 is a 52-year-old dental laboratory started by Barry Lampert, CDT. Based in Long Island, N.Y., Town & Country began as a two-man lab, and having grown significantly, they now employ 100 people, including three generations of Lamperts.

Serving hundreds of dentists in the region, Town & Country is the area’s leading provider of custom dental restorations. For decades, this laboratory has embraced change and routinely invests in many new and innovative technologies. Town & Country is also a founding member of TEREC (Technical Research Consortium), a strategic alliance of leading regional dental laboratories across North America. They meet every few months to discuss industry trends and share information on technical, marketing and management topics. Town & Country strongly believes, when considering a decision to purchase any new technologies, the more information you have, the better choices you make.

 (CAP) is a dental laboratory solutions company located just outside Boston. CAP’s goal is to help dental labs make the transition to a digital workflow. To do so, they offer multiple solution options, depending on the needs of the individual lab. CAP offers outsourcing services, including scanning, designing and fabrication; offers scan and design software for labs that are ready to invest in such technology; and sells fabrication equipment. With each solution, CAP offers extensive training and education assistance, emphasizing customer service along the way.

In keeping with its commitment to technological progression, Town & Country recently invested in several 

 five-axis milling machines to expand their offerings and capabilities. In making such an important decision, it was critical for Town & Country to find a vendor who was prepared and able to offer more than just a good price-T&C wanted a real partner. Getting more involved in digital dental technology required resources beyond their current levels. They needed a partner willing to go the extra mile and they decided that Custom Automated Prosthetics was the right choice.

See the DXW-50 in Action in the CAP Office:

“Of all the companies we interviewed, we felt that CAP was a right fit for our laboratory and our culture,” says Joe Apap, CDT/MDT and General Manager of Town & Country Dental Studios. “With any technology, the support before-and more importantly, after-the sale is a critical component. As you know, in a dental lab, we are bound by due dates. There is a patient, dentist and staff waiting for the case to arrive. CAP understood this clearly. CAP provided resources both by phone and in person, allowing us to quickly get production going and our knowledge growing. Even their website has many good resources and video clips. In addition, we intend to participate in the upcoming training course at their facility to learn about the 

Next page: How CAP supports Town & Country-and why they're a great option for a lab of any size.

When a laboratory is considering making an expensive purchase of any kind, they need to determine what will be the “real” ROI. It would be easy to just focus on the price of the purchase, but that is not the proper perspective. There are considerations like support, training, response time, problem solving, product knowledge and pleasant people that also add to the overall ROI calculation. Apap points out that’s what Town & Country looks for and this is what CAP delivered: real value, tangible and intangible.

“Dental lab technicians [are always] looking for different ways to use the tools we have at hand,” Apap says. “Our lab is no different. From milling wax, to zirconia, to PMMA, to nano composites; we want the maximum output and best quality. So far, the results are better than expected and we are very excited about the future. We feel now that we have a partner in CAP who’s going to help us through trying to reinvent our process digitally.”

That cooperative approach also suggests an even more vital component of T&C’s partnership with CAP. “[We get an] immediate response from support,” Apap continues. “Something’s down, they’re here. Not that we’ve had many problems with the machinery, but when we’ve called, we’ve gotten immediate responses. There’s great value in that. “

CAP’s approach to customer service and partnership has certainly left an impression with Town & Country. But, of course, T&C is a large lab. Would CAP’s approach be different to a one- or two-man lab? How would they partner with a much smaller lab?

“There are the obvious differences between a 100-man lab and a one-man lab, but we’re still confronted with one main hurdle that we have to jump over every day: cases have to get out by a certain date,” Apap says. “For all dental laboratories and technicians, this is what they do, whether you’re a small lab or a large lab. That immediate response is so important. We see CAP giving an immediate response. We see CAP really caring about the laboratories.

“We kicked the tires and did a thorough review,” Apap says. “We know who’s out there. CAP is a relatively newer company, and they had a fresh approach-they were very enthusiastic and willing to go that extra mile. It’s not just with us they’re doing this. We’ve seen them do this with other labs as well. Any lab, whether it’s small or large, would benefit from doing business with CAP.”

Articles

 The Lab Town & Country Dental Studios is a 52-year-old dental laboratory started by Barry Lampert, CDT. Based in Long Island, N.Y., Town & Country began as a two-man lab, and having grown significantly, they now employ 100 people, including three generations of Lamperts.

Real-Time ROI: Partnering with Custom Automated Prosthetics

 is a hybrid abutment with a titanium-alloy bonding base and customized zirconium dioxide coping, delivering the reliability of a titanium connection with the pleasing esthetics of a ceramic coping. The CARES Variobase Abutment can be used as a screw-retained, full-contour solution for your referring clinicians. The patented* engaging mechanism between the CARES Variobase coping and the CARES Variobase abutment offers reliability and efficiency when bonding the two components into a finished, one-piece CARES Variobase Abutment.  

Two restorative materials are available for a CARES Variobase Coping: zirconium dioxide zerion

 AE, a temporary material. The CARES Variobase Abutment can be used for single-tooth screw-retained or cement-retained restorations, or cement-retained bridges via a mesostructure. 

		Titanium-alloy bonding base with customized zirconium dioxide coping for individual patient situations 

		Precisely engineered engaging mechanism between the CARES Variobase Abutment and Coping is designed for a precise connection and optimal force distribution 

		Laser-etched Straumann logo indicating that it’s an original Straumann Abutment 

		Labs can create a CARES Variobase Abutment in three ways: Straumann’s in-lab CAD/CAM system; the CARES Prosthetic App for Dental Wings; or via the Scan & Shape online service from Straumann.

The Straumann® CARES® Variobase™ Abutment is a hybrid abutment with a titanium-alloy bonding base and customized zirconium dioxide coping, delivering the reliability of a titanium connection with the pleasing esthetics of a ceramic coping.

Quality, versatility and reliability with the Straumann CARES Variobase Abutment [VIDEO]

1. You ignore their-or their patients’!-requests

Every lab tech knows how frustrating it can be to get specific instructions that you know will be very difficult or just plain won’t work.

But that doesn’t mean you can just ignore requests because you know they won’t be the ideal solution. Take the time to work with a clinician to explain why a particular esthetic desire isn’t the best option. In the end, assuming they’re a good dentist, they’ll appreciate your advice-and so will the patient.

It’s easy to miss the importance of email and phone communication. You’re in the middle of your day, and trying to respond seems like busy work. But it’s vital, so carve out some space each day to get back to clients about questions or concerns. The other side of the communication coin also can be annoying, though. If you’re constantly sending out marketing materials or bombarding clients with information, that can lead to frustration on their part. 

3. You don’t explain why your method is better

You’re a great technician who has honed your artistry to perfection. But that won’t matter to a customer who doesn’t understand why you won’t do what they asked or exactly why what you’re doing is so important. Help each client understand 

 you’re doing what you’re doing and why the way you do it is preferable to what they could get elsewhere. They’ll feel like you’re both on the same team, and it will keep a great relationship going

1. You ignore their-or their patients’!-requests Every lab tech knows how frustrating it can be to get specific instructions that you know will be very difficult or just plain won’t work.

Top 3 ways you might offend your customers

1. You were one of the people who helped 

 porcelain to the U.S. What was it about Veracia SA that made you say “yes, this is great for the U.S. lab market”?

The Veracia SA has a simplified mould chart. I have yet to find a case where I couldn’t find a mould to fit. They’re glass reinforced, but it’s a homogenous mixture with shade layers. It’s a very esthetic tooth; very hard-wearing. The key factor that I really like about the posteriors is they have pre-milled/pre-worn wear facets. It allows patients to move into excursions a little easier. There’s less wear of the tooth during mastication because they’re pre-worn. Another thing I like is the space that is built into the occlusal surface. When the teeth are in complete occlusion there’s still room for food to come off the occlusal table. In most brands, the occlusion fits together so tightly that the food can actually become a dislodging force.

2. What makes Veracia SA different from other denture systems? 

The Q3 Pack is the thing that stands out-Q3 stands for “quick quality quadrant.” It’s not just a tooth holder-it’s a built-in occlusal template with individual teeth set into it. If you analyze your model correctly, and you align the occlusal templates evenly, you have a perfect curve of Spee and curve of Wilson. The opposing arch just drops right into place. You have a perfect set-up in less than half the time. There have been other companies that have teeth that are connected. The problem is they’re connected-you have to slice the teeth if you ever want to adjust them. The Q3 Pack is a time-saver. Even if the doctor is off on the bite, (which happens quite a bit), remount the case, reset the Q3 Pack and you’re done. It’s such a time saver. But more than time, it’s a quality enhancer. That sets them apart from almost every other tooth on the market. It’s so simple; it’s genius.

3. With both the Veracia SA and the OneShot, who is Shofu’s target customer? Why should someone switch to the Veracia SA from the system they’re currently using?

We’re in tough economic times. Veracia SA teeth are premium products but because Shofu is dealing direct, they’re able to offer these at an extremely fair price. You’ve got production in mind for a bigger laboratory with quality and consistency. It’s a learning tool, too, for technicians who don’t know much about setting teeth. You can make a beginning technician into an expert.

4. How has Shofu made strides in the U.S. denture market specifically with Veracia SA?

We’re trying to be on the podium a little more, to show people how easy it is. I’ve been at shows and I’ll be at the booth and I’ll do hands-on demonstrations. The sales team is willing to go into the laboratory and do a demonstration. I think by going out and educating people and showing it and explaining it, we’re getting more and more people to appreciate it. Dental technicians are smart-they get it right away. Denturists understand this as well-they see it one or two times and they’ve got it.

5. What about Veracia SA makes sense for a big lab? For a small lab?

For a big or small lab, it saves a great amount of time. You’re always in a hurry, you’re always working late. Maybe with a tooth like this you won’t have to work as late! It’s great for quality and production and it’s a time-saver. If this saves the average technician half the time, you’re going to set up three extra cases-in a small or a big lab, that’s a lot of extra cases. You’re not rushing the technique-you’re applying the technique.

6. What is it about the OneShot that you feel fills a need in the U.S. lab landscape?

For me, I’ve done ceramic work before, but I’m not a 9-layer build up guy; OneShot made it easier for me. In crown and bridge, I‘m not that experienced. Just one bottle, that’s it. The bigger the build up, the more transparent you get. It’s very simple to use. The first time I picked it up I did a 3-unit bridge and it looked beautiful.

7. What have you seen as the primary benefit with OneShot?

I think the primary benefit is ease of use and its consistency. Whenever you do an A2, it looks like A2. When you do an A3, it looks like an A3. It’s just the one bottle-you’re not having to mix-up shades. You can stain with Shofu’s Basic or Vintage Art Effects Set paste stains. It’s just such a simple production technique.

8. How have you seen OneShot change workflows for labs?

It’s such a simple method. You apply a masking paste; then apply a shade opaque; and you use one bottle of porcelain, that’s it. The workflow is just so much easier.

9. What is it about Shofu the company that you think helps them serve the dental lab community?

Shofu is a very close-knit company-everyone keeps in touch with each other. They’re up on everything. They all communicate. They’re steady and methodical-when they come out with something, you know they haven’t done anything halfway. I know everyone at the company, and I know they stand for quality. They have a lot of great products and it’s got a very good name.

10. What can we expect from Shofu in 2013 and beyond?

Shofu is a progressive company. They’re always looking to do things better. They’re looking at carrying more products, but Shofu will not just bring out more products for the sake of it. They’re going to bring out new products in the next year, and they are going to be quality. The company is careful and methodical and they plan things very well. 

1. You were one of the people who helped Shofu with their decision to bring Veracia denture material and OneShot Uni-layer porcelain to the U.S. What was it about Veracia SA that made you say “yes, this is great for the U.S. lab market”?

Q&A: Jim Collis on Shofu's OneShot Uni-layer and Veracia denture material [VIDEO]

Anybody who’s ever researched investing in a digital workflow solution for their dental lab knows all of the different terms. They also know how confusing these terms can be-how does one even begin to navigate the myriad of options on the market for scanners, mills, software and everything in between? What if you get something that doesn’t play nicely with tools you already own?  Is there a way to make sense of all the different features and system differences?

 is hoping it can provide some answers-or at least some guidance-through these thorny questions. “exocad is the only Dental CAD software company which offers true freedom of choice,” exocad America president Larry Bodony says. “exocad doesn’t make scanners or production equipment, so 100 percent of our company’s focus is to develop dental software to enable open scan, fabrication and material manufacturers to create systems that advance digital dentistry.

“[We] sell to resellers, who have complete freedom of choice to package, sell and support dental systems for labs and dentists,” Bodony continues. “End users have the freedom of choice to select 

 that best meets their technical, business and ongoing support requirements. 

Of course, the reason so many choices exist is because there are so many different needs from dental labs. Some labs might have a full digital workflow already up and running and are simply looking for a new software solution, while other labs might be exploring an initial entry into digital work-not to mention all of the labs somewhere in-between.

Bodony says exocad’s focus is to provide a way forward for labs, no matter what their needs are, which is why they work with a large number of resellers.

“There are three ways that labs can adapt [our software],” Bodony explains. “The first and most important is selecting the right reseller. Some labs want a complete turnkey solution, and many excellent exocad systems are available at incredibly low prices. Other labs want open, flexible solutions, and are willing to do some process engineering themselves, or utilize an existing scanner, CAM or mill. We have resellers that support one or both models. Second, all exocad systems can support scan-only, scan/design and scan/design/CAM software configurations, which allow labs to grow incrementally as business picks up. The third way is by purchasing add-on modules from your reseller, providing features as-needed by the lab. These reasonably priced modules include implants, bars, virtual articulation, bite splints, provisionals and next year, dentures. End users should shop for the right reseller, with the right level of support, for the options that they will need now and in the future.”

Next page: Should you opt for an open or a closed system?

Bodony also sees the need to help explain to lab decision makers what exactly everyone means when they talk about “open” and “closed” systems. The terms are regularly used to describe CAD/CAM systems, but they can be very confusing. Bodony says exocad makes its software to fill the needs of labs who want “open” systems 

 labs who want “closed” systems. And he says knowing the difference will be the key in working with an exocad reseller to identify just what your lab needs. “‘Open’ means that your system accepts and operates on, and generates publicly defined non-encrypted data files,” Bodony says. “There is also the distinction of ‘input,’ which refers to scan data, and ‘output,’ which refers to the restorations produced by the CAD system.

“The answer for exocad is that we develop our system to be 100 percent open on input and output. However, this doesn’t mean fully open is the right solution for everyone. Labs that want a verified process or trust a particular brand or reseller may be happier with a turnkey system. Since there are so many business options available, it again comes down to making sure your reseller has the same business philosophy you do.”

It’s all well and good to talk about the ins and outs and interoperability of software and CAD/CAM systems. But how does exocad actually work from a practical, ground-level, user’s perspective?

“In exocad, you don’t have to worry where the case comes from,” Bodony says. “You simply fill out the ‘database’ form, which describes the case. No matter what the situation, the database system works for all indications, even on both arches, and in many cases even for modules you don’t own.”

This means exocad prides itself on being a system that is user-friendly for all lab workers, no matter what their digital experience level might be.

“exocad’s ‘secret’ is software that creates a custom step-by-step wizard tool for any case you can describe,” Bodony notes. “The result is, we believe, the most intuitive program out there for beginner and intermediate lab technicians. For advanced users, they can bypass the wizard, to do daily tasks like fixing broken mesh, overriding specific parameters or even re-sculpting previously designed restorations after the fact.”

exocad also is committed to ensuring its software doesn’t quickly become out-of-date, a real concern in a time when technology advances so quickly that something can be cutting edge one day and obsolete the next. “exocad is committed to advancing digital dentistry,” Bodony says. “First of all, our licenses are perpetual, meaning that you actually own your exocad-based system and it will continue to function for as long as you own the system without additional cost. However, we do need to be profitable as we continue to develop features, so, after the one-year warranty period expires, exocad users can choose to pay an update fee to their reseller to receive the latest release.”

Bodony says, in the end, exocad is all about user experience, and he’s confident current users will help you know if an exocad system will be the right fit for your lab. “If you’re curious if exocad is for you,” Bodony suggests, “users can review our website, 

 or read the actual user documentation at 

Untangling the confusing world of CAD/CAM

WHY MASTER? More than 40 million fabricated  restorations are testament to its prominence.

 is a lithium disilicate glass ceramic that has optimized translucency, durability and strength for full anatomical restorations. IPS e.max lithium disilicate restorations exhibit superior durability featuring 360-400 MPa of flexural strength. When fabricated to full-contour, the monolithic structure provides an extremely robust restoration. The opalescence, translucency and light diffusion properties were all designed to replicate natural tooth structure for beauty and undetectable restorations. The material is also backed by more than  10 years of clinical evidence in which it shows a 98.2% crown survival rate. With more than 40 million restorations in the market, IPS e.max lithium disilicate is one of the most popular all-ceramic materials available.

Designed with simplicity and versatility in mind, IPS e.max is said to be the ultimate in metal-free esthetics and durability offering high-strength materials for both the PRESS and the CAD/CAM technique. If you prefer to work with the PRESS technique, two different types of ingots are available: IPS e.max Press, a high-strength glass-ceramic and IPS e.max ZirPress, an esthetic glass-ceramic that is pressed onto zirconium oxide in a fast and efficient procedure. For CAD/CAM applications, either the highly esthetic IPS e.max CAD ceramic glass blocks or the high-strength IPS e.max ZirCAD zirconium oxide can be selected, depending on the case requirements. The nano-fluorapatite layering ceramic IPS e.max Ceram completes the all-ceramic system. This material is used to veneer all IPS e.max components, no matter if they are glass-ceramic or zirconium oxide.

WHY MASTER? It is the most prescribed brand of full-contour zirconia. Enough said.

 is a monolithic zirconia restoration with no porcelain overlay. Since its launch, BruxZir has impressed dental lab technicians and dentists alike with its esthetics and its “chip-proof” durability, well suited for bruxers who have broken natural teeth or previous PFM restorations. BruxZir is glazed to a smooth surface to reduce plaque accumulation, designed and milled using CAD/CAM technology, and requires minimal preparation of 0.5 mm with feather edge margins, much like cast gold.

Now featuring a new BruxZir Shaded formulation, BruxZir restorations exhibit improved translucency and color similar to natural dentition, making them a restorative option in the anterior as well. Complete color penetration all the way through the restorations is said to ensure greater shade consistency and prevent any shade changes after occlusal adjustment.

	GC America || GC Initial Complete Ceramic System

WHY MASTER? In today’s lab, time is money and this system is built to maximize efficiency.

 can create metal-ceramic restorations all the way to full-ceramic. This product consists of six ceramics in one integrated product line with one color system. No longer does the ceramist have to spend valuable time learning to use a myriad of different ceramics from an array of manufacturers to create the variety of restorations that may be needed to complete a case. Each GC Initial ceramic is adapted to meet the needs of its particular fabrication process and framework, such as its coefficient of thermal expansion (or CTE). Stress cracks and fractures are therefore avoided, which ensures strong bonding, adhesion and retention. With GC Initial, the technician needs to master only one layering technique and one shade system.

With the time saved by using identical processing methods for all components using a single shade system and removing the need to re-adjust to other unaccustomed layering techniques or layering systems, GC Initial gives the technician more essential time to be creative. It doesn’t matter if you are working with full ceramic, metal-based, titanium or zirconium oxide or aluminum oxide frameworks; this system has its own components when low-fusing technology or the ceramic pressing techniques are used. With the same shading system and build-up technique, GC Initial requires a short learning curve and can be easily adapted by high volume labs or tooth design boutiques, regardless of the substructure or framework. This product was developed for maximum technique tolerance, which is very forgiving and has extremely low shrinkage.

WHY MASTER? It may be new, but the hybrid approach offers unparalleled strength that you’ll want to take advantage of.

is the first hybrid dental ceramic in the world with a dual-network structure that combines the best properties of ceramic and composite materials. The dominant ceramic network structure and the reinforcing polymer network structure of VITA Enamic are fully merged with one another, similar to the way that steel reinforces concrete. With the dual ceramic-polymer network, the new composite incorporates the benefits of ceramic and composite materials in one new product. Materials science testing shows that VITA Enamic offers high fracture load capacity, while also ensuring optimal levels of elasticity and integrated crack prevention.

VITA Enamic features significantly less brittleness than a pure dental ceramic as well as abrasion properties said to be superior to that of conventional composite materials. It is extremely resistant to the shear and compressive forces of the jaw and natural teeth, allowing the material to be used for a variety of applications.

Enamic CAD/CAM blocks, which are classed as a ceramic for insurance purposes, are not only suitable for fabricating inlays, onlays, veneers, crowns for anterior and posterior applications and crowns over implants, but because of reduced wall thickness, can be used for minimally invasive restorations such as no-prep veneers and restorations in areas where space is limited.

VITA Enamic is also highly reliable and offers greater precision, improved edge stability and, as a result, finer, more accurate outcomes than what’s possible with conventional dental ceramics. With the corresponding polishing set from VITA, the material can be quickly polished.

WHY MASTER? Because you shouldn’t have to choose between efficiency and esthetics.

Available in both metal and zirconia versions, 

 improves productivity and esthetic outcomes with a simplified, single powder build-up process. Just one baking cycle provides reportedly flawless color match for any VITA shade. The densely-packed homogeneous material yields vastly reduced shrinkage versus multiple firing techniques while allowing one powder to build to full contour.

WHY MASTER? Strength you can rely on - monolithic zirconia structure, high strength of 1200 MPa - from a partner you can rely on.

 provides a full contour Zirconia solution that allows for a higher level of esthetics over other full contour Zirconia systems. The system allows the production of all A-D shades plus 3 Bleach shades, while eliminating the need for coloring liquids or dipping, saving lab technicians time and money.

 Ivoclar Vivadent || IPS e.max WHY MASTER? More than 40 million fabricated  restorations are testament to its prominence.

Dental Lab Products-2013-10-01

Real-Time ROI: Partnering with Custom Automated Prosthetics

Quality, versatility and reliability with the Straumann CARES Variobase Abutment [VIDEO]

Top 3 ways you might offend your customers

Q&A: Jim Collis on Shofu's OneShot Uni-layer and Veracia denture material [VIDEO]

Untangling the confusing world of CAD/CAM

The Top 6 Materials You Need to Master