Veteran Denture Maker Embraces New Options
Digital workflow for printed dentures improves profit margins and patient satisfaction
A denture maker's son who has been in the business himself for more than 40 years could be expected to be a traditionalist, and indeed, honoring the past is very important to Stephen Wagner, DDS, FACP. But Wagner, who was pouring models as a teenager nearly 50 years ago in his father's laboratory, also likes to be on the bleeding edge of technology. He invented the Wagner Universal Impression Tray 2 decades ago, worked closely with some of the first digital denture manufacturers soon after that, and now proudly states that 100% of the dentures made in his Albuquerque, New Mexico, practice are digitally fabricated.
"Digital technology is an evolution, not a revolution, of denture making," Wagner says.
His father, Arthur, practiced at a time when, Wagner says, "If you made the best dentures, you were the best dentist in town because that was the standard of care." While the son followed in his footsteps to dental school, he never intended to make dentures himself. However, he found himself attracted to the craftsmanship of maxillofacial prosthetics, which eventually led him back to prosthodontics.
"I enjoyed making plastic models as a child," Wagner says, "and now I feel like I am being brought a new plastic model kit every time a patient visits my office."
He first went into practice with his father, who eventually retired, but Wagner Denture Group remains a family business as his brother, Jon, joined the practice a few years ago.
In addition to denture making, Wagner has a passion for teaching, as well as for learning what his peers are doing. The advent of digital dentures has been exciting in that regard.
"This is a dynamic time for denture making," he says.
Digital technology is not merely a gimmick or a hobby, however. The impact on a practice can be significant, especially in parts of the country where patients are more financially limited.
"Traditionally, a denture required four to five appointments, so the time you spent often did not match the dollar amount that you could charge in your community," Wagner says. "Now, we routinely make a denture in three appointments. Perhaps more importantly, digital dentures rarely require an adjustment afterward. I do not even appoint adjustments anymore. My profit margin has gone up, and my patients are happier."
For the past year, Wagner has been utilizing Dentsply Sirona's Lucitone Digital Print (LDP) Denture Workflow. The LDP material is extremely durable and esthetic.
"Lucitone changed everything, because now we have options," he says..
Wagner's workflow got another boost more recently, when he acquired a Primescan intraoral scanner from Dentsply Sirona.
"COVID transformed everything for me," he says. "I decided that now is the time to embrace what is new, so I finally invested in an intraoral scanner after 40-plus years in practice. It is extremely rewarding to see how much our results have improved."
Wagner still uses Aquasil impression material from Dentsply Sirona for any impressions of edentulous arches because it captures the surface of the tissue very accurately, and also displaces tissue slightly for a better fit. However, he then scans those impressions—or, in many cases, patients' existing dentures—with the Primescan.
"Already, all my partners and auxiliary staff are using it," he says. "It is so easy to use, and it is fast and accurate."
These digital impressions have taken Wagner's collaboration with his laboratory partners to another level. Scans are sent directly to the laboratory, try-ins are photographed in the patient's mouth and marked with markers, and more communication occurs than ever before.
"It has brought things that should have been done to the forefront," Wagner says. "The communication is much better now because it is easier. That is important because, in denture making, the dentist and the technician really need to be equals. I ask technicians to call me ‘Steve,' not ‘Dr. Wagner.' We are working on an equal footing, both adding our expertise. You are not doing it for me; you are doing it with me. The accumulated knowledge from 1850 to 2020 is in the heads of laboratory technicians, not dentists, so communicating as much as possible is critical in creating the best possible denture for the patient."
By combining that knowledge with the latest technology, Wagner has established a workflow that is more efficient and effective for all involved.
"I have never been one to do something a certain way because that is how it has always been done," Wagner says. "We need to honor the past while continuing to evolve. My practice fabricates a lot of Dentsply Sirona/Carbon 3D printed dentures, and I am proud to give them to patients, and patients are thrilled to get them."
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