Taking a Break for the Holidays

With the holidays fast approaching, we are looking ahead to our schedule during the last two weeks of December. This year, Tony and Cindy will be enjoying Christmas with Tony's family in Las Vegas, and they will return to the office on January 5th. From December 22nd to January 2nd, our office hours will be as follows:

Monday and Tuesday: 8AM-2PM
Wednesday: 8AM-12PM
Thursday and Friday: Closed

Please note that while the office is open for pickups, deliveries, and phone calls, we will not be completing any cases during this time. If you are seating a case during this time period, please call for a pickup no later then December 15th.

As always, we appreciate your business, and thank you for helping us have another successful year.

Happy Holidays, from everyone at AOA.

-Eric P.

Pacific Implant Institute - Dr. Ron Zokol

Implant Retained Removeable Denture

(Cementable/Overdenture)

On October 23 - 27, I will be out of the office and heading over to the Pacific Implant Institute in Vancouver, BC to take an Implant Prosthodontics course. The course will be about Implant Retained Removeable Dentures, both either with cementable restorations or, with Overdentures and will be presented by Dr. Ron Zokol.

"Due to implant rigidity in bone, laboratory tolerances are finer and requirement for acuracy and strong laboratory communication is essential to providing high quality services." - Dr. R. Zokol.

This program will provide solution for all prosthetic services involving implant retained dentures and will have a strong component for comprehensive diagnosis and case selection to ensure the case we are treating is suited to our skills.

For years now, I've always been intrigued by these implant retained denture restorations and have been very interested in how I might be able to create these in the laboratory. I'm fascinated as how beautiful they turn out, but hold reservations knowing these are not easy to do. Excuses aside, I will be stepping up to the plate to learn this boutique side of dentistry that is slowly becoming standard care.

I would like to whole-heartedly and personally, thank Dr. Kari Chellis for helping to make this course possible for me to get into. Thank you so much Kari.

- Tony L.

Dental Intelligence

Intelligence: the ability to learn or, understand or, to deal with new or, trying situations.

"Good Things We Learned From the Kois Center"

Q: Does alumina oxide particle abrasion affect the bond strength of self-adhesive luting cement for final restorations?

A: No. Our study reveals that alumina oxide particle abrasion does not have an adverse effect on the bond strength of the self-adhesive cement (e.g. RelyX Unicem, Maxcem, Multilink) but, to the contrary, helps increase it. It is clear from Scanning Electron Microscope (SEM) pictures and Energy Dispersive Analysis (EDS) that most of the particles were gone after being sprayed with water and an irregular, rough surface appeared on the tooth surface after particle abrasion. The roughness on the surface increased the bonding area, which consequently increased the bond strength. When applying the mechanical cleaning protocol before final cementation, it is advisable to use small nozzle tips (0.015), small alumina oxide particles (27 um), low parameters (e.g. nozzle tip diameter, nozzle tip
distance, air pressure, particle size and type of air abrasive) could affect the bond strength.

Q. Why is RelyX Unicem cement occasionally too thick and viscous?

A. Mostly, excessive cement viscosity and film thickness result from improper mixing. It is important that the capsules be securely placed in the activator and the lever arm firmly pressed down to activate the liquid for an adequate time period. If the capsule is activated for too short a time, some of the liquid will not be injected into the powder and a "thick" mix will be observed. We tested various mixing protocols to find the most efficient. Our data revealed that a long liquid activating time (5 seconds) and a longer mixing time (15 seconds) for both a centrifugal mixing machine (e.g. Rotomix) or a high frequency mixing machine (eg. Capmix/Amalgamator) yielded the best results. If possible, light-curing the restoration for about 20 seconds for indirect
restoration is also suggested. Recently, a new RelyX unicem paste named "Clicker" was introduced into the market, which we also included in our study. It was found that this
type of cement's shear bond strength was comparable to the capsule-mixed cements. Unfortunately, with the paste system you may need to use a hand-mixed protocol, which might cause the mixing to be technique sensitive again.


As part of the Kois Center program, we benefit from the knowledge and experience of doctors who support the Center. In the premier issue of our newsletter "Excellence", we found an informative monthly Q&A from Dr. Yada Chaiyabutr (DDS, MSD, DSc). - Eric P. & Tony L.

Tom is happy! Next, we'll do the lowers.

Back in July of this year, we fabricated eight beautiful teeth for Tom. We used, all-ceramic "Press to Zirconia" restorations to achieve the results seen here. We'll be doing the lowers next year.

(Tom's before picture below)

Teeth involved:

#6, 7, 8, 9, 10 & 11 = Nobel Biocare Zirconia

#12 & 13 = Cercon Zirconia

Pressed with DeguDent Cercon Ceram Porcelain Ingots

Finishing touches: DeguDent "Press & Smile" with GC IQ Initial

Dental Intelligence - incorporating the best elements of metal-free restorations, by combining the best of both worlds. If you like the unmatched strength of Zirconia (ie: Cercon, Kavo, Lava...), as well as the beautiful lifelike esthethics of Pressable ceramics (ie: Empress, Authentic, Finesse...), then we have something for you.

- Eric P. / Tony L.

AOA Lab Picnic

Below, you can see the photos from our annual lab picnic. The weather was perfect and the turnout was high. This year we had nearly 50 guests, and that number seems to grow every year. Thank you all for your friendship and support. - AOA

Study Conclusion

Study conclusion:

At two years, zirconi and metal frameworks performed equally well with no breaks. Alumina had a 26% breakage, which indicates a high risk in posterior multi-unit restorations. Veneer ceramics pressed to zirconia and metal had significantly fewer defects than layered ceramics. At this point, veneer ceramics designed for zirconia need close clinical observation with an eye to improvement in formulation and handling.

You can read the full results of the study HERE.


-Eric P.

Put to the Test

Dental Lab Products recently ran an article regarding a two year study of PFM, zirconia, and alumina restorations, to determine how new technologies stacked up against tried and true metal restorations. Partway through the study, press to zirconia restorations were also added into the mix.

--------------------------

TRAC Research Foundation study compares PFM, zirconia, and alumina frameworks to determine if new means better.

Four years ago, Dr. Rella Christensen of the TRAC Research Foundation began planning a research study to compare the clinical performance of PFM, zirconia, and alumina based 3-unit posterior prostheses. The oldest cases are now in their third-year recall, and the two year results are completed. DLP recently talked with Dr. Christensen about those results—what they are and what they mean for your laboratory.

You can read the article in its entirety HERE.

-Eric P.

The Art of Life Enhancement

Every once in a while we get a chance to radically transform a patient's smile. A few weeks ago we were given the opportunity to work on a six unit, upper arch anterior case.

We worked closely with the doctor to choose the perfect restoration for the patient, and a few weeks later the Press to Zirconia crowns were seated.

Most importantly, the patient is very pleased.

- Eric P.

AOA Schedule re: Las Vegas

Cindy and I will be out of town from Thursday the 26th and will be back at the office on Wednesday, July 2nd. We will be in Vegas visiting my parents.

As I mentioned before, when Dad turned 80, (August of last year) I promised him, that I would see him every 2-3 months, or so.

Eric is holding the Fort, just in case you need anything. The lab will remain open for downtown pick-up and deliveries.

- Tony L.

AOA Schedule re: Wedding

AOA Dental Lab will be closed this Friday, June 20th.

Cindy's cousin Molly is getting married to a wonderful guy, (Travis) this weekend in Spokane. It's funny how time flies. Molly was the flower girl on our wedding. Now, she's the bride. She also worked here at the lab doing model work, the summer of 2006.






(Picture of Mollie at 5 y.o. with my wife Cindy)





The lab will resume normal schedule on Monday, the 23rd.

- Tony L.





(The bride to be presently)

Dentistry and Other Acts of Sadism - from one cyclist's blog

A few of you already know that I'm a cyclist. Not a professional one, just the kind that enjoy bicycles and rides a lot. So, why am I talking about cycling on a dental blog? Well, while surfing the net I came across this guys' blog. He's a cyclist and this is how he defines his dental experience. - Tony L.

Dentistry and Other Acts of Sadism (...from his site)

I went to the dentist today to have a filling replaced. It hadn't come out, and it wasn't bothering me, but he told me at my cleaning in December that it needed replacing. I'm not sure if what he really meant to say was that he had another car/house payment coming up. Nonetheless, I went.The first question he had for me, as always, was "So, have you been riding the bike a lot lately?" My dentist is also a cyclist (though more of an occasional recreational rider). After the small talk (while he was waiting for the anesthesia to numb my jaw), he got down to business while he and the dental tech, Liddy, talked about her family. Liddy is from Mexico, and so my dentist has been trying to learn Spanish from her. Fortunatley I had two years of High School Spanish back in '79 and '80, so I can translate their conversation for you here.

• Dentist: Have you talked to your Uncle recently?


• Liddy: Yes, I spoke to him last evening by phone.


• D: How is his shoe?


• L: Very good. It has gone swimming.


• D: Did he have it pelted?


• L: Oh, no. It was suddenly appointed "hat"


• D: I'll bet he's happy. Did he drive it to wax?


• L: Very happy. Aunt Carmen stole photographs, too. And she also called a cow!

Now, I will have to admit that my Spanish is a little rusty, and the sound of the drill in my mouth was reverberating through my whole skull, but I'm pretty sure that's how it went. Oh, and something about the heart of a carrot as well, but I didn't catch all of that.

Foreign Dental Work Put To Test

From ABC news...

Recently, an Ohio news station ran a report on the potential risks run by outsourcing to foreign laboratories. The FDA and the ADA issued statements in response to the allegations of potentially unsafe amounts of lead found in some imported restorations.

COLUMBUS, Ohio - Chris Collier has been a patient of Dr. Dave Rummel for 30 years.
When it comes to teeth, Collier is more concerned about his health than his smile.
"The reason I come here is because I know I can trust the dentist I have," Collier said. "I know I can get good workmanship."

Rummel is one of the few dentists in central Ohio who makes his own crowns, bridges and dentures, but most other dentists rely on outside dental labs, 10 Investigates' Lindsey Seavert reported. The labs can be down the street or even overseas, increasingly outsourcing work to India, Mexico and China. Chinese imports, like jewelry and toys, have been under heavy scrutiny for the last year because of lead concerns.

The dental community is concerned that unsafe metals have reached their industry, too.
"It's one thing if it's a toy a child plays with for 20 minutes. It's another thing if it is somebody's mouth for a lifetime," Rummel said. "There is an issue here."

---------------------

You can read the article in it's entirety here.

U.S. Food and Drug Administration - http://www.fda.gov/

American Dental Association - http://www.ada.org/

-Eric P.

Dentsply Radica - AOA Feature Product

This month, we would like to take the opportunity to promote the Dentsply Radica provisional restoration system. We have recommended Radica to our doctors in the past, and we believe it provides excellent results in addition to being easy to use.

Radically Esthetic
Radically Enduring
Radically Strong

While no provisional material matches the esthetics, strength, and durability of a finished restoration, Radica offers the closest match to the real thing. Radica material provides for long-term provisionalization, a perfect fit for implant and periodontal cases. To locate a lab supplying Radica Provisional restorations and a trial coupon, visit...www.ceramco.com/radica.

________

This month, we will be including a Radica flyer with more information about the benefits of this product in our next batch of statements. In the mean time, we encourage you to call us if you have any questions.

-Eric P.

The Voice of Techno-Clinical Dentistry, SPECTRUM DIALOGUE

I am very glad that Spectrum Dialogue featured two of our favorite techno-clinical solutions here at the lab, in their March 2008 issue. Both systems serve us well, and have their own strengths and weaknesses.

For more info about these products and how we like to use them, please call AOA Dental @ 1-866-625-6992. - Tony L.


1. Nobel Biocare Zirconia Restorations

Nobel Biocare, the originator of CAD/CAM dentistry, expands it's market-leading and versatile treatment portfolio of all ceramic solutions with three new shades of Procera Crown Zirconia.

With Procera Crown Zirconia in four colors, dental laboratories stand to increase their focus on creating superior esthetics, instead of managing a shaded blank inventory. Furthermore, experienced ceramists can often achieve the desired final color with fewer steps by starting with shaded zirconia bases, thus increasing shade efficiency.


2. Cercon Zirconia Crowns and Bridges

Cercon Zirconia is an innovative system for esthetic metal free crowns and bridges and is a registered product of Dentsply. The system is used to fabricate anterior or, posterior single units or, multi-unit bridge restorations out of translucent, biocompatible zirconia, the strongest and toughest dental ceramic.

The reliability of Cercon restorations is backed by more than nine years of proven clinical success. Over 2,000,000 units have been placed world-wide since introduced.

Amalgam Controversy

A ban on mercury, including dental amalgam, that took effect in Norway on Jan. 1 has stirred similar activity in other Scandinavian countries, notably Sweden and Denmark where after April 1, dentists can no longer use mercury in fillings. The action spurred a denouncement from Derek Jones, Professor Emeritus of Biomaterials, Dalhouse University Halifax, Nova Scotia, and Chair of the International Standards Organization's TEchnical and Committee on Dentistry.

The Norwegian ban was in reaction to the detrimental effects mercury has on the environment and the availability of alternatives; Sweden banned mercury for environmental and health issues, stating that today's dental composites are a viable alternative because they are more versatile.

Jones denounced the ban, saying the media has bombarded the public with sensational, confusing, and misleading reports on health issues related to amalgam use.

A December 2007 Dental Products Report survey showed 57.0% of U.S. dentists place amalgam restorations. Of those who don't, 43.0% stopped more than five years ago. Of those who still place amalgam, most say they use it less today than 3 years ago.

Vegas and A Life Without Left Turns = Secret to Long Life?

I'll be in Vegas visiting my parents, until Tuesday, March 18th.

My Dad turned 80, August of last year. One of the things I promised him, was that I would see him every 3 months. Cindy is holding the Fort. If you need anything...

Not dental related but, speaking of Dads, one great read is this warm short story of the possible secret to long life,

"A Life Without Left Turns". - Michael Gartner

ONLINE COMMUNICATION

Forward Trends:

As the operatory makes it's transition from hands-on dentistry, to the use of digtitized tools to streamline chairside procedures, to diagnose and treat patients more accurately, and to bring efficiencies to front office practice management, dentists are increasingly using computerized tools to communicate with their laboratories. According to the Dentist/Laboratory Communications survey Dental Lab Products conducted in September 2007, the percentage of dentists using the Internet to communicate with their laboratories has gone up 125% in the last two years and a whopping 492% since 2003.


E-mail, Web-based image management solutions, Web and Videocasts as well as the newest tool, digital impression-taking devices, all enhance the ability of dentists to communicate case information quickly, easily, and more accurately. According to dentist respondents, nearly half (48.1%) of those who use the internet to communicate with their laboratories do so by sending digital images, and almost one-third (31.2%) of respondents said they use general-correspondence email. Although the percentage of dentists who report using computerized tools for communication purposes is still small (20.1%), the increase in their use shows promise for future two-way e-communication.

X-Rite Shade Vision System

"To implement the art of life enhancement, transformative dental art is only possible through communication and continuing education."
- Tony Licuanan, AOA Dental Lab

T.G.I.F.

Not quite a day at the beach...

But, due to scheduled maintainace of our mechanical room on the 8th Floor, here at One Union Square, to check our air compressor, etc., the laboratory will be closed all day on Friday, February 15th.

Our phone lines are open however, and we will be picking up and delivering cases as normal.

- Tony L.

All Ceramic Website:

To drive more awareness, Dentsply has increased marketing efforts to our community and added CE programs, DDS trade advertising, a new website: http://www.allceramiccrowns.comand the Certified Cercon Warranty.

Cercon zirconia frameworks now come with a 7 year warranty against breakage. Details in this program will be forthcoming and Certified Cercon 7 Year Warranty *case stickers* will be included soon.

- Tony L.

http://www.allceramiccrowns.com/
From Dentsply, 02-02-2008:

We are pleased to announce that the new Cercon Website - has officially launched. The site name was chosen to provide a more broad appeal than just the Cercon brand name and will position Dentsply and Cercon as leaders in the all-ceramic crown and bridge restoration category. This platform will also provide greater flexibility as we expand our all-ceramic product offering in the future. An added benefit is that the site name optimizes customer search initiatives by encompassing a wider, more general topic. This website will enhance the overall on-line identity of Cercon and our Cercon Certified Laboratories and will provide an excellent avenue for disseminating information and generating sales leads. One of the primary goals is to drive brand awareness to the Dentist and drive prescriptions. We will optimize the site through the main web search engines- Google, Yahoo and the Microsoft engine.

The site is broken down into the following key information areas:

1. Patient- This section provides consumers with information on Crown and Bridge options and will contain patient related information on Cercon Zirconia.

2. Dentist- This section provides Dentists with the following information categories- Cercon Research / Clinicals, Dental Trade Articles, Cercon Literature, Treatment / Restoration Images, Practice Tips and a Certified Cercon Lab listing.

3. Lab- This section provides Dental Laboratory information in the following categories- News and Events, Cercon Product Demonstration Video, Cercon System Components descriptions, Trade Articles and Lab Brochures/Advertisements

4. Club Cercon- This section is designated for our Certified Cercon Laboratories and requires a password. Here we will store Product Images which can be downloaded for marketing purposes, DDS Marketing materials available to the Cercon Lab, News and Promotions, Product Pricing, Cercon Product DFU's and Technical Tips for Cercon. Cercon Labs will need to activate access to this site by following the instructions for setting up their User name and Password.

5. Contact Tab- This provides an area for Customers and Prospects to request information and is emailed to Dentsply Prosthetics Marketing

As we move forward we will continually add to this website as we obtain more relevant content.

We hope you will find this a beneficial tool that will help build the Cercon Brand and your business. We are also always interested in your input on Cercon and the ways we can grow the business together.

Thanks for your support
Scott Martinet
Cercon Product Manager
http://www.allceramiccrowns.com/

Excellence Is Just Around The Corner.

On February 4-6th, I will be out of the office and heading over to the Kois Center, to take Course III - Restorative/Periodontal Interface.

Why take the course? What's this about? How can it help the doctors, patients and the laboratory?

For whatever the goal is, it's probably the same reason as to why dentists from all over take this course.

Here's my goal:

a) To take a closer look as to why some crown & bridge margins become exposed.
b) To better predict tissue and ridge management, following extraction.
c) Enhancing pontic site development – surgical and restorative guidelines.

In a nut shell, this course is designed to help me better understand what most dentists go through in their day to day profession. I believe that transfomative dental art is only possible through communication and continuing education.

Hopefully, I can always bring you my "A" game.

Excellence is just around the corner.

- Tony L.

50th Wedding Anniversary

Greetings,

Cindy & I will be out of the office from Thursday, January 24th to join my parents celebrate their 50th Wedding anniversary in Vegas, on the 26th of January.

We will be back at the office, the following Tuesday, the 29th.

The lab will remain open for all pick-ups and deliveries.

- Tony L.

Dentist Finder?

Being in the dental field, I'm frequently asked, "Hey Tony, do you know a good
dentist?".

Not the hardest question to answer, as I work closely with some couple dozen of them. Some, for over a decade, or so. Some from out of state, while some are just within steps, next door to the lab.

As a technician of 23+ years, I shouldn't say this but, I'm almost sure that I have seen it all. From good dentists, to great caring ones. From "by the book" operators, to great artistans like one Pablo Diego José Francisco de Paula Juan Nepomuceno María de los Remedios Cipriano de la Santísima Trinidad Clito Ruiz y Picasso of Malaga, Spain.

And, if you think Pablo Picasso's full name is confusing enough, try picking out a dentist using the Yellow Pages. I swear you would go blind, and may need to search for an eye doctor instead. As far as 1-800-DENTIST is concerned, I can't comment, as it is more or less, just another ad agency. Then there's Dr. Oogle, a website where one could rate a dentist or, share their experience and leave a feedback of sorts, which could either be helpful, or maybe just plain biased.

So, I guess it's easy to understand, how it can get quite confusing when looking for a dentist that is right for you.

My advise is to talk to loved ones, friends and relatives. Ask, how do they like their dentist? Are they treated well? Are they comfortable? How long have they been their family dentist? Then, look carefully at their teeth. Can you pick out their caps a block away? Or, do they have beautiful bright smiles?

In accordance with Washington state law, all dentists are required to take at least 21 hours of continuing dental education every year, which means that they are constantly upgrading their technical skills. As well, dentists who are members of the Washington State Dental Association must practice ethically to maintain embership. Their professional conduct is governed by the American Dental Association Principles of Ethics, the WSDA Code of Ethics, the Washington Dental Practice Act, and all applicable federal or state criminal statutes. You may call the Washington State Dental Quality Assurance Commission office at (360) 236-4700 to find out if a formal complaint has been filed against any
dentist.

I strongly add that the dentist be working closely with a good local dental laboratory, that extends the professional service of communication and custom color matching. You may want to think twice of those that send their dental laboratory work to China, as the materials used are not well regulated.

- Tony L.

2008 Fee Schedule

Dear Doctors,

We are working hard for you, to remain your #1 dental laboratory source. We appreciate your business, and will always create ways to continue providing, excellent products and services.

As a part of that effort, we reviewed our pricing structure in relation to a number of changes in the industry. And, due to the increase in raw material costs, we must unfortunately raise our fees to maintain the same level of quality in our products and services.

We have avoided raising our prices for as long as possible, but we can no longer prolong the inevitable. We have updated our new fee schedule, which goes into effect, February 1, 2008. Any cases started between now and February 1st, will be honored at the lower 2007 prices.

If you have any questions, please feel free to call, or email anytime. And again, thank you for choosing AOA for your dental laboratory needs.

AOA Dental Lab