of WOW! products, visit www.nadl.org, or pick up
the October issue of the Journal of
Dental Technology.
For more information about
the inEos Blue desktop scanner
or Sirona’s Biogeneric software,
call (800) 873–7683 or visit www.
Sirona.com. LT
AD

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How to eliminate shade-taking variables / CAD/CAM a central topic at IDS 2011 / Industry

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