When I do a webinar I usually build in a lot of content. My thought process is that if people are gracious enough to listen in, I have an obligation to give them as much content as possible. That means that I don't normally don't get a lot of time or even any time at all for Q&A. Due to that, I've recently had the idea of keeping the questions that come up via the chat function and answering them here.
Last Tuesday evening, June 18th, 2024, I did a webinar on the basics of 3D workflow and how that tech can improve your outcomes. I had a great time. It's always nice to know that people are wiling to listen to my experiences. I am really fortunate in that I get the opportunity to work with a lot of amazing tech due to my role at Dental Products Report and then I get to tell my peers about my experiences.
When I do any type of slide presentation, whether it's live or over the Internet, I always make a disclaimer when I start. That disclaimer is this:
I work with a lot of companies in my role at DPR. Frequently, but not always companies will provide me products to test or things to evaluate. Some of those companies have products I like. Some I don’t like…
I bring that up because almost all of the things I talk about are things that I have hands-on experience with. If things work, I talk about them. If things don't perform, I tell the company that had me try it and I do my best to let them know where I found problems. Frequently that kind of feedback from myself and other clinicians helps to improve products that I can then recommend. However, I will never tell my audience to use and believe in something that I know doesn't measure up. I want my audience to know that if I don't use it and believe in it, I won't tell YOU to use it.
Now on to Q&A. Last night I only had one question show up in the chat.
Tamer asked:
Do you think we are ready to shift to in office milling, or are there still some downsides to the milling machines as far as aesthetics?
My answer:
I think for speed, efficiency, and quality, in-office milling is just as good as what comes from a lab. The mills now on the market create incredibly accurate and aesthetic crowns. Plus the materials we now have available provide great long term results. Depending on the situation I currently use VOCO Grandio Blocs, Chairside Zirconia powered by Roland DGShape, and Ambermill Direct powered by Roland DGShape. All 3 of those materials come out of the mill beautiful and ONLY need to be polished before being delivered.
My one caveat would be on the subject of staining & glazing. Because the materials we are currently in-office milling are "pre-sintered", this means they can be placed without the need for an oven. That fact can affect results in the cosmetic zone. As any dentists knows, the most difficult cosmetic problem we encounter is trying to match a single crown to an existing dentition in the cosmetic zone. In that instance or if you are going for a custom shading solution, that will require an oven, staining, and glazing.
Now, there ARE ways to overcome that in many instances. Ambermill Direct Powered by DGShape has an option to use multi shade layered blocks which can sometimes provide a solution. My main point here is that there isn't always a perfect solution that will eliminate the need to stain & glaze.
However, I am incredibly happy with the results we are currently getting from in-office milling. It is definitely a technology that is viable and provides phenomenal results. The times when an oven is needed are becoming more and more rare. I think that dental labs will always be needed for certain cases that require the "artist's eye" that only human hands and eyes can deliver. However, for overall, every day bread & butter restorative solutions, in-office milling has evolved to be a great solution and is definitely something I believe in.
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