dlpmagazine.com September 2010 dentallabproducts 39
bench Masterybench Mastery
dlpmagazine.com38 dentallabproducts September 2010
an alloy alternativeTitanium’s versatility is matched by its strength and biocompatibility.
By Jamie Stover, Lab Manager, Ziemek Dental Lab, Olympia, Wash.
Fig.AScanningthediewiththeNobelProcera. Fig.BDesigningthetitaniumcoping. Fig.CThemilledtitaniumcopingisreceivedinaslittleas2days.
Fig.DThefitandmarginsarechecked. Fig.EGrindingthecopingtocreateretentivesurfacetexture.
Fig.FBlastingwithAlO2toenhanceadhesion.
Fig.GApplyingGCInitialTibonder. Fig.HThecopingisdarkafterfiringthebonder. Fig.IGCInitialopaquemodifiermaterial.
Fig.JApplyingopaqueandopaquemodifiers.
Fig.KBuildingtheporcelain.
Fig.LContouringthecrown.
Fig.MAddingstainforany
desiredcharacterization.
Fig.NThefinalporcelain-fused-to-titaniumcrown.
As laboratory technicians,weareconstantlymade
awareofnewproductsandmaterials,andaresubjected
tomuchofthesamemarketingasdentists.However,we
areintheuniquepositionofhavingtofulfillourdentists’
requeststoimplementthesenewmaterialsanddiscern
whatishypeandwhatworkswell.Atthesametime,
nowmorethanever,weareunderincreasingpressure
tokeepcostsdown.
Addtothisthetumultuousgoldmarkettoday,and
it’snowonderthatwefearourbottomlineshrinking.
Offeringalower-costnoblealloyasanalternative
tomoreexpensivehigh-noblealloysforPFMsisan
importantoption,butstillleavesthealloycostper
crowninconsistent.
enter titaniuMTitaniumislightweight,extremelystrongandverybio-
compatible.AlthoughIwouldn’tcategorizetitaniumas
a“newmaterial,”itisnowmoreattainableandeasierto
useasacrownandbridgealloy.Inthepast,usingtitanium
inPFMswasnotaneasyfeat,asanyonewhohasever
triedtocastitwillattest.Titaniumgivesyoutheabilityto
changetheworkflowinyourlabbyallowingtheCAD/CAM
fabricationofsinglecopingsandbridgeframeworksas
opposedtotraditionalwaxingandcasting.
Additionally,itgivesyouafixedalloycostperunit,
whichallowsyoueithertochargeafixedpriceforthealloy
percrownorstructurepricingtoincludethealloyinthe
priceofthecrown,regardlessofitssize.Labschoosing
nottoinvestinascannerandsoftwarecanstillusetita-
niumandreapsimilarbenefitsbysimplypartneringwith
anotherlabandoutsourcingthescananddesignsteps.
Althoughwiththespeedthattechnologyistransforming
ourindustry,it’sbecomingdifficulttoimagineanylab
withoutsometypeofscanningability.
Withtitanium,youpayafixedpricepermilledcoping
orponticregardlessofthesizeorweight.Theactualprice
alabpayspercopingwilldifferdependingonhowyou
acquireyourtitaniumframes,aslabsthatcanscan/design
theirownunderstructureswillmostlikelypaylessperunit
thantheonesthatchoosetooutsourcethesesteps.
Aswithzirconia,therearedifferentgradesoftitanium
availabletodayofvaryingquality,makingitimportantto
seekoutareliablesource.Forthisarticle,Iwillonlydiscuss
thematerialsIusetoproducetitaniumPFMsatZiemek
handling titaniuM handling titaniuM
about the authorJamie stoveris ManagerofZiemekDen-
talLab(ziemekdentallab.com),ahigh-qual-
ityfixedrestorativelablocatedinOlympia,
Wash.Hisfocusisusinghisexperience
atthebenchasatechnicianalongwith
newtechnologyandmaterialstoprovide
dentistswithhighlyestheticrestorations,
whilekeepingthemonthecutting-edgeof
dentaltechnology.Hecanbereachedby
calling360-943-6071orbye-mailinginfo@
ziemekdentallab.com.
DentalLab.WeusetitaniumalloyfromNobelBiocare,whichis
ahigh-qualityGrade5titanium,andIstackthemwithGCInitial
TiporcelainfromGCAmerica.Wehavebeenextremelyhappy
withbothofthesecompaniesfortheirexcellentproductsand
outstandingsupportandcustomerservice.Specialthanksto
RickSonntagofGCforallhishelpwhileIwasgettingoffthe
groundwithTi.
basic rulesIhearquiteabitabouthowdifficultitistointegratetitanium
intoalab,andhowtrickyitcanbetoworkwith.Incidentally,I
hearthismostlyfromlabsthathaveneverstackedatitanium
crown,andIhaven’tfoundthistobethecase.Thereareafew
basicrulesthatIfollowwhenworkingwithtitanium.
Ialwaysuseadedicatedcarbideburformetalfinishing
toavoidcrosscontaminationofourotheralloys,whichisno
differentintheorythanworkingwithnon-preciousalloysfor
MarylandBridges,etc.Iwouldrecommenddedicatingawork
stationexclusivelyforit;however,Ihaven’tneededtodothis
asofyet.Ijustkeepmyworkareaclean,useadedicatedbur,
anddon’thaveanyissueswithcrosscontamination.
Titaniumbuildsanoxidelayerbysittingatroomtempera-
tureforaboutfiveminutes,soyoudon’tfireitinanovento
degas.Thisisabonusinmyopinion,asfiveminutessittingat
roomtemperaturewhileIdosomethingelseisaquick,easy
degascycle.
Beforeyouopaqueyourcoping,you’llneedtoblastitwith
125-micronaluminumoxidetoreallyroughenupthesurface
textureandalsoapplyabonderlayer;again,notabigdeal.After
firingthebonder,thealloyisabitdarkergraythanournobleand
high-noblealloys,soIuseableachshadeformyfirstopaque
application.Ialsorecommendthatourdentistscutaporcelain
marginpreptoavoidanydarklineatthegingival.
Otherthanthesedifferences,Istackitjustlikeanyother
alloyweuseandhavebeensatisfiedwiththeoutcome.Iwould
followtheinstructionsprovidedwiththeporcelainkityou
choosetoworkwith.IonlyuseGCporcelainforourtitanium
PFMs,andsubtledifferencesmayexist.
building the PFt crown
01 WeuseourNobelProcerascannertoscanthemodel
(Fig. A)anddesignthecopings(Fig. B).
02 Twotothreedaysaftersubmittingthedesignedfile,
wereceivethemilledtitaniumcopingfromNobel(Fig.
C).Becausethecopingismilled,thethicknessissetat0.4mm
andrequiresminimalfinishing.
03 Afterthespruesareremoved,thefitischeckedand
themarginsarecarefullyfinished(Fig. D).
04 Thespruesarefinisheddownusingacarbidebur,and
contourisrefinedifneeded.Igoovertheentirecoping
tocreateamore-retentivesurfacetexture(Fig. E).Again,special
careistakentouseadedicatedbursothereisnocontamination
amongstourdifferentcopings/alloys.
05 Thecopingisblastedwith125-micronaluminumoxide
ata45°angletopreparethesurfaceformaximum
adhesion(Fig. F).
06 Thecopingissteamcleanedandallowedtositatroom
temperatureforfiveminutestobuildanoxidelayer.
07 IapplyathinlayeroftheInitialTiBonderandfireit(Fig.
G).Afterthebonderisfired,thecopingisquitedark
(Fig. H).Inullifythisbyapplyingableachwhiteopaqueshade
formyfirstopaquelayer,anddoaporcelainmarginwhenever
possibletoavoidagraylineatthegingival.
08 Iapplymysubsequentopaqueandopaquemodifiers
inthedesiredshade(Figs. I and J).
09 IdomybuildupsasusualwithGC’sInitialTiporcelain
(Fig. K).
10 Icontourthecrown(Fig. L),glazeandaddstainforany
desiredcharacterization(Fig. M).
Thefinishedcrownisreadytodeliver(Fig. N).
Manydentistsandlaboratorytechniciansalikearealready
veryfamiliarandcomfortablewithtitaniumwhenusedfor
customimplantabutments,bars,posts,etc.Timewilltellif
thisalloyachievesthesamepopularityforcrownandbridge
applications.Inthemeantime,labsshouldexperimentwithitand
decideiftitaniumcanimprovetheirworkflowandbebeneficial
totheallimportantbottomline.Iamheretosayitcandoboth,
andalsoissurprisinglyeasytoworkwith. lab