Both in the posterior and anterior regions.

For monolithic or minimal buccally reduced dental frameworks made of zirconium dioxide or lithium disilicate. One system allows labs to realize all its Zr and LDS ceramic restorations, micro-layering and painting techniques, and anterior or posterior restorations.

The Initial IQ ONE SQIN is a paintable color-and-form ceramic system that offers esthetic restorations comparable to conventionally layered restorations without the demand of a lab’s time. Based on the GC Initial “IQ philosophy,” the system consists of different ceramic materials adapted to be used together, assuring efficient and esthetically convincing finalization of monolithic and buccally reduced restorations. The system comprises Lustre Pastes ONE, Spectrum Stains, and SQIN.

The Initial IQ ONE SQIN gives lab technicians the choice of micro-layering or painting techniques. The GC Initial IQ Lustre Pastes ONE are used as a color and individualization layer, assuring a perfect connection firing before application of the SQIN powders. In the micro-layering technique, SQIN is easily applied in a layer thickness of 0.1 to 0.6 mm over the painted and fired Lustre Pastes ONE surface. The refined mixture of feldspar-based glasses creates a lifelike 3D effect, resulting in color depth and lifelike translucency. In the painting technique, the Lustre Pastes feldspar-based 3D paint-on ceramic adds color depth and lifelike translucency with a very natural glaze to monolithic restorations.

Articles

This ceramic system is a true 1-solution system for ceramic restorations.


5Ws* Initial® IQ ONE SQIN Ceramic System

Dental laboratories do vital work in dentistry, making it even more important for dental labs to be equipped with the technology they need for best practices. Dental lab technology has shifted and changed over the years, and with so many advancements, it can be refreshing and inspiring to look back at the humble beginnings of some everyday dental lab tech.

Dentures made from human or animal teeth originated from Etruria, Italy, around 700 BCE. The Etruscans would take teeth from a human or animal and insert them into a metal band of gold. This partial denture would then be fitted onto the remaining teeth. Ivory came onto the scene in the 1700s, followed by porcelain in the 1770s. Ivory became the (expensive) standard until the 20th century came around, when more resin materials made the crafting of dentures more affordable, more efficient, and most importantly, more structurally sound.

Although the first dental implants made of shells were seen in the Mayan civilization in Central America, it wasn’t until 1965 that Dr Per-Ingvar Brånemark created a successful implant system closer to what we do today. Using a variety of new, advanced materials currently on the market, today’s lab technicians have built upon Dr Brånemark’s achievements to create implants that achieve osseointegration.

With an early focus on prototyping, 3D printing as a technology has evolved past its beginnings to become a popular technology in many dental labs. Invented in the 1980s by Charles Hull, 3D printing was originally known as stereolithography, taking STL files, formatting them through CAD software, then finally transmitting those data to a 3D printer, where the object could be formed using photopolymer. The first commercially available 3D printer, the SLA 250 from 3D Systems, came about in 1988, and the technology has only gotten better from there.

Digital dentistry refers to the digital refinement of the dental workflow. Digital dentistry comprises cone beam computed tomography, CAD/CAM milling, digital imaging, and digital x-ray services. With its connecting force between lab and practice, digital dentistry is a key component of keeping customers happy and patients healthy. Digital dentistry has become the standard, paving the way for future technologies.

Artificial intelligence (AI) serves a purpose in both the operatory and the dental lab, creating a machine learning system that assists clinicians and technicians in making the right choices for their patients and customers. With applications in prosthodontics and periodontology, AI can make scanning and analyzing features easier for the dental lab. Implants, dentures, and a variety of other dental features can be designed using the precision of machine learning, being supplemented by the dental technician’s personal touch and experience. AI might just be the next step in optimizing dental lab technology.

1. Copy of an Etruscan denture, Europe, 1901-1930. Science Museum Group. Accessed July 25, 2022. https://collection.sciencemuseumgroup.org.uk/objects/co87800/copy-of-an-etruscan-denture-europe-1901-1930-dental-bridge

2. Abraham CM. A brief historical perspective on dental implants, their surface coatings and treatments. 

 2014;8:50-55. doi:10.2174/1874210601408010050

3. Ventola CL. Medical applications for 3D printing: current and projected uses. 

4. Spielman AI. Technology in dentistry, through the ages. NYU Dentistry. Accessed June 6, 2022. https://dental.nyu.edu/aboutus/history-of-nyucd/technology-in-dentistry-through-the-ages.html

We journey through the years and look at the origins of the various technologies that a dental lab uses every day.

The List: A Timeline of Dental Lab Technology

All dental laboratories apply technology and innovations to suit their specific needs. Whether big or small, they have the hands-on experience to not only manufacture dental inventions but also inform research and the future of technology. For labs, keeping up with the latest technology can give an edge over the competition when it comes to new customers and opportunities.

Knowing what technologies lie ahead can help labs in this way, and the best method of knowing is consensus. The 

® 2022 Technology Survey asked dental lab professionals which kinds of technology they use daily and what technology they hope to see in the future. Demographically, 81% of respondents are lab owners, with 19% being lab managers, and the majority working in the dental lab business for more than 2 decades. Read on to see what these experienced lab professionals have to say about the future of dental lab technology in the industry. Answers are rounded up or down to the nearest whole percentage.

Dental Lab Products 2022 Tech Census

We break down the results of the 2022 Dental Lab Products® Technology 
Survey.

Digital Technology Reigns Supreme for Dental Laboratories

Achieving a natural esthetic for 3D-printed teeth while maintaining flexural strength and wear resistance is not possible using ordinary material. That is where Trusana comes in, according to Steven Sadowsky, DDS, FACP, professor at the Arthur A. Dugoni School of Dentistry at the University of the Pacific in San Francisco, California, and dental implant expert. Trusana is a 3D printing resin that uses a photopolymer liquid to create denture teeth with fracture toughness, wear resistance, and esthetic translucency.

Created by Myerson Tooth, Trusana was formulated to fill the need left by materials that were prone to breakdown, a problem Dr Sadowsky noticed in his prosthodontic practice.

“We were seeing a lot of mechanical complications with the ‘All-on-4

’design, especially with the provisional prosthesis that’s used to provide immediate function and stabilize the implants during the integration during the first phase of treatment,” Dr Sadowsky says. “Even after we finished the definitive restoration, there was often wholesale wear on the teeth. So that within 5 years, we needed to completely retread that prosthesis, and someone who’s paying quite a bit for this type of definitive work was obviously going to be discouraged after a fairly short time of service.”

Dr Sadowsky cites several studies. “One investigation concluded that patients were 50 times more likely to need posterior tooth replacement at 5 years or less than at 2 years of service.

 A longitudinal study addressing prosthetic complications over 29 years found what was quite inflammatory for our work. After about 10 years, only about 10% of our prostheses were without mechanical problems.”

Equally troubling have been the higher fracture rates of up to 60% using the all-acrylic prosthesis that is delivered at the time of implant placement.

 These mechanical problems could jeopardize the integration of the implants. This led Dr Sadowsky and his colleague and notable polymer scientist, Jeff Stansbury, PhD, to additive materials using a urethane dimethacrylate formulation with robust physical properties. After researching and patenting a highly durable denture tooth material, Dr Stansbury and Dr Sadowsky discovered Trusana for additive manufacturing.

Trusana stood out to Dr Sadowsky because of its unique composition among other 3D printing materials. “Trusana has really formidable properties,” he says. Dr Sadowsky says that Trusana’s flexural strength is where it shines. “What we see from Trusana is that the flexural strength is 50% higher than present market materials. In comparison with methyl methacrylate, which was the conventional material most used in analogue processing, it is more than 100% better in terms of flexural strength.”

Trusana’s flexural strength is 160 MPa when dry and 171 MPa after being stored in water for 14 days. One of the pitfalls of additive and other denture material can be water uptake. Because water uptake degenerates the physical properties of the denture tooth, it can cause breakdown and staining over time. Trusana has the added benefit of being hydrophobic, meaning its water uptake is just around 0.3% and it is impervious to the aging seen with other materials.

The denture material not only displays high strength as well as toughness with an exceptionally good elastic modulus, but its esthetics are a big draw too. Dr Sadowsky says patient feedback to Trusana has been very positive. “The patient that was first to benefit from a Trusana implant prosthesis was very complimentary, and she felt like she could smile for the first time without being sensitive to her appearance,” he says. “She also felt like she had a lot of confidence in terms of the stability of the prosthesis.”

1. Purcell BA, McGlumphy EA, Holloway JA, Beck FM. Prosthetic complications in mandibular metal-resin implant-fixed complete dental prostheses: a 5- to 9-year analysis. 

2. Dhima M, Paulusova V, Lohse C, Salinas TJ, Carr AB. Practice-based evidence from 29-year outcome analysis of management of the edentulous jaw using osseointegrated dental implants. 

. 2014;23(3);173-181. doi:10.1111/jopr.12084

3. Lopes A, Maló P, de Araújo Nobre M, Sánchez-Fernández E, Gravito I. The NobelGuide All-on-4 treatment concept for rehabilitation of edentulous jaws: a retrospective report on the 7-years clinical and 5-years radiographic outcomes. 

. 2016;19(2):233-244. doi:10.1111/cid.12456

4. Wesemann C, Spies BC, Sterzenbach G, et al. Polymers for conventional, subtractive, and additive manufacturing of occlusal devices differ in hardness and flexural properties but not in wear resistance. 

. 2021;37(3):432-442. doi:10.1016/j.dental.2020.11.020

Trusana from Myerson Tooth features powerful flexural strength not seen in other materials. 

3D-Printed Denture Material Showcases Strength and Esthetics

DLP August 2022 New Products

A look at some of the latest dental lab products from around the industry.

New Dental Lab Products August 2022

 Labs that fabricate full-arch and other zirconia restorations.

 Whenever a case calls for milled zirconia crowns, bridges, or implant-supported restorations.

Not only does this zirconia allow full-arch restorations—including implant-supported designs—to be sintered in less than 4 hours, but multiple units can be sintered in the same fast cycle, and no base or support structures are needed during sintering, saving both time and material.

The formulation of this zirconia promises not only an efficient sintering process but also optimal physical and esthetic properties. Not just for use with full-arch cases, 3:45 is also suited for posterior crowns, which can be sintered in less than 30 minutes. It exhibits 1100 MPa of strength and 48% translucency and is available in 25-mm and 30-mm preshaded discs, with multiple shades available and more in development.

This new zirconia formulation allows full-arch restorations to be sintered in less than 4 hours.
Information provided Zubler USA

5Ws* 3:45 Zirconia

Relationships are key to a thriving dental lab business, but they need trust to flourish. As legendary sales expert Zig Ziglar says, “If people like you, they’ll listen to you, but if they trust you, they’ll do business with you.” So how do you ensure you have strong relationships built on trust with dental practices? We spoke to several dental lab experts who shared their secrets to solidifying client connections and strengthening lab-client relationships.

Dental practices want labs to provide value with their knowledge about dental restorative design and production. Conrad Rensburg, ND, NHD in Tech, the owner of Absolute Dental Services, and Jack Marrano, CDT, director of signature prosthetics at Absolute Dental Services, think being a resource to clinicians with new products, technology, and workflows is crucial.

For example, when Absolute Dental Services implemented new technology for dental implants in 2000, they became the clinicians’ resource on taking proper impressions for the workflow, Rensburg explains. With 2 education centers onsite, providing clinicians with educational opportunities remains a priority for Absolute Dental Services today. “From a business perspective, education has been the strongest driver in building these relationships,” Rensburg says.

Marrano agrees, adding that materials expertise is also essential. Clients can go anywhere to have a crown made, he says, so labs should position themselves as where to go for a solution. Rensburg and Marrano judge their success in this area by whether clinicians rather than their representatives call them to learn about new materials or protocols. “Then we know we’re doing our job right, because they trust us to give them the right advice,” Rensburg says. “The dental technician of the future should be a resource and not just a technician.”

“World-class restoration is a by-product of a first-class relationship,” Marrano adds. “Things are moving faster, and dental practices are leaning on the lab more than ever.”

Keith Crittenden, byproduct president and CEO of the AmericaSmiles® Network, says a dental lab can also leverage its knowledge gained from working with different practices. By working with multiple clinicians, labs learn much faster than dentists about restorative materials and techniques. “The lab needs to see itself as a valuable resource for communication and information about all dentistry rather than exclusively [make] false teeth,” Crittenden says.

Lisa Aguirre, product manager of dental solutions for Roland DGA, says collaboration is essential to building relationships. Aguirre refers to the adage “Two heads are better than one,” adding that working together is especially important for restorative dentistry. However, communication is a crucial part of that equation, too. “When things don’t go right with a patient’s treatment plan or restorative case, there was a communications breakdown somewhere,” Aguirre says. “Whether from dentist to laboratory or even from patient to dentist, any communication breakdown can affect the outcome.”

Aguirre says clinicians typically take extra time with patients to ensure they understand the risks and benefits associated with a proposed treatment plan and set realistic expectations for the final restorative treatment outcome. However, they do not always communicate this information to the dental laboratory, and that’s where the trouble starts. “Effective collaboration is vital between the dental laboratory and clinician to ensure that everyone is working toward the same objectives in addressing the clinical and esthetic needs of the patient,” Aguirre explains.

Richard Jentsch, head of research and development at Opulent Digital Specialists, agrees that communication with the clinician and their staff is essential. Keeping these lines of communication open with the office manager or dental assistant provides labs with the chance to fix problems or provide alternate solutions. Labs should also check in regularly to get feedback, even if there haven’t been complaints. “Don’t assume no news is good news, because it might not be,” Jentsch says.

Jentsch also recommends talking to the practice about their goals and timetable. A lab can then take a consultative approach. Without that conversation, the lab’s advice can point the practice in the wrong direction, creating gaps in the relationship. “At some point, the gap is so big they might feel a different partner would be better suited for them,” Jentsch says.

David Lesh, founder of Dale Dental and Concert Dental Labs and a consultant at 8&9 Dental Lab Consulting, agrees that regular contact and customer feedback are critical. The feedback card is an effective and overlooked tool in this effort and the closest a lab can get to real-time customer feedback. Lesh says doctors are willing to be more honest on a feedback card, compared with a phone call or in-person conversation, because it is less confrontational. “I don’t know [whether] there is a better way that keeps your finger on the pulse of client sentiment. It’s the No. 1 way to build relationships,” Lesh says.

Lesh also recommends keeping track of scores and celebrating your successes. For example, when his last dental lab reached a 4.9 out of 5 average overall quality score on their cards, they sent out a press release reading “Dentist Rated 4.9 Out of 5 for Overall Quality.” Lesh also told their customers the lab’s performance bonuses were tied to the feedback card scores. As a result, the clients thought the lab team was invested in their best outcomes.

“But like many things, feedback cards can do as much harm as good if you’re not looking at them. So if there’s a ‘poor,’ ‘fair,’ or ‘please call me,’ it needs a response immediately and cannot sit in an inbox in the unpacking area,” Lesh explains.

Humanizing the company is essential to relationship building as well, Lesh says. He encourages video conferencing over phone calls to discuss cases, putting pictures and bios for the customer service team and team leaders on the website, and adding photos to email signatures. In addition, he recommends open houses for local accounts at least once a quarter. Lesh’s previous lab hosted a Manicure Night a few times a year for local accounts and their entire office teams. “They loved it,” Lesh says. “And it changes the dynamic when you call that front office, or if something goes wrong with a case.”

David Turpin, the fourth-generation owner of Spartan Dental Lab, thinks availability is vital. He provides his mobile number and tells clients to call or text anytime. This access is helpful for digital workflows when dentists need immediate scan feedback or if practices need the lab to help with scanner problems. “It improves the digital workflows especially when, through our communication, we don’t have to bring the patient back,” Turpin says.


Sometimes practices do not know all you can do. Overcoming this hurdle and doing more for your clients starts with communication, Jentsch says. Practices will not know you have more experience or training unless you tell them. If they like their current supplier and are not ready to switch, Jentsch suggests offering a deeply discounted or free parallel case. “The important part is to have them produce it the way they’re used to with the provider they’re used to, but at the same time, give them one of your cases. Then, let the doctor and the patient decide which they prefer,” Jentsch says.

Crittenden takes the same approach with first-time cases. There is no shame in telling the doctor you have not done a case like this before; everybody has their first case sometime. Plus, it can help you do more things with them in the future. “If they trust you in other areas, maybe they will trust you with this one as well,” Crittenden says. Jentsch also encourages labs to discover their advantage. Maybe it is quality or a faster turnaround time than the other supplier. Perhaps you can integrate the practice’s technology, like the Imetric system or photogrammetry software, better than their current system. “Maybe the doctor is looking for something they haven’t been able to find with other laboratories,” Jentsch says. “If they don’t know how the technology works and nobody else they work with knows either, but you do, you have an advantage.”

Crittenden also thinks labs should ask dentists questions about how they choose a lab for a project. This conversation allows a lab to talk about other opportunities. “You can tell the doctor, ‘Look, I do these all the time. I’m just not doing them for you,’” Crittenden says.

Turpin agrees that finding out the pain points is an excellent way to uncover opportunities with your customers. “Honestly, most of the time, it’s communication,” Turpin says.

“In most cases, this sounds more complicated than it is, and the fear of the unknown comes into play,” Aguirre says of practices that do not want to try a new supplier. “As a dental laboratory professional, patience is key, along with a willingness to work closely with the clinician, especially on difficult or larger cases.”

When working on complex cases or helping doctors with new, more efficient workflows, Turpin will go to their practice. He’s found that explaining over the phone isn’t enough, and clinicians are hesitant to make any sort of change to workflow. Offering to go to patients’ appointments to walk them through step by step is a great way to gain trust and build a lasting relationship. “When I offer to come to their practice to help them through a process, they tell me, ‘I didn’t know you did that,’” Turpin says. “I explain we are partners, and it is my job to make sure they are comfortable with the process so we can deliver the best outcome for the patient. For the most part, they are grateful for the time spent with them.”

Aguirre says clinicians can also be hesitant to ask questions to avoid seeming unknowledgeable or out of the loop. She sees this as a prime opportunity for dental laboratory professionals to expand and solidify their relationship with the clinician by offering to educate and support them. “Knowledge is wealth,” Aguirre says. “Spending just a few extra minutes to assist a clinician goes a long way.”

Rensburg believes in anticipating the clients’ needs. He listens to what practices say and anticipates the questions they might ask. Providing pertinent information up front makes dental practices feel more comfortable that the lab is a valuable and knowledgeable resource. “So instead of waiting for them to ask it, answer it,” Rensburg says.

Avoid Damaging Relationships Unconsciously


You want to do what is best for your customers, and you do. However, what if what you thought was helping the relationship was hurting it? Certain actions can damage your relationship by mistake.

The fastest way to ruin a relationship is letting a practice go into arrears with payments, Crittenden says. When the terms stretch to 45, 60, or 90 days, Crittenden says the relationship sours and the lab suddenly cannot do anything right. “The doctor no longer sees you as a partner, but as this albatross or burden around their neck,” Crittenden says. “You’re helping maintain a healthy relationship by forcing the doctor to stay current.”

Crittenden says labs also unconsciously damage their relationships with practices by accepting unacceptable work. He says dentists want to be held accountable; they don’t want to do unsatisfactory work. If you let them give you less than what they are capable of, dentists will start to disrespect you and blame you for problems. “The lab has to say, ‘I need better quality,’” Crittenden says. “Some of my best customers now are customers with whom I took a very firm stance on payment and quality. As a result, they’re still with me, paying their bills on time and providing better quality work.”

“We are up-front in our communication with our doctors [if] what they sent will not work. If it’s bad coming in, it’s only going to be bad going out,” Turpin agrees. “We are all too busy to do it twice, so we do our best to let them know our concerns right away before starting the case. Most of them appreciate this feedback and will send a new impression or scan if asked.”

Language matters as well. How you ask for better work is essential, Aguirre says. “The worst thing a dental laboratory professional can do is make extra demands of the office or clinician while handling a case. Additional demands give the impression of being inflexible, too busy, or unwilling to help. Instead of placing demands on dental office staff or clinicians, provide them with options,” Aguirre says.

For example, a lab may ask the clinician to bring the patient back for a new impression to proceed with the case. Aguirre suggests an alternative, like “‘For optimal results, the best option would be to bring your patient back in for a new impression. Is this possible?’ By putting the control in the clinician’s hands, it shows you trust them to make the right call and that you are interested in collaborating, not dictating,” Aguirre says.

Jentsch says mid- to large-sized labs often implement quality control by choosing unified settings for their case output. However, while he understands what these labs are trying to accomplish, he thinks the standardized approach misses the fine details of the doctor’s expectations. “It might not be as custom or individualized as a doctor wants,” Jentsch says.

Along the lines of valuing individuality, Lesh thinks a commoditization mind-set can damage labs’ relationships with practices. Thinking labs do all the same work is a trap. Quality is always a competitive differentiator. “Some labs think the whole industry is on a downward spiral in price, but only because they don’t think they are doing anything better than anybody else. Labs that do good work can charge a fair price for it,” Lesh says.

Rensburg agrees that trying to be the most affordable lab can damage relationships. At Absolute Dental Services, they tell their customers how much they charge and why. “I always follow that up by saying, ‘If our quality doesn’t justify our price, you should not be using us,’” Rensburg says. “In a world where everyone’s nickeling-and-diming and trying to get a cheaper deal, it goes back to quality work. If you do quality work, you should be proud of it.”

Shying away from conflict is another crucial way labs unconsciously damage relationships, Rensburg says. He sees conflict as a relationship-building opportunity. When there is a problem, he advises labs to own the mistake, apologize, and offer a solution. This approach will help customers who are upset with you become your fans.

“I always say it’s not if I am going to make a mistake; it’s when,” Marrano agrees. “As soon as you say ‘I’m sorry,’ it immediately defuses the situation. But then, take immediate action and follow through.”

“The worst thing you could do is not deliver that solution,” Rensburg says. “Then that clinician loses faith in you.”

Most importantly, Rensburg wants dental technicians to be proud of what they do and their integral role in patient care. “You should be proud to say, ‘I’m a dental technician, and I bring value, which costs money. If you don’t want to pay it, then I have no problem not working with you.’” Rensburg says.

“Learn how to produce high-quality work, be proud of your standard, own what it is and what it is not, and charge accordingly,” Rensburg continues.

Our dental lab professionals describe how they develop long-lasting connections with dental practices. 