So you’ve invested in an Intra-Oral Scanner, now what… Top 10 tips to consider when choosing a Digital Dental Laboratory

Originally posted - 9 October 2018

1. Can the lab accept files from your specific intra-oral scanner?
Not all I/O Scanners put out raw files; Stereo Lithographic files (STLs.) Many systems are coded so are to be accessible by their own design software. It is best to choose a digital laboratory that invests in a wide variety of CAD (digital design systems) to ensure they are able to accept files from all intra-oral scanners.

2. What is the lab’s experience with digital technology?
Does the laboratory have recognised experience of using digital technology and are they able to advise you on the advantages and disadvantages of the different techniques available? Laboratories that were early adopters of Digital Dentistry have experienced the many challenges early technology threw at them and through learning, perseverance and working closely with dentists and dental companies they have been able to advance the technology collaboratively.

3. How easy is it to communicate with the lab?
Are you able to not only pick up the phone and email your chosen lab, but be able to communicate with them in new and innovative ways to deliver the best results for your patients? Leading labs are now receiving video and FaceTime calls from dentists and patients so they are now able to fully see the smile of patients whilst they talk, laugh and be natural. Video can be frozen and assessed so their smile can be seen from a different perspective.

4. Can the lab help you in the selection of the right materials?
Dentists keep up-to-date with dentistry. Lab technicians keep up-to-date with dental materials and technology. If, as a dentist you are open to being educated, your lab should be able to advise you of the best materials to use for your restorative work. Because lab’s work on so many different cases, this knowledge can easily be passed on to willing dentists.

5. How involved is the lab in education?
Lab technicians who attend courses to maintain their learning or even educate others through lectures, workshops and seminars are likely to be able to deliver the best restorations and advice to their dentists. With a shortage of technicians due to more leaving the industry than entering, it is very much down to the laboratories to select courses and educate the technicians to best serve the business.

6. Is the experience of the staff wide and varied?
Despite the introduction of digital technology and automated systems, nature is still difficult thing to reproduce which, consequently means a dental laboratory still needs to ensure the skills of its staff are not lost. Teeth still need to look natural, so the artistry required by highly skilled ceramists to deliver a single tooth restoration to a complex smile makeover for example, still needs to be there.

7. Can the lab fulfil all of the needs of your patients?
Not all labs are set up to deliver every treatment provided by the dental practice. For instance, is your lab known to deliver implant supported restorations, high-end aesthetics, smile makeovers as well as traditional crown and bridge work? As you grow and develop your practice, you want one lab that can support you through this journey.

8. How do they keep up-to-date with the latest technology?
A lab’s experience and close working relationship with dental companies, means they are able to keep abreast of the latest technologies and enable them to become ‘Experts’ in helping dentist make the right investment for their practice.

9. How forward thinking are they?
There are many forums and social media platforms that dentists use to seek advice from dental technicians. Is your technician active across these platforms providing advice and industry knowledge to dental professionals?

And last but not least….

10. Has the lab ever been recognised for any of their work?
Every year dental laboratories and dental technicians are recognised for the work they have delivered with a variety of industry awards. These are given to dentists, technicians & laboratories for the expertise they demonstrated when working closely together with the patient to deliver outstanding aesthetics from single tooth restorations all the way through to highly complex cases.

For more information about how Ambridge Ceramics can help support you in delivering high quality aesthetic restorations and smile makeovers, please contact our team on: 01765 607347 or email: info@www.ambridgeceramics.co.uk.

How using a fully digital workflow helps to deliver predictable results, superior aesthetics and delighted patients [Part 1]

Originally posted - 14 December 2017

Our client Sinead McEnhill BDS MSc (Imp Dent) MFGDP ADV DIP IMP DENT RCS (ENG) and director of Belmore Dental Implant Clinic had a 64-year-old patient who was having difficulty wearing his dentures and finding eating and speech a particular problem as his dentures were constantly moving. Also as he was due to retire, he wanted to do something to secure his future quality of life and felt strongly that his smile was something he should be more confident with.

This patient had 12 teeth remaining, all in various states of active decay. All teeth were asymptomatic, but he was embarrassed that his smile was ugly, his dentures were moving on chewing, and his ability to function and speak were greatly diminished.

His main hope at consultation was that it wasn’t too late to have implants placed and that his years of neglect wouldn’t have undermined his chances of being a suitable candidate. Using the digital workflow helped speed up the ability to get the go ahead with the treatment as the dentist and patient worked virtually with the dental lab.

The use of mainstream, everyday digital technology in treatment planning

Smartphones can be used as part of treatment planning as long as digital smile design protocol is followed. Photos of a retracted smile, full facial smile and in this case videos, are useful to a digital laboratory technician to capture important information such as dynamic smile and accurately chart the lips, smile, tooth position, buccal corridors in association with the eyes and the midline of the face. (DSD or presentation software can be used or 3Shape if you aren’t doing the full DSD protocol) DSLR images were also taken.

How Digital Smile Design helps dentists show their patients how they will look after treatment

DSLR images, CBCT and intraoral scans at this point can be sent to your digital laboratory, in this case Ambridge Ceramics. To help the dentist show both graphically and aesthetically how their patient could look post-treatment, we designed a new, highly aesthetic and achievable smile using the digital smile design principles and proportions. This is then sent back to our client via WeTransfer securely in a presentation format of choice. Our clients can then show their patients the presentation of how they could look post-treatment which really helps in treatment uptake.

In this case, and with the help of the key visuals from the digital smile design, it was decided to go with the ‘teeth in a day’ protocol – the first in the UK to be completed with Camlogs’ Conelog Implants.

How the different digital technologies are layered to provide precision and aesthetics

To allow for implant planning both CBCT and intraoral STL. scans were taken and transferred to the lab to show the upper and lower hard and soft tissues. These different files allow us as a digital laboratory to build a multi-layered picture of the patient as they present before surgery enabling us to plan the best treatment outcome possible.
This is done through:

Photos and videos of the patient as they present before surgery.
Obtaining information of the underlying bone and of the existing teeth in the maxilla and mandible through CBCT (3D X-ray)
An STL scan of the mouth or an existing model is taken to show current hard and soft tissues.
Images of how the patient will look post surgery created using Digital Smile Design protocol (DSD)
This helps the implant dentist and laboratory determine the ideal placement of the implants

With this information we then planned the optimum implant fixture placement from a purely aesthetic point of view, while at the same time collaborated with the dentist to choose the ideal osteomy/implant placement sites. With all this agreed, we then have all the information required for the planning, virtual extractions, designing and printing of the implant surgical guides.