	A female patient in her late 30s presented for custom shade matching at the laboratory with very specific demands. She was replacing her two natural centrals with crowns that required blending of color with her existing dentition.

Her focus was on bright color and not too much translucency. As a technician, the author’s focus was directly impacted by material fluorescence and stump shade selection in order to produce the best results possible for this patient’s case.

 the patient visited the lab for a custom shading appointment. The author removed the temporaries and checked the stump shade color as well as the lateral teeth’s transparency with his porcelain custom shade tabs. 

More shade matching: An anterior implant case

 He made note of several characteristics: 50 percent opacity with an A1 base and enamel opal in the middle and incisal 1/3 areas. He also noted his enamel overlay would be directed toward the gingival and incisal 1/3. But the most important factor his color matching session determined was to create the illusion of transparency with a halo effect as a key to matching the adjacent dentition.

, a color check of the mandibular arch was performed on the posterior teeth in order to evaluate and check the patient’s enamel. This finding related directly to the enamel color of the maxillary teeth for comparison and the final decision on the color of the enamel overlay. The 

results led the author to estimate that he would need to apply more transparency to the incisal 1/3 in order to match the dentition of the lateral number 7 (

 As a technician, the author will sometimes compare different products in order to determine which will give him the best results for a particular case. 

compares GC pressable materials (left side) with Ivoclar ingots (right side) and a natural tooth situated in between. The experiment was to determine which would provide the best fluorescence for this specific case. 

Bench Mastery: How to foresee a restorative outcome

In this test, the author’s opinion was that 

 BOO ingot color was best under the ultraviolet light, with 

). The purpose of the test was to determine which material would be best if the patient were out under fluorescent lighting in a public setting. Less fluorescence is desirable so that the teeth do not appear to be unnatural in comparison to the adjacent dentition when the patient is laughing, smiling or just talking. It can be very distracting.   

 When beginning work on the case, the author was able to utilize GC’s Low Fusing porcelain in order to achieve maximum results for his restorations, as seen in 

. A mirrored image of the final restorations was taken in order to compare and demonstrate the reflections and comparisons of translucency and transparency between the two restorations, with obvious color variation (

 For further comparison of the color variation, the patient was photographed in an upside-down view with different angulation (

). In comparing the two centrals between the adjacent laterals, the author paralleled the opacity and incisal edge coloration of natural teeth numbers 7 and 10 vs. the restorations created for numbers 8 and 9. 

 There is a difference between the intensity and amount of incisal edge coloration depending on which of the teeth we are comparing-7 vs. 10 or 6 vs. 11 (

 is a try-in for #8 only to double check the size and proportion of the teeth as well as their harmony of color. An edge-to-edge shot gave opportunity for incisal color comparison as well as maxillary/mandibular arch harmony (

 Next, in a final left-side try-in view, broad, wide interproximal contact is covered (

) as well as the incisal halo color gradation and transparency in the middle 1/3 area. 

This case study patient had high demands and expectations after her decision to have her teeth restored and her smile improved. However, as with most patients who make this choice, she was not completely sure how to explain what she hoped to accomplish. It was then up to the author to show her his own opinions about what he thought she might like to achieve. He spoke at length with her about material selection, what she could expect from each choice, and about the final design as well as color selection. He provided her with an outline of what she would see in her final restorations and, with her approval, was able to apply it to her final restoration color. She was quite happy with the results.

Articles

 A female patient in her late 30s presented for custom shade matching at the laboratory with very specific demands. She was replacing her two natural centrals with crowns that required blending of color with her existing dentition.

Technique: Kahng on creating fluorescence through shade matching

	One of the most senior companies in the dental lab industry is 

, who traces their roots back to the 19th century. Not content to rest on their history, Sterngold continues to pursue innovation in dental implants.

We recently spoke to Ryan Mansfield, Vice President of Sales & Marketing at Sterngold about his company's history, what they are excited about and what labs can expect from Sterngold in the future.

Sterngold has been around since the end of the 19th century. How does that legacy position you to serve the dental industry? 

Sterngold’s ability to provide its customers with industry-leading product and technical support, and manufacture high-quality products has stood the test of time. Our customers have great confidence that we will always be there for them as a trusted partner to support their businesses. Since we have been around so long, obviously many of our products are proven and reliable, but our longevity also shows that we have the ability to adapt and innovate, continuing to be on the cutting edge of laboratory and clinical Removable Solutions.  

In your opinion, what are the biggest trends and changes facing dental labs in 2014? 

The rapidly changing technological landscape-we have benefited from more technological advancements in the field of dentistry over the last 10 years than we experienced in the previous 50 years. The advent of 

 and synthetic restorative materials has significantly changed the landscape of restorative dentistry. As more and more clinicians begin utilizing advanced technologies, the lab must stay ahead of the curve to meet the clinicians’ needs and remain competitive.

Must read: Sterngold's cutting-edge new implant system

How is Sterngold helping labs meet those challenges head on? 

Sterngold has remained one of the most recognized and respected laboratory suppliers for over a century. This is because of ability and willingness to help our customers overcome challenges and exceed their goals. We have learned to adapt to current and future needs and demands of our customers. We currently, and will continue to, support all of our products as they relate to industry advances and bring to market new solutions to help our lab customers adapt to ever-evolving dental industry.

How does Sterngold help the communication between the lab and clinician when approaching an implant case? 

 and implant-related lab components, our customers represent both the clinical and laboratory segments of the industry. This gives Sterngold a unique perspective of both segments and how they interact with one another. Through our Technical, Education and 

 departments, we provide both technical lab and clinical support. This allows us to be versatile in supporting all aspects of an implant case, from surgical placement to the final restoration. We also provide ongoing educational support in all aspects on implant dentistry.

What new solutions has Sterngold released to the market that you’re excited about?

We continue to bring products to market that offer both labs and doctors versatile options for stabilizing full and partial dentures. We have recently introduced our 

, allowing doctors to place versatile implant diameter options (2.2, 3.25, 3.3, 4.1mm) with one simple surgical kit. This system supports stud attachments, the trusted ERA and the New ORA systems, as well as the new chairside bar system, SFI Bar. These attachment systems, the ERA, ORA and SFI, are also available for all other popular implant systems.

Next page: How does the Sterngold system fit into the lab workflow?

How does this fit into a lab’s workflow? 

Sterngold offers versatile options to the clinician and lab for stabilizing full or partial dentures on teeth and implants. We provide different implant options to meet clinical needs and flexible removable solutions for labs and doctors, including several stud attachment and bar systems. We also manufacture lab components, such as analogs, impression copings and transfers. Sterngold also offers lab consumables, such as the industry-leading attachment pickup material, EZ Pickup. Other consumables we offer include soft denture reline material, temporary material, custom tray and base plate material, lab putty and duplicating material. Our Educational department also offers ongoing product and technical support on all materials.

Where do you see an opportunity to make an impact with your implant system? 

I think we can continue to make an impact by understanding the needs and challenges faced by both labs and doctors from the restorative aspect of their cases. There are so many implant companies out there, and many of them are primarily interested in selling the implants themselves, and the restorative considerations are an afterthought. At Sterngold, we consider these cases from the restoration down, as opposed to the implant up. We will continue to do our best to provide innovations and solutions, not only with implant fixtures, but also 

 to provide the most complete package of removable solutions.

What differentiates your product line from that of competitors? 

Sterngold continually does its best to offer the highest level of support in our unique space in the industry. We have the ability to provide everything that the doctor and lab needs to stabilize a denture. We feature the most extensive catalog of implant attachment options, provide implant options for surgical implantologists and offer the restorative consumables to bring it all together.

What kind of support and education does Sterngold provide to lab techs and clinicians who adopt the Sterngold Implant System? 

Again, Sterngold is unique in continuing to provide the most ongoing education in the market relating to attachment dentistry on implants and teeth. For years, we have promoted and supported the extensive Three-day Attachment Seminar at our Massachusetts headquarters. Throughout the year, we support CE events around the country, proctored by our own CDT support personnel and technical and clinical KOLs. Sterngold know provides regularly scheduled and customized online training, and we will be featuring a robust library of online educational resources on our new website, scheduled to launch in September.

Related article: Who is REALLY looking for information on dental implants?

Sterngold strives to continue to reinvent itself. Our R&D pipeline remains robust. We have several new implant, attachment and CAD/CAM solutions in development. Our goal is to remain in front of the pack as an innovator in removable dentistry, further develop our surgical implant product offerings and provide more fixed restorative options to our customers. Our goal is for Sterngold to be even bigger and better for the next 100 years to come!

 One of the most senior companies in the dental lab industry is Sterngold, who traces their roots back to the 19th century. Not content to rest on their history, Sterngold continues to pursue innovation in dental implants.

How Sterngold is bringing their proven expertise to dental implants [VIDEO]

Going digital is increasingly important in a dental industry that has embraced technology like never before. As dental laboratories look to make a leap into the future of lab work, it's become increasingly important to identify systems and solutions that can provide dependable technology into the future.

One solution that has found an eager audience is ETI Digital Technology, which helps labs figure out what kind of CAD/CAM system will be best for their needs. We recently spoke to a lab about their experience partnering with ETI Digital Technology. Here's what they had to say:

 (ADC) is a three-person dental laboratory in Temecula, Calif. Owned by John Rounds, a dental technician with 18 years of experience, the crown-and-bridge lab opened in 2008, specializing in the production of cosmetic anterior work. As a result, their requirements for contours, fit, morphology and esthetics are very high. Rounds was looking for a way to manage the work flow more efficiently so he could continue to grow his business without sacrificing the quality for which ADC was known.

ETI Digital Technology is a division of ETI Empire Direct, specializing in offering digital solutions and support to laboratories looking to enter into a more digital workflow. They offer products like Dental Wings scanners and milling machines from Roland DGA, along with ETI’s UNIQUE CAM software that helps labs of any size produce high-quality restoration in less time using more efficient processes. ETI Digital Technology also prides itself on the support for its partner labs, offering immediate customer service and assistance on a variety of case types.

John Rounds, owner of Advanced Dental Ceramics and 18-year dental technician, found himself at a crossroads encountered by many labs. He found that there was enough work for him to expand, but he was having trouble finding a technician experienced enough that he could trust to do the work expected out of ADC. Seeing his business growth approaching a plateau, he knew he needed to find a way to output more work-without sacrificing the quality expected by his clients.

He found his solution by purchasing a CAD/CAM system from ETI Digital Technology-a system that included a Dental Wings scanner and a Roland DGA DWX-4 mill, which ran on ETI’s own UNIQUE CAM software.

Why did you invest in the ETI Digital Technology System?

“One of the main reasons I bought this system was to streamline that workflow. This system helps me out. In the beginning, I wasn’t a fan of technology in general-I’m a technician, not a computer guy! I didn’t think it could get the quality I needed. But I was extremely impressed with Dental Wings, Roland and UNIQUE CAM. The margins on the milled wax are perfect. The zirconia margins were great-and I’m hard to impress. It’s hard to find a technician anymore to help me out, and I knew this system could do that.”

How has the system changed improved your lab’s operations?

“I am actually saving a lot of money versus what I was spending when I was outsourcing, and I am still receiving the same high quality restorations. But the advantage is not only in the financial return-I can keep the quality up since I can do it with my own hands.

I was switching back and forth between a couple labs for outsourcing. When I was outsourcing with the full-contour zirconia, I didn’t like how they looked-whether it was what zirconia they were using, how they were staining it or what. I’m using stains now, and I can control it and make the final look really nice.

The doctors love it. Margins are great; the tissue response is great and for me, there’s less labor involved than even with a PFM. So I’m able to be more productive.

You invested in the Dental Wings-UNIQUE-Roland technologies. Can you describe how the different components work together?

“With a scanner, I need it to create abutments, copings, full contour crowns and I need it to be accurate. You want it to be fast while sitting in front of the computer. With ETI Digital Technology we did a demo on the Dental Wings scanner. I went through a couple crowns and a bridge, and found it easy to use. The accuracy was great, and the workflow was fast. For the price I looked at it and said, ‘This can really help me out and do what I need to do.’ It does crowns, bridges, veneers, everything I was asking.

“The UNIQUE CAM is so easy to use, and it’s so fast. With UNIQUE CAM, it’s, ‘click, click, and you’re done.’ Also, it lets you overlap on your blocks so you can get more restorations out of a single block.”

How did you manage the transition to become a digital lab?

“That’s probably what I’m impressed with the most. John Just has been there every step of the way. Like I said, I’m not a computer guy at all, so there have been a few “Hey John, how do I do this?” calls! And with those calls, he’s there. He answers his phone, and he’ll log on to Team Viewer. You have a question? He’s on it. If he doesn’t know, he’s emailing you in 20 minutes with what he found out. ETI Digital Technology has been great with all of their after sale technical support.

What have you heard from your clients (and by extension, the patients) about the restorations you’ve been able to produce with your new system?

“The doctors love it-there’s no porcelain to fracture off, they love the fit, and they love the esthetics. Their reaction to it was, ‘I love it, let’s do it.’ I haven’t seen a PFM from one doctor since I started with this. The margins are much thinner and accurate than with a PFM; it’s a really nice fitting, good looking and, obviously, the strength is there, too.”

Is there anything else you’d like to add about your transition to ETI Digital Technology?

“From a technician standpoint, there’s less labor involved. It’s opened up my day. I’m leaving earlier than I used to. It’s cut out my labor significantly, and I’m still happy with my quality. It’s not a compromise in quality at all-it’s actually an improvement.”  

 Going digital is increasingly important in a dental industry that has embraced technology like never before. As dental laboratories look to make a leap into the future of lab work, it's become increasingly important to identify systems and solutions that can provide dependable technology into the future.

Going digital with a little help from ETI Digital Technology [VIDEO]

, I shed light on how moving from manual to digital methods can help lab owners take a major step towards securing the 

. However, the transition from manual to digital can be difficult.

To ensure a successful transition, labs need to know what to look for in a new system and they must consider both short- and long-term perspectives.

Greatly increased productivity is one of the most important advantages that contributes to business success with the introduction of 

. Your system’s overall performance will depend on how well the individual workflow steps are connected. Your system should include efficient workflow management that enables easy control and seamless execution of all steps-starting with order management, through scanning, design, and ending with sending of orders for manufacturing. A well-integrated system with strong workflow management features will enable you to access and exploit information from any stage within the case-making the lab’s job much faster and easier.

FREE ebook: Understanding the digital workflow, from start to finish

An important long-term consideration is the range of dental indications and design tools available. Since its dawn, CAD/CAM technology has moved far beyond the earlier stages of “digital coping systems,” and today there are solutions that can digitally handle a 

wide range of dental indications and service functions

. Such systems will not only cover and improve a lab’s current business models, but their additional indications and services can open new business opportunities. The range of advanced tools available is also important. Many labs find they soon “grow out” of their CAD system because it only supports basic tools. Obtaining an indication-rich system with a wide range of advanced tools, or alternatively, starting with a basic system that includes easily obtainable expansion and upgrading options, will increase a lab’s potential for growth and its ability to compete-not only for today, but also in the future.

Related: 5 things every lab needs to know about outsourcing for digital work

A lab’s CAD/CAM system will seldom function as an isolated entity. It gets its original input from 

 in clinics, desktop scanners or other external systems, and afterward its output is fed into all types of 

. A lab should consider their future system’s openness to different input and output sources and its ability to cover all steps in dental workflows digitally.

The future in dental clinics is also digital, and therefore interacting with major digital impression systems in clinics is increasingly important for labs. Interfacing flexibility will allow the lab to work with a wider range of dentists, and to select the best manufacturing machines and materials for the specific case, models and restoration. Some CAD/CAM systems include dedicated and optimized interfaces for commonly used third-party equipment.

Next page: Explore the full potential your CAD system ...

Exploit the Full Potential of Your CAD System: Push for digital changes

Still too many labs purchase a CAD system and use it sporadically or for very specific indications. Labs should go “all-in” with their digital investment-bring as many indications and services as possible into new digital workflows. This is the only way the lab can ensure they will remain competitive and be prepared for a future industry in which full-digital labs have the upper hand. Going from all-manual to all-digital may often require a mental shift-however, going only halfway will simply fail to add enough value in relation to any CAD/CAM investment.

Must read: 5 ways to go digital the RIGHT way

Support and training: exploit your system’s full potential

Adapting digital methods can be a challenge without expert help. The more a lab’s technicians know about their new CAD system, the more value that system will return. This becomes increasingly important as digital dentistry encompasses more and more indications. Therefore, labs should ensure their system is solidly backed by extensive learning channels, such as training packages, user guides, local language support, online webinars and so on. Without these, a lab can risk investing in a full-featured system that runs at half its potential because too many profit-bringing workflow options remain hidden and unexploited. Continuous uptime is also important. Any CAD/CAM investment should include a reliable and straightforward support arrangement with accessible services during local business hours-and preferably in your local language.

The dental industry and CAD/CAM technologies are evolving at a rapid pace and not all existing technology providers are expected to survive in such a highly competitive and innovation-demanding market. In recent years, the industry has witnessed a decreasing amount of CAD technology providers and some industry leaders predict that soon only three to five key players will exist in the CAD market. However, what does this mean for labs that are choosing their new CAD system? The last thing a lab needs is to be left with a CAD software system that is no longer backed by support or upgrades. Labs need a provider that will still be around in the future to improve and support its products. Labs should invest in a system from a provider that is strong on innovation and continuously stays at the forefront of the industry. The lab should also take a close look at version upgrade agreements and feature expansion possibilities.

Learn all about 3Shape's latest benchtop scanner

Your checklist: 6 things to remember when going digital

		Select a CAD system with a high degree of workflow integration and workflow management.

		Look for a system with a wide range of indications and design tools.

		Remember the importance of the system’s openness to input and output options such as digital impression systems, manufacturing machines and materials.

		Ensure you get continuous support, training, learning materials and documentation.

		Invest in a system from a solid and future-secure provider. 

Editor’s note: This article is the second in a four-part series. Make sure you check out upcoming issues of Dental Lab Products to find out what the future of digital dentistry holds and much more. Don’t miss it!

Tais Clausen is the CTO and co-founder of 

. Since the founding of 3Shape, Clausen has been a key visionary driver in the company’s technology development. His close, almost daily involvement with dental labs and clinics using 3Shape worldwide is the integral factor underlying his recognized expertise when it comes to the current and future needs of modern dental businesses.

 In my previous article, I shed light on how moving from manual to digital methods can help lab owners take a major step towards securing the future of their business. However, the transition from manual to digital can be difficult.

How to transition your lab from traditional to all-digital

 now supports intraoral scanning for ATLANTIS patient-specific abutments using an 

 cases helps to improve the treatment workflow and offers process efficiency for the dental laboratory. The key to using the 

 for producing ATLANTIS Abutments is the ATLANTIS IO FLO. This easy-to-use and reusable impression component is designed to allow for an accurate intraoral scan of the patient’s clinical situation. The ATLANTIS IO FLO is designed for multiple uses and can be placed in an autoclave. The scan data is then sent to DENTSPLY Implants and used to design an ATLANTIS Abutment. The ATLANTIS IO FLO is indicated for use in all indications, and compatible with all of the major implant systems.

Related: Learn about DENTSPLY Implants's exciting Astra Tech syste

The streamlined process of using the iTero scanner for ATLANTIS Abutment orders is engineered to ensure efficient coordination between the clinician and dental laboratory and to create a traceable workflow that maximizes time and profitability.

		Brings ATLANTIS patient-specific abutments into a fully digital environment

		Allows clinicians who own an iTero scanner to easily incorporate ATLANTIS patient-specific abutments

		Ensures laboratory produces a restoration with an ideal fit and esthetics

		Streamlined, efficient workflow that ensures efficient coordination between the clinician and the technician

		The clinician takes a digital “impression” with the iTero intraoral scanner.

		The laboratory reviews the digital file and submits an order in 

		DENTSPLY Implants designs and produces the ATLANTIS Abutment utilizing 

ATLANTIS VAD™ (Virtual Abutment Design) software

		The laboratory receives the milled model and die replica from Align.

		The laboratory finalizes the restoration using a milled model and die replica or utilizing ATLANTIS™ Abutment Core File.

		The clinician places the final restoration received from the laboratory.

10 Questions with DENTSPLY Implants's Craig Rodriguez

For more information, contact DENTSPLY Implants by calling 800-531-3481 or by visiting 

 DENTSPLY Implants now supports intraoral scanning for ATLANTIS patient-specific abutments using an iTero scanner.

Dental Lab Products-2014-09-01

Technique: Kahng on creating fluorescence through shade matching

How Sterngold is bringing their proven expertise to dental implants [VIDEO]

Going digital with a little help from ETI Digital Technology [VIDEO]

How to transition your lab from traditional to all-digital

A new intraoral scanning option for ATLANTIS abutments