PDF Version - Glidewell Dental Labs
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Letters to the Editor<br />
Dear Dr. DiTolla,<br />
I have been watching the free clinical videos<br />
on the <strong>Glidewell</strong> website and am impressed.<br />
Thank you for making these resources available<br />
at a price that’s hard to beat.<br />
If you wouldn’t mind, could you answer a<br />
few questions? These questions focus on<br />
the video “Diagnosis & Placement of No-<br />
Prep Veneers”:<br />
1) Would it be helpful to relate midsagittal<br />
and interpupillary planes to the lab, as in<br />
a Kois Dento-Facial Analyzer (Panadent;<br />
Colton, Calif.), or in your experience is this<br />
not necessary?<br />
2) What brand of retractors were used (two<br />
types are shown)?<br />
3) How do you deal with interproximal contact<br />
issues — hyper or hypo — at try-in,<br />
especially as there is no gingival margin to<br />
act as a stop?<br />
4) How do you know when you need to use<br />
“shade-adjustable” porcelain?<br />
– Vincent Johnson, DDS<br />
Bay City, Mich.<br />
Dear Vincent,<br />
Thanks for writing and for the kind<br />
words! Here are some attempts at answering<br />
your questions:<br />
4<br />
www.chairsidemagazine.com<br />
1) It is very helpful to include that<br />
information; however, if you parallel<br />
the incisal edges of your preps to the<br />
interpupillary line, that is our default<br />
way of mounting the cast. That being<br />
said, it is much easier for us to do<br />
that if a Kois Dento-Facial Analyzer, or<br />
even a stick bite, is included.<br />
2) The one I like best is the SeeMORE<br />
retractor from Discus <strong>Dental</strong>. There<br />
are rumors that they may stop selling<br />
that product, so I am looking into having<br />
it made here at the lab because we<br />
have an injection-molding machine on<br />
the premises.<br />
3) The contact/seating issue is the<br />
worst thing about no-prep veneers.<br />
Sometimes I have the lab make a little<br />
finger of ceramic on the incisal edge<br />
of the veneer to prevent overseating,<br />
but then you have to grind that<br />
all away after bonding it into place.<br />
Really, it all comes down to “feel” and<br />
some educated guesswork. I hate procedures<br />
like that, but I haven’t found a<br />
better way yet.<br />
4) You never have to ask for shadeadjustable<br />
ceramic anymore because<br />
it is now the material we use on all<br />
these types of cases, except for the<br />
ones where we are trying to block out<br />
a darker shade of tooth — something<br />
lower in value than an A3. In those<br />
cases, we either need to opaque the<br />
inside of the veneers or have the doctor<br />
prep the tooth so we can make the<br />
veneer a little thicker.<br />
Since that video was produced, however,<br />
I now do nearly all my veneers<br />
in IPS e.max ® (Ivoclar Vivadent; Amherst,<br />
N.Y.). Because it is three-times<br />
stronger than IPS Empress ® (Ivoclar<br />
Vivadent), I have yet to experience<br />
any of the incisal chipping or breakage<br />
that I did over the years with IPS<br />
Empress. In fact, IPS Empress is dying<br />
a slow death in our laboratory, while<br />
the number of IPS e.max veneers we<br />
do continues to grow. I foresee a time<br />
in the not-too-distant future when all<br />
veneers will be IPS e.max because of<br />
its optimum esthetics and strength.<br />
Hope that helps!<br />
– Mike<br />
Dear Dr. DiTolla,<br />
Just wanted to send you a note to say<br />
how much I enjoy reading your interviews<br />
in Chairside magazine. The two with<br />
Drs. Howard Farran and Paul Homoly are<br />
must-reads for all dentists. Sometimes I<br />
feel you read my mind with your questions.<br />
Keep up the good work.<br />
– Steven Bellantese, DDS<br />
Bronxville, N.Y.<br />
Dear Steve,<br />
Thank you for your kind words. I love<br />
long-form interviews, yet they seem to<br />
be such a rarity in dental magazines<br />
these days. I never feel like I learn<br />
anything from the one-pagers. It takes<br />
a few pages to ask follow-ups and give<br />
someone the space to answer.<br />
– Mike<br />
Dear Dr. DiTolla,<br />
Thank you very much for the practically<br />
helpful educational support your lab provides<br />
to dentists. I wonder if you give written<br />
directions or drawings to the lab technician<br />
about the desired thickness of the wax-up<br />
design (in other words, how much dental<br />
tissue it is safe to prep). As a rule, technicians<br />
overprep teeth on the model, which<br />
leads to extra time to fit.<br />
Cordially,<br />
– Alex Zavyalov, DDS<br />
New York, N.Y.<br />
Dear Alex,<br />
Yes, when I am having a diagnostic<br />
wax-up done, I will often send along<br />
one of my 0.6 mm depth cutters from<br />
my Reverse Preparation Set (Axis