The zirconia lies

Zirconia replaces gold?

Zirconia can not replace gold! In fact, nothing replaces gold. If a patient bruxes and there is very little occlusal clearance, fabricate a gold restoration!!! Zirconia is a poor substitute for gold.

Some laboratories advertise their zirconia to be used instead of gold. In fact they are proud to say that their zirconia is the answer for that ugly yellow, high priced gold. They claim that zirconia can be fabricated very thin on the occlusal and still be super strong. That is a lie!

The fact is that zirconia and emax both need to be at least .8mm thick. That means your prep needs to remove .1 for cement spacer, .3 for clearance, .8 for material thickness (minimum, it may be thicker in other areas) leaving us at 1.2 mm of occlusal prep bare minimum. The walls, M,D.B.L. must all be 1.2 mm (minimum) thickness, thinning out to the correct gingival contour  towards the margin. There can be no sharp edges around the occlusal edge. At .8mm you are still flirting with disaster, so always prep a little more instead of less.

How did this material grab such acclaim and popularity in such a relatively short time? The general public wants all natural looking teeth, as white as possible. It had to pass all the tests of a material that survives in the oral environment, (strength, hypo-allergenic, and others) as well as being a material that can be shaped or milled into the exact likeness of teeth. While avoiding the high price of gold, relatively. We begged until we got what we wanted.

That does bring up the question; If gold is the most superior material ever found to restore teeth with, but it is not a natural tooth color, and the price of gold is higher than usual, does that mean we have just traded the most superior material known to man for something cheap, and white (vanity). So our pocket books and vanity are dictating treatment? #cheapnvain

Scott Emett

 

 

The Daily Grind

Why do you always have to grind and adjust new restorations to get them seated?

It’s frustrating for sure. It feels like you have been betrayed by your lab. It feels like your lab does not care about you. It is embarrassing to grind on a beautiful new crown in front of your patient. The more you grind the more you imagine your patient refusing to have that put in their mouth. The longer this goes on the more you think about calling your lab and complaining. Maybe you are thinking of changing labs for certain things.

What do the high end laboratories do to make their crowns so “seat friendly”? Why doesn’t someone in your lab go get trained in having crowns seat easily?

What’s my secret?

It’s not just one thing. It is many techniques, systems, employees, coming together as a high functioning team. It is happy employees with  great attitudes, working towards a game they can win.

Here is a couple of easy techniques for the lab that will make your life so much easier.

1-   Mix stone according to manufacturers specs (not the way your model man has done it forever)

2-   Let the stone set and harden for the recommended time. Pin and section.

3-   Assuming you did the same for the opposing, articulate the case correctly.

4-   Equilibrate the occlusion over the whole case with marking silk and a #8 round bur. Remove any junk or bubbles, then tap lightly with the articulating tape and softly grind the stone where it marks on the working model. Continue until the case is equilibrated and the occlusion looks socked in. Do not over grind. Use common sense and adjust until the bite looks natural and most all of the teeth are occluding.

5-   Seal all of the occlusal surfaces on upper and lower.

6-   Pour working model 2 more times. Once for solid model adjacent contacts. Once to check solid model accuracy. Overkill? Not on your life!

7-   Fabricate the restoration as normal.

8-   Tap and adjust the crown out of occlusion. Remove the stone sections and tap on the crown only. Adjust each of those marks on the crown. Repeat.

9-   Seat the crown carefully on a solid model. Do not force down or abrade the adjacent contacts. Mark and adjust slightly each distal and mesial  contact. Take your time as the crown seats. Only adjust where the red marks are, also adjusting the inside where it abraids on the stone. When the margins are fully seated and the contacts are broad, change to the 2nd solid model.

10-   This is surprising for most technicians as they find that they did indeed abraid the stone on the 1st solid model and the crown needs further adjusting to fit onto the the 2nd solid model.

 

This new technique will take some practice and repetition to master. The only excuse for not following this technique for every case, is if you did not provide an impression that can be repoured, or a digital case.

This comes from almost 40 years of watching chair side while my work gets seated. Trust me! Technicians start this technique today. Dentists, have your lab read this and follow exactly. I promise you will both be very happy with the chair side time cut to nothing. And your patients will love you for it.

I sincerely hope this helps.

Scott Emett

 

 

 

 

The Seattle Study Club of Southern Utah

The Seattle Study Club of Southern Utah has the amazing reputation of providing cutting edge continuing education.

Unprecedented for a study club in Southern Utah!

Continuing education in dentistry has reached a new level world wide, and now in Southern Utah.  6 years and going strong, the Seattle Study Club of Southern Utah is the first continuing education in dentistry to last more than a few months.

Of course the reasons are many. Starting with the plain fact that the dental community (the top 30 dentists) in Southern Utah have a strong desire to build on the education that they have gained so far in their careers. Seattle3

Providing a mingle time, a superb dinner with lots of visiting, and hosting a presenter at the top of his

Seattle Study Club of Southern Utah

Seattle Study Club of Southern Utah

 

field for 2 to 3 hours is the agenda. There are 9 of these evening meetings annually, and we take the 3 summer months off. There are 2 to 3 lunch and learn meetings in the same 9 months. The venues are different every meeting for variety, and they are always incredible in their offerings. The things they have in common are always great food, plenty of room, exceptionally good A.V., and attentive hosts.

This particular continuing education for dentists is as varied as the venues.  The fundamentals are revisited often such as diagnosis and treatment planning. The materials and techniques in dentistry are changing and growing faster than ever before. The Seattle Study Club of Southern Utah is dedicated to keeping the members abreast of the latest in laser, x ray, painless, and digital dentistry, just to name a few topics.

The continuing education in dentistry in the Seattle Study Club of Southern Utah is truly second to none. It is a tried and true model of almost 30 years.

The meetings are designed for the members to learn from each other, noting clinical successes, failures, and approaches to business. The meetings also bring well known national presenters in to an intimate setting that allows for questions and answers that could never happen any place else. Taking into account just the few opportunities and high level continuing education that has been mentioned, it’s easy to surmise that the value to members is priceless.

If you are not in Southern Utah, I recommend that you look up and join the nearest Seattle Study Club to you. Count on the excellence that has been mentioned, but count on other things also. Perhaps the true value of continuing education is the higher level of confidence you feel with your staff and patients, and the rejuvenating of your spirit and re-dedication to your chosen career.

Scott Emett

20150507_192544