Friday, May 23, 2014

Custom Abutment Upgrades

Several months ago we upgraded our zirconia custom abutments. We began infiltrating a dentin shade throughout the abutment and adding a pink hue below the finishline, so that the abutment is less visible on patients with thin biotype or tissue recession.

Now, on select titanium abutments  and on all hybrid bars, we are anodizing - a process of releasing an anode/hydrogen and cathode/aluminum current through the titanium. This electronic concentration can produce an array of colors, determined by the amount of voltage applied. The process changes the surface of the abutment without adding any thickness, and produces a chameleon effect on the metal substructure to help provide more esthetic restorations. Yellow and pink are the two colors we utilize.
 
Anodizing is used in ma

ny industries as a safe alternative to coatings. If you wish to be excluded from this new standard, please indicate on your work authorization or call your technical consultant.


We are not charging for any of these product upgrades, but we believe these small changes will have a big effect on the success of the restoration.

Datron D5 - Dental Milling at its Finest

If you would like to observe something impressive, stop by the laboratory to see our new milling machine. Weighing nearly a ton, our new 5-axis mill is something to behold. We could go on for pages about its 13-station tool changer with automatic length and tool-break sensor, or its 8-disk automation system for one hundred hours of uninterrupted milling, and all that might sound great. But, what is ultimately important to our customer is that, with the D5 onsite, we can consistanly deliver accuracy and fast turnaround time.


Purchasing this equipment is a serious investment in the future of CAD/CAM at ROE. The D5 was built from the ground up to meet the specific demands of the dental market for the production of complex tooth and implant geometries. The D5 mills materials within +/- 5ยต, which means extreme accuracy. In addition, we fabricate abutments, implant bars, copings and substructures more quickly than ever before. The D5 mills all dental materials, but we have dedicated  our new machine specifically to titanium and cobalt/chrome (read below). We are very excited to provide this level of engineering and sophistication to our clients.

Cobalt/Chrome, the New Biocompatible PFM

Given the ability to mill extremely precise substructures with our Datron D5, ROE is introducing cobalt chrome (Co/Cr) as an excellent alloy for PFM restorations. There are many reasons to make the switch to Co/Cr. It has been a trusted alloy in dentistry since the 1940’s in tens of millions of restorations. The alloy has been the standard-of-care for PFM’s in Europe for many years. Co/Cr is a very strong alloy that is biocompatible and free from nickel and beryllium. All Co/Cr PFM restorations are produced with our new D5 high-tech milling machine. These CAD/CAM-designed, porosity-free copings are extremely precise. The days of waxing, investing, casting, divesting, and finishing are gone. Due to the elimination of so many variable-filled steps, greater predictability and accuracy are inevitable with milled PFM restorations. Once the copings are created, ceramists use traditional layering techniques to produce esthetic restorations.


Milled Co/Cr PFM restorations represent the most technologically advanced PFM restoration available. With the high cost of precious alloys, the flat fee of $150 per unit makes these restorations a great value. 

Ultra-Z The Next Generation of Metal Free

ROE now offers the perfect combination of low-cost, high-strength, and esthetics. Resin-filled zirconia is being introduced to dentistry as the next-generation, monolithic restoration.  Ultra-Z is 20% nano-resin and 80% zirconia, yeilding high flexural strength. Ultra-Z also offers compressive strength of 480 MPa, which is the strongest of the esthetic ceramics on the market. Its unique material blend offers a high modulus of elasticity, which promises to prevent fracturing under stress. The resin filler also delivers a translucent effect that is not found in other monolithic materials of this strength.

Similar to monolithic zirconia, this material is primarily suitable  for posterior restorations.


Due to lower material cost, less laboratory production time, and no sintering requirement, Ultra-Z is available for only $79 per unit. 

Available Cusp Shades A1, A2, B1, C1. We can custom stain the body and gingival, but the cusp shades are limited at this point... more shades coming.

TLZ-IB Prettau Bridges Update

We continue to have great success with our full-arch zirconia restorations. Unlike many companies, ROE designs and fabricates all phases in-house for better design-control and improved turnaround time.


TLZ-IB Prototype
Base upon our experience with this prosthesis, we recommend utilizing a PMMA prototype.This milled provisional is used to finalize all functional and esthetic aspects of the prosthesis, and is kept in the mouth for no less than 6 to 8 months to allow adequate time for the tissue and bone maturation. Without this healing-adjustment period, it may be necessary to add to the intaglio surface with Gradia composite. Please visit our web site for additional details and processes.

Thommen & SynOcta - Custom Abutments Now Available

If you restore either of these systems, you’ll be glad to hear that they are now compatible with ROE’s line of custom iRIS abutments. Thommen is available in both titanium and zirconia, and Straumann’s SynOcta can be produced with titanium. Also, both are compatible with our very popular TLZ-SR screw-retained, monolithic crown or bridge. Furthermore, if you posses a digital impression machine, such as 3Shape, iTero, Lava TDS, Cerec, E4D Nevo, or CS3500, we can offer scan-bodies for intra-oral scanning. This increased accuracy reduces both laboratory and chairside time, while reducing cost.

Avadent Partner Laboratory

ROE is now an Avadent partner. Avadent is a digital denture company that boasts the ability to produce a complete denture in 2 appointments. The ability to mill a denture base and teeth from a dense, porosity-free, zero-shrink puck of acrylic, and the sophistication of their tooth-manipulation software is very impressive.


Ivocap Update

ROE has utilized Ivoclar’s SR Ivocap Pressure Injection system since the mid 1980’s to process dentures with great success. Ivocap virtually eliminates the problem of acrylic shrinkage by controlling heat/pressure polymerization during the injection process to continuously adding acrylic into the flask as the acrylic cools and shrinks. For our customer this means dense, strong, porosity-free dentures that fit. Recently, we upgraded our entire system to the new Ivobase processing equipment. The computer-controlled system eliminates the possibly of human error, ensuring outstanding success on every case.

Wednesday, January 22, 2014

Root Tip – A Natural Abutment



When a partially edentulous case presents, and the coronial aspect of a tooth has been or will be lost, before removing the tooth root you may want to consider a tooth-borne attachment.  Using the root to retain an attachment, similar to how an implant is placed, is a conservative alternative, and can be accomplished using a Micro Era from Sterngold, or Locator or Zaag from Zest Anchors.

The technique is somewhat sensitive. To achieve optimal results we suggest discussing the design with us in advance of the preparation appointment. How you prepare the tooth and canal differs depending upon the attachment selection and which technique is chosen to create the impression and indirect, telescopic attachment. It is usually best to minimize the height of the attachment, allowing space for the prosthesis. In fact, when vertical dimension is limited it may be advantageous to use a direct-technique, eliminating the cast coping and bonding the attachment directly to the tooth structure and canal. With proper planning, this type of case design can be a great service to your patients. 

Partial Denture Digital Presentation



For the past four years ROE has employed CAD/CAM technology to create cast-partial dentures. Master casts are digitized and sophisticated software is used to create the final design. A stereo lithography framework pattern is then printed for casting. Our CAD-produced partial dentures are far superior to their hand-fabricated predecessors.

ROE has always provided a complimentary conventional survey and design service. The design is penciled on the study cast and returned for rest-seat preparation and final impression. Now, because of our high-tech approach, clients can send study casts and request a digital survey and design, which includes virtual teeth. This virtual work-up is emailed as a viewable 3D model that can be rotated to any view. The web-based preview can be shared with patients who may be particular about the design. The service even allows you to email a full-smile photograph of your patient to be used in the work-up. The patient photograph allows us to provide a 2D image of the final result, allowing the patient to be aware of clasping in the esthetic zone. This service is available for $25.

Zirconia or Emax, Monolithic or Layered – Decisions, Decisions



Based upon our experience, and reinforced by gurus in our industry, we’d like to make a recommendation of restorative materials and how they relate to location in the arch. The basic selection process for dental materials has not changed over the years - the stronger the restoration the less esthetic, and vice-versa. In the mouth, this directly correlates to stronger in the posterior, esthetic in the anterior. Fortunately, due to material improvements over recent years, the range between the two ends of the spectrum is narrowing. But a combination of treatment around an arch often presents a conundrum.



ROE’s standard recommendation for material-selection is as follows: in the molar area we suggest full-cast gold restorations or full-contour zirconia (TLZ, BruxZir) as the most predictable and reliable. With centrals and laterals, when occlusion is stable, we suggest our very esthetic, layered eMax. Our choice for bicuspids and cuspids varies depending upon a number of factors, such as occlusion, guidance, opposing surfaces, translucency, final shade, and stump shade. For example, if strength is the primary concern, full-contour zirconia might be the best choice; conversely, if a younger patient presents with translucency requirements and a stable occlusion, layered eMax or even monolithic eMax might be well-suited. If the patient has a dark preparation-shade, PFZ, full-contour zirconia, or monolithic eMax is the best choice to mask the discoloration.




In more extensive restorations, it may seem prudent to use the same material to maintain continuity within the smile. However, the patient’s particular needs, and the spectrum of materials available, may complicate the choice of material. In these situations, feel free to gather information and discuss treatment-options with your ROE Technical Consultant. They are experienced and trained to help dentists decide the best material for the situation.