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    Inside Dental Technology

    July/August 2013, Volume 4, Issue 8
    Published by AEGIS Communications


    Digitally Designed Implant Abutments

    Partnering with Straumann to achieve the best outcome every time

    There is nothing conventional about how business at Minnesota Dental Laboratory is run. Success is not measured or quantified in the traditional sense, based on the number of employees sitting at the bench fabricating restorations. Rather, success is measured on the amount of throughput in units produced per day, week, month, and year. And this year, the small two-person laboratory, located in the heart of Minneapolis, is poised to gross over a half-million dollars. Here automated technologies efficiently do the work that once required two or three technicians to complete. Waxing, pouring models, casting, and layering porcelain have been minimized. The routine bread-and-butter cases feeding the financial coffers of this business are not commonplace crown and bridge. Digitally designed and milled implant abutments, temporary implant crowns, surgical guides, and milled full contour zirconia restorations, have largely replaced the more traditional, analog cases. Even denture cases move through this laboratory in digital virtuality. For owner Tom Dippel, restorative elements that can be produced in the digital environment is the niche market he is targeting for his business growth and, today, within his Minnesota surrounds, he has captured that corner of the market.

    “I’ve been in business for five years,” says Dippel. “And in that short time frame have produced nearly 1,500 custom patient-specific implant abutments for my dentist and laboratory customers.” Dippel is a young, next generation dental laboratory owner who broke away from his parents’ conventionally-run laboratory operation after working there for 13 years to set up his own dental laboratory. He could envision the future of the dental laboratory industry and, having grown up with computer technology, understood how mechanization and automation would transform and streamline production processes to deliver a more accurate and consistent end product without losing any of the esthetics, all while improving on the form, fit, and function demanded by astute customers.

    Over the course of these five years, he has invested $250,000 to $300,000 in digital scanning, design software, and milling technologies. He carefully researches each technology before the purchase to ensure he has chosen a manufacturing partner committed to continued growth and expansion as well as support, which he believes is critical to success, especially when dealing with implant cases.

    He admits the transition from a conventional analog background to operating a digitally integrated production platform comes with a steep learning curve. However, his entrepreneurial spirit and innate understanding that trying new things and taking risks are the only ways to learn and grow a business have paid off. Likewise his choice of manufacturing partners has been critical to his success. “My business decision to partner with Straumann was essential to building the implant division of my operation,” he says. The local Straumann sales representative recommended Dippel’s laboratory to restorative dentists and surgeons in the immediate area who needed a laboratory team member well versed in providing digital implant planning, seamless production of surgical guides, custom milled abutments, and the quality restorative elements that would result in a successfully delivered case.

    Dippel has become an expert in helping guide customers who are caught outside their comfort zone through the treatment planning, surgical, and restorative phases of implant cases. “There is no such thing as a simple implant case,” says Dippel. “There are so many variables that can go wrong. And many restorative dentists in particular are caught outside their comfort zone when it comes to implant cases.” He has found that asking the right questions helps guide the process, from identifying the implant brand being used, to more complex inquiries that determine whether the implant is tissue or bone level, the clinicians’ preference for using an open or closed impression tray for case transfer, establishing whether they have the right impression coping on hand, and discussing the type of emergence profile desired and the depth of the implants if it is a multiple implant case. From there he moves to questions about what material will be used for the abutment, the level of tissue thickness, height of smile line, and finally the choice of restorative material and which adhesive technique the clinician plans to use.

    Being able to guide the conversation helps all team members get on the same page and understand the expected outcome before the surgical appointment. It also shows the value Minnesota Dental Laboratory brings to the treatment and helps to establish them as a thought leader and partner to specialists. “With the ability to virtually plan an implant case using CBCT scans and Dental Wings’ coDiagnostiX™ implant planning software, the team can examine the 3D image and the surgeon can provide feedback on the ideal placement of the implant based on adequate bone, the restorative dentist can provide input on best positioning for function, and I can offer my advice for the best esthetic outcome,” says Dippel. He can then go about CAD designing the custom abutment, temporary, and final crown using the Straumann’s user-friendly CARES® 8.0 software. The surgical guide is constructed using primosplint light-cured composite splint material (primotec, www.primotecusa.com)and guide sleeves drilled to exact specifications using the gonyX™ drill guide system. He can deliver the surgical guide and all-in-one screw-retained temporary to the surgeon so that the patient can leave the surgical appointment with a tooth in that position. “I can count on the fact that whatever abutment design I create in the CARES Software, it will be exactly what I get back,” says Dippel. “I can count on the fact that the abutments will go back on the model just as I scanned and designed them and on the abutment quality being consistent. Each abutment is returned from Straumann’s centralized milling facility with a validation sticker and you can even see the care and craftsmanship in the return packaging. From start to finish the emphasis on quality is evident.” And if a problem is encountered during the planning, design, or final processes, Dippel relies on Straumann’s technical support team of CDT’s to guide him through. “Support is critical in highly complex cases,” he says.

    More recently Dippel has begun receiving digital impression files from Align Technology’s iTero™ and 3M™ True Definition intraoral scanners to assist in the planning and generation of the surgical guide. “The vision for my laboratory business is to continue being on the front lines of technological development, to be an early adopter and pioneer of these technologies because they are the future of dentistry.”

    Disclaimer: The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dental Technology.

    For more information, contact:
    Straumann
    P 800-448-8168
    W www.straumann.us/CARES8


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    Image Gallery

    Figure 1. Designing a Straumann CARES®
Customized Abutment and zerion® crown
with CARES® Software.

    Figure 1

    Figure 2. CARES Customized Abutment and
zerion crown with authenticity labels from
Straumann’s centralized milling facility.

    Figure 2

    Figure 3. Final CARES abutment and zerion
crown ready for assembly.

    Figure 3

    Figure 4. Soft tissue model with Straumann
Scan body and trimmed sulcus for anatomical
emergence profile design.

    Figure 4