Aesthetic Dentistry Awards 2014

It's been almost a year since we won an award at The Aesthetic Dentistry Awards 2013, and thanks to a nomination by Dr Andy Denny we're going to the awards again and hoping to make it 2 years running!

Back in 2013 we were surprised and delighted to be nominated by Andy, and overjoyed when we won, as you can see from the picture below.

(Mark Ambridge - Centre, Andy Denny - Right)

And here was the case

So what are we up for this year?

The categories we are nominated in for 2014 are:

Restorative case – single arch

Andy Denny
Mark Ambridge (technician) 

Conservative Ceramic – Smile Makeover

Andy Denny
Mark Ambridge (technician) 

We think these awards are a welcome recognition of the hard work and beautiful smiles that are created by the surgical and laboratory team working closely to ensure the best restorative outcome and care for the patient.

This year, just as last we will be flying the British Bite Mark Flag. The British Bite Mark shows that a lab is using skilled General Dental Council (GDC) registered professionals to produce world class dental restorations which are produced in a laboratory that fully complies with strict MHRA and MDD regulation.

The work is anonymously assessed by a well respected panel of judges, each of whom is recognised for their skill and contribution to great dentistry, so the recognition of our work in 2013 was very much appreciated by the whole team.

We are in great company at this years awards, a full list of surgeons and technicians that have been nominated this year is available to download as a pdf here

We look forward to seeing all the nominees for a great night at the awards on the 21st March.

Atlantis titanium screw retained crowns now available

There's nothing worse than having a secret you cannot talk about! Due to a number of Beta programs we are currently running with our partners that we find ourselves with lots of secrets to keep.

Which is why it's a great relief to finally be able to talk about the Atlantis titanium crown abutments that we have been working on in the lab in Beta trials with Atlantis abutments and Dentsply implants.

For many years there has been a struggle to get a good aesthetic result and stable bond to titanium which is why most labs have tended to stay with the bonding alloys or chrome which we know well and avoid the potential for aesthetic issues that early titanium bonding systems could produce.

However, when it comes to implants there is undoubtedly an advantage to using titanium as the substructure materials for our bonded crowns and, during our in house testing we have been getting fantastic results with the Duceram Kiss porcelain which has been specially developed for fusing to titanium which ensures beautiful aesthetics and a strong stable bond.

Atlantis abutments, which are supplied by Dentsply implants have up until now only been available as a crown abutment (meaning a nucleus design that is intended to have ceramic layered and fired directly onto it, rather than a cement retained crown) in zirconia material, which although a good materials is not what we might want in certain restorative situations.

Kiss ceramic was not the only system we were trialling on on these cases (although the results with this have been very impressive) we also have another system as we want to really test these new abutments and see if we can generate any problems. We will share more on the other ceramic systems on the many implant cases that our surgeons are now restoring using the titanium crown abutment.

Maximum strength & biocompatibility

For us this is a very exciting day, we now are able to offer our surgeons the opportunity to use the most biocompatible material available when restoring their implants, with the confidence of a great aesthetic result and bond strength as our tests have so far shown no negative outcomes.

This is how the new atlantis titanium crown abutment comes back to the lab.

You can see on the case that this is indeed a milled Atlantis titanium crown abutment.

We used the 3D editor in the Atlantis WebOrder to ensure we had the support and design we wanted for the final crown, which you can see in the images below.

Cost efficient

The other great news is that we can offer the new titanium bonded screw retained crowns at the same cost as our screw retained chrome units, which on average also save the surgeon £80 compared to traditional cast gold screw retained crowns, and even more when compared to cement retained implant solutions.

No compromise

Once again we are managing to utilise CAD/CAM to deliver a restoration that is of a higher quality and biocompatibility than the traditional cast gold options, and also offer a significant cost saving purely on the efficiency and consistency that CAD/CAM technology offers us. This new option to our clients ties in perfectly with our belief in delivering the widest range of excellent restorative solutions and doing all we can to eliminate compromise.

No Cement to clear at fit

As the ceramic is fired directly to the abutment you have a one piece implant crown solution where you screw down the crown and then fill the access hole with composite, which also makes it easier to retrieve the crown or get to the screw should you ever need to.

Final result

This solutions is still not widely available so if you would like to offer Titanium bonded implant restorations to your patients then get in touch with Sean on 01765 607347  or email sean@ambridgeceramics.com and he will get all the details to you

Making the most of new materials and technology

We're very proud of the fact that we have worked with many pro active surgeons, which has allowed us to become known as a cutting edge CAD/CAM dental laboratory, with all the benefits this brings to our surgeons and their patients.

Over the years we have been involved in many Beta trials with some of the worlds biggest dental companies, which has given us a great insight into some of the benefits and potential weak points in some of the current materials and systems available today. The companies that we work on the Beta testing with are looking to overcome any potential weak points they see and improve the restorative options by heavily investing in research, and testing using the latest materials and technology.

For us as a laboratory one of the biggest leaps forward was definitely the use of CAD/CAM systems such as Atlantis and Isus to produce our titanium, chrome and zirconia sub structures (and even whole crowns in some case) as this allowed us to move away from some of the inconsistency, inaccuracy and wasted expense that the old traditional wax and cast or manual milling methods had.

But recently we have seen a very exciting shift away from focussing on the machining of the custom component parts and sub structures, and a focus on the materials which we use to deliver the final prosthesis to our patients.

What's wrong with what we have?

Realistically with many cases there's absolutely nothing wrong with the Porcelain, composite or acrylics we have successfully used for many years to restore our implant cases, but if we have an implant restoration on a posterior tooth where the patient has shown a history of destroying restorations then maybe we can look to the new hybrid materials that are now available? These mix the higher aesthetics we want from ceramics with the qualities that we would ideally want on an implant restoration such as shock absorbency and chip resistance.

Shock absorbency

One of the main characteristics of new Hybrid ceramics like Vita Enamic or 3M ultimate is the fact that they actually absorb shock from the opposing dentition.

Chip resistance

Due to the fact that these materials are produced using CAD/CAM technology, they are a monolithic structure which greatly reduces the risk of delamination, further more these new engineered materials have been specifically designed to prevent crack propagation as shown in this pdf

What does this mean for us?

Thanks to our knowledge of CAD/CAM and depth of experience in using this with the new materials such as Visio.lign (which we use on full arch cases) and Vita Enamic we have been able to produce a screw retained CAD/CAM Hybrid Ceramic crown that offers the benefits mentioned above.

Below is a Vita enamic screw retained crown which has been milled and is awaiting final staining.

Further to being an ideal posterior restoration, this crown is also vastly more cost effective than a traditional screw retained ceramic layered implant crown (although if you do prefer ceramic for the very best aesthetics, we can now produce ceramic bonded to titanium implant crowns for maximum biocompatibility)

Thanks to our partnership with Atlantis we are also able to offer a restoration that has a custom titanium contour against the tissue and then transitions to these new Hybrid Ceramics in the rest of the screw retained crown restoration, think of it as a custom link abutment +

This is not a one size fits all solution, in fact we still produce many porcelain bonded screw retained units where aesthetics are absolutely critical, but it's always great to have another solution that we can mix and match into our restorative toolkit when we are looking at the needs of our patients.

We have used monolithic crowns on cement retained restorations for many years, starting initially with full zirconia and then moving on to the new Hybrid Ceramics such as Vita Enamic purely because of the improvements in aesthetics and functionality they offer.

No patient you see is exactly the same, which is why we want to ensure we have the widest range of restorative solutions available to match their specific restorative requirements.

These materials can be used for cement retained, screw retained or even angle corrected screw retained implant cases. We have more information on both of these over on our website

Atlantis CAD/CAM abutment article re published in the USA

The article we created along with Dr Tim Doswell on the Atlantis duplicate technique (which was originally published in the EDI Journal and Implant Dentistry Today) is being re published online and in print in the USA.

Well done Tim!

In the article (which was originally printed in Implant Dentistry Today, and the the European EDI Journal) Tim and the team from the lab showed how you can use the unique benefits of the advanced Atlantis CAD/CAM milling service to create an exact duplicate of the final abutment.

By having this exact duplicate (milled from titanium also, which means  either abutment can be fitted in the mouth) you can choose to design your abutment from an impresssion taken immediately at implant placement, and design the optimal soft tissue contour you wish to have.

So when the implant is ready to uncover, instead of fitting a healing abutment you place the Atlantis CAD/CAM abutment with a temp crown that has been designed to be very light in occlusion.

You then keep the original model and simply tell the lab to proceed to making the final crown (without having to take any more implant impressions) once you have reviewed the soft tissue healing weeks later.

The lab simply uses the original model and the duplicate abutment to make the crown, and because Atlantis CAD/CAM abutments are milled to such an exacting high standard the crown you made will transfer over to the abutment in the crown perfectly!

There's obviously many more steps and images to show the technique, but they are in the article and too deatailed to cover here.

You can contact Tim about his technique or article here

http://www.timdoswelldentalimplants.co.uk/

Or contact us at the lab and we will send you over a pdf copy of it to read.

sean@ambridgeceramics.com

Communication Tools

We have recently started to use Digital Smile Designs to assist our implant surgeons when it comes to  explaining the potential benefits of having grafting or GBR on an implant placement to their patients.

To make it quick and easy we simply take a picture that the surgeon has provided of the case they have aesthetic concerns over and then use this to do a quick mock up of how the final teeth may look if the patient decides they just want to have the implant placement without any grafting or GBR.

At the very least it allows the patient to clearly visualise the potential aesthetic compromise that may occur if they choose not to have the Grafting or GBR

Of course none of these are guaranteed outcomes and in fact we are careful to show that the false tissue may in fact not be a perfect match, but it does offer a clear visual indicator of where we are likely to end up if the patient feels that Grafting or GBR are not right for them.

We have found that by working together with our surgeons and offering this service at the very beginning that the patients are much better informed and able to make a choice based on clear visual information.

In this way we all hope to avoid a situation where the patient does not really understand just what we mean when we say they may end up with 'longer looking teeth' or a false tissue that attempts to make the proportion of the teeth look right, but may not be a perfect match to the pink tissue for a number or reasons, particularly in short span anterior cases.

We are always looking for ways to assist our surgeons and ensure that everyone is satisfied with the end result, this Digital Smile Design service is just another of the useful tools that we offer to our partners in order to ensure we make their management of cases simple and predicable, even on a case like this where the patient was not intending to have any other work done to the existing teeth.

Recreating Nature using Creation Ceramic

Our latest addition to the ceramic team has created 5 beautiful teeth from ceramic to show his understanding of nature and tooth morphology.

We will soon be presenting all 5 once we have our photoshoot done at the locate gallery, but for now here's one of them that Jack has made as a little teaser of the beautiful work to come.

Christmas Closing 2013

Did we really just give you all Christmas notice already?! I'm afraid we did but We’re just trying to give enough notice to allow for patient scheduling over this period by your surgery team.

Laboratory closure during Christmas period 2013

  

The lab will be closed from Tuesday 24th December 2013

and will re-opened on  Thursday 2nd January 2014

Collection & delivery

The last collection will be Monday 23rd December 2013

The first delivery after will be Thursday 2nd January 2014

Work required for fitting before Christmas 

All work which needs fitting before Christmas must be received by the laboratory on the 9th December

Any work received after the 9th December will need an additional 6 days to the usual 2 weeks required in the lab to allow for the closure period

For example a job received in the lab on the 13th December 2013 would be returned for fit on the 7h January 2014

Please take the chance to plan the appointments accordingly to avoid any disappointment for your patients.

Here's a link to the pdf so you can save or print it off for quick reference https://dl.dropboxusercontent.com/u/3248981/Christmas%20Closing%202013.pdf