Thursday, January 19, 2012

All.In.One Fixed-Fee Implant Restorations

We are pleased to report that state-of-the-art CAD technology and our tech-savvy team of CAD/CAM technicians enable us to reduce fees and turnaround time on our premium, patient-specific, iRis custom abutment and bar implant prosthetics. We call our simple and straightforward fee structure All.In.One. It is intended to remove the uncertainty surrounding lab fees. These low fees, and our decades of restorative experience, can help you become more efficient and profitable in the restoration of implants   while providing optimal treatment.
Fees for fixed restorations are per implant and include the following: special soft-tissue model, analog, articulation, iRis custom abutment, CAD abutment seating jig, and fixed restorations, including noble alloy. Price excludes high-noble alloy, shipping, and tax. Removable fees are per arch and include: custom trays, models, special soft-tissue model, articulation, standard and processed bite rim, fit-verification jig, setups, resets, cast metal or Fiber Force strengthening substructure, acrylic  finish, one full set of premium teeth, one set of economy teeth, protective night guard, iRis titanium CAD/CAM bar on an unlimited number of implants, final screws for bar, analogs, and your choice of standard attachments (e.g., locators, hader clips, era, o-rings, bredent). Price excludes in-office technician labor, impression transfer, transmucosal  and multiunit abutments (usually not required) shipping, and tax.

The fees represent maximum costs for the specified designs (call for new Implant Fee schedule). Actual fees may be lower depending upon processes that may not be required or performed clinically. Individual fees will be itemized and billed at the time service is rendered. All.In.One components are produced by ROE’s preferred suppliers. When original manufacturer parts are requested there will be an increased cost.

iRis abutments and bars featured in our All.In.One service are fabricated on the ULTRASONIC 20, a 5-axis, robotic milling machine capable of 42,000 rpm. The 2.3 ton machine is considered the most stable in its class and is capable of milling both titanium and zirconia from single unit to full roundhouse bridges, as well as implant bar frameworks, all within 10 microns.

Digital Impressions Now for Implants

Offices equipped with digital impression machines (iTero & Lava COS) can now transfer implant position directly to the laboratory via special scan caps. These coded, aluminum, digital-impression posts are seated and thumb-tightened into implants and scanned. With this information ROE creates a virtual implant model for abutment and restoration design. There are several advantages to this service. First, the soft-tissue architecture is precisely captured and used to create ideal emergence and margin placement. Second, digital impressions are received by our laboratory very quickly allowing us to design abutments and restorations earlier, leading to much quicker turnaround time. And third, digital files are imported into ROE’s iRis (intelligent restorative individualized system) to engineer restorations to your specific parameters. Scan caps can be ordered through ROE in both plastic and radiopaque aluminum.

Refrigerate Cement??

Some cements require refrigeration, some don’t. For example, PANAVIA™ F 2.0 recommends refrigeration, while Kerr’s Maxcem does not. To avoid “pseudoplastic behavior”, AACD recommends not refrigerating veneer resin cements. The European Journal of Dentistry (2010 Apr;4(2):150-5) published a study conducted on the effects of refrigeration on viscosity and conversion kinetics of dental adhesive resins and concluded that a “significant time and material-dependent effect” resulted during the warming phase. Based on the results of this study, the recommendation was to remove adhesive agents from the refrigerator 20 minutes prior to use. Conclusion - read the instructions on each adhesive in the office to ensure they perform optimally.

Zirconia and Porcelain Polishing & Adjusting

Due to the incredible popularity of ROE’s monolithic zirconia restorations (TLZ) we are frequently asked to recommend products to adjust and polish zirconia. Komet USA developed ZR Polishers a special line of burs specifically designed for hard materials like zirconia and lithium disilicate (emax). They incorporate interspersed diamonds for a “consistently, outstanding sheen in just two steps”. They are identified by blue for pre-polishing and light-gray for high-shine final polishing. Both are available in three shapes: point, flame, and cone.

Z-Systems’ Zirconia Implants

Z-Systems is a Swiss manufacturer of metal-free dental implants. Its ceramic implant systems, Z-Look3 and Z-Look3 EVO are made of a special ZrO2-TZP-A-Bio HIP Zirconia. A special production process incorporates this unique bio-ceramic to create 100% zirconia implants which satisfies the cosmetic demands of anterior cases.

Z-Systems have been approved by several safety regulatory agencies across the globe, including the U.S. Food and Drug Administration (since 2007), and has over 6 years clinical experience and 20,000 implants in use. The promise of an esthetic, healthy, and safe alternative to metal implants is appealing. Z-Systems USA Inc. can be reached by calling (877) 874 9407.

Restore-Refresh your Patient’s Partial Denture -Bite of Interest

Patients often wear their worn, ill-fitting partial dentures far too long. Quite often a reline, new teeth and clasp adjustment or replacement are all that are required to update an appliance. We now offer a partial denture refresh service from $199 - $270. The type of teeth and complexity of metal repair will determine the final fee. Please send a pick-up/reline impression, with an opposing model and bite registration. This service requires just 2 days in the laboratory.

New Employees - Bite of Interest

In 2011 we added several experienced technicians to our staff. We also added an experienced clinical assistant to our customer service team, promoted an exceptional technician to CBCT Surgical Guide Consultant, and added a chemist/quality engineer to implement and lead our FDA/DAMAS Quality Management system.

Implant Supported Denture Process - Improvments

Within the last six months we have made several improvements in the materials and processes used for screw-down, fixed-detachable hybrid dentures and overdenture cases.

First, to ensure that we are processing at optimal levels we completely updated our premium Ivocap processing system: replaced flasks, injectors and the processing bath. Second, all bar cases are now processed on a separate analog model. Screwing the bar down at processing ensures the best result. Third, we redesigned our CAD/CAM bars and are now placing titanium posts within the long axis of all denture teeth for added tooth support. Fourth, the standard teeth we use in implant-borne removable prosthetics have been changed to Heraeus Kulzer, Mondial and Mondial i Denture Teeth. Research has shown that these teeth have a stronger bond to acrylic. In fact, these teeth are used by ClearChoice Centers and at the Malo Clinic, originators of the All-on-4 process. Finally, we now provide a vacuum-formed night-guard to protect the appliance from nocturnal parafunction. We believe these five improvements have added to the long-term success of our restorations and reduced the maintenance for doctor and patient.