All-On-X Live Surgery performed by attendees !!

All-On-X Live Surgery performed by attendees !! a great experience for the dentist who is ready for full mouth !! Guided bone reduction, guided implants, guided prosthetics... there is not substitute for GuidedSMILE

GuidedSMILE – The Digital All-On-4 Solution

Offices involved with full-mouth, implant-supported cases should consider GuidedSMILE. Although most All-On-4 type cases are predominantly completed free-hand, there is a growing regard for a CBCT guided solution. GuidedSMILE, a proprietary and complete surgical package, can reduce surgical time to a third of the conventional non-guided approach, while improving accuracy.

The GuidedSMILE package includes bone reduction, osteotomy, and abutment guidance, and pre-converted PMMA provisional, all anchored using the same bone-pin sites. GuidedSMILE follows ROE’s classic CT planning work-up. Utilizing a CBCT scan and master casts, ROE digitally transforms the patient, proposing a new ideal tooth arrangement and implant locations. During a pre-surgical, scheduled web conference, implant locations are finalized, and necessary surgical and restorative components are discussed. The surgery is very straightforward. GuidedSMILE applies a 4-guide process. Guide One sets the pins with which all three subsequent guides are anchored. This unique pin-guide is the key to ensuring the subsequent guides and provisional are accurately seated. Once it is removed, the teeth are extracted and the second guide is anchored for precise bone reduction. Guide Three directs the drills for angulation and depth. Then, abutments and temporary cylinders are placed. Guide Four is the PMMA provisional that is luted to the cylinders and picked up for quick, final adjustment. The unique system allows the last three guides to be seated using the pins only, meaning the guide itself floats above the bone for ease of seating. This is particularly helpful with the bone reduction guide.

In our experience, following many hundreds of All-On-4 cases, both traditional and digital, GuidedSMILE is the best method of delivering accurate prosthetics the same day of surgery. We are excited to share this technique with you. Please call to discuss GuidedSMILE.

Teeth Chatter: Wanted: Implant Case Information

With so many implant companies exhibiting similar and even duplicate interfaces, providing implant specs couldn’t be more important than it is today. We ask that you please include the manufacturer, brand, and platform, and any other pertinent information for each implant submitted to the laboratory. An easy method of communicating this vital information on new placements is to include a copy of the letter that is generally sent from the specialist. Our experienced staff does an excellent job of identifying systems. However, this information will ensure we begin each case with the correct impression posts, a somewhat frequent error. Without detailed implant specifics, cases may be compromised. Thank you in advance for including this information with the work authorization.

FDA 510K Cleared Titanium Custom Abutments

Several years ago we undertook the painstaking steps to implement an FDA style quality management system specifically designed for dental laboratories called DAMAS. With this in place, we were able to strategically partner with a Swiss company to become FDA Cleared as a Class II medical device manufacturer for milling titanium abutments. Our classification and special partnership bring a very high level of compliance, precision, and peace-of-mind.

Custom Abutment Blank / Digital Scan Body

Custom abutments have been a ROE standard for more than a decade. What does 510K Cleared mean for you? Doctors want options when restoring implants, with more versatility than stock parts. 510K Cleared means your abutments have been designed, milled, and inspected according to a strict protocol. Our partner ensures that the interface specs are within the original implant manufacturer’s guidelines, and ROE ensures the patient’s needs are meet with an anatomical abutment design.

510K clearance is unique for dental laboratories. There are a few milling centers in the USA with this status, but very few dental laboratories. With regard to timeliness, cost control, and quality, this solution provides our clients with significant advantages. Of course we do, and will continue to, provide OEM stock parts. Simply indicate your preference on the work authorization. If you have digital impressions and would like to transmit your cases to us digitally, precision $39 scan bodies are available for all popular systems. We also accept exchanges on other system’s scan bodies for a discounted trade-in price of $29 each.

DigiDenture – An Economy Digital Denture that Yields Outstanding Prosthetics

As an Avadent and PALA partner laboratory, with over three years of providing digital dentures, we strongly believe in the development of computer-aided design for full dentures, and feel this is the future standard practice. So far, in lieu of the premium price, the results have been very good. To improve upon this technology, ROE has unveiled a new, amazing product called DigiDenture, which employs conventional records, to deliver a high-quality, efficiently-created denture, with an economy denture price.

DigiDenture, with economy teeth, provides a perfect solution for affordable dentures. It begins with conventional bite blocks, rather than the tedious Gothic Arch tracers of the aforementioned systems. Our system uses traditional bite blocks and master casts. Once the records are scanned and become virtual, ROE creates an amazingly accurate digital set-up and a fully printed, white resin denture for the try-in. Tooth position, bite, and fit are verified or adjusted as needed at the dental office and returned for final processing. The final product includes premium processing with Ivocap and plastic teeth. The savings is realized by the laboratory fabricating the CAD white denture, in place of the labor-intensive, manual set-up process.

If you are wondering how the patient will react to trying-in a white denture, put your worries at ease. After completing thousands of white resin try-ins, Kulzer Dental found patients focus more on the fit, tooth position, comfort, and suction of the prosthetic rather than the color. Tooth cards, containing the actual teeth selected, are provided for this appointment to share with the patient.

If you provide dentures for patients who are limited by government or insurance remuneration, we highly encourage you to try this product - an outstanding denture at a great price. 

Next-Gen TLZ Zirconia Superior Hygiene & Wearability

Today, the vast majority of posterior crowns fabricated in the United States by major laboratories are composed of fully-milled zirconia. This staggering shift in materials is trumped only by the fact that research shows there is a much better method of finishing zirconia surfaces. Since early 2014, when we hosted Rella Christensen RDH, PhD, to discuss wearability studies on monolithic zirconia, there has been revealing evidence that highly-polished zirconia is far superior to a glazed surface. Polished zirconia is so smooth that one is challenged to even pick up a crown without gloves. And, unlike glaze, this glassy, hygienic surface prevents plaque, rendering it much more biologically friendly.

Studies have shown polished zirconia surfaces are also kinder to opposing dentition than abrasive, glazed surfaces. And, once the glaze is worn, exposed rough zirconia is even more unkind to opposing teeth. Polished crowns, according to TRAC Research, retain their polished state as natural wear occurs. Polished also exhibits improved translucency and esthetics, as the transmission of light is unobscured.

Today, all ROE monolithic TLZ crowns are polished. We are excited to be leading the way with this improved modality. We know you will notice the difference on your next TLZ case.

LMT Laboratory of the Month - ROE Dental

http://roedentallab.com/downloads/2016%2010%20LMT%20ROE%20Featured.pdf

Nicely Priced 3Shape Launches TRIOS® 3 Mono

3Shape Launches TRIOS® 3 Mono Intraoral Scanner - In the 20,000's range

World’s first upgradable entry-level intraoral scanner

3Shape launched last week TRIOS 3 Mono – a new entry-level version of its award-winning TRIOS 3 intraoral scanner.

TRIOS 3 Mono delivers the same documented-accuracy, insane speed and ease of use of all TRIOS intraoral scanners but takes digital impressions without color. It will sell at an extremely competitive price point at nearly 40% less than TRIOS 3 color models.

TRIOS Mono delivers many of the same award-winning features of TRIOS 3 color models, including:

• TRIOS documented-accuracy, insane speed and ease of use
• The widest range of indications and delivers texture and stone model scans plus HD photos
• Doctors can offer same-day dentistry using optional 3Shape practice lab

Upgrade to color model at any time

As a special bonus, the TRIOS 3 Mono is upgradable to a TRIOS 3 color model at any time. The cost of the upgrade is the price difference between the two scanners and service fee. When upgrading to a TRIOS color model, the upgrade includes RealColor™ scanning, digital shade measurement and an integrated intraoral camera.

3Shape President and CEO, Flemming Thorup said about the new TRIOS, “Doctors are definitely looking to go digital with their dentistry. There are just too many documented advantages to ignore. To make the jump easier, we created an intraoral scanner they can start and keep growing with, one that does not compromise speed and accuracy or use powder.

Adding, “The TRIOS Mono delivers the award-winning performance of our TRIOS 3 intraoral scanner, but at a terrific price and importantly, like all 3Shape products is future proof, and with the opportunity to upgrade to a color model at any time.”

See the TRIOS 3 Mono movie: https://youtu.be/HT0RdNPXgRs

As a reminder, some TRIOS models may not be available in your country. Check with your reseller for more information.

OPEN HOUSE ANNOUNCEMENT

Hello friends and clients of ROE Dental Laboratory!

We are thrilled to announce our laboratory’s move, the new facility, and an Open House event! We’d love for you to join us! Take a tour, or stay for 7 hours to attend our many CE courses throughout the day of August 19^th. Celebrate a new era of ROE with whole team, which includes you!

We are planning several continuing education courses in a symposium style of 50 minutes each. Guests also have the opportunity to get scanned by the latest 3Shape digital impression scanner to receive their own patented MiniComfort splint (1 doctor & 1 staff). We will have contests for some great prizes, stations set up for doctors and staff to observe new products being manufactured, food and time to meet with your technical consultant.

Many more details to follow, and a place to register for our courses.

Save The Date – We Hope to see You!

ROE has Moved ! 7165 E. Pleasant Valley Rd. Independence, OH 44131

We are thrilled to announce that on our company’s 90th year in business, we have moved to a new, ultra-modern facility. During the past year we’ve been designing, remodeling and significantly updating a well-built telecom building in Independence, Ohio, with an eye on future development and growth.

With a significant increase of space, we were able to design improved work flow, build special rooms for milling and 3D printing, strategically integrate digital technology, increase the amount of natural light and workspace, and provide for future technology. Some highlights include an educational conference center with 80 work stations, three professional treatment area to meet with patients, surgical suite with cone beam CT, state-of-the-art telecom system to stay in touch with our clients, a building UPS battery back-up system for critical equipment, and a back-up generator to ensure that we never have a down day due to mother nature or our local power grid.
Our goal is to provide a first-class atmosphere for our team and our clients, provide a venue for outstanding educational events, and create an infrastructure that allows us to continue to provide high-caliber dental laboratory work for the foreseeable future.

Images Based Upon Restoration

Laboratories have always requested pertinent photographic images from clients. As photography as a whole continues to evolve, so does our opinion on what images are most helpful, and the best method of their capture. For eons, sharing individual images taken with expensive cameras has been the standard. This technique still works great and is superior for photography intended to communicate color, shade and texture.  But with the quality and convenience of smart phones, more doctors are using their devices to efficiently transfer images. In fact, recently we have been suggesting sending short videos, which will provide thousands of extractable, high-quality images. The key to sending videos is to make sure they are short in duration, under a minute, to allow them to be transferred with minimal size compression.

We are often asked, “What pictures are the most helpful to the lab?” Below is a list of the prosthetic requests which we feel most benefit from photographs, as well as what images are the most valuable to us as technicians. These images should be uploaded through our web portal.

Denture Bite Rim – Full Face and Profile Providing these two images at the bite stage, along with midline, incisal, cervical, and high smile line position, goes a long way in getting a great setup. Both images are equally important.

Denture Set-Up – Full Face and Profile Similar to the bite rim images, if a reset is needed, these images and written instructions dial-in the result.

Single Anterior Teeth – Full Face, Retracted Close Up with Shade Tab   When matching a single tooth, a few items are critical. First, the image must be focused on the tooth we are mimicking, with the shade tab body-to-body, and edge-to-edge. This provides the needed color scale to make porcelain selection and staining decisions. Feel free to send the actual tab with your case.

Anterior Restorations / Wax-ups / DSD – Full Face, Profile(s), 12:00, Retracted These images are desired and helpful with fixed, anterior work. We feel it is significant to provide images of both teeth and face. BELOW

Profile Left / Right

Full Smile Full Face

Retracted Smile

The 12 O'clock Smile

Twin Clasp – Provide Contour with Pre-Prep Model

ROE’s Twin Clasp Technique is a wonderful service for the patient who prefers not to give up their partial when fabricating a new crown under one of the clasps. When restoring this abutment tooth with a monolithic, milled crown, the impression protocol is simple.  If the tooth to be prepped is intact, capture a pre-prep impression to provide the contours, then a normal impression of the prepared tooth. With these two impressions, we will design a new crown with similar contours as the previous crown or natural tooth.

Temp Tabs – Quick Temps and Bites

Thermoplastic Temp Tabs are an efficient and stable alternative for making quick and easy matrices for temporaries up to 4 units, and bite registrations. These flexible, polyester wafers offer sustained recording ability, yet remain firm enough to be sensed by opposing dentition. If the desired recording is not achieved, the operator can backtrack by reheating and reusing.

DSD Partner Laboratory – Dr. Christian Coachman

ROE now offers a new service called Digital Smile Design (DSD) which is transforming the protocol for evaluating and testing cosmetic treatment. This is how it works. Provide five specific images (Full Face, Left and Right Profile, Retracted, and 12:00) and detailed design instructions. We will return a PowerPoint or Keynote presentation (please specify which you prefer) showing 2D renderings of the proposed design for your approval. After approval, we convert the 2D line drawings into a 3D design for final approval. Once you are pleased with the design, we print models of the 3D design and make technique-friendly, dual-layered matrices for temporization for an in-office mock-up to encourage treatment acceptance. Detailed information on this great new service and the future of diagnostic smile design is available on our website’s Shade & Smile page.

DSD was developed by Dr. Christian Coachman, an international smile design expert. If you’ve ever attended a course, or watched a DSD video of his digital analysis and patient presentation (youtube.com), you’ll understand why ROE became a Partner Laboratory. Dentists have the ability to present glamourous before and after composite photographs and videos, incredibly visualized 3D work-ups, CAD/CAM models, and amazing in-office temps. ROE is bringing Dr. Coachman DSD-DAY seminar to our laboratory on Nov 2nd, 2016.

New Clear & Tissue-Colored Clasps

A new brand of premade clear and pink clasps is available. They are rigid, esthetic, designed with ideal parameters for flexible clasping, and are a new favorite of ROE. We love the fact there are no visible transition lines between the acrylic saddles and the clasps, and that the initial clinical feedback has been outstanding. These clasps are available for traditional partial dentures as well as all acrylic flippers. Simply request us to use Tissue Colored or Clear Clasps. More images are posted on our web site.

MiniComfort Daytime Deprogrammer Great Survey Results & New Design

To better understand our customers and market, we solicited and completed MiniComfort trials with 140 of our clients. A prerequisite of the evaluation was that the “patient” must be the doctor, staff member or doctor’s spouse, and have some history of splint therapy. We were energized by the overwhelmingly positive the feedback. Nearly all participants agreed that MiniComfort provides ample tooth protection, that they would recommend the appliance, and that it is nearly undetectable when worn.

MiniComfort is a daytime, compliance-promoting, segmental oral appliances that does not affect speech. According to Dr. John Kline, the inventor of MiniComfort, people can only deprogram muscle activity during waking hours, which is why the MiniComfort so unique and effective.

Further, due to customer feedback and requests, this month we introduced MiniComfort 6.0, a heavier-duty version that offers more protection for the bruxing community.

Create the Ideal Implant Emergence

Today, implant-dentistry is all about the interdental tissue, emergence and esthetics. CBCT surgical guides are on the rise, facilitating ideal position, and custom abutments are the standard of care. Custom healing abutments are also becoming more popular. With all of these tools available, why does abutment design sometime miss the mark? Often, the ideal sulcus is not captured in the impression, and therefore not transferred to the soft tissue model. We would like to suggest a technique as a solution.

 

When a flared healing collar or custom healing abutment is removed, quickly screw down the impression post, capture an x-ray if needed, and fill the void between the post and the surrounding sulcus with composite. ROE will create a tissue moulage that duplicates the captured sulcus, then digitally create an abutment that meets tissue, or blanches, based upon doctor’s preference. All the work up to this point will not be in vain, and the ideal sulcus form should be achieved. On cases where the tissue contours have been idealized prior to taking the impression, please request “no blanching” on the work authorization.

MiniComfort - Daytime, Nighttime, Anytime - What Flexibility!

MiniComfort, a self seating splint that is comfortable, increases compliance, protects teeth, deprograms, and will barely effect speech. No other splint offers these benefits. Price is $99 for 2, and reorder does not require new impressions.

MiniComfort - “Best Brux Guard Ever Made”

Wearing Her MiniComfort

MiniComfort, a U.S. Patented product, is the outcome of a six-year research and development project by Dr. John C. Kline DDS, a practicing dentist of 40 years, who used both his practical experience and personal observations to create a different kind of bruxism appliance. MiniComfort sets a new standard for comfort and fit while protecting the teeth and decreasing symptoms. ROE is pleased to have been selected as the exclusive U.S. manufacturer of MiniComforts.

MiniComfort is a mandibular, self-seating, zero-adjustment, deprogramming device, light and flexible, that does not protrude from the lips. It can be worn day or night and will simply amaze your patients, particularly those who currently wear a traditional splint or NTI appliance. Due to its very thin design, it will not interfere with a person’s speech or appearance. 

Almost Invisible - no speech issues!

The secret to MiniComfort is two discluding elements (rigid 4-6mm therapeutic bands), which are placed just behind the canines to keep the teeth separated at a patient’s normal freeway space. The Elements deprogram by minimizing the patient’s bite force, similar to an NTI appliance, preventing the patient from fully occluding, and thereby maintaining a comfortable position. Due to this deprogramming design, wearing the appliance at night contributes to less clenching during the day. When worn during the day, the appliance is almost undetectable. As with any partial coverage appliance, it is important that the patient be instructed to wear the appliance only for a portion of the 24-hour day, at your discretion, depending on the stability of the patient’s dentition.


Dr. John Kline’s extensive research, patent trials and use of MiniComfort reveal:


• Almost 100% of participants in the study adopted use of the MiniComfort and continued to wear it because of its comfort and undetectability

• 98% of participants were pleasantly surprised with the excellent fit

• Participants were asked to wear MiniComfort during waking hours including work and social situations. Nearly all of the participants reported satisfaction with day time performance

• Participants who suffered from headaches reported a drastic reduction in the frequency and severity

• Upon examination, participants who wore MiniComfort on a daily basis had no damage to their teeth related to clenching or grinding

• A MiniComfort should last between 12 to 36 months, depending on the user’s severity of clenching and/or grinding

MiniComfort affords the dental practice a self-seating, five-minute-appointment appliance. Because the two therapeutic bands are the only points of occlusal contact, adjustment is a thing-of-the-past. Once seated, the appliance forms a hydro seal over the dentition and mucosa, providing very good retention and comfort. Auxiliary staff can manage the seating appointment.

2 Discluding Therapeutic Elements 

MiniComfort also offers two more unique advantages, an Instant Wear guarantee and a digital record for easy reorder. Due to the nature of the appliance, MiniComfort is designed to be replaced periodically. For this reason, we include a second complimentary appliance (Instant Wear guarantee). We also digitally archive each case to simplify the reorder appointment. Allowing appliance to be reordered without taking another impression, provided the patient’s dentition has not changed.



Order MiniComfort for your next patient suffering from bruxing, clenching, headaches and TMD. If for any reason you and your patient are not thrilled with the appliance, a conventional appliance will be made at no charge.

Best Bite Registration Materials

The correct bite position is clearly one of the most critical steps in restoring a case. Consequently, the bite registration protocol and choice of material are a continuous subject of discussion between our clients and us. When recording a bite for single crowns, or for bridges, there are a few crucial considerations. We recommend using rigid materials, avoiding ones that are rubbery with bounce that distort when articulated. Rigid materials provide a positive stop similar to that of natural teeth. It is equally important that bite materials not be brittle when set. This causes the bite to fall apart when trimmed, or after repeated use.  Three of our favorite materials are Futar Fast Bite - Kettenbach LP, Blu-Bite HP - Henry Schein Dental, Vanilla Bite – DenMat.


We suggest using small amounts of bite material in key areas, such as over the prepared teeth or edentulous areas, and where centric stops do not exist. Overuse of material can obscure the centric stops, making it difficult to confirm that the remaining teeth fully interdigitate. We find that clients who, after taking the bite registration, trim the bite down to an area just over the preparation and adjacent teeth, test in the mouth to confirm, experience the most consistent success with minimal occlusal adjustment.  When preparation involves the terminal tooth, or when multiple preparations exist, full arch impressions are highly recommended. This allows visual verification on the articulator via the contralateral side.

If you have made the leap to digital impressions, some systems offer an opportunity to digitally trim the bite. It is important that care is taken when trimming, and that a similar  method is used as described above, in order to achieve an accurate orientation of the casts.

When restoring a large case, where a patient is provisionalized and there is no natural tooth-to-tooth occlusion, bite tripodization is required to accurately capture the bite position. To maintain the newly established bite position, the provisional should be removed in small sections and bites recorded in these areas. This should be accomplished bilaterally and anteriorly, and again we suggest trimming and verifying the bite as previously explained.

We share these suggestions from our experience. By all means, if you are having great success we encourage you to maintain your current technique. Please contact us any time to discuss the best bite technique for your case.

Malocclusion - a Sign of Civilization

Click for Intriguing Lecture

UK, declares that of the 4629 mammals, only humans exhibit malaligned teeth. In the British Dental Journal, an article featuring Dr. Mew explains that “in the fields of both anthropology and archaeology, malocclusion is considered a sign of civilization. It is not present in any of our pre-civilized ancestors, who had well aligned teeth (regardless of attrition) from birth until death. The origin of malocclusion does not follow a genetic pattern but appears wherever and whenever cooking and tool-making appear, and progresses from mild imbrications to skeletal manifestations as civilization advances. There is also no evidence that we should not accommodate 32 well-aligned teeth today or that there has been any genetic change.” The causes of malocclusion, according to Mew, are environmental factors, mainly soft diet, high-nutritional/calorie foods, lowering the amount of chewing, and nasal obstructing allergies. Both lead to long-term postural lowering of the mandible, effectively shortening the space for teeth. Dr. Mew humorously suggests that the best method for young people to achieve ‘normal’ maxilla-facial architecture, is to stand up straight, chew multiple pieces of gum at the same time for 2 hours per day, and keep the mouth shut (“just like your parents taught you,” adds Mew).
https://www.youtube.com/watch?v=NvoX_wEtwDk 

Cement Tips for Implants

During a recent CE course, ROE gained some valuable insight from Matthew Palermo DDS, Interim Chair Department of Restorative Dentistry at Temple University. One recommendation is the use of densely radiographic cement for implant seating. With the prevalence of peri-implantitus, the ability to observe and remove cement is critical, and TempBond and ZincPhosphate are ideal. He suggests checking your current implant cements for radiopacity. 

Keeping the amount of cement to a minimum is advantageous. Dr. Palermo shared a method of minimizing the amount of cement using an extra-oral technique. Apply one thickness of Polytetrafluoroethylene (PTFE) inside a crown and then fill it with bite material. Before setting, insert a cotton tip. Once set, remove this plug and fill the crown with cement. Reinsert the plug (essentially creating a duplicate of the prep) until excess cement exudes; then quickly deliver the crown. This will provide approximately 50μ of cement.

Staub Cranial Dentures - Receive a Maxillary Set-Up for the Bite Appointment

Since the 70’s Staub Cranial Dentures has delivered tooth set-ups from master casts. Fully edentulous Maxillary and mandibular casts are measured and the recordings are entered into a software. This information instructs technicians where to set the teeth, while a special Staub device articulates the maxillary cast. From these two records, doctors receive a full maxillary set-up and mandibular bite block ready for the bite registration. Once captured, doctors have the option of a full try-in or going directly to finish. This highly successful denture technique will prove itself on 

the first case. If the setup is not ideal, send reset information for another try-in or finish. You’ll agree that this is a big improvement over the traditional two bite block appointment. It is Imperative that shade, gender and age is sent with master casts!

Monolithic Zirconia in the Anterior?

By now you’ve seen anterior BruxZir advertised in the dental journals. Did you ever think fullcontour zirconia would be indicated for anterior restorations? Although the new BruxZir is only ½ the strength, it is much more translucent and is specifically designed for anteriors. 

We are producing this product now, along with our TLZ for anteriors, and although it is still new, there is promise in translucent zirconia; we will keep you updated.

Did You Know that ROE is a Leading Provider of Surgical Guides?

Since 2004 ROE has produced more than 12,000 surgical guides for a national and international clientele. Today, guided surgery is accessible for all doctors wishing to place implants. Our simple protocols work with practically any treatment situation. The process is so efficient that with most cases the office simply provides a CT scan (with patient biting on cotton rolls), master or digital impressions, and a bite. In a few days we are on-line with you planning the final position of the implants. A few days later your guide arrives with a simple-to follow Drill Report, applicable for any implant system. Complex cases may require a diagnostic work-up, which will add one more appointment. Call for your CT Welcome Package today.

What’s new with Guided Surgery this year?


• We unveiled our new improved CombiGuide II – a
two-piece bone reduction osteotomy guide for quick
accurate surgery. Images can be viewed on the
Surgical Guide page on our website.


• ROE has been selected as a Premier 3Shape
Implant Studio Laboratory in the USA. For Implant
Studio users, this means domestic support, training,
and easy-to-order guide sleeves.

• Digital impression scans are accepted for quicker
turnaround, lower cost, and model-free guide cases.

ROE On-Line Saves Time

ROE clients now have online access to their cases where they can view current case status and return dates, check case history, and even add images, DICOM, and other files … all of this from a computer or device! This is a great solution to today’s demand for communication. If you would like access to your account, and have worked with us in 2015, email info@roedentallab.com and request “online access”. We will email you an invitation promptly. If you have not worked with us this year, visit our web site, click the “Upload” link on the top right of the home page, click the Red Button “I am new to ROE” and create an account. If you are a Dentrix DDX customer you will be automatically connected. Search for ROE in your DDX account and start sharing your digital fi les and records today. Send your E4D fi les, photographs, Rx’s etc. (Is this last sentence complete?)

Beyond All-On-4 - The RAPID Appliance / CombiGuide

The All-On-4 protocol has become very popular and successful. Patients can predictably leave the surgical
visit with a new, fixed, provisional prosthesis and enjoy an improved quality of life. According to plan, the patient should now have an ideal set-up and VDO. The patient enjoys this provisional for a few months and returns for the final prosthesis. At this point, we ask the question: If the provisional denture was well thought-out, and the patient is comfortable with the prosthesis, why start all over again with implant-level impressions and bite blocks, why not work from what is established and accepted? Our RAPID (ROE Advanced Prosthetic Implant Device) is our answer to this question.

With the RAPID we've developed a chairside procedure that allows us to create a master cast and capture tooth position, the VDO, and verified implant position on the day of surgery! With these records, during the first restorative appointment the doctor will simply reline our RAPID Appliance with impression material to capture the healed tissue surface. From this impression, we skip 3 clinical appointments and progress right to the tooth set-up and bar fabrication. The case is tried-in, reset if needed, and taken to completion. We think this is an excellent method of saving time and appointments, reducing variables and significantly increasing profi tability. If you restore or place implants using an immediate All-On-4,5,6 protocol, we encourage you to call us to discuss how the RAPID appliance can accelerate the restoration of the final hybrid or Prettau bridge.

CombiGuide II

One Step Further
ROE will soon announce a product called the CombiGuide for All-On-4, which will
revolutionize the All-On-4 surgical visit, and facilitate a much quicker surgery and rapid conversion process. For surgery, the doctor will receive a bone model, two-piece bone reduction/osteotomy guide (image to the right), transfer and seating bites, and an immediate flange-free provisional that is seated via the bites, rather than jaw manipulation. We will  also provide an immediate conventional denture as a backup, when initial torque is not achieved. We will explain

PALA & Avadent Digital Dentures - Amazing Technology

We are proud to be one of only two laboratories in the country to offer both PALA and Avadent Digital Dentures. With either of these systems, two and three appointment dentures are now possible.

Often, patients have dentures with worn teeth and/or multiple repairs. They may like their dentures, but it is time for an update. With Avadent, a doctor can use a patient’s existing denture as a guide to fabricate the ideal denture. When these cases present, the denture can be duplicated using a Lang duplicator, to be washed with medium- or light-body polyvinyl, and border-molded. This, along with an opposing


model and full-arch bite, are sent to our laboratory to be scanned and digitized. If you are local,
you can complete the wash impression and bite and send the patient to us for a convenient 45-minute scan. Be sure to schedule this appointment.

Avadent offers milled and, now, color gradated teeth for added strength. This is our standard for hybrid and overdenture cases when vertical space is limited. Please visit our web site for examples of our fine work http://www.roedentallab.com/product_removable_dentures_ESP.html.

With PALA, from Hereaus Kulzer, doctors can complete full dentures in 3 appointments. They also have the benefit of a trained Hereaus representative who provides all the necessary materials and over-the shoulder assistance free-of-charge! During the fi rst appointment, all the records are captured using special trays that perform a Gothic Arch tracing. Then, PALA uses algorithms calculated from twenty-six anatomical landmarks to digitally create the ideal tooth position. During the second appointment the patient tries-in a 3-D printed, resin prototype of the final denture. At this point adjustments can be made for a second try-in, or simply taken to finish. We are excited to be a digital partner and have seen very
promising results.

CONUS Overdentures - A New Development

For many years ROE has fabricated the Conus Overdenture using CAD 4 degree tapered abutments combined with Locators for a rigid, retentive, removable overdenture that is hygienically friendly and durable. Now, Atlantis offers a system called the Conus Concept. This is a ROE-fabricated all-acrylic overdenture (recommended with FiberForce® or metal substrate) that utilizes 4 or more precision-milled, friction-fi t, Atlantis telescopic abutments and copings. These abutments are either stock or custom, depending upon the angle of the implants. When implants are parallel, stock parts are ordered. This product is a patient- and doctor-pleaser. The parts are not subject to wear and therefore require little maintenance. When restoring a case with minimal VDO, Conus can be combined with a milled Avadent denture for added strength.

PCC - Milled Copings We’d Like You to Try

When ordering PFM’s, we’d like you to consider porcelain-fused-to-chrome cobalt (PCC), a restoration we’ve been raving about for more than a year. PCC copings are precisionmilled, utilizing intuitive software that produces copings far superior to any conventional casting. There is no porosity or miscasting and no margin finishing errors. There are clear transitions on bands, precise die space, and great fit. And, because PCC is a well tested base metal, there is considerable cost savings. We hope you’ll make the switch from your current alloy to PCC. 

Did you Know? Submitted by Hobe & Lucas CPA’s Inc

The state of Ohio has been stepping up its efforts to collect more revenue! Taxes based on the “honor system”, like sales tax, are lucrative targets. Did you know that buying dental products such as implants, Invisalign, and other tangible property out-of-state does not protect you from paying Ohio sales tax? If out-of-state vendors are not charging sales tax, the purhasers are responsible for paying use tax to the state of Ohio. Recently, Ohio has audited vendors such as Straumann Implants and Invisalign and determined that they are not charging sales tax properly. During the audit process Ohio auditors have extracted names of vendors’ dentist customers, and consequently audited them as well. This has been quite a gold mine for Ohio when you factor in tax plus sizable interest and penalties. 

One other thing…unclaimed funds audits are picking up in Ohio. Does your dental practice have old accounts receivable credit balances or uncashed refund checks that are over 3 years old? In many cases, these must be remitted to Ohio. 

Honesty is the best policy – if you don’t have a usetax account, you probably should; if you aren’t remitting unclaimed funds, maybe you should be. Contact Hobe & Lucas CPA’s Inc. or your tax advisor, or go to: http://www.
tax.ohio.gov/sales_and_use.aspx and http://www.com.ohio. gov/unfd/HolderFaq.aspx for more information.

TLZ-SR - Compatibility for A Great Solution

TLZ-SR is an incredibly popular restoration for restoring single and multiple unit implant cases. As we mentioned in a previous newsletter, screw-retained has made a big comeback due to the absence of intraoral cementation, the low fee ($299), and the high quality. However, not all TLZSR cases are the same! If we do not have what’s called a Ti base, the stock component attached to the crown, then we must order a stock abutment from the manufacturer and raise the fee an additional $100-$180. When completing the work authorization request that we call to discuss pricing.

Check out our compatibility and implants that require special parts and fees: http://www.roedentallab.com/product_implant_options.html 

Digital Dentures - A Quantum Leap

Avadent Digital Denture

Leading the Way For more than 5 years, Avadent has offered a digital option for dentures. Its product is very impressive, and can be reviewed on our web site. If a patient has an existing denture, and it is time for an upgrade, you simply duplicate the denture chairside, capture a reline impression
and bite and send to ROE to be digitized. In 3 days you will receive a virtual preview, and in 2-3 weeks an amazing new denture. If you are within driving distance of ROE, you can capture the records using the existing denture and ask your patient, or our currier, to deliver the case to ROE for sameday scanning! We call this our 35-minute denture! Call us for more information.








Pala Digital Denture - A New Heraeus Product

Heraeus also offers a digital denture. Its system is more ideal for patients who do not have an existing denture. With Pala, the doctor selects one of four sized Gothic Arch Tracing devices, captures an impression, adjusts the device to record the vertical dimension, then is functionally manipulated to capture centric. Pala then uses science to map tooth location based upon the arch-form and other anatomical
features. The case can be returned for try-in, if desired, prior to fi nishing.