Noah Levine

Dental labs and the technicians working there must become experts with the materials they use. A technician needs to understand the specific nuances of a material relative to the techniques for shaping and processing the material as well as the techniques for finishing the restoration. An understanding of a material’s physical properties is key because restorations must be engineered to meet functional demands as exacting as the esthetic expectations of patients and clinicians. With this in mind, we asked what materials technicians are most likely to recommend for different restoration types, as well as what factors are most important when selecting a new material to use.

When it comes to choosing materials to recommend for different clinical situations, it should be no surprise that the response depends on the type and location of the restoration. While zirconia is proving to be the Swiss Army knife of indirect materials and was the most popular choice for use in the posterior, glass ceramics and layered ceramics were other popular options for single anterior units. When it comes to the posterior for crowns or bridges, porcelain-fused-to-metal (PFM) or porcelain-fused-to-zirconia (PFZ) options remain common recommendations. The opinions were most divided on the best option for anterior bridges, where zirconia, PFM, and layered ceramic restorations were all popular choices.

When it comes to removable partials, the recommendations are all across the board. Cobalt-chrome (CoCr) frames were the most popular choice, but titanium alloys were close behind, and newer polymer options received strong support from the lab providing removable partial services. From this variety of recommendations, it’s clear there are many workable options for designing removable partial frameworks.

It’s likely no surprise that the factors rated most important when considering a new material are enhanced durability followed closely by enhanced esthetics. Those factors were rated as “very important” by more than half of the survey respondents, and when the “important” votes are added to that total, both factors were cited by more than 9 in 10 survey respondents. Every factor in the survey was rated as “very important” or “important” by more than half the respondents, so it’s clear that lab technicians are evaluating every aspect of a new material before bringing it into a lab.

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The Dental Lab Products® 2021 Materials Survey provides a look at what materials are most often recommended in various clinical situations, as well as the most important properties for a dental material.

The 2021 DLP Materials Survey: An Open Approach to Find the Best Materials

The evidence of humans replacing damaged and missing teeth goes back centuries. Based on the archeological and anthropological records, it appears these restorations were undertaken for both functional and esthetic reasons. Although dentistry was likely quite painful for patients back then, especially in the earliest days before the dawn of the concept of anesthesia, some of these ancient techniques and the materials used can be easily connected to modern dental restorations. Gold, for example, is among the earliest materials used to fix and replace damaged teeth.

Although the use of gold is less common than it was in the mid-20th century, gold is still a part of the dental industry today. However, other materials have been left to the pages of history books, and this was a smart move, as some of these indirect dental restoration choices sound far less than optimal. Here’s a look at a quintet of abandoned restorative materials from throughout history.

Animals come in a variety of shapes and sizes, and so do their teeth. Animal teeth were used in many ways for dental restorations. Some evidence shows that animal teeth were used as direct replacements for missing teeth in humans. More commonly, the large teeth of animals, such as the hippopotamus, were carved to create sets of dentures that were likely not very comfortable but durable enough for long-term use.


Wood is plentiful. It’s durable, and it’s fairly easy to shape. For this reason, it shouldn’t be too surprising that wood, specifically bamboo, has been used for dental purposes dating as far back as 4000 years ago. Human remains were found with carved bamboo pegs pounded into the jaw, creating an effective but likely extremely painful replacement for a missing tooth.

Used both for decorative and potentially functional purposes, stones as dental restorations date back more than a millennium, with evidence that the Mayan civilization would drill holes in teeth and fill them with precious stones. But stones have also been used to replace missing teeth, with some archeological evidence showing that rocks had been specifically carved to fit in place of a missing dentition.

Although the esthetics and functionality of seashells as dental restorations remain something of a mystery, the archeological record does demonstrate this material might have been one of the more successful attempts at replacing a missing tooth. Once again, the Mayans are behind this dental innovation. In 1931, investigators discovered remains dating back to the seventh century, when seashells had replaced several missing teeth. Most significantly, evidence of bone growth around the shells indicates these restorations were placed while the patient was alive. This is ome of the earliest known evidence of osseointegration.

Much like with animal teeth, this option seems pretty straightforward. Someone is missing a tooth, and the dead person isn’t using it anymore. However, implanting a cadaver tooth in place of a missing tooth can lead to infection, rejection, and a range of other complications, and this doesn’t even account for the fact that many of the teeth sold to dentists were sourced from unwitting donors by grave robbers. As gruesome as the practice of using cadaver teeth must have been, it still doesn’t compare with the brutal practice of slave owners replacing their teeth with dentition taken from living slaves.

A look at some materials used to replace missing teeth from the times before organized dentistry.

5 Historical Indirect Restorative Materials Unlikely to Be Used Again

Any dental lab with a 3D scanner or the ability to accept digital impression scans from practices.

Whenever a case comes into the lab, because DentalCAD 3.0 Galway features powerful tools for designing fixed and removable restorations.

This single software platform is designed to make restoration design simple and features enhancements, including instant anatomic morphing where proposed tooth anatomy automatically adjusts when the crown proposal is moved on screen. A new interface makes the software easier to use and more intuitive and tool updates make it easier to plan restoration insertion angles and bridge connectors. Updates to the implant module allow easier implant connection switches as well as easier implant positioning adjustments.

 Automation allowing this software platform to accomplish more in less time is a focus of the enhancements in this latest version of DentalCAD. Beyond the automated anatomical morphing, the latest update also adds artificial intelligence–driven smile design that can aid in both treatment planning and patient communication. The model creator module is designed for efficiency and can be used with any 3D printer. For removables, the software includes preset tooth setups and the ability to save custom setups from completed cases.

With more than 90 new features and an updated user interface, this impressive CAD application is even more powerful than previous generations of exocad’s flagship software.

5Ws* DentalCAD 3.0 Galway

Implant cases with screw retained restorations where either or both esthetics and access are priorities.

During case design and at delivery of the case so the implant screw channel can be hidden or positioned for easier access during placement of the abutment and final restoration.

The SMARTbase abutments are designed to improve both esthetics and accessibility with a screw access channel that can be redirected from 0º to 25º, allowing for easier hiding of the screw channel in anterior restorations and easier access to the screw channel in posterior restorations. The abutments are designed with dual hue anodization to seamlessly blend with surrounding dentition to provide a natural look. The versatile abutment solution is compatible with both screw-retained and cement restorations. With a variety of cuff heights and widths available, the abutments can be used with a range of situations.

 The off-axis screw channel allows cases to be designed with lingual screw access as well as other configurations for enhanced access. Specialized off-axis implant drivers are used to attach the screw, and the abutments are designed with grooves that are said to enhance cement retention when the abutments are used with cement-retained restorations. The dual-hued abutments feature gold color at the top to naturally blend with the restoration, and a pink hue in the lower section to better match the gingival tissue. Additionally, the abutments are designed with a concave profile that is said to enable subcrestal placement without the need for major tissue manipulation.

With its angulated screw access channel, this implant abutment system from Implant Direct aims to make implant cases simpler and more esthetic.