The Immediate Indirect Restoration - BelleGlass and Cinch
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The Immediate Indirect Restoration - belleGlass and Cinch 90 Make It Possible |
90 Make It Possible
Thomas K. Hedge D.D.S., F.A.C.E.
Contemporary Esthetics
January 2000
The ability to fabricate an indirect restoration for a patient in one visit that has desirable strength and aesthetics has been a goal in restorative dentistry for quite some time. Early attempts with light, heat, and or pressure cured composites had numerous and various shortcomings.
The Cerec CAD-CAM system has given us a strong, tooth colored restoration that can be fabricated at chair side in a fairly short period of time.The technology is awe inspiring, however fit and aesthetics have raised some questions amongst practitioners. Perhaps the biggest barrier is cost. The system is priced around $90,000. The argument is that the lease cost is $1800 per month, and the practitioner will save this amount each month in laboratory expenses. Twelve restorations per month at $150 each will cover the lease cost. It is seldom mentioned that each block of Vita Mark II porcelain costs $25 and accessory materials such as milling diamonds and impressionspray all add additional expense.
Recent reports from CRA and other research have brought some of the new processed composites to the forefront as viable replacements for traditional crown and bridge materials. These new materials include belleGlass, Sculpture/Fibrecore, and Targis/Vectress.
My interest in belleGlass in particular began when I took the laboratory technician course offered by Kerr on the belleGlass laboratory system. I purchased the system last year, and have fabricated in excess of ten restorations per month since then.
My frustration with this system was not with the material, or it’s fabrication, but with the fact that there was no impression material on the market that would allow me to make a fast setting, accurate impression and be able to pour it within a few minutes. The crown and bridge impression material that I have used for the past ten years with great success cannot be poured until two hours from the onset of mix has passed.
We have made all of our restorations over the last year by pouring the impression the next day and fabricating and delivering the restoration in the next day or two. This is still an incredible improvement over the traditional two weeks or more that a commerciallaboratory takes. Tissue is healthy and patient care of the provisional is almost irrelevant. This is critical with bonded restorations. Besides, we live in a society accustomed to fast delivery in an era of FedEx and the Internet.
A new impression material introduced recently by Parkell has changed the way we deliver some of our restorations. Cinch 90 allows us to pour our impression five minutes after mix. The material is removed from the mouth in 90 seconds. That’s a big patient benefit and a time saver for the dentist. Our stone takes ten minutes to set, so we have a working model within 15 minutes of the initiation of mix of the impression material.
Paragraph about Cinch 90 and it’s properties and cost.
A belleGlass restoration requires about ten to fifteen minutes of my time (or my assistant’s – she makes beautiful restorations!) and then ten minutes in the oven for complete polymerization. A few minutes of finishing, contouring, and sand blasting the interior takes about three more minutes.
We are ready to go the mouth in forty minutes. Remember that the doctor can be performing other procedures during most of the forty minute time period.
This enables the dental team to provide a high quality indirect restoration in one visit.
The cost of the material with belleGlass is about five dollars per restoration. The cost of the system is $5000. This must be amortized over each restoration. The more you do, the less relevant the system cost becomes. It takes a very long time and a great number of restorations to justify $90,000, as with CEREC.
The cost of the other half of this equation, Cinch 90 is six dollars per impression. This combination is a Ferrari at the cost of a Chevy. How often do we see this in dentistry?
