hello and welcome to episode 151 of chairside lives I'm Megan strong and as you may have
already heard my longtime co-host and friend dr. de Tola has moved on to other opportunities in the
dental industry it was an amazing 15 years he was with us here at Gladwell laboratories and he will
be truly missed but as they say the show must go on tear aside magazine will continue and we
will continue to provide you with helpful clinical tips here in chairside live with that said let me
now introduce you to dr. a by doctor by welcome why don't you tell us a little bit about your
role here at the lab Thank You Megan yeah well I joined Gladwell about four years ago my background
is that I'm a prosthodontist and I have a strong clinical research background and when I joined
Gladwell I was actually doing clinical research with material sciences eventually I moved on to
the implant department and I was doing a lot of clinical research with implants on patients no
after obviously FDA approval and all that good stuff and we're using a lot of that data for our
studies we're glad to have you on board thank you I'm really looking forward to being here
and being part of chairside live I think we have a lot to provide Glidewell is not just a dental
laboratory it's really an institution and what we do here really affects the way that dentists
treat patients so I'm excited to be a part of that great and I hear you have your first
case of the week with us today we have a very exciting case of the week it is a product that
we've been working on is called brookster now and it is a the first fully centered chairside
zirconia milled product where in this case of the week we actually have a patient that
needed a crown so we brought the patient in and removed an old crown and utilizing a chairside
intraoral scanner and a mill called the TS 150 i was able to build a brook Surnow product and
deliver it to the patient so why don't we go ahead and take a look at the case of the week
alright let's go over the case of the week for this week and we have a patient who presents
with a lithium die silicate and material crown full-coverage crown with a fracture to the
distal and this is tooth number 30 so my clinical challenge is that this patient requested a crown
to be placed fairly quickly on this tooth and he wanted to be done with the treatment what better
type of case to do then having a extremely strong crown in terms of abrooke sir and also being able
to mill it chairside so we have been developing a product called ruksar now and utilizing this
chairside fully Center Azura Konya restoration I can provide this patient with an extremely
strong crown that's gonna last him a long time so essentially when the patient came in I went ahead
and I provided him with some local anesthetic and because of the nature of the lithium dye silicate
material here I actually had to segment this crown several times in order to remove it am I sure was
cemented with the resident cement and this is the situation immediately after removal of of
that crown so what I'd like to do is especially for chair side milling I almost have to predict
how the spindle of the mill is going to work and we have to prep accordingly so what I'd
like to provide for the mill and for the digital scan is a nice chamfer margin usually I like my
axial reduction to be about a millimeter depth and then also a good occlusal reduction of about
a millimeter and a half you have to keep in mind this is a zirconia restoration so we don't have to
go to two millimeters of occlusal reduction and the tooth was already prepped so essentially I
just had to clean things up and utilizing the two core technique I went ahead and placed both cords
waited a couple minutes and then removed the top chord and I was able to take an intraoral scan in
this situation I utilized the 3m true definition scanner and as you can see the images are captured
very quickly I believe the scan of the tooth took me almost a minute I spent a little longer than I
usually do capturing this image but we were able to capture it in 56 seconds as you see here so we
have a nice image of the tooth that we prepped and we also go ahead and impress the opposing and a
bite registration and then utilizing this digital information with the fast scan software it is a
software that we can use to fabricate virtual crowns and it's very intuitive so the software
basically has built into a library of teeth that it will import based on adjacent teeth and the
shape and the size of the adjacent teeth and you also have the option as a clinician to go ahead
and play around with how much tooth structure you want to add or remove and also take a look
at the mesial and distal contacts to make sure that you have enough contact area so you get a
lot of freedom with the software there are two different versions there's the lab version and
then there's a clinic clinicians version and you're just looking at the clinicians version
here so once the crown is ready to be milled I'll go ahead and press the finish button and
it will communicate directly with the chairside mill the TS 150 and in a series of a couple of
steps where I have to load the program and also load the material in this scenario it's the Brooks
are now fully centered chairside zirconia I'll go ahead and place that into the mill and essentially
with the touch of a button it will start the mill for this crown I took the mill about 45 minutes to
two mill the advantage here is that you don't have to go through a lot of the staining and centering
and you don't need an additional oven so all you would really need is is the chairside mill and the
intraoral scanner so the mill creates the crown for us and my job now is to remove the crown from
the sprue and polish it which really just takes a couple of minutes and then it's ready to be
delivered usually what I do is I place the crown on the tooth and without any cement and I have my
assistant radiograph I want to make sure that my margins look good I also checked the margins intra
orally with my dental Explorer as well and I'll go ahead and deliver the crown once everything looks
good so in this situation the patient had the advantage of having the strength of the Brooks or
crown and also the efficiency and convenience of having it done chair side and not having to take
an impression and sending it to the laboratory so that's our case of the week and I hope you enjoyed
it so if you want to read more about Brooks or now please go to Brooks sir calm and there's a
lot of clinical and research information on the product and we've been working on the product
development and the research and development department here at Glidewell dental laboratories
and I think it would really benefit from taking a look at all the literature that's online well
thank you for that doctor bye you're welcome Megan I'm really excited that we have a fully sintered
chairside zirconia product in the Brooks are now I think it's going to be a game-changer yeah for
sure we should take a look at the news what do you think absolutely all right if you're a new
dental graduate looking for work you might want to consider heading to Florida they need all the help
they can get right now the state is experiencing some of the most severe shortages of dentists
in the country according to the American Dental Association there are plenty of dentists they just
aren't practicing in the rural and lower-income areas of Florida in one such County there is just
one dentist for every 3500 people a lot of people in these areas rely on Medicaid which means a low
profit margin for dentists a strong deterrent for new dental grads to fill the gap many dentists are
regularly volunteering in areas of need that's really interesting you know why they you know
why we have this issue why because many dentists can't see rule right it's hard rule well rule
yeah very difficult see easy for you to say yeah and we have a lot of dentists here in California
that probably be more than happy to go to Florida and treat patients right the Sunshine State I mean
what did they have like 330 days of sunshine a year I think we should put them on buses and
send them over sounds like a good plan let's do it okay and then another story we have for you
I guess at Nashville Tennessee dentist's office was nearly destroyed after a drunk driver slammed
into the clinic going nearly 90 miles per hour the father-and-son dentist team spent most of the day
trying to assess the damage which left a massive hole in their front lobby the crash happened at
4:00 a.m. when the truck slammed into a sign a bus stop and two trees before coming to a stop
inside the dental clinic the driver stepped out of the car on his own and then passed out on the
grass he was taken to the hospital and charged with driving under the influence really I don't
think ever comments about that right don't drink and drive people and to me is just crazy that at
98 I mean 90 miles per hour he ran into a stop sign two trees I mean and then still had the
the momentum don't just absolutely plow through a building he could have just waited a couple hours
for the dentist to come in and do some work right yeah so it I mean this is crazy so I'm I'm just
glad that it happened at 4:00 a.m. when no one was in the office and probably less people were on the
road and but he got charged and hopefully this will deter him from drinking and driving because
it never ends well absolutely yeah all right well thank you so much dr. by for joining us I
think today's show went really well I think so too all right well on behalf of everyone here at the
laboratory my new co-host dr. Bai and myself big and strong thank you for tuning in and please come
back next week for episode 1 52 of chairside live Wow totally awesome cool okay so the wait time for
some news right just like that if you're looking for a new knowing what I'm not that was dyslexic
let's try that again according to the amiracle did a miracle a new word it's a miracle wait
should we take a look absolutely let's go ahead and go to the case of the week was that a question
you