Making the Right Choice

In 2004, May opened the doors to May Dental Arts. He had been closely following the impact new technologies were having on the dental laboratory industry and believed the future of the profession hinged on the precision, predictability, and efficiencies that could be achieved by tapping into and integrating automated production capabilities. After two years of outsourcing models and digital designs to a milling center, May wanted more control over the fit of the final restoration. He had been researching the myriad scanners and CAD-design software modules on the market and was impressed with the hardware engineering and evolving CAD-design capabilities of the German-made etkon™ scanner. When the company opened a distribution center in the United States, May did not hesitate to invest. “My initial investment then turned to gold when Straumann bought the etkon company,” says May. “Since the acquisition, Straumann has made three major machine upgrades, and the recent partnership with Dental Wings and 3M ESPE has resulted in new CAD-design software from Straumann that is much faster and considerably broadens restorative options and material choices such as the new Lava™ Ultimate material from 3M ESPE that is getting great response from our clients.” Straumann’s acquisition and subsequent corporate partnerships with 3M ESPE and Dental Wings also played nicely into the direction May was positioning his business for the future. “As implant dentistry moved mainstream, we became involved early on. We built a reputation for precision implant work as well as our ability to assess the patient situation and recommend best-case customized restorative solutions to the implant team.”

May and his team try to get involved in implant cases before the implant is placed. They believe any implant case should be built from the top down in order to meet patient esthetic demands and to provide both the clinician and patient with a long-lasting solution. Most often that means suggesting to the implant team that they consider a custom-milled implant abutment. “When I explain to the surgeon how a precision-milled, patient-specific abutment will help us best utilize the space and positively affect the tissue and the esthetic outcome of the case for slightly more cost, most choose the custom-milled option over the standard stock abutment.”

May’s clients also rely on his expertise for choosing the appropriate abutment and restorative materials to achieve the outcome the implant team has carefully mapped out with photographs, diagnostic wax-ups, and a surgical guide for precise implant placement. Material choice is critical, says May, and depends on a number of factors including how well the implant is placed, implant position, patient esthetic demands, and gingival biotype. If implant placement is in the posterior, he most often chooses to design a milled-titanium abutment. If the implant is in a favorable position in the anterior and the patient’s lip line demands an esthetic abutment, then he will choose to restore the site using a milled zirconia abutment.

Whether receiving an iTero™ digital fixture-level impression scan from the practice or the physical impression for traditional master model production and model scanning using scan bodies to orientate the implant’s exact position, once the case is digitized it moves into the virtual world of CAD design. “The new Straumann CARES^® 7.0 software is intuitive and easy to navigate,” says May, who participated in beta testing the software prior to its launch this year. “However, there is a learning curve for any transition to digital design. Designing implant abutments requires a depth of knowledge and experience to achieve a highly accurate final abutment. But in the end, the virtual design process saves an extraordinary amount of time in comparison to conventional hand waxing and the precise fit of the final product far superior to its cast counterpart.”

He estimates it takes a skilled CAD designer 10 to 12 minutes to complete the design of a single implant abutment and send that digital file to Straumann for milling. While the abutment is being milled by the outsource center, the designer can begin the CAD design of the restorative crown. If it is a full-contour restoration, that design can also be transmitted to Straumann or another outsource center for milling. “The bottom line is that cases undergoing the CAD-design process sit less time on the shelf and move seamlessly through a streamlined digital production workflow.”

May’s business has been growing at an unprecedented rate since he opened the doors eight years ago. Starting out in a 560-square-foot facility, he has moved his operation three times to accommodate his expanding staff of talented technicians, and now is operating out of a new state-of-the-art 10,500-square-foot space with room to grow even more. He attributes his success to his choice of manufacturer partners. “I have aligned my business with companies that have a mantra toward standard operating procedures and good manufacturing practices,” says May. “It is especially important for laboratories working on surgical cases to have a company behind them that not only provides high-quality products but also a documented traceability and a validated workflow.” That assurance, he says, is a powerful statement he can take to his clients to assure them that the choices he is making are in the best interests of the practice and the patient.

Equally important, he believes, is the technical support the company provides as well as education for his staff and his clients. “When you invest in technology, one of the most important aspects of the purchase is the support behind the equipment,” says May, who appreciates access to Straumann’s free technical support service staffed with CDTs who can remote-click into his PC with permission to troubleshoot any problems that may arise. “To run my laboratory efficiently and effectively, I need unlimited access to a technical team that can keep my business on track if I run into a problem and manufacturer partners with a corporate culture built on educating their customers and their clients to the highest level. Those are the pillars upon which to build a business positioned for long-term success and stability.”

The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dental Technology.