The "Message in a Bottle Mailbag" is a monthly feature of the e-newsletter, Pearls for Your Practice: The Product Navigator. Each month, Editorial Director Joshua Austin, DDS, FAGD, answers reader-submitted questions to help you navigate your dental and hygiene product decisions (and more!). This month, he revisits the alternatives to using an ultrasonic, gives his take on the accuracy of digital impressions, and makes his predictions for the NBA playoffs.
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ADDENDUM TO LAST MONTH’S COLUMN:
In April’s mailbag, a reader asked for help debriding plaque and calculus in a nursing home facility. The reader asked for something that didn't have the noise and water spray of an ultrasonic because the patients were sometimes scared by those aspects of the equipment.
In my response, I told the reader that he or she was probably stuck with hand instrumentation. But a periodontist friend, Dr. Eric Rindler, called me the morning that the newsletter mailed out and recommended a sonic scaler. You've still got water spray but probably less than an ultrasonic—and far less noise. Most companies that make an ultrasonic also make a sonic scaler. Check out the StarDental Titan sonic scalers by DentalEZ. It might be a solution for your nursing home practice.
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A prosthodontist and a rep from Glidewell both warned me that the models from 3M are poor. They report that porcelain-fused-to-metal (PFM) and full-gold (FG) crown margins are not as accurate as poured models. There are no problems with doing milled crowns or model work with other scanners.
I wondered what your experience has been. Are you comfortable doing non-milled crowns, prosthodontic appliances, and orthodontic appliances with this scanner? Thank you.
ANSWER:
Thanks for the question and compliment, Dr. Compton. I find this question to be really interesting for a couple of different reasons. At the surface, it seems to be questioning a particular product, but when you dig deeper, it’s really a skepticism of the technology itself.
The question mentions Glidewell, so I went to the source. I called my friend, Dr. Michael DiTolla (with whom I co-host a podcast called “AcciDental Geniuses” . . . pardon my shameless plug), and asked him this question. His response was almost the exact opposite of the response staged in the question.
DiTolla said that the 3M TrueDef scanner is one of the better scanners that Glidewell gets scans from. The few studies out there on digital impressions shows that even the very early iterations of digital impressions are much more accurate than traditional impressions and stone models. So, let's move past brand name, and let's talk about digital workflow.
No matter what scanner you have, the goal should be working model-free, especially when we talk about single-tooth dentistry. There is just no reason to have a model made for a single, all-ceramic crown today. 98% of my single unit crowns are made completely digital and are delivered in a solitary case with no model. If you work with Glidewell, they digitize your model anyway, so just skip this step.
For more sophisticated dentistry, when you need a model, there are some differences in the scanners. The 3M TrueDef generates a stereolithographic (SLA) model, which is made from a vat of resin being cured by a laser, one layer at a time. Some of the other popular scanners, like the Cadent iTero, produce a milled model.
The consensus is that SLA models are more accurate than milled models. No matter what, the data tells us that both SLA and milled models are more accurate than traditional stone models. Another thing to remember is that a digital impression machine isn't magic. The fundamental prosthodontic principles still apply. No scanner will overcome an undercut or a J-lip margin.
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ANSWER:
As most of you know, I live in San Antonio—city of champions, title town, home of the beautiful game. Like every other San Antonian, I love the Spurs. They are the epitome of a team, with a bunch of good guys who care more about the game and the team than themselves. Last year they played perfect basketball en route to routing Lebron James and the Miami Heat. This year was a different story. The Spurs-versus-Clippers first-round matchup was totally insane. It could have been the Western Conference finals. The level of basketball in that series far trumped the level in all the other series combined. The Clippers just made plays down the stretch of Game 7, and the Spurs did not. I think pretty much everyone agrees that we would all enjoy just playing that series again.
Also, I think we can all agree that the Clippers are a total whining mess. They are impossible to root for. They argue and whine about every single foul call and non-call. Chris Paul is a whiner. Blake Griffin is a whiner. DeAndre Jordan is a whiner. Doc Rivers is a whiner. Even Clipper fans are tired of the whining. I know that the officials are tired of it.
Now that the Spurs have been eliminated, I can look at things more objectively. Since the Kevin Love and John Wall injuries, the Eastern Conference is considerably weaker than the West, so it's pretty much accepted that whoever comes out of the West is going to win the title. The Golden State Warriors are easy to pull for. They are a fun, run-and-gun team. Steph Curry could drop 50 on any given night. They score and play defense like mad dogs. Historically, the Warriors are a great team. I think—and Vegas thinks—they are the odds-on favorite to win it all. If they do, it's going to be a fun ride. Now that the Spurs are eliminated, I hope the Warriors do win it all.
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Editor's Note:Do you have a question for Dr. Austin? Is there a product you'd like to see him review? Or would you like to submit your own "Pearl"? Tweet to @pearlmail or send an email to [email protected]. You might just see it in the e-newsletter, Pearls for Your Practice: The Product Navigator! If you're not a Product Navigator subscriber, click here to sign up.
MORE MAILBAGS
April 2015 | Ultrasonic alternatives, amalgam polishing and mercury, March Madness and patient retention
March 2015 | Livionex dental gel, obturation with EdgeEndo, hockey, and the 2015 Oscars
February 2015 | Avoiding complaints, treating lip biters, a baseball glossary, and the Super Bowl
