Full-Service Laboratory Gets the Most Out of Removables Department
New digital denture system helps increase efficiency and accuracy
Alexander Wünsche does not consider himself a ceramist, a removables technician, or an implant specialist. Having studied dental technology at the Otto-Umfrid-Schule in Nürtingen, Germany, and earning his CDT accreditation in Friedrichshafen, Germany, Wünsche was educated in the full scope of laboratory disciplines.
“I am a dental technician,” says Wünsche, owner of Zahntechnique in Miami, Florida.
Wünsche concedes, however, that he has become more active in the arena of removables in recent years. He will even lecture at the International Digital Denture Symposium on October 27-28 in Baltimore, Maryland.
“Dentures are becoming increasingly important because of the popularity of implant dentistry, and subsequently, I have become more active in that area,” Wünsche says. “My philosophy is that you need to know principles of denture setup such as occlusion and function for even zirconia and porcelain crown-and-bridge cases, but it is especially important for high-end, full-mouth implant reconstruction.”
Wünsche’s laboratory reflects that mentality. At first glance, he says, the removables department might look like that of any other laboratory. Operationally, however, it is anything but conventional.
“We have traditional removables technicians, but we also have some who work in the CAD/CAM department,” he says. “These CAD/CAM removables technicians work with scanners and setting up teeth digitally, and they work closely the removables department.”
For complex implant reconstruction cases, a denture setup is created first to evaluate the positions of the teeth. A removables technician creates the setup for the CAD/CAM department to scan. If the setup is sent to the dentist for a try-in, it is then reset in the removables department and sent back to the CAD/CAM department for another scan. When the prototype is milled in acrylic, it goes back to the removables department for processing on titanium abutments or cylinders, or to add composites or acrylics for esthetics.
“There is always back-and-forth between the removables department and the CAD/CAM department,” Wünsche says. “For new technicians coming from other laboratories, it can be challenging at first because internal scheduling becomes important as each department depends on the other. But they always adapt.”
The process became even more productive with the introduction of Amann Girrbach’s Ceramill Full Denture System (FDS). This system is characterized by the consistency and seamless linking of all software and hardware components, and uses high-quality, commercially available denture teeth from well-known manufacturers. In contrast to full dentures milled from acrylic, including the dentition, the denture bases fabricated using wax can, if necessary, be adjusted by the dentist following try-in to ensure an exact intermaxillary relationship for the patient.
“Ceramill FDS is a hybrid between a fully digital denture and a traditional workflow,” Wünsche says. “We are able to obtain all the necessary patient information via a regular bite registration and custom tray registration, and we place that in our scanner to create a digital setup. From that point, we can mill the denture base in wax and mill the teeth such that the intaglio surfaces match the base. We can send that wax try-in to the dentist, which is comforting to them because they can make changes in the office. For us, the system is more efficient because it is far faster than creating a manual setup with an articulator and festooning. We can set up teeth very fast and festoon the wax quickly and effectively.”
Dentists also can be involved earlier because of the digital aspect. Wünsche utilizes screen sharing and virtual meetings to discuss the scans before creating the try-ins.
“It saves so much time when we can eliminate some of the physical back-and-forth,” he says.
Even more time is saved because the mill handles much of the labor.
“I can jump on another case while the machine is milling the wax,” Wünsche says.
The accuracy of digital dentistry is another benefit of Ceramill FDS.
“Our festooning is more consistent when it is not subject to human error,” Wünsche says.
Amann Girrbach also offers a second option via Merz Dental—the Baltic Denture System (BDS). This system allows the laboratory to mill the entire denture from one block.
“With the BDS, teeth do not need to be glued, bonded, or set in wax,” Wünsche says. “We can fabricate a denture with only two patient visits: one for taking the impression and bite registration, and the other for the delivery of the denture. You do not need a denture setup because the teeth are already set.”
Between the Ceramill FDS and BDS, Amann Girrbach offers a wide array of solutions and the necessary resources to provide a great fit for any patient need.
“Taking advantage of both systems is really exciting,” Wünsche says. “The technology is amazing.”
For more information, contact: