Cost-effectiveness analysis of two impression methods for the fabrication of mandibular complete dentures.

OBJECTIVES: To compare the cost and to evaluate cost-effectiveness of fabricating mandibular complete dentures (CDs) using two different impression methods. METHODS: A crossover randomized controlled trial including 27 edentulous participants was performed. Mandibular CDs were fabricated using two different impression methods, as follows: (i) conventional method using a custom tray border moulded with impression compound and silicone and (ii) simplified method using a stock tray and alginate. Cost analysis was performed from a clinical practitioner's perspective. The total cost included labor cost, which was calculated using the time spent by dentists and technicians in fabricating CDs and their hourly wages, and the material costs, which were calculated using purchase prices. To evaluate cost-effectiveness, we used general patient satisfaction as an indicator of effectiveness and calculated the incremental cost effectiveness ratio (ICER). ICER represents the cost per one unit of effectiveness. RESULTS: The trial was completed by 24 participants. The total cost was 43,904 Japanese Yen (JPY) (330.91 EUR / 395.78 USD) for the conventional method and 39,792 JPY (299.93 EUR / 358.70 USD) for the simplified method, and this difference was statistically significant (p<0.001). The ICER showed a cost of 633 JPY (4.77 EUR / 5.70 USD) for every one point change in general patient satisfaction. CONCLUSIONS: The results indicated that the total cost of the conventional method was significantly higher than that of the simplified method (p<0.001). CLINICAL SIGNIFICANCE: The conventional impression method for fabricating mandibular CDs, which took additional 633 JPY (4.77 EUR / 5.70 USD) for improvement of general satisfaction, is supposed to be clinically meaningful1.

Understanding dental CAD/CAM for restorations--dental milling machines from a mechanical engineering viewpoint. Part B: labside milling machines.

Nowadays, dental numerical controlled (NC) milling machines are available for dental laboratories (labside solution) and dental production centers. This article provides a mechanical engineering approach to NC milling machines to help dental technicians understand the involvement of technology in digital dentistry practice. The technical and economic criteria are described for four labside and two production center dental NC milling machines available on the market. The technical criteria are focused on the capacities of the embedded technologies of milling machines to mill prosthetic materials and various restoration shapes. The economic criteria are focused on investment cost and interoperability with third-party software. The clinical relevance of the technology is discussed through the accuracy and integrity of the restoration. It can be asserted that dental production center milling machines offer a wider range of materials and types of restoration shapes than labside solutions, while labside solutions offer a wider range than chairside solutions. The accuracy and integrity of restorations may be improved as a function of the embedded technologies provided. However, the more complex the technical solutions available, the more skilled the user must be. Investment cost and interoperability with third-party software increase according to the quality of the embedded technologies implemented. Each private dental practice may decide which fabrication option to use depending on the scope of the practice.

Simplifying the implant treatment for an unrestorable premolar with a one-piece implant: a clinical report.

The routine and frequent use of dental implants to replace missing teeth is accompanied by high expectations from patients. These expectations are not limited to function and esthetics but extend to patient comfort and time spent receiving treatment. Replacement of an unrestorable maxillary premolar can be challenging when considering the concerns of patients. This clinical report describes a short, simple, and cost-effective treatment option for replacing an unrestorable premolar tooth with a 1-piece implant.

No compromises the new CEREC MC XL and inLab MC XL milling machines.

Cerec 3 and inLab will soon be augmented by the new CEREC MC XL and inLab MC XL milling machines. Dentists and dental technicians who are on the threshold of introducing CAD (Computer Aided Dentistry) to their practice or laboratory can either opt for a low-cost solution or for a system which offers an extended range of indications as well as enhanced reliability and ease of use. The Cerec 3 and inLab milling machines are well-tried, accepted and proven. They offer an interesting balance between price and performance. The MC XL series is not only faster and more precise, but is also quieter and easier to use.

Cement-retained versus screw-retained implant restorations: a critical review.

This article presents a comparison of screw-retained and cement-retained implant prostheses based on the literature. The advantages, disadvantages, and limitations of the 2 different types of restorations are discussed, because it is important to understand the influence of the attachment mechanism on many clinical aspects of implant dentistry. Several factors essential to the long-term success of any implant prosthesis were reviewed with regard to both methods of fixation. These factors include: (1) ease of fabrication and cost, (2) passivity of the framework, (3) retention, (4) occlusion, (5) esthetics, (6) delivery, and (7) retrievability. (More than 50 references).

The milled implant bar: an alternative to spark erosion.

Patients who cannot tolerate total coverage of the hard palate or whose maxillary arches are poorly formed, because of congenital, developmental or surgical defects, may be unable to wear a conventional complete denture. These patients can be successfully treated with implant-supported prostheses that cover only a minimal amount of palatal tissue. With spark-eroded castings, very precise restorations can be constructed to fit such implant supports. However, these castings are so expensive that cost precludes their use for many patients. This article presents an alternative approach, developed with the refined techniques used for removable partial dentures, which can yield results similar to those for spark-eroded castings at a fraction of the cost. The clinical and laboratory procedures involved in this technique are described.

A clinical and cost-benefit evaluation of five facebows.

OBJECTIVE: Although the use of an arbitrary facebow and a full-sized articulator can reduce laboratory errors, many dentists do not use a facebow routinely because the procedure seems to be both intricate and time consuming. The purpose of the present study was to evaluate four earpiece-type facebows and the Snow facebow and to compare the time required for registration, the ease of manipulation, and cost-benefit considerations. METHOD AND MATERIALS: Twenty-five dentists who routinely used only the Snow facebow were asked, after a brief explanation, to perform registrations with the Snow facebow and four new-generation, earpiece-type facebows. The time required for each facebow registration was recorded. Dentists were also asked to fill out a questionnaire concerning ease of manipulation and cost-benefit factors. RESULTS: The Quick facebow was the facebow of choice of most of the dentists because of its favorable design and usage characteristics and cost-benefit ratio. The Artex 3-D facebow proved to be both the easiest and the fastest to manipulate. The Spring-bow and the Whip-Mix Quickmount were next in rank, and the Snow facebow scored the lowest. CONCLUSION: The use of earpiece-type facebows is both simple and fast, and practitioners judged this type of facebow to be superior to the Snow facebow.

Brånemark Novum: prosthodontic and dental laboratory procedures for fabrication of a fixed prosthesis on the day of surgery.

PURPOSE: The purpose of this report is to describe a new technique to fabricate and deliver an implant-supported fixed prosthesis to the patient on the day of surgery, and to propose a protocol for the prosthodontic and dental laboratory procedures. MATERIALS AND METHODS: The development of the Brånemark Novum prosthodontic protocol is reviewed, and clinical and dental laboratory assessments and methods are described. RESULTS: The total treatment time to fabricate a permanent implant-supported fixed prosthesis in the mandible can be reduced to 1 day with the Brånemark Novum technique. The new method includes a precise surgical technique using drilling templates for predetermined implant positions, a rigid splinting of the implants immediately after placement, the use of a prefabricated titanium framework, and elimination of implant impression procedures. CONCLUSION: With the technique described in this report, it is possible to provide patients with a permanent implant-supported fixed prosthesis in the mandible on the day of implant surgery. Patient benefits are obvious, with drastically reduced total treatment time, lower cost, and fewer clinical visits.

CEREC: the power of technology.

Dentistry has had a remarkable history. Technological advances have contributed immeasurably to efficient procedures, quality treatment, and patient satisfaction. CEREC, a computer-assisted design/computer-assisted manufacture (CAD/CAM) development that has been on the market for 15 years, is one such innovation. Capable of providing a durable, cosmetic, nonmetal filling in only one appointment and in less than an hour, the efficient use of the CEREC unit contributes markedly to quality care, patient satisfaction, and practice profit. CEREC, an acronym for ceramic-reconstruction, is a technology developed in 1985 by two Swiss researchers, a dentist and an electronics engineer, from the University of Zurich. With 15 years of research and development and more restorations placed than any comparable unit, the CEREC family of products has earned its role in dental history as the technology that gives patients one of the finest restorations in the world in only one visit.

Affordable implant prosthetics using a screwless implant system.

Many dentists have been reluctant to place dental implants because they have found that most implants are costly and time-consuming to place and have long-term maintenance problems. Most of these problems are caused by using screws to connect the abutment to the implant, the crown to the abutment or both. The use of a screwless implant system and conventional prosthetics, the author contends, can make implant dentistry affordable, versatile and easy to incorporate into all general dental practices.