Monday, March 7, 2016
Every year in February, the bitter cold of Chicago drives people indoors to the Midwinter meeting where we can expect to have dozens of amazing new products introduced to the industry.
But a strange thing happened this year: The sun came out. I’m not sure if that affected attendance, but there was a palpable sigh of relief as the temperatures rose into the 50s. Amid that Twilight Zone moment, we were introduced to some fantastic new materials and equipment.
My usual disclaimer: No one paid me or Dentalcompare to feature these products. These were products only chosen for the reasons mentioned below.
Chairside Zirconia…Really…
Years ago the team at Sirona cast a vision to move dentistry to a completely digital platform. We have watched that come to pass, with high speed digital impression acquisition and the creation of new workflows such as CEREC Connect to submit cases digitally to the lab.
While the technological advances have been impressive, the rise of newer, stronger materials has allowed us to perform chairside CAD/CAM fabrication of restorations in virtually every corner of the mouth. The exception to that has been in cases where we still experienced fracturing of material with full contour bridges or second molars with little occlusal clearance. We could send the case off to the lab for a PFM or zirconia restoration, but it still required the use of a temporary crown or bridge for the patient. The same day crown was put on hold as the lab had needed to sinter the zirconia in cycles of 6 to 8 hours.
Sirona addressed this issue by creating the SpeedFire Furnace, a combo oven and sintering furnace that could crystallize lithium disilicate, stain and glaze any porcelain, and sinter zirconia in 18 minutes. That’s right: 18 minutes. It currently is packaged with a new milling machine called the MC X, which can dry mill the pre-sintered zirconia. This allows you to skip the time needed for zirconia to dry before sintering. The big picture here is clinicians can now fabricate single-unit crowns, multi-unit bridges, or custom anatomic implant abutments in the same day without having to outsource it to a lab or push the limits of a weaker material.
But Wait…There’s More…
Glidewell Labs also introduced a different approach to fabricating single-unit crowns in your office with the new BruxZir Now material. The company made a fully sintered zirconia block that can carve out your crown with the IOS milling machine. (The True Definition Scanner from 3M or the PlanScan from Planmeca is needed for acquisition of the prep image.)
Glidewell had one of the best demos with the material, providing a board and an actual hammer you could use to try to smash the zirconia. If anything, people were just embedding the crowns into the board, and not one person was able to break it. While you can’t fabricate custom abutments or bridges, this is a nice option for non-CEREC users.
Speaking of Zirconia…
If there was one trend I saw across the show floor it was the presence of zirconia. We saw BruxZir, NexxZir, BioZX2 and more. There is no question this material is the future of dentistry. Dr. Mike DiTolla probably said it best: “This is A2 shaded gold.” The material is available in many shades and translucencies, massively strong as seen in the hammer demonstration, and the cost of fabrication is a fraction of the cost of gold. Also consider the digital workflow. Currently the most common method to create a high strength crown for that second molar is to take an impression, send the impression to the lab, pour that up in stone, create a second die, mount the models, trim models, wax up the case, invest the pattern, cast the gold, and on and on. At the end of that, you just made one crown. It’s not that they aren’t great restorations, it’s just that the time and cost are so significant.
Compare that to zirconia. You can submit a digital impression or the lab can scan your impression. The case is designed over a few minutes on the computer, and then often milled out from a zirconia hockey puck that has multiple other units on it. You can get the case back in a matter of days, at which point you can use conventional cement instead of bonding. What’s not to like?
Occasionally I hear from dentists who say CAD/CAM restorations don’t look great, or don’t have a great fit. The reality is most lab fabricated restorations have some step in the digital world, and the esthetics and margins rival any hand-made restoration. If you have ever had a zirconia crown made, or a zirconia coping under stacked porcelain, you’ve used CAD/CAM dentistry.
Sectioning Zirconia? We're Gonna Need a Better Bur…
Microcopy did some research into cutting zirconia and found the super course diamonds are not exactly the best to cut through it. They have a specific bur that is more of a medium grit that can cut through the material much faster. But that wasn’t the most impressive product they had. They figured out a way to create carbide burs that have no distinct weld joint between the shank and the cutting end, creating a virtually-unbreakable carbide. They currently have the NeoBurr 5572 series, but will soon be releasing almost every common preparation carbide you have. The 5572 also has square cross-cuts rather than a v-shape to reduce clogging and increase cutting capacity.
Bonding Made Simpler
Kerr released a new cement that is perhaps one of the easiest resin cements I’ve used. Maxcem Elite Chroma comes in three different shades (white, yellow, translucent), but when you first dispense the material it comes out pink. It has an extended tack curing phase to give you more time to clean up, even if you shine your curing light a bit too long. You can tell how much time you have by watching the pink color fade to its normal color. When I tried it out, it cleaned up in chunks like a glass ionomer rather than flakes like most resin cements.
The LED Operatory Solution We Have Been Waiting For…
When you look at this product, there is a beautiful simplicity that makes you appreciate it, but also makes you want to smack your own forehead for not thinking of it yourself. CAO Group introduced the new ClearVue bulbs for your operatory lights. Rather than having to upgrade to an entirely new light to get the benefit of LED, they have a bulb that is the same shape as your halogen but has integrated LEDs. This allows you to upgrade almost any old light to LED, giving you reduced heat, lower power usage, and the potential to never have to replace the bulb ever again. Simple right?
See any new products that caught your interest? Drop a comment below and let us know. Also keep an eye out for more articles and webinars on Dentalcompare that will keep you on the cutting edge of our industry.