Sophisticated Laboratory Equipment -
Necessary for Ultimate Quality of Care—Page 2

On page one, we showed some of the sophisticated laboratory equipment that allows Dr. Chal to produce only the highest quality of dentistry for every patient. That equipment allows him to create models of the teeth that are as accurate possible, so that every restoration in your mouth fits precisely and functions perfectly. On this page we will explore what Dr. Chal does with these models to insure a predictable, successful outcome for every case.

Every laboratory-fabricated restoration is first created as a prototype before it is created in its final form. This begins with a laboratory preparation phase. He will drill on the models of your teeth on his laboratory workbench before he ever puts a drill in your mouth. Not only does the ensure that the goals he envisions for your case can actually be accomplished, but it maps out an exact plan for achieving those goals.

The photographs below are an example of a recent case. He has prepared the posterior teeth on the model to help him design the ideal occlusion for this patient. One of the things that makes this possible is the use of the sophisticated articulator (engineering instrument) that is capable of reproducing all of the natural movements of the patient's jaw. As mentioned on the previous page, fewer than 5 percent of all dentists use these articulators, even though they were taught in dental school to use them. Fewer still use articulators with this degree of sophistication.

As all well-trained cosmetic dentists know, the foundation of every successful smile design is the incisal edge of the front teeth. Placing this incisal edge accurately is not only fundamental to good esthetics, but is fundamental to proper speaking and jaw function. For this patient, where the incisal edge is in the correct position, it is important to keep that as a landmark while the posterior teeth are prepared. The posterior preparation is shown above.

Below, Dr. Chal has continued with this complete oral reconstruction by now preparing the anterior teeth on the model. The proper inter-occlusal dimension is now marked by the incisal guide pin that has been inserted in the front of the articulator.

Following the tooth preparation, Dr. Chal uses a titanium-impregnated wax to reconstruct the teeth. This is not a simple matter. Jaw movements are extremely complex. There are protrusive, lateral, and up-and-down movements, and if there are any discrepancies, the patient can experience jaw disfunction, a disorder that is marked by spasms, headaches, and other maladies. Dr. Chal is an expert in jaw function and lectures on this topic to other dentists internationally. He collaborates with his expert laboratory technician, Rick Durkee, CDT, AAACD, to develop the architectural blueprint of the esthetic and functional reconstruction.

As a patient, you will also be brought into this process. The fundamental requirement of all dental esthetics is that the smile needs to be pleasing to the patient. You will therefore have an opportunity to review the esthetics of the case at every point, so that when the work is done, it will not only be comfortable and functional for you, but you will be thrilled with the appearance.

In order to transfer this functional and esthetic design to your mouth, these models with the waxed teeth are duplicated with a special silicone material to help create a hard stone model of this design. In the photograph below, the duplicated models are shown on the left, and the clear plastic guides that transfer the design to the mouth are shown on the right.

Creating a clear plastic guide that has the level of accuracy that is needed requires more highly specialized equipment. Below is a photograph of Dr. Chal's Biostar unit. It generates five atmospheres of pressure to create a highly accurate preparation guide and matrix for the stage one prototype restoration. The model is positioned on the unit, as shown, ready to create the guides.

This Biostar unit is not only used to create the preparation guides, but is also used to create prototype restorations. As mentioned above, every laboratory-fabricated restoration Dr. Chal makes is first created as a prototype, to make sure that it meets all the functional, comfort, and esthetic requirements of the patient. Accuracy is supremely important in this process.

The Biostar is also used for the creation of TMJ orthotics. These appliances are important in the treatment of TMJ disorders. They restore harmony to the jaw function of patients who many times have severe pain because of discrepancies in their bite. Accuracy is also important for these orthotics.

Then, once your surgical guides, prototypes, or TMJ orthotics have been fabricated, they need to be trimmed and polished at the Quatro Air Technologies grinding station.

Below is a photograph of some of the selection of burs, trimming stones, and polishers that are used. There are various types and grades of abrasives, and each has its specific purpose in the process.

Below is a photograph of the Quatro Air Technologies vacuum grinding station. The grinders, burs and polishers are held by the motor unit so that both hands can be used to hold and guide the restoration. The loose particles created by the grinding and polishing are picked up immediately by the vacuum.

Here Lesa is custom tinting the prototype for eventual glazing in the Triad oven, which is to the right of the lamp. She is highly skilled in the esthetic characterization of these restorations. Dr. Chal has treated many media and Hollywood patients who have been seen on television and on film wearing their prototype restorations, looking only like they had a beautiful, natural smile. But that is one of the purposes of the prototype—it needs to closely mimic the final result to help Dr. Chal know if any modifications are needed before the final restorations are created.

The next step is to clean the inside of the restoration with the glass bead blaster pictured below. This precision instrument, made by the German Denerica company, will clean the prototype restorations and the final zirconium or ceramic restorations. It is like a sand blaster, but it uses tiny glass beads instead of glass.

The glass bead blaster is accompanied by a vacuume unit below that separates out the debris from the glass beads.

The photograph below is of Dr. Chal's porcelain furnace. Having this on the premises rather than in a distant laboratory the way most dentists do enables Dr. Chal's expert crown and bridge technician, Rick Durkee, to customize the restorations right at the chairside. For example, when Jennifer was anxious to get her beautiful zirconium bridges in place in time for her wedding, Rick sat at this furnace and detailed the esthetics of her case while she sat fifteen feet away in the dental chair. (Click here to read about Jennifer's case.) This Ney Centurion porcelain furnace is computer-controlled, and generates temperatures of up to 1700° F.

After final tinting and characterization and then being fired in the furnace, a zirconium bridge will come out looking like this:

The fit and appearance of the bridge is then verified on a precision model of the patient's prepared teeth, as shown below.

The final step for the restoration is sterilization in the steam generator, pictured below. It steam cleans and sterilizes the restoration so it can be inserted in the patient's mouth.