The revolutionary one-visit crown: CAD/CAM not required

March 6, 2018

Same-day dentistry is becoming increasingly popular and easier than ever - and the Rhondium OVC3 is leading the way.

No doubt many of you read my Top 5 Test Drives column in the December issue. In that column, one of my favorite new products from 2017 was the OVC₃. While I got a chance in December to give you a rundown of the product and why I like it, I really felt that in order to do the product justice it needed a complete article. So sit back, prop up your feet, and see how OVC3 may just be a dramatic world changer for dentistry.

CAD/CAM in dentistry has, believe it or not, been with us now for over 30 years. I remember being in a fixed prosthetics class in the spring of my fourth year, which was 1987. I can clearly recall one of the instructors talking about a new concept for crowns that relied on “Computer Assisted Design and Computer Assisted Manufacturing,” hence CAD/CAM. During the lecture the instructor told us that while the system was in its very early stages, he could envision a time in the future when impression materials would be limited in use… if they were needed at all.

I remember this as if it were yesterday for the simple reason that I really, really disliked taking impressions. It wasn’t that I was terrible at it. I suppose my skills were “adequate”, but the whole process (especially in the late 80s) was complicated, messy and the patients hated it. I recall thinking during the lecture “if I don’t have to take impressions, I need to buy one of those things.” It’s funny now because the “thing” didn’t even seem to have a name back then, or if it did, my instructor didn’t know what it was.

That device became CEREC and it sure changed our world. It ushered in the entire category of digital impressions and in-office milling.

Of course, starting around 2004-2005 we started to see an increase in the entire category of digital impressions. Then the entire product category exploded somewhere around 2010 and now we continue to see new players enter the acquisition market. We are also seeing lots of companies enter the market with mills. This allows the doctor to mix and match their preferences and budgets with what they need to accomplish their tasks.

However, let’s stop and take a breath in this discussion. There are lots or reasons why same-day fixed prosthetics are a game changer for both patients and providers. From patient satisfaction to increased hourly profitability for offices, most of us that have been in practice for even a year or two can clearly see the why of same-day dentistry. The why questions have all been answered for a long time.

What we, as a profession, are asking now is not “why,” but “how.” And by that I mean:

• Selecting the proper acquisition unit

• Selecting the proper milling unit

• Learning to use the acquisition unit

• Learning to use the milling unit

• Learning the design software

• Deciding which material/block to purchase and use

• Deciding (somewhat based on material/block selection) do we need to purchase an oven

• How much chair time based again on material/block selection

• Determining what bonding system to use

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And then there is the biggest *”how” of them all, which is “how do I pay for all of this?” Here is an example of this: I was recently speaking with a dental salesperson who does not have any financial interest in this particular area of dentistry. She told me one of her customers had told her that composite sales in dentistry would soon be seeing a massive decrease as most dentists were now doing inlays instead of Class II direct restorations. She wanted to know if that was my opinion as well. I asked her if the office in question had recently purchased a CAD/CAM unit. She said they had and my reply was “I thought so.” That’s the unfortunate part that sometimes happens with purchases like this. The father of behavioral psychology, Abraham Maslow, once said, “When the only tool you have is a hammer, every problem begins to resemble a nail.”

What if I told you that you could offer a solution to your patients that allowed you to do one-visit crowns without a near six-figure investment in hardware? That is the concept from a company named Rhondium and their product OVC₃. The product is named for the concept of one-visit crown and may very well change some aspects of our perspective on same day crowns.

The OVC₃ is a fairly unique idea. The system consists of either a hybrid composite/porcelain or lithium disilicate prefabricated crown that is designed for molars or premolars in a variety of shades. The difference between the OVC₃ preparation and a traditional crown preparation is that the OVC₃ prep requires reduction of the occlusal surface only and, if possible, keeping the margin above the height of contour. This allows the tooth to retain its maximum internal strength.

The OVC crown comes in a variety of sizes for every posterior tooth. A plastic “blank” that is identical to the OVC is used after occlusal reduction to determine the proper size and if enough reduction has been accomplished. When proper fitting and isolation have been accomplished, the natural tooth is etched and bonded with whatever bonding system the doctor is comfortable with. The OVC itself has a layer of composite added to the crown-tooth interface area during manufacture. The OVC is pressed into place and tack cured. Then the excess composite is removed and the system is cured from multiple angles by a high intensity curing light. Once properly cured, the margins are finished and polished

The OVC₃ kit comes with everything necessary to complete the case. This includes, a special matrix band, the plastic “blank”, and traditional plasticized wedges. There is also Rhondium’s special “Stretch Wedges” that provide greater separation force than sectional matrix rings and the OVC porcelain crown itself.

For years, practice management professionals have been telling doctors that the greatest potential source of income in our practices is the undone dentistry in our patients’ charts. That is definitely something I agree with and it is definitely something the OVC can help with. Many patients have reasons against getting crowns done and two of the most common are expense and time. Many simply cannot afford a crown and many others do not have a job that allows them to take off from work for two crown visits.

In my office we have positioned the OVC as an affordable option to the more expensive lab fabricated crown. In our offices, we are all frequently faced with clinical situations where a tooth is just too broken down to support a direct composite. However, if the patient does not have the finances or the two appointments required for a crown, what is there we can offer? The OVC provides the restorative option dentistry has been looking for without the need of a large capital outlay. Since the cost of an individual OVC₃ kit is less than a traditional lab fabricated crown and requires less time and appointments, that savings can be passed along to the patient.

There is a brief learning curve, but I will emphasize the word “brief.” After two or three cases, the procedure can be completed easily in under an hour.

The company has created training videos that will help you to come up to speed, but perhaps the best way to become proficient is to do a hands-on course. These training courses are offered in lots of different areas.

The company website also has lots of doctor specific information and tutorials. To order your own OVC₃ Kit or to learn more check out www.rhondium.com.