Richard Palmer

, a leading provider of dental milling devices, announced the release of its latest five-axis dry mill, 

	Roland’s DWX-51D dental milling machine is equipped with a 10-station automatic tool changer (ATC), a new C-clamp with torque wrench for reportedly easier loading of materials and an expanded Virtual Machine Panel (VPanel) with built-in maintenance routine. It’s designed to be capable of producing copings, crowns, full bridges and abutments and other prosthetics from zirconia, wax, PMMA, composite resin, PEEK and gypsum with unparalleled speed and precision.

	Simultaneous five-axis machining with 360-degree rotation in clockwise or counterclockwise directions (A axis) and 30-degree tilting toward the front or back (B axis) are said to support complex restorations with undercuts. For higher quality output, the DWX-51D reportedly employs an improved airflow system that boosts vacuum performance and prevents dust from building up in the milling area. The 10-station ATC is designed to enable multiple tooling options, as well as unattended operation from start to finish. For optimum convenience, a color-coded light reportedly informs the technician of the machine’s operational status.

	“Because many labs run their machines unattended, we also equipped the DWX-51D with an automated e-mail notification system,” said Brian Brooks, Roland DGA’s senior product manager. “The user receives an email if an error occurs or when a job has been completed.”

Related reading: Roland DGA announces new wet milling machine

	The DWX-51D boasts touch-button controls and automated milling said to make it simple to operate.

	“Users will find the workflow to be easy, smooth and seamless,” Brooks said. “Just install the material and milling tools into the machine, use the VPanel to configure the settings from your computer and, with a few mouse clicks, the precision milling begins.”  

	The new dental mill reportedly also features a slim, attractive design, but the beauty of the machines is said to be much more than skin deep: Unsurpassed performance, accuracy and efficiency reportedly also come standard. Ball screws for the X, Y and Z axes are designed to help maximize accuracy and reliability. Multicast capability is said to be yet another extremely useful DWX milling machine feature. Users can connect up to four respective DWX machines to a single system for centralized control from one PC.

More on milling: Learn how to calculate the ROI of the DWX-4 milling machine from Roland

, Roland is said to now offer the dental industry the option of a comprehensive, two-mill combination capable of producing a wide range of dental prosthetics from a variety of materials.

	According to Brooks, Roland’s multiple device solution,combining the DWX-4W with a state-of-the-art dry mill like the DWX-51D, offers significant advantages over single machines that offer both dry and wet milling.

	“The beauty of our two-machine system is you can perform both wet and dry milling at the same time, as well as process different materials, without a changeover,” he said. “In addition to saving time, effort and money, this ensures superior results by allowing each machine to specialize in its intended function.”

Innovator Profile: Roland DGA's new wet mill

	Since its launch in 2010, Roland’s DWX series reportedly has gained industry recognition for its five-axis capabilities, ease-of-use, robust reliability and open architecture. It is said to have quickly became an industry standard with more than 3,000 units sold worldwide.

	“The open architecture of Roland’s DWX mills is just one of the reasons these devices are so popular." Brooks said. “Users aren’t locked in to one manufacturer with our milling machines. They can choose the type of software, scanner or materials they want to use.”

	“The new DWX-51D is the culmination of more than three decades of proven Roland 3D milling technology. We also based the design of this next-generation device on extensive feedback obtained from current Roland DWX-50 users. This enabled us to create the ultimate dry dental mill-a machine that’s not only advanced, precise and efficient but also incredibly easy to use.”

	Along with Roland service and support, the DWX-51D is backed up by a comprehensive two-year manufacturer’s warranty.

	To learn more about Roland’s newest DWX dental milling machines, or the complete DWX lineup, visit 

Related reading: New tools for the DWX-4 that provide new material options

Articles

Roland’s DWX-51D dental milling machine is equipped with a 10-station automatic tool changer (ATC), a new C-clamp with torque wrench for reportedly easier loading of materials and an expanded Virtual Machine Panel (VPanel) with built-in maintenance routine. It’s designed to be capable of producing copings, crowns, full bridges and abutments and other prosthetics from zirconia, wax, PMMA, composite resin, PEEK and gypsum with unparalleled speed and precision.

Roland DGA unveils new dry mill

Quality control measures like Lean manufacturing and DAMAS can increase your efficiency and productivity.

No one likes to be told what to do. As kids, your parents told you to clean up your room and eat your veggies. In school, your teachers instructed you to write neatly and follow directions. On the job, your bosses demanded that you do it their way because that’s the way it’s done. They might have told you it’s all for your own good, but you didn’t really believe it and vowed that someday you’d be your own boss, and no one would tell you what to do.

Then you opened a dental laboratory and faced myriad commands and regulations that you couldn’t say no to. The funny thing is, all those demands from parents, teachers, and bosses turned out to actually be for your own good in a way and now can help you make your business stronger and more profitable.


	While there are official regulations mandated by the U.S. Food and Drug Administration that dental laboratories must adhere to as a manufacturer of medical devices, having a basic in-lab system of quality assurance and standard operating procedures just makes practical business sense. Any system where the laboratory regularly reviews standards and practices and then establishes working guidelines will only move operations to a higher level of efficiency by flagging areas of weakness and showing areas needing modification.

“When you have a quality system, it allows you to catch [problems] quicker and take corrective action rather than waiting for a firestorm to hit where you can’t really recover,” NADL Executive Director Bennett Napier said. “The damage is done, and you have hundreds of cases that have been affected rather than a few.” With a quality system in place, the lab can trace the problem back to the source and take corrective measures to help ensure the problem does not reoccur.
	One system of setting benchmarks for quality standards that is widely used in many industries is known as Lean manufacturing. Although it isn’t a formal certification or regulation process, Lean manufacturing is more of a philosophical way of looking inward to advance the current of things moving forward.

The heart of Lean is the fundamental concept of eliminating waste and excess and streamlining procedures, said 

, Vice President of Sales & Marketing. “In the dental lab, it’s the flow of the work,” she said. “You are determining how you can improve workflow and make sure each of the steps you are taking is providing the maximum amount of value.”

Bob Long, Whip Mix Lab Relations Manager, said many instances of lab waste would seem common sense, but need to be observed and noticed through impartial eyes. “The biggest thing we try to do is get rid of the clutter, confusion,and chaos,” he said. “I’ve watched guys sit there and fumble with all these burs on their bench. They pick one up, put it in the handpiece, throw it back down, right back into the stack because it’s broken.”

The idea of eliminating waste goes beyond just squandering materials and supplies but permeates through many overlooked areas, Steinbock added. “Anytime someone has to wait for something to move through the process. Any time someone has to wait for a machine to become available. Any time they have to wait on materials to become available. Any time they have to wait on instructions. We’ve looked at that and tried to eliminate all those things that we call waste,” she said. “Those are basically just delaying the process and adding costs to the operation.”


	Not one to just talk the talk, Whip Mix also walks the walk of Lean manufacturing. A certified ISO 9001:2008 manufacturer, it is accountable for its own quality systems from producing materials, supplies, and equipment, which, in turn, help labs with their own Lean operations.

“Lean is really an integral part of our DNA,” Steinbock said. “Everything we make is with this mission in mind. We practice it here, and we certainly try to build that into the products that we make.”

Part of that genetic makeup is in what Long refers to as “cellular design” in the company’s facilities layout. “We haven’t added on in space, but we’ve made three acquisitions. We’ve been able to fit new product lines and production into our existing square footage by putting all the equipment into a cellular organization so the machine operators don’t take steps to work different machines. It’s all much more condensed in the space. We can put more product line manufacturing in the same space,” Steinbock said.

Long said he has heard from lab owners who have implemented a cellular design into their own production workflow schemes with exceptional results. The only complaint he has heard from the labs is they had expanded their footprint before incorporating the cellular design. “Now they have all this extra space they don’t need,” Long said. “They could have saved themselves money,” if they had used Lean cellular strategies instead of expensive construction.


	For many smaller labs, implementing and maintaining Lean manufacturing processes or similar quality assurance standards is as far as they need to go. They are able to improve efficiencies through an informal internal audit of their operating procedures and make adjustments when necessary without outside involvement. However, a handful of labs have decided to make the extra effort beyond basic compliance and on to third-party certification, and have seen additional benefits as well.

One such system is the Dental Appliance Manufacturers Audit System (DAMAS), which was created in Europe in the 1990s as a quality control standard geared specifically for dental laboratories that did not need full-scale ISO certification meant more for industrial mass manufacturers. The NADL modified DAMAS to fit the North American industry and to closer fit FDA regulations.

“DAMAS is really a boiled-down version of ISO for labs who can’t afford or don’t need ISO certification,” said Nick Azar, Founder of Azar & Associates (azarandassociates.com), an NADL-approved DAMAS trainer and consultant based in Santa Clarita, Calif.

Napier said lab owners are turning to the systematic format of DAMAS for different motives. “The primary reason, the driver for them, is they finally understand that if you implement something like this, it makes you more productive, reduces your waste, and in essence will make you more profitable, which allows you to be more competitive, in terms of turnaround times and consistency of product.”


	In addition to the benefits of increased efficiency, consistency and reliability to a lab’s everyday production advantage, DAMAS certification provides the bonus of long-term marketability.

“Dentists want to do business with a lab that has a quality system,” said Mary Borg, Co-Founder and President of SafeLink Consulting Inc. of Cumming, Ga. “And having been certified toward that or registered, that’s an assurance to that dentist, who is ultimately responsible for that device going into that patient’s mouth.”

“There’s a lot of quality-minded dentists out there,” Azar said. He sees the demand for quality as coming not just from the dental practice, but eventually from savvy consumers who may even ask for specific products, brands, materials, and labs based on strategic consumer-based marketing and advertising. “Ultimately, the consumer is going to ask the dentist, ‘Who made my product?’”

Azar said it might be a few years down the road, “But many people who are at the forefront, they are always thinking 2 or 3 years ahead. They have a good vision of where their company’s going to be 5 years from now, and they are positioning themselves to be at the front.”

Other labs may be positioning their business for a different consumer. With a growing percentage of lab owners nearing retirement age, growing fatigued by overwhelming competition from more and more supersized labs and chains, or worrying about uncertainty from overseas, the idea of merging or selling has become an attractive option.

Napier said labs that have a quality system in place will be more eye-catching to purchasers. They recognize that if they incorporate some of these systems, it’s going to make them more attractive because people will know that there are systems in place. They aren’t going to have to completely go in and start from the ground up to build an operational structure. All these forces that have taken place, the light bulb has finally gone off for people to see that this is just good business,” he said. Napier added that the labs that have systems in place also are seeing a higher payout at the time of purchase than those where the buyer has to start from scratch with their own quality system.


	In spite of all the benefits to a lab’s workflow and cash flow, less than 50 labs in the United States are DAMAS certified. The primary reasons cited are the burden of paperwork, the shortness of manpower, overregulation, staff reluctance, and the long-term commitment, Azar, Borg and Napier said. However, each is clear that the positives will outweigh any such negatives, which aren’t as difficult or time- and money-consuming as often perceived.

“Once you get a system in place and it becomes part of the protocol, it gets instinctual,”Napier said. “The mechanics of managing a quality system, to some extent some part of the process is going to touch every point in the lab so it’s layered out. It’s not like one person now has a 40-hour-a-week job; it could be five minutes at this particular task at this particular production department are now in the mix. Everybody now is involved in managing the process.” He goes on to caution that labs will need to have one person to monitor and oversee the entire process, but who is not responsible for all the details involved.

Of course, having a specialized DAMAS consultant like Azar or Borg onboard to help implement the process never hurts. But ultimately, it will be up to the owner or manager to keep things going.

“Top management needs to show their commitment that this is a priority, that this is important to the organization,” Borg said. “If you’re not supporting it from the top, all it’s going to be is paperwork.”

With administration backing the quality system, staff at the bench are more likely to be behind it as well. “We’re hearing less if they can sell this to the workforce in terms of the benefit,” Napier said. “The benefits are more clear now.”

“It’s about employees having a better understanding of why they’re doing things the way they’re doing them,” Borg said. “It gives a reason for the accountability. This Generation Y and now the Millennials, you’re bringing in a workforce that wants to know why. What’s in it for me? You have to deal with that.”

Richard Palmer is a former editor for Dental Lab Products and has years of experience covering the dental and dental lab fields.

How your lab can reap the benefits of Lean manufacturing

As the oral-systemic healthcare link gains wider acceptance, and as clinicians are promoting a whole-body approach to dental treatment, the term "probiotics" pops up occasionally as a new approach to treating the entire patient. But what are probiotics, and how can they help with oral health as a gateway to overall health?

"There is a certain amount of misunderstanding about probiotics," said Michael Shahani, CEO of Nebraska Cultures and son of Khem Shahani, PhD, the company founder who discovered the DDS-1 strain of L. acidophilus in the 1950s. "Probiotics are actually live bacteria that confer some sort of benefit on the host organism that takes them or ingests them." Probiotics also is the term used for the dietary supplements containing these bacteria, such as Nebraska Cultures' Pro-FloraTM.

According to Shahani, the amount of naturally occurring probiotics in many people in this country has diminished over the past few generations for three main reasons-changes in diet, over-processing of food, and over-prescription on antibiotics-which has resulted in their need for a supplemental boost.

"The diet we eat today is the diet a very few rich people ate 100 years ago," said Shahani. Most people's diets would have consisted of more fresh fruits and vegetables in addition to more fermented food products. Traditional foods such as certain sausages, pickles and sauerkraut as well as fermented milk products like fresh cheeses and yogurt  use healthy bacteria as a means to preserve foods without refrigeration. However, today yogurts often are processed to such an extent that the healthy bacteria are killed, and the yogurt loses most of its probiotic benefits. 

Khem Shahani, PhD, began his landmark research on Lactobacillus acidophilus at the University of Nebraska in the late 1950s.

"Also, we've become quite phobic about washing and sterilizing everything," he added. "Because food wasn't quite as clean a couple generations ago, there definitely were bacteria left on these foods that came out of the garden. Now, it's too clean and sterilized."

Shahani also feels that the overuse of antibiotics has contributed to the dearth of healthy bacteria. "We're taking antibiotics for things we don't need to be taking them for,  we're taking them just as a preventive measure, and we're giving antibiotics to our food animals. There are plenty of instances where the use of antibiotics is necessary, but at the same time, there are instances where people are taking antibiotics where they don't need to. What that does is kill off all the good bacteria as well as the bad."

As a result, certain health ailments, allergies and intolerances have become more prominent and more pronounced throughout the population. The addition of a daily probiotic can help return the body to a more healthy balance.

"Any probiotic activity you can get into the body is going to improve every part of the digestive process, including the oral part," said Shahani. "Because the digestive track is such an important part of the rest of our body, it affects a lot of other areas."

Specifically, probiotics can produce enzymes that help in food digestion, including the creation of lactase that helps in the digestion of sugars in milk. Other benefits of probiotics include the production of B vitamins and folic acid, stimulation of the immune system, prevention of carcinogenesis, and keeping harmful bacteria such as E. coli from attaching to the intestinal walls.

"There is some evidence that there are probiotic bacteria that live in the mouth," said Shahani. "They're a kind of specialized group of bacteria, of which Streptococcus salivarius is one, which act as a probiotic in the mouth and can inhibit dental infections of various kinds such as dental caries and fungal infections." He adds that there has been more research into growing oral bacteria as a probiotic but that he is not aware of anything being done at a commercial level.

Shahani cautions that probiotic supplements should be considered just that: a supplement to traditional antibiotic treatment in cases involving serious disease. "I'm not sure that there's evidence that shows that taking probiotics is really going to combat periodontal disease. But it is certainly not going to hurt."

He adds that in cases where there is a legitimate prophylactic use of antibiotics to halt an infection, those antibiotics will have systemic effects on all bacteria, bad and good.

"Dentists should be as aware as any doctor of the importance of putting back those healthy bacteria in every part of the body."

Probiotics: Good bacteria for good health

	Designed specifically for the dental market, the open-platform DWX-30 CNC milling machine features three types of clamps, one for discs and two for blocks, making it easy to securely hold a wide variety of material sizes and thicknesses. Materials can be cut on the top, bottom and at ±20 degrees for complex geometry. Aided by a maximum machine speed of 3600 mm/min and a maximum spindle speed of 30,000 rpm, it cuts material quickly with precision, helping to reduce errors, saving time and money. It also has a virtual panel that makes it easy to create copings, crowns and bridges. Other features include an integrated dust collection system and a tool sensor that automates machine and tool setup, saving valuable time and eliminating errors.

Applying New Technologies: Roland DGA Corp. DWX-30

	“Those who fail to plan, can plan to fail.” This is more than just an old proverb or trite saying, but should be considered words to live by, to be posted up on the front office of every dental laboratory and practice as well as any other myopic small business that focuses too much on day-to-day survival and not enough on setting and striving to achieve long-term goals.

	Unfortunately, the dental industry is comprised of thousands of dedicated professionals with a singular avidity toward what they do-create exceptional dentistry and provide optimal patient care-that often inhibits them from seeing the forest for the trees. The technician who opened his own small lab or the clinician who started up her private practice exhibits a passion for dentistry that frequently precludes the mundane, yet vital, running of their business.

	“They’ve spent 20 years learning how to make a crown, not learning how to manage a lab,” said Gary Maxon, CDT, a former lab owner himself who learned his craft during a four-year stint in the navy in the 1960s. “Unfortunately in our business, myself included, most of us only have the equivalent of a high school education or maybe a little bit of college. Not too many in the dental lab industry have financial background, so it’s difficult to understand sometimes.”

	After building a successful laboratory business, Maxon turned what he learned from his experience back in to the industry and now 

consults and lectures on dental laboratory management strategies

. He mentions one recent instance when he was lecturing to a room of 400-plus lab owners along with a pair of computer science majors right out of school. “They were absolutely amazed at how little lab owners know, or how to figure, about their business.”

	Bob Creamer, CPA, President of Creamer & Associates, P.C., an accounting firm in Salem, Ore., that specializes in dental businesses (practices and laboratories), said lab owners need to learn how to separate the financial and artistic sides of their operations.

	“What dentists do and what lab owners do is they work in their practice and do not work on their practice,” he said. “They don’t take the time to step back and say, ‘Do we have goals for this business, for our family, for our retirement? Have we set those goals, and have we set up the plan to reach those goals?’”

	Creamer adds that even though the average dentist in the United States earns more than six times the income of the median household in the country, most are not in the position to retire at age 60 without facing a “substantial drop” to the standard of living to which they are accustomed.

	“The lab owner is not much different. They’re doing the exact same thing, except they don’t have the 6X income,” he said. “The underlying problem is they do not have a plan.”

	In most cases, because dental lab owners are not experienced in business management protocol, meeting with a financial planner is a wise first step. Ideally, it should be one who has worked directly with dental business and is familiar with the specific demands and nuances involved with producing dental restorations.

	“Unless you found an accountant who’s already working with a lab, they’ll have no idea where to put the different costs” on a balance sheet or on the profit-and-loss statement, warned Maxon. “Ask them if they know the manufacturing costs to produce a unit. Most accountants don’t know.”

	But there are accounting professionals available who do have the knowledge and training necessary to help dental lab owners navigate through the foreign waters of finance. In addition to being a certified public accountant with more than 30 years of experience working with dental business owners, Creamer also is co-founder of the 

, which is comprised of more than 25 accounting firms located throughout the country that work specifically with dental practices and laboratories on accounting, tax services and what Creamer terms “quality of life issues,” meaning ADCPA firms help clients set short-and long-term plans so they can enjoy a comfortable life while they practice dentistry as well as after they retire.

	It all starts with taking a good, hard inventory of what you own and owe. Look at where you are now, where you want to get to, and when you want to be there. Then develop and follow your roadmap.

	Creamer discussed Monte Carlo computer analysis that works out a number of possible scenarios based on certain criteria. For example, you enter your age, income, assets, liabilities, expected retirement date, and your desired cash withdrawals. Depending on the specific inputs, you would be able to ascertain the probability of which will last longer: you or your money.

	“If after running all those variations, it came up with a 48% chance you’ll outlive your money if you live to age 78, most of us wouldn’t feel very secure under that scenario,” he said.

	The next step would be to make adjustments where possible to current income, retirement withdrawals, and debt payment schedule and retirement age to improve the statistics to a comfortable range.

	“Every client is different and every analysis is different, but it helps to test the waters and helps the lab owner to make the appropriate plan,” he said. “It’s going to be constantly changing, and it has to happen simultaneously with you running your business. This is what is going to get you there in the long run, but we need to start today.”

	Or more appropriately, you should have started a long time ago. Ideally, retirement planning should start the first day on the job. Just as your life and career change with growth and recession, your retirement plan should change as well. Creamer said his clients typically make changes to their retirement plans four or more times during their working life.

	The next step would be to build a well-diversified portfolio spread among different asset classes. Monitor your portfolio, and rebalance when necessary.

	A big part of your financial picture should be debt management. Creamer points to a misconception many clients bring with them concerning student loans. They often carry an interest rate lower than that of a standard business loan, so the lab owner thinks it is more practical financially to pay off the business loan first. In fact, it is just the opposite tactic that you should take because the business loan is tax deductible where the student loan is not. So in the long-run (and that’s what retirement planning all boils down to), it makes more sense to eliminate the student loan and take the tax break on the business loan.

	“Most accountants are morticians,” Creamer said. “The patient died on Dec. 31, and the client brings their tax stuff in-usually just before the 15th of April-and they want you to embalm it and get it ready to send off, and that’s it. We’re not morticians. Our 2010 tax planning started at the end of last year or before.”

	Part of this plan-ahead tax strategy is a multi-faceted plan centered around tax code Section 179. According to Creamer, “It allows a lab owner to invest up to $250,000 in equipment and technology. They can write it all off in one year against their taxes even though they haven’t paid any money down on it, as long as they meet certain requirements of the law, which are very easy to meet.”

	Creamer added the tax savings can be used to pay off student loans, reinvested in additional business improvement equipment, or placed into a retirement plan.

	“You can buy $40,000 of equipment on time, and by expensing that, you can take the tax money saved and have extra money to put into your retirement, which will further reduce the taxes. Over a couple year period, the taxes will pay a good share of the equipment and the retirement,” Creamer said. “By funding the retirement plan, you get a second deduction. So it’s a snowballing effect. You save money by putting it in the retirement that you got by saving money on the taxes from buying the equipment.”

	But government assistance for lab owners doesn’t come just from knowing the tax laws and using them to their full advantage. The 

 also is set up specifically to assist small-business owners.

	“Whether it’s access to capital or finance, general business and coaching, or access to government contracts, the SBA provides resources for small-business owners often in their own neighborhood or in their local community,” said Jack Bienko, U.S. SBA Deputy Director for Entrepreneurship Education. “They can walk into SBA resource centers, or they can schedule an appointment and more often than not get free counseling. There might be a very affordable fee for a workshop on a specialty topic.”

	Bienko said the resource centers are staffed with volunteers who are experienced business counselors from a variety of industries. “So a lab owner or a lab executive could request somebody who’s been in the industry. If they can’t find somebody from that industry, they may be able to find someone who’s leased equipment before and can walk them through the basics. They provide practical business knowledge, not only because they know it, but because they’ve lived it with their own firms. They can talk very hands-on about the negotiation tactics involved with leases, equipment, real estate, or anything else related to business management.”

	Bienko stresses that, while the SBA is a federal entity, it is aware of the intricacies of local economies. “There’s a local face of SBA in communities. They interact with, coordinate, and direct folks to the proper resource,” he said. “They are very attuned to the local lending scene if someone is looking for a local resource. Also, knowing local economies are diverse, they may know about a local initiative for a tax abatement.”

	While there are SBA resource centers in every state and most major metropolitan areas, online resources also are available to help business owners who can not get to an office. “We have about 30 online courses available on a range of business topics, such as starting a business, how to manage your money, how to market yourself, dealing with regulatory issues,” Bienko said. “We cover all those bases, either in conjunction with a partner or directly on our website.”

	In addition, the SBA recently announced that it will launch a redesigned website this fall that will allow visitors to more quickly find the information they need through a simplified navigation structure. New features will allow users to tailor their experience to provide information that is specific to their needs and location. The new website also will offer a dedicated lender area that helps banks and other financial institutions that partner with the SBA.

	Our goal as an agency is to get information, tools and services into the hands of small-business owners more quickly so they can spend more time doing what they do best -creating the jobs that will drive our economic recovery,” SBA Administrator Karen Mills said, according to a news release. “Through a new, personalized and dynamic SBA.gov we will be better able to support job growth across the country.”

 “Those who fail to plan, can plan to fail.” This is more than just an old proverb or trite saying, but should be considered words to live by, to be posted up on the front office of every dental laboratory and practice as well as any other myopic small business that focuses too much on day-to-day survival and not enough on setting and striving to achieve long-term goals.

Strength in numbers

	The quest for a direct dental restorative material that combines the ease-of-use and durability of amalgam with the biocompatibility and esthetics of composites has lead a team of scientists at Southwest Research Institute (SwRI) in San Antonio to develop a material concept on a nanometer (10-9 meters) scale.

	According to Kent Coulter, Ph.D., SwRI Surface Engineering & Materials Chemistry Section Manager, the process involves evaporating zirconia then condensing it onto a roll of PET film substrate that has been nanoembossed with a checkerboard pattern that transfers to the condensed zirconia layer. Once the patterned substrate is dissolved, the zirconia layer breaks off into flake-like nanoplatelets that measure 200 nm by 200 nm and are only 40 nm thick.

	“The key is the flat shape,” said Coulter. “It has a high aspect ratio with around 395 times more surface area than a sphere with the same mass.”

	The zirconia nanoplatelets are then incorporated into a liquid crystal polymer matrix that causes the flakes to orient in a specific direction, which Coulter said allows the zirconia to self-heal in the event of any crack formation through aphase transformation. In addition, the liquid crystal polymer would act as a delivery medium for the zirconia material. “It would be delivered just like a standard dental composite,” said Coulter.

	A practical zirconia nanoplatelet restorative is not quite ready for chairside availability. “We’ve demonstrated the science behind it, now we are in the that product development phase,” said Coulter. Part of the problem now is that the material at its current stage of development needs to be thermally cured to achieve the desired hardness. Coulter added that research continues on developing the material into a form that can be photocatalyzed using a standard UV dental curing light.

	While SwRI has applied to continue the National Institutes of Health-funded research program, the practical application of the material is starting to attract outside interests. “We’re in the process of working with a couple commercial clients to take it to the next step,” said Coulter. “That is where we’ll focus our efforts.”

	Southwest Research Institute is an independent, nonprofit applied research and development organization. The staff of more than 3,200 specializes in the creation and transfer of technology in engineering and the physical sciences. SwRI occupies more than 1,200 acres in San Antonio, Texas, and provides nearly 2 million square feet of laboratories, test facilities, workshops and offices.

 The quest for a direct dental restorative material that combines the ease-of-use and durability of amalgam with the biocompatibility and esthetics of composites has lead a team of scientists at Southwest Research Institute (SwRI) in San Antonio to develop a material concept on a nanometer (10-9 meters) scale.

Materials of the future

	Featuring USB output and built-in LED illumination for high magnification, with no additional microscope required, the d-VID USB handheld digital microscope provides exceptionally clear detailed images for viewing and documenting margins, impressions, waxing, dissections, reductions and other procedures. It includes auto-load software that makes it possible to capture high-resolution digital images and digital video clips, as well as measuring capabilities and image manipulation tools that allow the user to add text or graphics for clarity when communicating details to dentists. The camera can be mounted on an included tripod or hand-held for convenience. Though not recommended for shading applications, the camera produces vivid color.

Tech Brief: d-VID USB

	We had always used traditional radiography, complete with processor, chemicals and film. As a practice, we realized we were ready to move up to the next level, and our Patterson rep suggested digital radiography.

	I had the opportunity to go and look at the system and it seemed like the right thing to do and the right time to do it. We had the money to refit the operatories with computers and officially move our office into the future. And, to be completely honest, no one really felt like cleaning the processor or dealing with the chemicals anymore. So it was a good move on multiple levels.


	Our Patterson rep was someone who I trusted immensely. He explained the details behind Schick’s CDR Elite, how great it was and that it would work well with Eaglesoft. What really sealed the deal for me, though, was the fact that we could replace the cord. There’s always this nagging fear that after spending all this money on a new piece of equipment, you or a staff person might break it. With the CDR Elite, every sensor comes with an extra cord that you can easily replace. If something did go wrong, I didn’t have to throw a $10,000 sensor in the trash. Instead, I felt like I was getting double the sensors for my money.

Has this product increased your clinical confidence?


	We’ve realized that in addition to patients being impressed, we were becoming better diagnosticians which, in turn, helped improve production since we were finding things that we hadn’t been able to catch before. And, as a GP who does a lot of endodontic procedures, digital radiography has been very helpful in accurately determining canal lengths using Eaglesoft so that I can get to the end of every apex without an apex locator.

	The biggest change, though, is that I feel more confident that I’m not missing things. When you look at a little tiny X-ray, many dentists fall into the bad habit of saying, “Let’s watch it.” The film is 1” x 1.5”. Now, on the computer screen, it’s big and you can invert the image to a negative, you can change the color of it, and the brightness can be easily manipulated using Eaglesoft-no more holding films up to the light. You can see where that decay goes into the dentin and you know it’s not “a watch”- it’s something you take care of. I don’t promote dentistry that isn’t needed, but I’m not saying, “Let’s watch it,” as much. Patients are impressed. They feel like we’re making a better decision together.

 We had always used traditional radiography, complete with processor, chemicals and film. As a practice, we realized we were ready to move up to the next level, and our Patterson rep suggested digital radiography.

"Patients feel like we're making better decisions together..."

	It's often said that you can please all of the people some of the time, or some of the people all of the time; but you can't please all of the people all of the time. Or can you?

	When it comes to creating dental restorations, there are myriad differences between posterior and anterior teeth in terms of esthetic expectations, functional requirements, strength needs, material indications, build times, and so on. Yet, your carefully planned fee schedule most likely charges the same for a posterior unit as an anterior. And not every case will require the same precision and esthetic detail, regardless of tooth number.

	"Most people on their posterior teeth, all they want is something simple and fast. They just want it to be close. And, they don't want to pay an arm and a leg for it," said Rob Teachout, CDT, LVI, BSc, owner of Patriot Dental Lab in South Branch, Mich. "For your anterior teeth, they're willing to pay for that extra color, to put  that internal stain in there and go with those 9, 10, 11, 12, 13 different porcelain powders to make it really stand out. And, they're willing to pay more for it."

	Teachout added that a conversation he had with well-known and respected dental technician Buddy Shafer centered on the benefits of establishing different price structures for different levels of service. Shafer told him that large, multi-department labs could actually establish a mini-lab within the overall business structure of the existing laboratory to handle high-end casework, primarily cosmetic anterior cases, at a higher fee. "They could charge $250-$300 a unit, and the doctors would pay for it without a doubt," Teachout recalls of the advice.

	It's not unusual for larger, established laboratories to create spinoff business focused on specific areas to bring in new business or expand options for existing clientele. Pittsburgh-area Albensi Laboratories began outsourcing CAD/CAM work to an offshore milling center through the separate Innovative Dental Arts business to provide clients with a lower-priced alternative.

	Teachout setup a simple 2-tiered price schedule within Patriot Dental Lab-Basic and Premium-complete with different prescription forms and workflow schedules on which of his three technicians works on which cases, though all cases remain in-house. "I'm the only one who touches a Premium case when it comes in," he said, though he has started training one of the other technicians on the model work for the Premium cases.

	Once the case is identified as a Premium prescription-and placed on Teachout's bench-it is handled in an appropriately higher level from start to finish. "I use a different stone than I normally do with the Basic, I mount them on Stratos articulators, I use Adesso plates, and I package it differently. It would be like sending it to two different labs."

	He commented on other labs that have gone even further with a tiered system, saying, "They broke it down into different powder porcelains, different materials, and different technicians, too. When you get into the larger labs, you've got a little more room to play with."
	Makes a difference

	Teachout estimates that of Patriot's total business, his Premium case load is between 10% and 20%, most of which is single anterior units with an occasional multi-unit case. Only about 3% of the Premium cases involve posterior restorations for patients (and the dentists) who want and pay for the extra work involved. "Sure, I'll charge them Premium for a second molar," if that's what they want. Some cases even mix Basic on the posteriors and Premium on the anteriors, and are priced accordingly.

	Teachout said that "once or twice" a client has commented about the price difference between the tiers, but he is able to easily appease them by explaining the experience, skill, and time involved with creating a Premium as opposed to a Basic crown.

	And, indeed, a picture is worth 1,000 words. "I show them the difference between a 1-body layered Basic technique vs. a 15-powderPremium technique," said Teachout. "They're like, 'OK, I want to do Premium.'"

 It's often said that you can please all of the people some of the time, or some of the people all of the time; but you can't please all of the people all of the time. Or can you?

Stepping up to tiered pricing

	The decision to start up your own business is never an easy one, especially in troubling economic times like now. But for Joe Dennison and Jon Rogers, CDT, their recent decision to open the doors of Classic Dental Studio was assisted by being shown the door, and a pathway to a new business.

	Dennison and Rogers had been working together at a San Diego-area lab as a consultant and manager, respectively, when they were dismissed unexpectedly due to staff cuts. While consoling each other and discussing their separate futures, they had a mutual epiphany. “Jon and I had a lot of the same philosophies of business and a customer-oriented approach to doing business. We realized it could be a good fit,” said Dennison. And the wheels were set in motion for them to start a new lab venture, with Dennison handling the business end and Rogers working on the artistry. “Together, working as a team, we believed we could do a great job and compete very well locally.”

	Their combined experiences and connections in the dental industry helped the duo hit the ground running. “Leaning on my partner’s reputation in town as being a high-level technician, we were able to do the quick jump-start without any debt threshold that would impede us from the growth we wanted,” said Dennison.

	Rogers had various equipment and supplies in storage from his previous run as a lab owner, which greatly minimized capital need for start-up. “I had a business line of credit from when I had a small marketing company as well as a business card that I used during my consulting time,” said Dennison. “I was able to transfer those two items over to our new corporation. That was really the only funding we needed to get it going.”

	Even with a solid financial footing to begin with, as with any new business operation, the owners needed to cut as many corners at the onset to help stay on course. Dennison said that he and Rogers did not take a salary the first month, but that helped with cash flow enough to be able to hire a third staff the following month. They sublet 1,400 square feet of space from another lab in Escondido at the beginning, but added Dennison, “By months three and four, I was building capital to be able to make a move. We knew we were going to have to move right away because we wanted to be in our own space.” After a few tight months-financially and physically-they were able to move into a new location in Poway with 2,500 square feet that would allow them to accommodate their expanding staff. “We grew and hired four more people before we moved.”

	Now, just more than a year after its inception, Classic Dental Studio has a total of nine employees, and Dennison said they are looking to add a few more key people this year. “When you look at the statistics, we’re already in the top 25% of labs in the United States in terms of size of staff,” he pointed out.

	However, he said their focus will be on a core clientele of 35 high-end dentists. “We’ve added 50% of our customers in the last six months. That was our goal, and that was what we had to do to meet our payroll,” he said.

	The goal now is to put together a team of experienced and qualified technicians and ceramists. “My biggest challenge is finding talent. We really don’t have a desire to get big,” he said, acknowledging that “We’re not trying to do quantity but quality.”

	Part of that desire for quality over quantity that his objective client base of “the higher echelon of customers” such as dentists involved with the American Academy of Cosmetic Dentistry. “We want to attract that higher-dollar clientele that wants a local custom lab” as opposed to a larger production-type operation. He and Rogers have contemplated AACD technician accreditation and have weighed accreditation as a business proposition. Dennison is the marketing chair of the local AACD chapter, which he sees as extremely valuable as a means of indirectly promoting the lab to potential, desirable clients. “I also do a lot of networking with local supplier reps. We work together,” said Dennison. “They know what kind of customer we’re looking for ,and they can help us out in that direction.”

	For the time being though, Dennison said Classic Dental Studio is right where it needs to be in terms of workload, which allows the business to build connections with its doctors. “We provide a high level of attention to our current customers. It’s a small-business-to-small-business relationship that demands a greater level of communication.”

 The decision to start up your own business is never an easy one, especially in troubling economic times like now. But for Joe Dennison and Jon Rogers, CDT, their recent decision to open the doors of Classic Dental Studio was assisted by being shown the door, and a pathway to a new business.