customized healing abutments can improve the esthetic and the emergence profile. Patient satisfaction plays a significant role in determining the success of an implant case.
The goal of any dental restoration is to restore the patient’s oral environment back to its natural or improved appearance and functionality. Dental materials have come a long way since porcelain-fused-to-metal (PFM)
Teeth experience gradual wear on the occlusal surfaces throughout life. This can be from erosion, abrasion, or attrition. Severe cases can result in worn, cracked, or broken dentition, compromising esthetics
Among the diverse array of dental restorative materials, Zirconia has emerged as a forerunner. With its exceptional mechanical properties and aesthetic appeal, Zirconia is a game changer in prosthodontics, effectively
According to the American Academy of Implant Dentistry, over 30 million people have missing teeth in one or both arches. More than 69 percent of adults aged 35 to 44
The overall quality of care in dentistry is measured by clinical outcomes and overall patient satisfaction. While clinicians are often concerned with patients’ dental health as a whole, patients can be focused on other issues, such as esthetics or costs. Understanding a patient’s concerns is paramount in ensuring a positive experience. By uncovering their goals, a case plan can be developed to incorporate managing the patients’ expectations and ultimately ensure their satisfaction.
At Burbank Dental Lab, our role in the dental process is to take the direction of the clinicians we work with and create dental restorations that fit what the patient and clinician have envisioned. The more planning that goes into a case, the closer we can come to fulfilling the desired results.
Even before a handpiece is used for preparation, a case should be well planned. This will ensure the proper preparation design, shade match, and material selection are made to achieve the agreed-upon results.
The following case came to Burbank Dental Lab, where Dr. Mitchell Rubinstein prescribed tooth #8 (figure 1, shown below). It is no secret that working on matching single units is one of the most challenging things to do in dentistry. It is not uncommon for cases to need a few adjustments to get these cases just right. Without managing patient expectations, these cases can lead to frustration. When matching a single central incisor, it is very common for a clinician to choose to do both central incisors at the same time to ensure proper symmetry is achieved.
Patient Expectations
This patient was unhappy with the shape, size, and color of tooth number 8 and disliked the diastema between 8 and 9. The patient was happy with the rest of his teeth. He was presented with a treatment plan that included preparing both 8 and 9 to ensure symmetry and handle spatial issues.
He, however, was adamant about only adjusting tooth #8. It was explained that the space for #8 would be wider than #9 and that we could make it look better but only by about 50 to 60% if only tooth #8 were restored. The patient indicated that he would be happy with this amount of improvement.
Photographs
Dr. Mitchell Rubinstein took several pictures to help the Burbank Dental Lab technician match the tooth to the adjacent teeth (Figures 2 & 3, as shown below). Photographs are essential for revealing the characteristics of the surrounding dentition being matched. Pictures reveal character traits such as crack lines, calcifications, and degree of color transitions.
The following images should be sent along with the case to help with the matching process:
Photo showing the patient smiling.
Photo with the lips retracted.
Pictures showing the shade tabs directly in the same plane as the dentition being evaluated.
Figure 2
Figure 3
Shade Evaluation
In addition to photographs, Burbank Dental Lab also recommends the following steps to ensure adequate information is provided:
Take the shade before preparation, and prioritize it early in the appointment to minimize dehydration.
Take the shade while the patient is in an upright position.
Eliminate possible shadowing by using cheek retractors.
Hold up the entire shade guide to start the process.
The shade tab should be held directly under the area being evaluated. For the best results, the shade guide’s incisal edge should be placed at the tooth’s incisal edge.
Take a shade of the tooth after preparation.
This case was then prepared for a veneer on tooth #8 (Figures 4 & 5, shown below). A provisional was placed for the patient to wear while the final restoration was being fabricated (Figure 6, shown below).
Figure 4
Figure 5
Figure 6
Material Selection
The ultimate success of a case relies on material choice. When evaluating what material to choose, the key factors include strength and esthetics. IPS e.max is an excellent option as it is both a strong and esthetic material. Specifically, this material is one of the most widely used and highly successful materials in dentistry.
To restore tooth #8 for this case, it was determined that IPS e.max would be the best option. E.max is a lithium disilicate ceramic that provides excellent esthetic results and a precise fit.
Versatile applications as this material can be used for:
A wide variety of ingot colors and translucencies make this an excellent esthetic choice.
High Flexural Strength (500 MPa).
Conservative preparation design.
Less wear to opposing teeth than some other materials.
IPS e.max
Veneer Fabrication
Once the information was provided to Burbank Dental Lab, the case was waxed up to an ideal contour to ensure the tooth restoration would address all of the patient’s concerns.
One of the main concerns was the large diastema between teeth 8 and 9. Once the desired shape was achieved, the case was pressed and then layered to match the existing dentition using the photographs and other information provided by the dental clinician.
The case was returned to Dr. Mitchell Rubinstein for insertion (Figure 7, below). This case had a great result, and most importantly, the patient was happy. It required a team approach consisting of the patient, clinician, and dental lab input. The proper plan was created and then implemented.
Proper preparation design, material selection, data gathering, and ultimately appropriate insertion techniques all played a role in achieving an excellent result.
This treatment plan was driven by listening to the patient’s desires and Dr. Mitchell Rubinstein’s pre-op vision. When working on a single unit matching is by far the most challenging type of case and can often lead to unmet expectations for the patient. They don’t always understand the challenges that these types of cases pose for the dental team.
Managing patient expectations is a vital step in ensuring these cases provide patient satisfaction, and this case exceeded the patient’s expectations.
Figure 7
Before & After
BEFORE
AFTER
If you want more information about Burbank Dental Lab or your next restorative case, call us at (800) 336-3053 or click the Chat icon in the right corner to start a conversation with our ceramic team.
Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.
Our New State-Of-The-Art 3d Printers
Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.
a new baseline for innovation in fabrication.
Burbank Dental Lab has the next generation of Carbon DLS™. Meet our new Carbon M3 and M3 Max printers. These advanced printers enhance fabrication possibilities using Digital Light Synthesis™ technology, enabling us to provide quality and innovation for our clients.
Meet Our New next generation of carbon DLS™ M3 Max Printers
The M3 printer is the cutting edge of DLS printing with a true 4K light engine. We save time and improve quality with Automated Print Ppreparation which ensures high-quality assurance and results.
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