Milling Partner Helps Innovator Develop Revolutionary Bar

“I really like the Kois system,” Bourke says. “It is a very logical approach. You are always studying literature and updating techniques and practices. I like that very high academic approach, married with a hands-on clinical approach providing the steps to put the techniques into practice.”

One of the first innovations Bourke undertook with Dr. Kois was improving overdentures. Patients frequently had problems with Hader clips and acrylic breaking, so dentists often steered away from overdentures altogether. However, Dr. Kois had some patients who really needed the lip support of an overdenture, so they endeavored to develop a better design.

Dr. Kois came up with the idea to use a bar with an MK1 attachment—something that previously had been used only for partials and combination cases, not full bars. Despite some skeptics, Bourke cast and milled a gold bar with the MK1 attachment in it, and then cast a secondary passive fit gold frame to go over it.

Over the next few years, they made slight adjustments to the design, including putting an angle on the front of the bar, creating a path of insertion that acts as retention against the vertical dislodging force in the maxilla.

While Dr. Kois experienced success with the innovation, it was limited by the fact that the bar had to be hand-milled and cast.

“We were teaching this in the Kois classes, but many of the dentists did not have a laboratory that could fabricate these bars,” Bourke says.

She tried purchasing CAD/CAM equipment to do it, but the results were unsatisfactory.

“You still could not do that MK1 attachment or cantilever a nice profile bar from missaligned implant fixtures,” Bourke says.

A turning point arrived when a friend in Canada recommended Bourke reach out to Bernard Robichaud, who along with his brother Gabriel had recently founded Panthera Dental in Quebec. Bourke sent a milled copy of her bar to Panthera and asked, “Can you do this?” When they sent the bar back, Bourke said to herself, “That’s it.”

“That first case that came back from Panthera was beautiful,” she says. “It was slightly depressing because I had been casting bars for 25 years and now this machine’s fit was better than anything I had done. But I was happy.”

Everything changed from that point. Bourke would still manually cast for cases that featured anomalies, but then came to realize that Panthera could handle it all.

“If I could not explain to Panthera what I wanted,” she says, “I would just snap them a picture of one of my gold bars, and the next day I would receive a screenshot and they had done it. I thought, ‘Is this real?’”

One week, Bourke would have a new request for a custom bar feature. The next week, that became a dropdown option on Panthera’s website.

At the time, some associates cautioned Bourke against giving away her design, saying it was an unwise business move. However, her passion for the industry prevailed. She wanted dentists at the Kois Center to be able to learn about the design, and more importantly be able to just go to Panthera’s dropdown menu and access it.

“I said, ‘There are many edentulous people out there that will benefit greatly from this design,’” Bourke says. “The whole goal and focus is to achieve the best outcome for the patient.”

She did request one thing: With Dr. Kois’s blessing, she asked Panthera to name it the REBourke concept bar. It is now among Panthera’s most well-known products.

Bourke now works with Panthera on all of her bars, not just REBourke. She says after 27 years of casting, she has not cast anything in more than a year.

“We are a small laboratory focusing on quality,” she says. “The difference in quality is night and day. When a bar comes back from Panthera, I put my silicone jigs on, I put my teeth in, and I pour my acrylic base and pour in the wax. It goes straight to try-in.

“With the 3D viewer on Panthera’s website, there are no scanner or software fees and I can accomplish more than I could with a scanner and software in my laboratory. You just pull up the screen, and off you go.”

Now, despite her laboratory’s size, this disciple of so many well-known figures in dentistry has made quite a name for herself.

Ruth Bourke, owner of RE Bourke in Redmond, Washington, helped develop the REBourke concept bar

For more information, contact:
Panthera Dental
418-527-0388
pantheradental.com