Laura Dorr is the former executive editor of DPR's Modern Dental Network and a regular contributing author.

At one point, the microscope was considered a cutting-edge tool. Motorized dental drills were novel and unique. Digital x-rays were the next best thing. Now, we don’t think twice about them. A new generation of technology has taken the place as the latest and greatest—and it’s evolving every day.

But how have these technologies shaped dentistry, and endodontics in particular? Endodontically diseased teeth that would have been deemed unsavable are now being saved and restored, thanks to new technologies, treatments, and approaches. As the arsenal of tools has grown, so, too, has endodontic predictability. From lasers and 3D imaging to microsurgery and dynamic navigation, there have been developments in tools and techniques.

Advances in minimally invasive treatment have perhaps been what has shaped endodontics the most in recent years. Departing from manual files and other tools, many clinicians are exploring lasers and acoustic energy as alternatives, for quicker and more effective treatment as well as faster healing times. And Dr Richard Mounce, an endodontist practicing in Pacific City, Oregon, sees many areas of new innovation.

“Some of the big trends in endo today include minimally invasive shaping philosophy, improvements in activated irrigation, improved bioceramic sealers, the use of come beam computed tomography (CBCT) in targeted endodontic microsurgery and canal location, and reciprocated endodontics, to name a few,” he says. “While there are several partisan camps in endodontics; one camp advocates minimally invasive approaches using the Sonendo GentleWave System for canal cleaning. It could be argued that GentleWave is changing the specialty.”

The GentleWave procedure provides standard root canal treatment, but with a minimally invasive process that is reported to preserve tooth structure and promote rapid healing.

By utilizing fluid dynamics and broad-spectrum acoustic energy, the GentleWave minimizes—and even replaces—much of the need for manual instrumentation in root canal procedures, preventing the removal of extra tooth structure while providing effective cleaning through its fluid-delivery system, which distributes fluid throughout the canal system. Reportedly, this procedure is, in most cases, a single-visit treatment option.

Other advances in canal cleaning and disinfection include nanotechnology, which Dr Mounce thinks is a noteworthy area of study in endodontics. He predicts that commercial products and clinical techniques are likely to soon emerge using these particles.

In addition to this technology, other options have become attractive, made possible largely by the development of CBCT. Many clinicians, including Dr Mounce and Dr Rebekah Lucier-Pryles, agree that CBCT has made a huge difference in endodontics in the previous decade. In fact, much of the advancement in endodontic treatment and technologies stems from CBCT’s capabilities, particularly for dynamic navigation and targeted endodontic surgery.

“CBCT-guided surgery and non-surgical root-canal therapy are at the forefront of endodontic care,” Dr Lucier-Pryles, an endodontist in White River Junction, Vermont, and cofounder of Pulp Nonfiction Endodontics, says, noting that non-surgical therapies are attractive to patients who balk at the idea of surgery. Even when surgery is the only option, however, Dr Lucier-Pryles finds advances that have made the process easier.

“Technologies associated with CBCT-guided nonsurgical and surgical root canal therapy are now available and facilitating the delivery of endodontic care thought impossible years ago,” she says.“For instance, palatal apical surgery can be readily performed with the aid of CBCT-developed surgical stents. Additional surgical innovation beyond CBCT guidance now includes the use of piezoelectric devices to remove bony windows prior to accessing root apices. This approach offers more predictable postoperative healing than older techniques.”

Dr Mounce agrees. With these technologies, and the development of targeted endodontic microsurgery, guided dynamic navigation, and lasers with multiple applications, he believes the field has been pushed forward immensely.

“We now have techniques that are advancing our clinical capabilities well beyond previous limits by allowing treatment of previously untreatable clinical scenarios,” he summarizes. “Lasers have provided excellent results, and GentleWave partisans would likely argue that their technology is the most cutting-edge the industry has seen.”

The technology gains of the past few years have been impressive, but there’s more to come down the road. As innovative companies continue to do their research and develop cutting-edge products, treatment will be further simplified and care will be improved. Trends look to continue toward medical treatment over surgical, and future regenerative endodontic materials will change how we think about growth factors and material matrix designs—all benefiting patients and the field of endodontics. As these developments progress, Dr Mounce hopes to see these technologies become more accessible and affordable to clinicians.

“At some point, the technology is priced out of the range of the general dentists (and possibly some endodontists), even in the most advanced economy,” he says. “Every clinician must decide for themselves if the clinical result obtained is superior and/or justifies the expense based on the literature. The same cost, risk and benefit analysis should be made for all technology decisions. Right now, prohibitive costs mean treatment hasn’t been simplified for many clinicians; but has the technology improved endo care? Most probably, yes.”

But while some advances are currently cost-prohibitive, the growth continues (hopefully becoming more affordable in the future, Dr Mounce says), and opportunities for development continue to present themselves across the board.

“I see room for continued advancement in CBCT-guided technologies, in disinfection, and in restorative care following endodontic therapy,” Dr Lucier-Pryles summarizes. “As technology improves, our treatment strategies become more appropriate.”

Dr Mounce agrees that big things are just around the corner.

“While I don’t have any inside information, I suspect that we will see a GentleWave-like handpiece that facilitates obturation of the canal using some form of sonic or ultrasonic vibrational waves,” he says. “I’m confident that this concept--putting a handpiece over the access, cleaning and obturating all the clinical anatomy, and placement of a coronal seal via a robotic console--is being developed now.

“It's the Holy Grail of endodontic treatment,” he continues, “and would, for practical purposes, make endodontics as we know it obsolete.”

Molina B, Glickman G, Vandrangi P, Khakpour M. Evaluation of root canal debridement of human molars using the GentleWave System. 

. 2015;41(10):1701-1705. doi:10.1016/j.joen.2015.06.018

Sigurdsson A, Garland RW, Le KT, Woo SM. 12-month healing rates after endodontic therapy using the novel GentleWave System: a prospective multicenter clinical study. 

. 2016;42(7):1040-1048. doi:10.1016/j.joen.2016.04.017

Articles

Technology in endodontics is evolving every day to provide better tools and techniques in dentistry.

What's Cutting Edge in Endodontic Technology Today

Dentsply Sirona has now acquired the assets of orthodontic products manufacturer and seller, Propel Orthodontics.

This acquisition will open up opportunities for Dentsply Sirona to innovate clear aligner technology and orthodontic treatment, according to a press release from Dentsply Sirona. It will also add digital capabilities to Byte and SureSmile.

The High Frequency Vibration (HFV) product line from Propel can be used as part of an orthodontic treatment plan and is also said to increase patient comfort and reduce treatment time.

To learn more about this acquisition, visit the website 

Dentsply Sirona has acquired the assets of Propel Orthodontics.

Dentsply Sirona Acquires Propel Orthodontics

Researchers from UNLV’s College of Engineering and School of Dental Medicine have teamed up with NASA and Colgate will test periodontal disease prevention in space, according to a press release from UNLV.

On June 3rd, the rocket Space X CRS-22 launched on a journey to the International Space Station. On board was a selection of test kits containing saliva from the mouths of 30 UNLV dental clinic patients as well 3D-printed, battery-powered microfluidic pump devices. These kits will test the germs’ growth and the treatment with Colgate products.

This research was spurned by the question as to whether dental hygiene products would be effective for long-term space travel.

The test kits will return in July for analysis.

UNLV engineering and dental researchers partner with NASA and Colgate for the June 3rd space launch. 


UNLV Engineering and Dental Researchers Partner with NASA and Colgate

Polaroid HealthCare has introduced a new Windows-based imaging program called Polaroid DDS.

Polaroid DDS uses dental and medical imaging algorithms to produce digital images that clinicians and practitioners can observe in detail. The software is said to have “no limits” and “no fees” according to a press release from Polaroid HealthCare.

Polaroid DDS contains data converters for popular practice management programs, allowing practices to convert existing digital images into the software.

To learn more about Polaroid DDS, visit the website 

Polaroid HealthCare has introduced a new DDS imaging program. 

Polaroid Launches Polaroid DDS Imaging Software

Robert Maguire, DDS, MA, is a dental speaker, coach, practice consultant, and DiSC trainer, passionate about leadership and communication. If you would like more information about Dr Maguire and to learn how he can help you and your team experience more fulfillment, more joy, and more financial success, visit https://www.thefulfillment.coach/ or email him at contact@thefulfillment.coach.

The power to transform your practice begins with the “right thinking.” Often, I will meet or hear of dentists who are unhappy with their dental practices, many telling me they feel “stuck.” On numerous occasions, they have tried to make changes to improve their practice production, tried to build a collaborative and happy team, but eventually they have been unsuccessful. They failed because the steps they took were transactional in nature rather than transformational. In this article, I will explain the difference between 

. I will explain why transactions rarely result in long-lasting positive change and why transformational thinking is the key to sustainable happiness and increased practice production. Lastly, I will provide practical steps you can take to experience more profound, significant, and lasting change.

Often, when dentists start to search for ways to improve their dental practices, they look for quick fixes. These quick fixes are essentially transactions that include such things as enacting new systems or policies, or quickly hiring team members based solely on their skills. Additionally, many “impulse buy” and purchase new pieces of equipment, often on credit and often without thinking about how it will be used to improve the lives of their patients and their teams. Other examples of transactional steps include learning new procedures or taking practice management courses to schedule more efficiently, decrease broken appointments, or improve collections.

Transactional steps are an important and necessary part of running an efficient dental practice. However, implementing these things alone, without thinking about the deep-down desires for you and your practice, will rarely lead to more happiness and increased profitability. It is like the steps people often take to lose weight. We know statistically that most diets work for the short term. We also know that most people who have dieted relapse and end up right back where they started. The reason most diets fail over the long haul is that the dieters have not fully envisioned their desired result, or how they want to look and feel once they have lost their weight. Here is the reality. Many weight loss programs only provide the transactions, the steps people need to take to lose their weight. What they do not and cannot provide is a picture of the end result, the 

This vision or desire for a long-lasting result can only come from the individuals themselves.

With regard to your dental practice, if you want more profitability, more happiness, and long-lasting change, focus and think about the transformational steps, or those steps that involve using both your head and your heart. Transactions are steps that involve using only your “head.” Your “heart” is the place where your emotions are found. Transformation

are most effective because they take into consideration our emotions, our deep-down desires, our passions, and our dreams, not only for ourselves but for our patients and our teams. They provide the motivation, the power that sustains us as we strive to build a happier, more productive, and thriving dental practice.

Another way to look at transformations is to think of them as your blueprint, your inspiration, or your vision. For the past several months, I have watched a new house being built in a lot across the street from my home. Before the construction began, the owner had a vision of the house he desired. When I chatted with him, he spoke about it in detail, with excitement in his voice and joy on his face. He told me that 6 months ago, he had hired an architect and together they had worked through and drawn up the blueprints. Once the final plans for his dream house were completed, the owner hired a reputable general contractor, someone he knew did quality work, someone who had a team of excellent workers to help him.

Over the next several months, I observed the whole transformational process, the building of this dream home for my neighbor. Watching this construction was like watching synchronized swimming: each step was coordinated and seemed to seamlessly flow from one step to the next. In a timely fashion, his high-quality home was built just as he had imagined it and just as he had planned out ahead of time.

In this example of the construction project, the transactions included things such as the excavation, the pouring of the foundation, purchasing the building supplies, working with the subcontractors, and using the right equipment to do the job. Every detail had been spelled out ahead of time in the architectural plan. Can you imagine doing all these steps without having blueprints, a vision of the finished result, or the right workers to do the job? This is no different than building the practice of your dreams. Having a vision and formulating a plan are the keys to transforming your practice.

For you and your dental practice, start by asking yourself transformational questions like “What is my current situation?” Think of today’s reality and imagine your dental practice as an empty lot for your new home. What do you want to build on your lot? What is your dream for your dental practice? In other words, what kind of dental home do you want to construct for you, your team, and your patients? Asking yourself these kinds of questions helps you envision your ideal practice.

Other questions might include “What will my practice physically look like and what type of equipment will I purchase? What about my team?” It is especially important to think about the people who will occupy your “dental home” with you. And how about the other occupants, your patients? “Who are the patients I’d like to serve? What procedures would I like to be doing? How about the quality of my dentistry and the quality of my team members’ work? What will my estimated costs be and how much would I like to make? What fees will I need to charge to make my dreams a reality?” The questions listed here are transformational in nature, getting you closer to envisioning your future practice. You may have some of your own questions.

Looking for more happiness, more joy, and more financial fulfillment from your dental practice? Your first step is to stop and begin by drawing up a blueprint for the life you want, for the practice you want, with the team you desire, and the type of patients you want to serve. Some dentists accomplish this on their own. Others reach out to practice coaches or consultants to first, help them first organize their thoughts and second, help them outline a plan to make their dreams a reality.

Whatever route you choose, start with a well thought out blueprint of your heart’s desires and make sure you hire the right team. Remember to think “transformation before transaction.”When you start with transformational questions and a basic idea of your vision, you will end up having a more profitable practice, one you will enjoy, with a team and patients you enjoy, one that will sustain itself for many years to come.

The key to having a thriving practice is changing your way of thinking. 

Transformational Thinking in Your Practice

Although a map proves useful in getting you where you want to go, it pales in comparison to a globe for determining the relative location of different places or destinations. A map may be better than nothing, but when it comes down to it, a 2D representation of a 3D structure cannot provide an accurate depiction. 

As well as applying to our mental image of latitude and longitude, this geometric configuration can skew our interpretation of images of complex anatomy. For a long time, endodontic radiographic assessments were limited to panoramic or intraoral x-rays, which, due to a lack of 3D precision, often make it hard to accurately visualize dentition. For example, a periapical radiograph can be distorted due to superimposed anatomical structures (including the zygomatic arch, maxillary sinus, and roots), making it difficult to get a clear view of root canal anatomy. And, for precision procedures such as the treatment of root canal systems, this lack of clarity can lead to treatment failure. However, newer imaging technology has provided a solution.

According to a joint statement from the American Association of Endodontists (AAE) and the American Academy of Oral and Maxillofacial Radiology (AAOMR) in 2015, cone beam computed tomography (CBCT) has presented a groundbreaking advancement for endodontics. This is due to its ability to visualize the dentition and the relationship of anatomical structures.

“CBCT has been hugely beneficial to endodontics,” says Dr Richard Mounce, an endodontist practicing in Pacific City, Oregon. “Much of the guesswork about canal location, numbers, curvature, optimal access location, bone levels, pathology, possible nonendodontic lesions, etc, has been eliminated or aided through application of CBCT. In my view, having access to CBCT is the standard of practice, and in certain clinical situations it is the legal standard of care.”

The AAE-AAOMR statement reiterates that small field-of-view (FOV) CBCT images are the image of choice if unusual canal morphology is suspected. These images can be invaluable to diagnosis as they allow clinicians to assess the relationship of teeth to other vital structures, assess traumatic dental injuries such as fracture or resorptive lesions and pathology, and aid in treatment planning for nonsurgical retreatment or surgical endodontics. CBCT is particularly ideal in areas subject to anatomic noise or in cases with symptoms that are difficult to localize, as it can better pinpoint the side of the endodontic issue.

“CBCT imaging has become an essential part of the endodontic world,” says Dr Rebekah Lucier-Pryles, an endodontist in White River Junction, Vermont, and cofounder of Pulp Nonfiction Endodontics. “2D images, like periapical or bitewing radiographs, are limited in their detection ability due to structural overlap (referred to as anatomic noise). 3D imaging removes this overlap and allows clinicians to visualize all areas of the tooth independently.”

These CBCT images are also valuable in retreatment cases, and the AAE and AAOMR believe that previously endodontically treated teeth warrant CBCT scans. According to the organizations, limited FOV CBCT is the imaging modality of choice when examining issues of nonhealing in previous endodontic cases or when assessing endodontic treatment complications, as it can determine what follow-up treatment should occur.

CBCT has myriad benefits, but like any technology it also has limitations. This makes it critical that clinicians understand when its use is appropriate.

“Opinions differ,” explains Dr Mounce. “Some endodontists take a CBCT on every patient, others when they feel it’s needed for complex anatomy, surgery, retreatment, or resorption cases, etc. I have no hesitations about taking scans, but I personally don’t take a scan on every case. That said, I don’t have any [problems] with clinicians who do.”

The primary concern with CBCT imaging is a possible higher radiation dose for the patient. The AAE and AAOMR recommend that CBCT should not be used routinely for endodontic diagnosis or screening purposes if there are no clinical signs or symptoms that indicate a necessity. Likewise, the organizations state that CBCT imaging should only be used when the imaging needs cannot be met by lower-dose 2D radiography.

“CBCT should be used only when the patient’s history and a clinical examination demonstrate that the benefits to the patient outweigh the potential risks,” the associations state. “The use of limited FOV CBCT should be considered on a case-by-case basis, with due consideration given to the risks and benefits of exposing the patient to ionizing radiation, the patient’s history, clinical findings, and preexisting radiographs so that superior treatment can be provided to the general public in need of endodontic care.”

In addition to the risk of higher radiation doses, CBCT has other limitations. High levels of noise and scatter and the potential for artifact generation can throw off a clinician who isn’t accustomed to reading CBCT images.

For clinicians who aren’t comfortable using CBCT, Dr Mounce recommends substituting a surgical microscope. He believes that the lack of both CBCT and a microscope can be of great detriment to the clinician.

“The surgical microscope is a critical piece of equipment and vastly superior to loupes,” he says. “If you don’t have a CBCT and don’t have a microscope, it is exceedingly difficult to envision that a dentist can practice at the same level as a specialist without the microscope. Without a microscope, you simply don’t have visual and tactile control. The double whammy of not having CBCT and/or a microscope is the harbinger of problems.”

Although CBCT presents some challenges that may sway a doctor’s decision to forgo the technology, its increasing availability and expanded applications are making the tool more valuable, despite its current drawbacks. Findings from recent research show that after reviewing CBCT images, many clinicians often change their previously proposed treatment plans because the images so effectively eliminate the concerns over distortion that accompany conventional 2D radiography.

 And, when used as indicated, this 3D imaging can provide clinicians with critical information that allows them to treat cases that may have previously been deemed untreatable.

“CBCT imaging has changed the face of endodontic care, both in its ability to diagnose obscure pathology but also in our ability to treat cases,” Dr Lucier-Pryles says. “Our ability as clinicians to diagnose resorptive dental diseases and to evaluate fracture pathology with CBCT technology has significantly improved, and as a result our treatment strategies are more appropriate.”

1. AAE and AAOMR  joint position statement: use of cone beam computed tomography in endodontics–– 2015/2016 update. AAE. 2016. Accessed June 6th, 2021. https://f3f142zs0k2w1kg84k5p9i1o-wpengine.netdna-ssl.com/specialty/wp-content/uploads/sites/2/2017/06/conebeamstatement.pdf

2. Suomalainen A, Pakbaznejad Esmaeili E, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. 

. 2015;6(1): 1-16. doi:10.1007/s13244-014-0379-4

3. Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography. 

. 2014;40(7):910-916. doi:10.1016/j.joen.2014.03.002 

3D Imaging and Endodontics – How, when, and why to use cone beam computed tomography in endo cases.

Using Cone Beam Computed Tomography in Endo Cases

Stan Goff is the Managing Editor of Dental Products Report, Dental Lab Products and Modern Hygienist. He has covered the dental industry since 1999 and can be reached at sgoff@mjhlifesciences.com.  

Since June is Oral Health Month, we think this is a great time to share some tips to help young children start their healthy mouth journeys out on the right paths.
Here are 6 helpful things to know about your youngster’s teeth.


6 Things to Be Aware of to Protect Kids’ Teeth

Align Technology has released the iTero Workflow 2.0 software, a software that provides a better digital treatment experience for the practice, according to a press release from the company.

The iTero Workflow 2.0 software includes faster scanning, improved visualization, and patient communication tools that can digitally share information with patients. Align also previewed the new iTero Element 5D imaging system auto-upload functionality.

This functionality is said to eliminate extra steps and streamline case submissions by means of color scan images that can be used in place of standard intraoral photos. 

To learn more about Align Technology, visit the website 

Align has announced this new software as well as previewed the new Element 5D imaging system. 

Align Technology Release iTero Workflow 2.0 Software, Preview New Functionality

Designed to help clinicians and lab technicians achieve more accurate shade matching with BruxZir Zirconia restorations, Glidewell recently launched the BruxZir Zirconia Shade Guide.

To ensure accurate shade measurements, the new shade guide features tabs fabricated from BruxZir Zirconia with the translucency of the BruxZir Esthetic formulation, according to a press release. This material choice makes this a more accurate shade guide for BruxZir restorations when compared with most shade guides that feature porcelain or acrylic tabs that feature different optical characteristics than zirconia.

The BruxZir Zirconia Shade Guide features 8 tabs, with seven tabs—Z2 through Z8—matching up with the most popular shades in the VITA shade system, and the eighth tab being a bleach shade. Each tab features a glazed side and an unglazed side to allow clinicians and technicians to match both final and stump shades with a single tab.

Featuring shade tabs made from BruxZir Zirconia, this new shade guide aims to make it easier to achieve highly esthetic outcomes with the material.

Glidewell Launches the BruxZir Zirconia Shade Guide

3Shape has introduced a new and improved service agreement for the TRIOS intraoral scanner, called TRIOS Care.

This service agreement adds benefits for TRIOS users such as a 5-year warranty, replacement services, technical support, and 3Shape Academy training points. Full-service coverage is free for the first year of TRIOS scanner ownership.

Doctors can focus on improving treatments and workflow with this new service agreement as they invest in the digital impression system, according to a press release from 3Shape.

To learn more about 3Shape or TRIOS Care, visit the website 

3Shape introduces a new service agreement for the TRIOS intraoral scanner. 

3Shape Adds New Service Agreement for TRIOS Scanner

Dentures are a big part of his practice, so Miles Cone, DMD, CDT, FACP, has spent countless hours working on denture relines and doing his best to remove the excess reline material as efficiently as possible.

Dr Cone also admittedly hoards instruments he has used over the years and has a drawer full of worn-out burs that could handle only so many tough cases. So when he first got his hands on a line of ceramic cutters from Komet USA, he expected them to be solid because of his experience working with many Komet products, but he also expected them to have limitations in terms of their cutting ability on tough materials and in terms of lasting long.

Much to his surprise—and happiness—these instruments have withstood everything he has thrown at them. They not only speed up his workflow, but seem as if they may last forever. “Maine has one of the oldest demographics in the country, which means we do a ton of dentures,” explains Dr Cone, a prosthodontist in Portland, Maine.

Although he loves the reline materials he works with—namely, a “tenacious material from GC America”—it can be difficult and time-consuming when it comes to removing them.

“I struggled for years, and I’ve tried every bur that’s out there from every company,” he says. “I’m a hoarder and keep things around, so I’ve got a drawer full of burned-out burs and carbides and sandpaper.”

When Komet first sent him a kit of ceramic cutters, he wasn’t sure what to expect. “I was thinking, ‘This thing’s going to break. It’s going to chip,’ ” says Dr Cone. “But what is awesome about these burs is [that] they don’t generate heat the same way that carbides do. It’s an absolute lifesaver when slogging away at the bench with tough denture material.”

He learned that the ceramic cutters dissipate the heat well and don’t clog and get gummed up as is typical with carbide burs. He now confidently reaches for a number of instruments in his Komet denture repair kit, with some specifically designed as part of a flexible partial contouring system.

“These cutters are so good at hogging out just globs of denture reline material, and they get it out quickly and efficiently,” he says. “Normally, by the end of this, you’d be sore and feel like you have carpal tunnel syndrome. But that is no longer the case.”

Komet offers a variety of instruments that can help laboratories, specialists, and general practitioners alike.

“These burs are not just for high-end laboratories,” he says. “[For] every lab doing dentures, and for the doctors who have bulk patients, [such as] the community dental center—these [will] make your life so much easier.

“Imagine using a carbide on days where I’ll have 2 or 3 denture patients,” he adds. “I couldn’t possibly do it. My hands and joints wouldn’t be able to tolerate it.”

Dr Cone loves the different coarses and shapes in the denture repair kit.

Komet USA’s lab cutters are engineered with durable, high-performance ceramic and can be used to precisely shape, trim, and carve soft acrylics, denture reline materials, and green-state zirconium dioxide. The cutters resist heat buildup and reduce clogging with their unique toothing design. Another advantage of these instruments is that they generate less vibration than traditional tungsten-carbide cutters.

“These ceramic burs have been an absolute game changer just for what I do day-to-day in the trenches,” says Dr Cone, whose office consists of himself, his wife as office manager, and an assistant. “I like having beautiful things in my hands, and these instruments are kind of like having a MacBook Air or an iPhone. There’s a certain level of cool factor for my lab bench and they work so well.”

Another benefit of these instruments, according to Dr Cone, is that dentures and denture reline work are not going away anytime soon, even as many labs shift from analog to more modern, automated methods of work. “I tell people all the time that where we currently stand right now, doing denture relines is going to be a thing for a long time. You can make a digital denture, but when that patient has a sore spot or their tissue starts to break down, you still need to have those [reline] skills,” he says. “As long as we’re doing relines, people are going to need to remove those.”

That is why he suggests colleagues give Komet ceramic cutters a try: “I think this is something that the denture technicians and the clinicians that are doing the same procedures that I’m doing really need to invest in. You’ll want anything to make your life easier.”

The Komet kits also assist in the finishing and polishing of flexible partials despite the difficulty of dealing with some resins when using some carbide burs. “These ceramic cutters go through and leave such a clean finish to it. They have multiple applications. They’re not just for dentures,” he adds.

For this CDT/prosthodontist, Komet USA’s durable instruments make benchwork and denture relines much easier.

Workhorse Burs Improve Denture Case Efficiency

Kellie Nock is the assistant editor for Dental Products Report. She graduated from Kent State University in 2018 with a Bachelor's in Journalism. Kellie enjoys multimedia content creation with a focus on audio and video storytelling. 

When Benny and Gail Johnson of Perfect Impressions dental laboratory in Carrollton, Texas, were looking for a way to reward their regular doctors for using their services and increase payment efficiency, they found tfg Loyalty, a program offered through tfg Payment Solutions.

Relationships with practices and doctors are important to the Johnsons.

“Before Gail goes in and takes on an account, we will visit the doctor, visit the practice, get to meet everyone, and make sure that we understand what the doctor’s expectations are and what their preferences are. So we go in and build that relationship from the beginning,” Benny Johnson says. “We don’t take on just any practice—we want to make sure that it’s the right practice for us and that we’re the right lab for them. That’s all about communication.”

As a part of that key communication, the Johnsons use the tfg Loyalty program to promote retention and reward practices for their business.

Created to make payments more efficient, tfg Payment Solutions is an online platform that allows practices to schedule secure payments through credit card, check, or ACH payment. Consistent, on-time payments are rewarded directly from tfg in the form of merchandise, gifts, and money, creating and fostering stronger relationships between laboratories and practices.

“With that, we also decided that we wanted to provide a program that would say, ‘Your business means a lot to us. We appreciate your loyalty and this is our way of saying thanks,’” Benny Johnson says. “Most of our doctors have been with us for 5, 6 years, so our retention is pretty good. It’s all based on communication and how Gail and the team work with the practice.”

Practices in the loyalty program are rewarded for consistent payment with merchandise, gifts, travel, and more. The program also can be used by practitioners to treat their employees, assistants, and technicians with things such as lunches and gift cards.

The payment process works through a payment card industry (PCI)-compliant, secure, online platform. Practices can schedule payments with a credit card, check, or Automated Clearing House (ACH) electronic payment.

“It allows us, as the lab, to get paid sooner because if they pay us by the 15th of every month, whether it be a credit card or a check or an ACH, they get points and dollars toward the rewards. It really helps both parties,” Benny Johnson says.

The platform allows clinicians and practices to keep track of payments, pay faster and more efficiently, and track rewards they may have accrued from on-time payments.

“A lot of them like that. They will take that and they’ll go out and maybe get a Starbucks card or they’ll treat the team to a lunch one day,” Benny Johnson says. “It’s just a way for them to also give back to their employees or assistants and technicians.”

The company is also working on QuickBooks integration, which will boost efficiency by incorporating and sharing important information from software to software.

“That’s going to be a huge, huge help for me as far as a timesaver. With the integration and how it’s all coming together, it’s going to allow me to do it in a period of 30 minutes, versus an hour and a half, which it’s taking me to do it today,” he says. “So, they’re doing the right things by integrating the software. As a matter of fact, the next step is to link to my lab production software to transfer invoices saving even more time. After all, time is money.”

Since the Johnsons started using tfg’s Loyalty program in January 2021, about 10 doctors have set up their accounts in the loyalty and payment portals. It allows doctors who may otherwise find it difficult to remember to set payments up automatically.

“We give them opportunity to...go on a secure portal and make a payment without having to call me and give me a credit card or having to write a check and put it in the mail,” Benny Johnson says. “That’s just going to save them time, too.”

Laboratories save time and money while rewarding practices and doctors. 

Loyalty Program, Payment Portal Boost Relationships Between Practices and Lab

When Anthony K. Senegal Sr, cofounder, president, and operations director of Partners Elite Dental Laboratory Services (PEDLS), decided he needed to streamline his lab’s workflow for monolithic removable dentures, he wasn’t sure where to turn. He wanted a system that simplified design while reliably producing quality dentures with little need for extra manual work. After searching, he found his solution through Ivoclar Vivadent.

The Ivotion Denture System offers a complete digital manufacturing process for the fabrication of removable monolithic dentures. The digital system comprises an integrated workflow of digital laboratory fabrication methods, simplifying the creation of dentures and reducing opportunities for human mistakes.

“It’s an extreme benefit when you are talking about reducing mistakes,” Senegal says. “There’s less human error that can take place when you’re dealing with the milling of Ivotion.”

This denture system is a digital manufacturing process that simplifies the creation of dentures. Combining 3Shape’s scanning capabilities, materials from Ivoclar, and manufacturing strategies from PrograMill, this workflow seamlessly and efficiently creates dentures.

The Ivotion Denture System workflow uses materials from Ivoclar, software and scanning technologies from 3Shape, and milling machines and manufacturing strategies from PrograMill. These combine into a seamless workflow. Senegal integrated Ivotion into his workflow at PEDLS in November 2020 and was impressed with the accuracy and quality of the system. He has found that the fast manufacturing time, quality materials, and predictable results have been a great benefit to his lab.

Richard Wilson, DDS, cofounder and chief clinical consultant and director at Partners Elite Dental Laboratory Services, LLC, stands with a patient who has received Ivotion's upper denture esthetics. 

“If you ever want to make a technician go from a smile to a frown, just say the word 

,” Senegal says, laughing. “That’ll make them frown really quickly. But we haven’t had a single remake since we started using Ivotion. You’re guaranteed you’ll get a quality denture, with few to no mistakes.”

With the slogan “1 disc, 1 milling process, 1 denture,” Ivotion has an uninterrupted milling process that machines monolithic complete or individual complete dentures, immediate complete dentures, and overdentures on 2 attachments from 1 disc, reducing the need for manual work. Although he has had a few patients with larger arches who required the 2-step method, for most patients, 1 puck fits the bill.

He has found that Ivotion’s Shell Geometry technology has been beneficial for design quality and esthetics, streamlining the process more. Located within the Ivotion disc, the Shell Geometry is a 3D tooth and dental-arch structure designed for the fabrication of mandibular and maxillary dentures and allows technicians to mill accurate complete dentures—which rarely require more than polishing after production—in 1 operation.

“You design it, then you send it to manufacturing, and the machine does the work for you,” Senegal says. “So you’re guaranteed to get a quality denture with no mistakes. And that’s a huge benefit, to the lab, the clinician, and patient satisfaction.”

Although Senegal says the initial investment in Ivotion can be high, he has found his investment has paid off. Between the high-quality polymethyl methacrylate tooth and denture base materials and reduced manual steps due to milling accuracy, he has cut down on case time and been able to increase his case load.

“If you get the fit right, there are fewer patient visits after you deliver that denture,” Senegal says. “The likelihood of a patient coming back is minimal. That’s huge when you think about the time you spend on a particular case, when you could be focused on another one. You can save time to do other things and work on other accounts—and still be able to deliver a quality denture.”

Senegal has deemed the investment so worthwhile that he and his business partner, Richard “Al” Wilson, DDS, cofounder and chief clinical consultant and director at PEDLS, are in construction to build a full-service digital commercial lab and are planning to add 3 more PrograMill units, or, as they call them, Ivotion machines.

“When we first looked into this milling system, I quickly said, ‘That’s it, we’re all in, we need to offer this accuracy of milling to our patients,’” Senegal says. “That’s how much we believe in this system and how much benefit we feel that we can get.”

This system offers a total digital manufacturing process to simplify the creation of dentures.

Ivotion Denture System Streamlines Workflow

Stratasys J5 DentaJet™ , the only multimaterial 3D dental printer

Suitable for any dental lab that wants to reduce costs, maximize efficiency, and create more dental parts with less handling.

The J5 DentaJet enables technicians to load mixed trays of dental parts and can produce at least 5 times more dental parts on a single mixed tray than competitive 3D printers, giving dental labs 3D printing efficiency paired with realism and precision.

Typically when dental implant cases require multiple materials, separate 3D printers are needed for each individual material. The J5 DentaJet can handle up to 5 different materials, including support materials, by utilizing mixed trays of dental parts. The single mixed tray can hold a full array of opaque, clear, flexible, and color resins, creating dental implant cases and denture applications faster and more accurately.

This new system scales 3D model printing efficiency for dental labs. 

5Ws* Stratasys J5 DentaJet

Videos

Dental practice coach Mike Massotto joins editorial director Noah Levine for 30 minutes of practice help and advice. In this episode, Mike and Noah discuss the best ways to retain good dental staff. 

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Loyalty Program, Payment Portal Boost Relationships Between Practices and Lab

Ivotion Denture System Streamlines Workflow

5Ws* Stratasys J5 DentaJet

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