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I’m sitting in the airport on my way home thinking about what has happened over the past few days in Las Vegas at the Townie meeting. A few things stand out.

The presentations I went to were really good, great quality across the board, great responses from the audiences. Many of the GALILEOS and CEREC-based presentations were given by individuals who will be presenting at CEREC 27 & a Half, August 16-18 in Las Vegas. This material is inspiring and thought-provoking; I can’t wait to see what these presenters bring to the big event. There are a lot of developments with the software and the materials that will make the life of the CEREC dentist easier, and the treatment we deliver to our patients better. These people are pushing the CEREC boundaries, and this August they will share much of what they have figured out.

The other thing that stands out is the people of the cerecdoctors.com Mentor Group. These are individuals who are truly special – always willing to answer questions, spend the time spreading the advantages of CEREC and cerecdoctors.com even when they didn’t have, they were in Vegas after all, vacation time. Many I already knew, many I met for the first time, but it was like we were longtime friends. I guess it shouldn’t have surprised me since I have interacted with many of them on a regular basis through the website. The mentors are a fantastic group of individuals, always there to support their fellow dentist, to help them advance and improve their dentistry.

I recently had the privilege to be part of the cerecdoctors.com mentor field trip to Bicon Implants. The trip included an implant surgical and prosthetic course held at their headquarters, a facility second to none.

The first thing that caught my attention was the person in the front of the room. Why was my Uncle Bill standing in front of the class? The same mannerisms and that Irish smile jumped out at me. But it was not Uncle Bill, or as his nephews and nieces referred to him, “Sweet, lovable, Old, Bill - SLOB.” A nickname that he cherished; it always brought a smile to his face. And as we got older a quick and witty sarcastic response would just as quickly be returned that made the room erupt in laughter. If you dish it out, you’ve got to take it was how he lived. He was a man stuck in his ways and had the experience to prove his point.

After shaking my head I realized it wasn’t my Uncle Bill, but Dr. Vin Morgan, the head of Bicon. He started by telling us the story of Bicon, how they have met opposition in the past and still face it from companies with larger marketing budgets. These companies unwilling to accept the position and products of Bicon – a company that hasn’t changed the basic design of its implant since it started in 1985 – while these other companies make a normal practice of switching this and changing that on a regular basis.

The hard facts of implant dentistry are not hard facts any more, and Vin Morgan helped to open the eyes of the mentors in the room. He said that they say what they say and you can accept it and bring it into your office, or you can stay set in your ways and at least have a good dinner at the end of the day and go home.

As the day went on I started to see how the advantages of their system worked. The advantages of their surgical protocol definitely raised eyebrows all around me. Case after case of fantastic soft tissue. Case after case of bone growth around the implants, even those that have significant discrepancy with the crown-to-root ratio. In fact, as they have matured as a company, they have gotten away from implant lengths that we would consider the norm. All of their long implants have been discontinued since the shorter implants have a better response from the host. There were implants placed in sites I would never had attempted to try and these implants did more than just stay, they grew bone.

As Rich Rosenblatt said in his blog, there are a lot of similarities with the journey of Bicon and CEREC. Just as I find Sirona a great company to work with as a partner in my practice, I see Bicon being another great partner.

As I finished my dinner at the close of the course, surrounded by some great CEREC friends, we asked Dr. Morgan, “So how was the dinner?” I tried to stir the pot and say, “The first course was good, but I expected some good Irish food!”

He said, “Well if that was the case, then you pick up the tab.”

Uncle Bill, are you in there?

We all left with smiles after a great weekend and Dr. Morgan shared some words that mean a lot to me:

“The doors to this house are always open for you; we are here to help you however we can.”

In order for the tools to work correctly, turn the Minimal Thickness option OFF when doing thin restorations.

This video demonstrates this when doing single and linked restorations.

I have to admit that when I heard the name Scotchbond I immediately thought of the old bonding agent I used for years and years. It worked well in my office but I moved on to newer – and what I thought was better – technology for bonding. I was wrong, and am glad I looked further into what Scotchbond Universal has to offer. I also learned how a new family of products has been developed to work in synergy to create a fantastic union.

Scotchbond Universal can simplify bonding for directs and indirects. Its chemistry may be complicated, but it has been created to be precise in what it does while offering the flexibility to deal with the variable environment that is the oral cavity.

Scotchbond Universal is a single-bottle system that can work equally well with whatever bonding protocol you favor – total etch, selective etch, and self-etch. Many of the pitfalls associated with the different generations of bonding agents can be avoided due to the unique composition. The sensitivity issues of fifth generation bonding agents have been removed since it can rehydrate the collagen if you have over-dried the preparation after etching. A Vitrabond co-polymer is included in the mixture that allows superior bonding to dentin, both dried and moist, to the same extent as we get with glass iomomer materials. It also contains heme which also helps in this area. As a self-etcher, it does a great job   of etching enamel, creating a perfect surface for bonding. Since it is a self-etching adhesive, it is more tolerant if there is a bit of moisture present.

For bonding of indirect restorations it has even more attractive features. Silane is incorporated into the material so it can be used to prepare the intaglio of our ceramic restorations after the application of HF. Another component is MPD, which has the ability to bond with metal oxides, opening the door to bonding metal and zirconia to the tooth structure without any special pre-treatment. Or the bonding of our CEREC restorations to stock or custom abutments.

Seventy percent of dentists use more than one bonding agent, complicating the daily operations of their offices. Scotchbond Universal gives the dentist one solution for their bonding needs for all the different situations that arise: directs, indirects, ceramic, metal and fiber, simplifying one of the most widely done procedures in the office for you and your staff.

Being a mentor is not just being happy where you are with your knowledge and thinking you can teach others.

It is a path you take when you realize you can never really know everything and want to learn more. Dentistry is a never-ending journey; there is always something to learn. The naive or lazy dentist can get to a point where they think they now enough to do well, but that can create a static practice that can quickly fall behind and wither and die.

CEREC Dentistry is no different. You want to be comfortable and efficient, but it is such a dynamic field that very quickly you can fall behind. Mentoring with cerecdoctors.com online, in Scottsdale and on the Mentor field trips can really shock you with reality. There is always more to learn (there is always “more than one way to skin a cat,” as my grandfather use to say. Still not sure what he really meant. But he grew to be old and was successful so I guess he knew what he was talking about.)

I just had an opportunity to join some of the cerecdoctors.com Mentors in Minneapolis to have a rare look behind the curtain at 3M. This company that has turned out to be a great materials partner with CEREC. They are constantly pushing the envelope to make the life of the CEREC dentist better, to make the dentistry we render to our patients better. They don’t sit back and think they have done everything and are happy with where they are right now.

We took a tour of the Innovation Center, where we were introduced to the past, present and future of this remarkable company. They say you are never farther than 15 feet from a 3M product or something built with the help of 3M. After this trip, I believe them.

We learned about the philosophy of the company, how it refuses to be locked into a linear train of thought. It encouraged cooperation among the six platforms that shared the 46 building blocks. Fifteen percent of time at work is to be devoted on personal projects. Employees are free to think, be creative, to team up with other individuals from all different parts of the company. These teams are encouraged to be creative, not be afraid of taking chances – and not be afraid of failing.

This is a company that has decided that it wants to be a bigger player in the dental materials market. And they have a budget of $1.6 billion to make sure it happens.

The Mentor program came to mind as the discussions went along. The cerecdoctors.com family is also a very dynamic community, with many doctors from all over the world  sharing their viewpoints and  advice, that enriches those who  participate in the discussion.

Less than six months to go until a fantastic worldwide CEREC event. Hard to believe it is approaching so quickly.

I look back and reflect on what happened with CEREC 25 and it was more than just sitting in a room listening to some of the sharpest minds in CAD/CAM dentistry. It was so cool listening to a presentation through headphones spoken in Japanese, translated into English by a person with a German accent. Where else could you have the chance to shake the hands of an individual who developed a technology that has changed the ways I d things on a daily basis. Or talk with peoplewho developed materials that look better and are stronger than what I use to get made for my patients.

This picture demonstrates what the event was really about:

It was an event filled with education, fun and good times – but it was also event that created relationships that are the foundation for the CEREC movement. This was a gathering of thousands of dentists from around the globe that do not accept mediocrity with the dentistry they perform and want to help the profession as a whole develop into something better.

At this event, I did what I tell my kids not to do. I interacted with individuals online on cerecdoctors.com and then went ahead and met them in person. On this hat are the signatures of a number of people who have become great mentors and friends, people who have made me step up and improve the patient care I give.

A group of people so generous with the information that they freely give out, they are great ambassadors for the technology and are fanatics that everyday help improve dentistry.

If you have not thought about going to Cerec 27 and a half, please do. It is a unique event that happens only once and awhile, and it always promises to be something unforgettable. You will return so energized you will not regret it.

I just had the chance to sit in on an implant technique course. It was a course that I originally took 15 years ago, but as we all know, the world of implant dentistry has changed a little. Or I should say that my implant dentistry has changed a lot. It was nice to see how there have been some changes in techniques, but nothing I would describe as revolutionary. Some tweaking of principles and materials from years of experience.

There was a surgeon there who was the sponsor of the event. Very nice guy and knowledgeable, but a not a big believer of guided placement. For routine placement, the additional expense of a guide would make the patient decline treatment and irritate the referring dentist. The surgeon didn’t want to get tied into a specific location because the bone might not be good there.

There was a lab guy there who was also knowledgeable. Gave great insight on the larger cases. When we were diagnosing, he was very familiar with the principles of facially generated treatment planning. He was able to answer every question but one, and that one was from me: “What is an Implant handling fee?” He offered an explanation and I told him it didn’t make any sense. I told him it is a remnant of times past when dentists didn’t know any better. Implant dentistry is not rocket science; there is no reason to be intimidated.

I am not saying that all the tried-and-true methods that have given us success in the past need to be forgotten, but as with most things in life, we need to see how the technological advances of the day can make our lives better.

Calendars with pencils, pegboards and card files, film and diptanks – I can’t imagine going back. Digital imaging and computerized practice management software have allowed us to streamline the practice.

Shouldn’t dentists have the same opinion on technology and implants?

People are going crazy over curing lights that save a few seconds, bulk fill materials that may save a minute or two. Why wouldn’t people be interested in making their implant dentistry easier and more predictable? Know how the bone is before dropping a flap, know where the implant should be placed for an ideal restoration, be able to have the temp prepared prior to the surgery, and be able to produce perfect custom abutments designed for the idea restoration. The advantages are huge; in the words of a popular commercial – PRICELESS.

Sometimes you have something, but you really don’t know how good it is until you force yourself to use it.

I have been interested in improving my handpieces by converting to electric, but have been put off by the cost. Always seems there is something that takes priority. I am also a very cheap person.

So, a few years ago my handpiece service guy comes in and talks to me about a product – ProDrive.

It is a turbine replacement for you existing handpieces, which due to its innovative design, increases the power output of your handpiece. They have kits for many of the handpieces on the market; your Paterson rep can help you out with what models are available. I still use the Star 430s that I started with in dental school. The ProDrive is almost a direct replacement for my Star push-button Autochuck. Maybe a slight increase in height, but not something that has made a clinical difference.

The other part of the equation is that this turbine does require a special bur. The good news is that these burs are manufactured by Meisinger, a premier bur manufacturer, the same company that produces the depth router burs. Not every shape of carbide or diamond is available, but there selection is extensive.

These turbines are well-made, no additional vibration noted during their use. No special maintenance has to be performed on these turbines to keep them in top shape.

More power in the handpiece, great cutting diamonds, throw in an Isolite and liquid reference and you have the recipe for a fast and efficient appointment.

The year has come to an end, and it was touch and go for awhile. The normal week-before-Christmas cancelations didn’t come, but of course all the emergencies came out of the woodwork.  Five long days, from morning to night, it was bananas.

Broken teeth, people in from out of town, and the following week I am to be out of the office. The perfect storm that CEREC can help tremendously.

One particular case that stands out and makes me publicly thank (Sirona’s Manager of CEREC software) Mr. Ingo Zimmer was a broken crown I did a few years ago. The patient was back in town to visit her family. I got her to come in at 6:30 a.m. prior to my other patients, and proceeded to redo it. I proceeded to do the visit as normal. Give a block, apply Liquid Reference, take buccal bite and opposing, and in this case I took a pre-op even though I was planning on utilizing Biogeneric.

I took the pre-op because:

1. I was trying out a new workflow
2. I wanted to copy an old PFM with a fractured DB cusp
3. No real reason

I removed the old PFM and the recurrent decay that extended pretty far sub-G, rebuilt a core and refined prep. Nothing out of the ordinary, and things looked good, just took some time to get this completed. Rendered the proposal and looked from the buccal and saw my marginal ridges were way off. Then I looked at the clock and saw that the appointment time for my next patient was quickly approaching. In my sleep-deprived state, I messed up the buccal bite and didn’t pick it up.

What to do? Re-image buccal bite and possibly the prep and opposing? Guess at the occlusion and grind it in? But this would take time. Then it hit me I had the extra folder! Even though I was doing Biogeneric I have the flexibility in 4.0 to do so many things efficiently. I could edit restoration and turn it to Bio-copy if I wanted. In this case, I just overlaid the Bio-copy folder on the virtual model and used that to establish the occlusion. By taking 30 seconds to take the Bio-copy folder, I save a bunch of time in the long run due to my missing a good buccal bite.

So the answer is C. But I was real lucky that I did do the extra imaging. The extra folders help add flexibility to an already powerful system

Thank You, Mr. Zimmer.

A Sunday afternoon drive through central Vermont. The sun was up and it looked like a beautiful day.  On the surface it was a beautiful day. But on closer look, you could see that things were different than they were in August. Hurricane Irene has changed the people and the countryside.

Many of the main roads have fresh pavement and new guardrails; a tremendous amount of work has been accomplished in the few short weeks since the storm, but many of the side roads were still roped off.

The normal stops were closed, when you would think they would be open and getting ready for the “busy” season that comes when the ski areas start to open. As you look closely, you can see they are actually more than closed, they are destroyed, having succumbed to the forces of the water.

You look up the hillside where the streams and brooks run down, and they look like lacerations and gashes violating the Green Mountains.

The lakes don’t have that clean, mountain-lake look; they look more like chocolate milk. Large trees sticking out of the water that weren’t there before. At the sides of the rivers you see bare rocks, missing trees and the rough-hewn timber that held up a barn for 150 years. You see remnants of what was, destruction of peoples’ lives and livelihoods.

It’s scary how in today’s world – where we think we can control so many things – we still are at the mercy of nature.

At this time of year it is important to remember what is really important in this world.

Our families, our friends, their safety, health and happiness.