Tech Tips
Resolve Fitting Issue with Zirconia Crowns
We have seen an increasing popularity of Zirconia Crown requests in the Dental industry. This is due to the fact that zirconia restorations provide strength and lifelike esthetics.
In addition, zirconia is an extremely durable metal and can withstand forceful chewing and grinding over an extended period of time. If properly maintained, zirconia restorations can last a patient’s lifetime. Because of its newness, many dentists refrain from using zirconia crowns or learning how to properly implant them into their patient’s mouths. This lack of experience can sometimes lead to ill-fitting crowns.
Dental crown issues are not something that you can ignore. Any problems with dental crowns must be addressed immediately for the safety of your patient. Because zirconia crowns are designed to help seal and protect your patient’s teeth from further damage, it is imperative that you know how to properly implant a crown and how to adjust the fit of the crown should complications arise.
What Can Cause Ill-Fitting Zirconia Crowns?
1) Rushed Dental Crown. When crowns are rushed, errors occur, such as incorrect margins. Crowns cemented with an open margin allows entry or seepage of saliva inside the crown, which causes decay in your patient’s gums.
2) Crown was not cemented properly. Clinicians must meticulously check the crown margins to avoid potential errors during cementation, such as a gap in the patient’s crown. This gap allows saliva and bacteria to enter the crown and can lead to tooth decay and infection.
3) Impression was questionable. Air pockets, drag or pull marks, missing impression data, inaccurate marginal impressions and poor impression material will all affect the quality of the impression.
4) Preparation anomalies.
How to Fix Debonding Complications
If you find your zirconia crowns are debonding, try altering your cementation process. Most technicians will test out the fit of the zirconia crown in the patient’s mouth before cleaning the tooth with pumice. Next, decontaminate the intaglio of the zirconia restoration before you prepare it with a priming agent or adhesive if your zirconia crown does not have a built-in primer. Finally, cement the crown in place, tack the cure, and remove any excess cement.
Even though these are all standard procedures, clinicians sometimes fail to decontaminate the intaglio thoroughly, which causes the bonding process to fail. Because zirconium oxide bonds with phosphate groups, it’s critical to properly remove the phosphate groups so the oxide sites can bond successfully in your patient’s mouth.
Three Ways to Remove Phosphate Groups
Sandblasting. Although sandblasting the internal surface with 50-micron diameter aluminum oxide is sometimes not recommended, most manufacturers do recommend sandblasting the internal surface very lightly at a low pressure. Always refer to the manufacturer’s recommendations before attempting this method.
Sodium hypochlorite. The intaglio of the crown is wiped with gauze soaked in a 5% concentration of sodium hypochlorite or full hydrogen peroxide, which is removed by rinsing with water and air-drying the restoration.
Ivoclean. Use a proprietary solution such as Ivoclean. Leave the solution on the crown for 20 seconds before rinsing. The crown is then air-dried and ready to bond.
Ensuring Restorations Don’t Rock Facial-Lingually
Do you find the margins of zirconia crowns fit perfectly, but that the crown rocks facial-lingually? This problem occurs more often than you’d think and takes longer for properly fitting zirconia crowns on patients.
When the digital image of the patient’s tooth is constructed, any irregularities are removed as milled restorations have smooth surfaces internally and will not fit over irregularities or undercuts. Usually, a die-spacer is used on conventional models, which creates a space of approximately 50-100 microns. When fabricating zirconia restorations, have your clinician ensure that the computer program is set to create well-fitting margins, while specifying the size of the space between the fit surface and the prep site. This simple step replicates the function of a conventional die-spacer and will prevent zirconia crowns from rocking facial-lingually.
Crowns which do not fit can lead to unhappy patients. If you ever experience fit issues with a zirconia crown, call our lab directly to discuss your specific case with our expert technical team. Precision Esthetics Dental Lab’s technical team is ready to help solve any issues regarding ill-fitting restorations and will work with your office to find the best solution.
We are Expanding!
Precision Esthetics Purchases new Facility for Expansion and Growth in the Dental Industry
December 17, 2019 - West Palm Beach, FL - The Business Development Board of Palm Beach County (BDB) is pleased to announce that Precision Esthetics is expanding its headquarters and technology division in the City of West Palm Beach. The company recently purchased an 8,000 square foot building at 4912 South Dixie Highway. The seller was represented by BDB member Constance Thomas, Senior Director at Tower Commercial Real Estate. The company had outgrown its former facility, also in West Palm Beach, and will now have space for 30 new positions. This year, Precision celebrated 30 years of being in business. The company has a reputation as an industry leader among full service boutique dental laboratories that provide high quality Dental Lab Service to approximately 400 dentists.
ABOUT THE EXPANSION:
- Projected 30 new high salary jobs for local residents
- Expanding in West Palm Beach to a new facility
- 8,000 square feet
- Soon to be located at 4912 South Dixie Highway
- Dental products are made in America
- More than 80,000 completed dental implant cases
- Recognized as one of the top dental laboratories in the United States
Read More at https://www.bdb.org/news/2019/12/17/economic-development-news/30-jobs-coming-to-palm-beach-county/
Our 30th Year Celebrations
Celebrating 30 Years
Congrats to James Han on his promotion to Lab Manager!
PEDL Community Outreach
We were happy to partner with Dr. Sundeep Rawal, Prosthodontist and the Florida Dental Association to participate in the Florida Mission of Mercy (FLA-MOM).
This is a large-scale, two-day, professional dental clinic that provides care to any patient at no cost to them, with the goal of serving the under-served and uninsured in Florida — those who would otherwise go without care.
We are very happy to give back and touch the lives of patients within our community.
In picture: Dr. Steven Schmidt,
Rafael Candelaria , Dental Technician, Precision Esthetics,
Dr. Sundeep Rawal, Prosthodontist.
We are Leaders in Digital Technology
Digital Technology
Our highly qualified Digital Technology & CAD CAM team consists of the best in the Industry.
With James Han, our Director of Digital Technology & Assistant Lab Manager at the helm, we are always keeping abreast of the latest cutting edge technology that keeps our Lab a leader and driving force in the Industry.
As an industry leader in Esthetic Dentistry and Digital Implant Dentistry, we are always striving to provide better, more efficient services with faster turnaround time. With our two new Mihm & Vogt Speed HT Sintering furnaces we are able to sinter up to 190 Zirconia Crown and bridge units in less than 3 hours! This together with the new DOF HD Freedom scanner and our two new Roland DWX-51D CAD CAM Milling Machines put our team of Master Dental Technicians in the wonderful position to work more precise and extremely efficient and to deliver a consistent and better quality product with faster turnaround time!
Faster Turnaround time: our new Roland mills provide faster turnaround time to dental labs and dentists in the dental community.
(James Han our Director of Digital Technology & Lab Manager)
Corporate Retreat 2018
The Future is here!
August 2018
At our most recent Corporate retreat, were were happy to officially introduce our new General Manager Mr. Carsten Busse, highlight the launch of our new lab in Rockledge, Florida and highlight our acquisition of the latest technologies including the latest 3D Printing technology.
Dr. Sundeep Rawal aong with Nobel Biocare also discussed the new Trefoil (All on 3 implant system).
In picture from left: Ed Zak, Nobel Biocare; Johanna Podkowa, President, Precision Esthetics; Dr. Roy Blake, Prosthodontist; Achim Renner, CEO Precision Esthetics; Dr. Sundeep Rawal, Prosthodontist
Shade Tips from our Master Dental Technician
How can I Improve the accuracy of a shade
Here is what our Master Ceramists at Precision Esthetics recommend:
1. The First Impressions are the most accurate in shade selection and work the best!
2. Keep in mind that you cannot provide too much descriptive information to your master ceramist. A properly taken digital photograph with the shade tab and exposed shade number included in the photo provides many of the anatomical characteristics that can help you achieve excellence.
3. The patient should remove any lipstick or bright makeup.
4. Make the shade selection at the beginning of the appointment before the
tooth becomes dehydrated and your eyes become fatigued from the other
procedures. Whenever possible take a shade prior to tooth preparation.
Click here for more recommendations (link to website)
5. The canines are a good reference point in selecting a shade because they
have the highest chroma (intensity) of the dominate hue (color) of the teeth.
6. Make your final shade selection after comparing your shade selections with those of another team
member. This works to double check these very subjective measurements.
7. When making shade selections it is important not to view the comparison for more than 7 seconds at
a time to avoid fatiguing the cones of the retina. We recommend you gaze at a neutral grey wall card. In
fact, looking away at a grey card between each 7‐second shade evaluation will reset the focus of your
eyes and depth perception.
8. Compare your shade selection under varying conditions such as with lip retraction versus lip down
and when the patient moves their head in different directions or lighting angles. Request the patient sit
up or stand up when determining the shade. The tab should be parallel with the tooth being shade
matched so to minimize depth perception errors. View the shade under color corrected lighting.
9. Many doctors feel that selecting a shade of slightly lower value from the adjacent teeth helps the
porcelain “blend” nicely with the patient’s natural dentition.
10. Be aware that shade tabs degrade due to aging and disinfection. Have a new guide to compare the
consistency of other guides and always designate the name of shade guide used; remember that A‐2
may not be consistent between guides. For e.max crowns please include the natural die shade
(stump shade) to ensure the proper end result.
Outcome Driven Results
From the Desk of Johanna Podkowa, President, M.D.T.
During this interesting and unprecedented time in dentistry,
we realize the necessity of choosing the right lab partner
to serve any dental practice which prides its reputation on
high quality products.
In a technology driven industry, personal relationships
become more and more important. With a proven track
record for over 29 years in the industry, we pride ourselves
in open communication and availability to our clients in
order to deliver the best quality to patients.
As such, we see our lab as an extension of your team.
We are aware that the future of Dentistry is rapidly
changing. While our lab has been abreast and equipped
with the latest state of the art technology, what makes
us standout is the great pride in which we continue
to encourage and hone the individual craftsmanship of
our technicians.
News
Annual Corporate Retreat- “The Change is here”
Posted November 22, 2017
Precision Esthetics hosted its Annual Corporate retreat on November 20 at Café Sapori in West Palm Beach. During the Keynote Presentation where the main theme was “The Change is here”, Founder and CEO Achim Michael Renner, M.D.T. pointed out that in keeping with the rapid changes and growth in the dental industry, labs and technicians will need to keep abreast of the new technology complemented by quality craftsmanship. Achim pointed out that “there is no doubt that digital technology is a great! But compensating for a lack of skill with technology is progress toward mediocrity. As technology advances, craftsmanship recedes and we use it less resourcefully. The one thing we’ve gained is automatism, which is useless without perception!” Other guest presenters included Dr. Alexander Wang and Mr. Pierre Rodrigues, Vice President, Comerica Bank.
From the Desk of the President, Ms. Johanna Podkowa, M.D.T.
My mentors and instructors Willi Geller,Oral Design Team - Switzerland and Klaus Muterthies, Germany influenced and changed the way I looked at outcome and result driven esthetic restorations and made me redefine my approach: "Watch and Copy Nature" is the quintessence for every artist". It always was my vision to bring the philosophy of my mentors together with European Quality Craftsmanship to the USA. It is now my mission to delivery it with each and every case. Our Clients and their Patients deserve the best. Thank you very much for your business and for continuing support.