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5/16/2018
1
The Nuts & Bolts of Veneers
TODD C. SNYDER, DDS, FAACD
Accredited Fellow, American Academy of Cosmetic Dentistry
Fellow, International Academy for Dental Facial Esthetics
Member of The American Society For Dental Aesthetics
Former Faculty, UCLA Center For Esthetic Dentistry
Todd Snyder, DDS, FAACD, FIADFE, ASDALaguna Niguel, CA
Aesthetic Dental Designs®
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To Learn:• Preparation Designs• Tips & Materials• Provisional Techniques• Cementation Protocols• Technology
• a d d fadf jas
Why Are YOU Here?
• a d d fadf jas
What Do YOU Want?
• Advertising
• Staff Training?
• Office Appearance
• Expertise
• Emotion and Value
• Financing?
• Follow up?
Will That Get You What You Want?
More Patients, Money etc…
Better Outcomes?
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According to the American Academy of Cosmetic Dentistry 50% of patients are
unhappy with their smiles and 3 out of 5 people will invest in their smiles.
How Do You Get More Cases?
Consumer/Patient Impression
• Do they know what a Cosmetic Dentist is?
• Do they perceive you are one?
• Will they go somewhere else because they think you are a family dentist?
• Do they think you are capable of providing a great smile for them?
• How can you alter their perception?
• What is your brand image?• Your office appearance?• Website?• Your ads?• Your social media?
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Invest in technology.
-Office iPad (Large)
-35mm Digital Camera
-Big Lobby Television
-Software Systems
Personal Case Books
Office Displays
Referral Cards
Gift Cards
Custom Smocks & Bleach Kits
Modern Tools**
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One of the most powerful & fastest tools you own to create cosmetic opportunities??
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WHITENING
Immediate Call to Action Motivator
Start Here
Over-the-Counter Teeth
Whiteners: $1.4 billion
(MSNBC) ...
(Consumer Reports).
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Over The Counter Whitening
Whitening
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Opalescence GO!• Fast, Easy, Effective, Better
Experience• Convenient & affordable
professional whitening to GO• Pre-loaded, disposable UltraFit™
tray for a custom-like fit• Molar-to-molar coverage• No chair time
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Reduce or Eliminate Sensitivity
• Potassium Nitrate & Fluoride
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Opalescence Go Sample Tower
“Total annual revenue in the teeth whitening industry topped $11 billion at the beginning of
2015, with $1.4 billion spent on teeth whitening products. These figures suggest a steady annual increase in the teeth whitening market industry, which is expected to continually climb over the
next 10 years” AACD Research
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So why are people willing to pay top dollar for a beautiful smile
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Cosmetic Alterations
• How many of you want to buy something sight unseen?
• How many of you want to experience something first before investing?
• Your patients are no different!
• They are concerned about how it will look and feel. They want to be excited and happy!
• Don’t Just Tell…..Show & Tell!
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The Key to Success:
VisualizationWhat is the patient’s perception or desired outcome in their mind to create the EMOTION and DESIRE?
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• Designed for dentistry
• 8 modes
• 12 Megapixels
• Dental cropping and grid lines
• Large LCD touchscreen
• Water and chemical proof
• Durable rugged Exterior***
• Fast autofocusing & anti-shake capabilities
• Held with one hand – weighs only 1lb
• Compatible with the Eye-Fi X2 card –
Immediately upload images onto PC, iPad,
Tablet or Smartphone
EYESPECIAL C-II (SHOFU)
MAGNIFICATION RANGE• Chose the magnification ratio/range by rotating the dial key
• Icons to help you determine and select the range properly
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STANDARD MODE
EDIT & DRAW FUNCTION ON THE
EYESPECIAL C-II
• Edit functions are ideal for
patient education
• Under the Menu key you can:
• Draw on images to show
areas of focus
• Rotate the image
• Protect the image against
being deleted
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WHITENING MODEFOR SHADE COMPARISON BETWEEN BEFORE AND AFTER WHITENING
• Similar to “Low-glare” mode but with lower light intensity
• Reduces glare and emphasizes the surface texture and shade
• Delegated Whitening & Imaging Assistant
Upper arch whitened
Lower arch not whitened
ISOLATE SHADE MODEFOR OPTIMAL SHADE MATCHING
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EyeSpecial C-III
Quadrant Dentistry
35mm Pro
EyeSpecial C-III35mm Pro
Cosmetic Dentistry
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EyeSpecial C-IIIKodak DCS-N
Cosmetic Dentistry
What do they want or envision?
Look at books or your cases.
Bring in examples of smiles.
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Everyone has an opinion & priorities
How WHITE?
Translucency?
What Texture?
Color Transitions
What about example
pictures?
◆ Are they relevant and
realistic?
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REALISTIC
Photographic Manipulation
• Cosmetic “Imaging” Software• SmileFy app• PreVue app• SmileVision• DentalGPS• DSD
• Digital Agents• Virtual Smiles ($125/image)• DreamSmiles (<$4000 a year?)
• Ivoclar/Kapanu?
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Why Does this Work?
✓Creates awareness
✓Suggests the possibility
✓Promotes discussion
✓Provides bridge to clinical evaluation and
presentation of options
✓Creates EMOTION and DESIRE
Digital Smile Mockup
-is a proven practice building program that can:
Dramatically increase your patient’s interest in a smile
transformation
Remember, 50% of your patients want to improve their
smile
The goal is to help them visualize themselves with an
improved smile
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When you hand a Digital Simulation to your patient, you plant a seed of what is possible, a constant reminder of what their potential new smile can be. They can show it to their friends and family, you can put a copy in their chart for follow-up, have them hang it on their refrigerator...!
VIRTUAL SMILES©
• Tooth shape
• Length, width, & style #
• Tooth color
• Translucency, effects
• File Format
• Paper
• CD
• Flash
• Logo & Office Info
• Smile Simulations
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SMILE DESIGN SOFTWARE VS DRAG AND DROP SMILE GALLERY?
Overall Feel
Appearance…what is it? who decides, Dentist? Ceramist? Patient? Combined effort?
THEIR DECISION √
BUT YOU HAVE TO GUIDE THEM
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The Key to Success:
Traditional Veneers
Diagnosis & Treatment Planning
The Key to Success:
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Traditional Veneers
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You are selling the Emotion…
Do you know “THEIR” desired outcome?
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MARKETING
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Advertising Evolution- Internet & Social Media
• Traditionally Marketing was Expensive• Internet is very Inexpensive comparitavely• Website (SEO Management/Quality Code/Page Speed)• Reviews• Social Media (need to claim them all with same name)
• YouTube• Facebook• Twitter• Flickr• Instagram-no cost High Return
• Cosmetic Imaging• In Office • OUTSIDE OFFICE?
Google Website Speed, Responsive Design and Build Issues/Code
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WEBSITE PAGE SPEED IS VERY IMPORANT (and so is relevant content too)
https://www.wordstream.com/blog/ws/2018/01/22/google-speed-update
Jan. 22 2018
https://webmasters.googleblog.com/2018/01/using-page-speed-in-mobile-search.html
Jan. 27 2018
https://www.forbes.com/sites/jaysondemers/2018/01/29/will-googles-new-page-speed-criteria-affect-your-site/#6c3dbe8f6a8f
Jan. 29 2018
July 2018
CHECK YOUR PAGE SPEED
https://developers.google.com/speed/pagespeed/insights/
CHECK YOUR PAGE SPEED
MOBILE FRIENDLY?
https://search.google.com/test/mobile-friendly?id=De1nibkdCgXmmSqhS04nzw
https://validator.w3.org/nu/?doc=https%3A%2F%2Fwww.blux.com%2F
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NGenys
Pronounced Ingenious
Websites, Photography, Brand, Social Media and More
www.NGenys.com
Proof of Work / Transparency
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• There never seems to be enough of it…
• It has to be built into the schedule or out source to employee
• Take the time to huge profit
• Know what the case is going to entail ahead of time
• What is the patients Chief Complaints?• Pick 3 to address
• Why do they have these problems?
• Are they going to drive you crazy?
Time
• Immediate Smile Change Consultation?
• Can they come back in a week?
Time (CONSULTATION)
OR
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-Patient wants to fix the small
lateral incisor
-No tooth reduction
OPPORTUNITY
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Beadline Provisional Mockup
Beadline Provisional MockupBeadline Provisional Mockup
Diagnostic Models with a waxup are duplicated. Special over impression is created and used to deliver temporary mockup
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LISTEN For Yourself
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Show & Sell Possibilities..
COSMETICChanges
3 out of 5 • Patient came in to fix small lateral incisors
• Wants “Absolutely” no tooth reduction
• What drives him?• Appearance
• No Tooth Reduction
• Emotion
• Desired Outcome…. Feel Better, more confident?
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Results
Confidence, Dating,Work,Emotional Goals
Cosmetic Dentistry
• Do YOU WANT more Cosmetic Cases?
• Patients desire a change• But don’t know what they want (typically)
• What are their Chief Complaints (pick 3)
• Why?
• And What will that accomplish? Reasoning behind Tx.
• Always look at the big picture
• Take photos
• Write down where they can see their Chief Complaints• Signature on waxup
• Signature on provisionals
• Signature for final cementation approval
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Free TIPS on my Instagram Story
2 New Smile TIPS coming soon!!
How Do We Create The
Intraoral Mockup?
• First take an impression of teeth with a material that allows you multiple repours.
• Want one original model
• One model for laboratory
• Extra model if you need bleach trays or practice preparations
• Photos
• Facebow
• Horizontal Plane Indicator
• Teeth that are too far facial will remain untouched. When photos are taken they will be less obvious.
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Final Impression
• Pack #00 ReCord
• Take final impression with light body PVS (Affinity) and heavy body PVS (Affinity) tray material
• Use a custom HeatWave Tray
Final Impression
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Final Impression
Final Impression
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Final Impression
REVIEW
• Existing In Office Patients (3 out of 5) want to fix their SMILES!
• Shade Evaluation every exam & everyone in Hygiene Department
• Website, Social Media Accounts all setup and posting RELEVANT content
• Photos of everyone to send home (possibly with imaging) GET A CAMERA
• Take a photo and do a Cosmetic Simulation/Mockup
• Instant visualization through software on an iPad or possibly internet
• Instant Composite Mockup in the dental chair
• Take an impression and have lab do a waxup to facilitate a Beadline
Provisional Mockup (reduced fee or no fee agreement with lab)
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Diagnostic Models & Records
Silginat - Kettenbach
Counter FIT- Multipurpose Replication Silicone
(Clinician’s Choice)
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Counter FIT- Multipurpose Replication Silicone
(Clinician’s Choice)
Silginat - Kettenbach
Wear Facets & Interferences
3 Sets of Models-One is untouched for legal documentation-Second to practice preparations (It will be waxed up)-Third is a spare to practice on or make bleach trays
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Mounted and Equilibrated
—MEG BIRAM
111
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TRAIN
Are you confident in creating beautiful outcomes on anterior teeth quickly &
easily? IF NOT, PRACTICE!
1
Tooth Size Averages
2nd Premolar 1st Premolar Canine Lateral Incisor Central Incisor
6.6mm 7.1mm 7.6mm 6.6mm 8.6mm
7.7mm 8.6mm 10.6mm 9.8mm 11.2mm
Width
Length
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0.6-1-1.68
Golden Proportion Measurement.
SculptPad (Ivoclar)
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• Practice Preparations
• Waxup
ADDITIONAL TOOLS
◆ Panadent: Multi Purpose Ruler
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◆ Erskine: Dentagauge 1 & 2
ADDITIONAL TOOLS
What Records & WhenDiagnostic & Prep Reduction Models
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Diagnostic Guides
Diagnostic Guides
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No Preparation Veneers
No Prep Veneers• Do a waxup
• Duplicate into a stone model
• Over impression of stone model w/ PVS BEADLINE TECHNIQUE or Siltech Putty
• Intraoral mockup using the over impression filled with temporary acrylic**
• Is thickness and appearance okay?• Depth cuts through over impression if necessary.
• Typically no provisionals are necessary
• No undercuts
• Color change varies based on tooth position/color
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Tooth Preparation Conservative Preparations
Mockup & prep
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No Prep Case: 1
• Angulation of teeth
• Spaces
• Lingually positioned
• Lack of lip support
• Thinned enamel
• Fuller smile
• Microdontia
• Chairside Mockup**
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Mockup & prep-Minimally invasive
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Mockup & prep
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Mockup & prep
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Mockup & prep
Preparations
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Veneer Preparations
• Depth Cuts
• Tooth Reduction
• Margins
• Retention Form (Line of Draw)
Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”
Veneer Preparations
• Depth Cuts
• Tooth Reduction
• Margins
• Retention Form (Line of Draw)
Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”
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Veneer Preparations
• Depth Cuts
• Tooth Reduction
• Margins
• Retention Form (Line of Draw)
Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”
Veneer Preparations-Feldspathic Porcelain
Depth cuts of 0.2mm-0.8mm*
1.0mm-1.5mm incisal reduction*
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Veneer Preparations-Pressed Ceramics
Modern Ceramics
• Stand Alone Strength Properties
• Feldspathic (80-120 mpa)
• Lithium disilicates (360-500mpa)
• Lithium silicate (373 mpa)
• Zirconia (Monolithic 640-1200 mpa+)• Layered Zirconia Feldspathic (80-120mpa)
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Incisal edge preparations
a) No incisal lengthening
b) Changing color or wear
c) Lengthening tooth
Veneer Preparations
Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”
labial reduction options Depth Limiting Burs - Brasseler USA
Average enamel thickness
At CEJ .3-.4 mmMiddle third .8-1.0 mmIncisal third 1.1-1.3 mm
Veneer Preparations
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Preparation Reduction• Depth reduction burs
• Safe reduction
• Lasco
Veneer Preparations
Independent Depth Cuts (Lasco Burs)
▪ Depth Cuts▪ Tooth Reduction▪ Interproximal & Margins▪ Retention Form (Line of Draw)
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Burs• Organization
• Diamonds
• Carbides
◼ K0096 Finishing Kit $126.47 each
◼ K0095 Preparation Kit
$125.47 each
Preparation
Aesthetics
Function
Bonding to Enamel
Material Options
Minimal Prep Case: 2
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Minimal Prep Case:
Wax-up Case:
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Preparation Guides:
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Disposable Single Use Diamonds-medium or coarse grit
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• NeoDrys
• NeoDiamonds
• Bite-Check 18um
Offer not valid for previous purchases or in conjunction with any other offer.
Free Pack of NEODiamonds
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• Photomed (818) 908-5369
SHADE SELECTION
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Shade Assumptions
BW, B1, B2, A1, A2
Provisional Techniques
-Free hand
-Beadline Provisionals
-Putty over impression of waxup
-Premade temps?
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Review-Chief Complaint
-Occlusion
-Photographs/Imaging?
-Whiten first
-Waxup/BeadLine Provisional
-Material Selection
-Practice Preps
-Photograph Prep Shade
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EMOTIONFocus on overall appearance
Stay away from little details
“Going to look & feel great”
Instant Ortho/Un-Rotating Teeth
• Do initial workup
• Diagnostic preps
• Diagnostic waxup
Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”
◼ Sequence
– Reduce all excess tooth structure
– Ideal reduction
– Margin placement
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Cementation**
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Selection Process
◦ Open Bite Trays
Plastic-full or quadrant
Metal-full or quadrant
Custom Trays
Non-perforated or perforated (metal or plastic)
Rigidity can eliminate tray distortion and rebound
Spring back after impression is possible with plastic
Cross arch stabilization
Ideal occlusal stops for proper model articulation
Able to recreate excursive movements if mounted on a
semi or fully adjustable articulator.
Potential for errors & adjustments are low
Impression Trays
Custom trays create more
ideal placement
Thinner material creates
less distortion
USE TRAY ADHESIVES for
all open bite trays, not just
custom trays.
Only negative is time
Impression Trays Selection Process
Custom Tray
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▪ 4 upper & lower trays
▪ 60 sec. @ 158°F
▪ Fast, efficient
▪ Virtually custom
▪ 30% less impression
material used
Impression Trays
HeatWave by Clinician’s Choice
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Impression Trays
HeatWave by Clinician’s Choice
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Impression Trays
HeatWave by Clinician’s Choice
Dry all teeth in arch
Place tip in most difficult area first
Keep tip on margin and immersed in material
Go around entire margin first
Next go to adjacent teeth
Then do coronal aspect of teeth
Double Mix Single Impression is the most accurate
Syringe Placement
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Ultradent’s NEW Thermo Clone VPS
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Simplified Provisionals**
Siltech Putty Matrix
Bead Line Veneer Provisional Restorations. Pract Proced Aesthet Dent 2009;21(3):E1-E7.
Duplicate waxup model in stone
Scribe a 0.5-1mm line with a sharp instrument into the
model where the tissue and tooth come together.
Provisionals (Bead Line Technique)
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Duplicate model with a fast setting polyvinyl impression material.
I have used light and medium body washes with a heavy body tray
material.
Provisionals (Bead Line Technique)
Provisionals (Bead Line Technique)
The scribed line creates the Bead Line in the over impression of the cast.
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The Bead Line in the over impression creates pressure along the tissue
and preparation margin. This causes a thin cut or separation of the
acrylic flash from the provisionals for easier clean up.
Provisionals (Bead Line Technique)
Typically the excess acrylic can be removed with fingers, a spoon or discoid instrument. Minimal
to no effort is required to remove excess flash. If a void or a margin is exposed simply fill the
void with a flowable. Etching and a bonding agent are not required as the flowable will adhere to
the air inhibition layer of the temporary acrylic and you do not want to adhere to the tooth.
Provisionals (Bead Line Technique)
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The Bead Line Provisional Technique creates less work and risk of damaging tissues and tooth
structure. Typically the process takes 5-10 minutes to make provisionals. Consepsis (Ultradent)
can be placed on the teeth and dried prior to fabricating provisionals.
Provisionals (Bead Line Technique)
-Visalys (Kettenbach)
-TempSmart (GC America)
-Inspire (Clinician’s Choice)
-ExperTemp (Ultradent)
Provisionals
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Cling 2 (Clinician’s Choice) for all my full crowns & bridges,
retentive inlays & onlays.
My Favorite Temporary Cements
ClearTemp LC (Ultradent)
For either veneers or thin
anterior cosmetic restorations
-Aesthetics
-Function
-Gingival Embrasures
-Excess cement
-Patient homework & questions
Post-Op Check
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From Imaging & Diagnostic Wax-up the entire case was duplicated
Case #4: Single Tooth Aesthetics
Veneers
Function
Gingival Bonding
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Remove old restorations & repair abfraction lesions on cervicals
• Stump Shade (dehydration factor)
Base Shade
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• Contact lens effect
• At or above gingiva
• Masking tooth or color changes
• At gingiva, then place cord and
reduce another 0.3-0.5 mm
Veneer & Crown Margin Placement
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Impressions
Facebow & Wax Bite Registration
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Provisionals
ULTRADENT• Nanohybrid
• Superior handling
• High polishability & gloss retention
• Exceptional wear
• Unique syringe design
• Intuitive shade offering
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Three Shades of Mosaic
Three Shades of Mosaic
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Free Hand Provisionals
Free Hand Provisionals Example
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• Materials
• Rigid Bite Registration
• Light and Heavy Body
Prefabricated Over Impression
AESTHETIC RESIN TEMPORARY CEMENTS
• Materials
• Bifix Temp-VOCO
• TempBond Clear-Kerr
• ClearTemp LC-Ultradent
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Before & After Photos
Mixed Provisionals
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Waxup, Reduction Guides &
Temporaries (Case 6)
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Preparation Guides
Preparation Guides
A-TYPE PREP
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Removing provisionals that are locked on.
Removing provisionals that are locked on.
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Nine Years Later
QUESTIONS?
Red Blood Cells 2 – 5um
200-500nm
Human Hair 60 –120um
6,000 – 12,000nm
?
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Shimstock & Articulating Paper
What do you use…..
.…and why?
Parkell Accufilm II is 21µm for
dentistry
Great Lakes articulating
ribbon 12µm
8µm Almore Shimstock foil
8µm articulating paper??
Shimstock & Articulating Paper
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What do you use…..
.…and why?
8µm articulating paper
Available in blue
And red too!
TrollDental-8µm Articulating Paper
TIP
Booth # 573
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What Percent of Impressions per
Laboratories have visible
errors?
89%
1-Samet N, Shofat M, Livny A, Weiss EI. A clinical evaluation of fixed partial denture
impressions. J Prosthet Dent 2005; 94:112-117.
And the key to remember, routinely, it’s voids, bubbles, and tears
“Approximately 90% of impressions have defects” G. Christensen
▪ Superoxol
Epinephrine
Ferric Sulfate
ViscoStat 20%
Astringent 15.5%
▪ Aluminum Chloride
Viscostat Clear 25%
Expa-syl
Hemostasyl
▪ Aluminum Sulfate
Tissue Goo 25%
▪ Various Cords
Astringents Enhancing Moisture Control
Fluid/Tissue Management
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Fluid/Tissue Management
Fluid/Tissue Management
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Fluid/Tissue Management
Lasers (Diodes) Fast
Hemostasis
No crevicular fluid
No cord
Better healing
Enhancing Moisture Control
Fluid/Tissue Management
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Aesthetic Contouring
Aesthetic Contouring
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Time??
ROI??
Aesthetic Contouring & ExperTemp Provisional
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Features
• Number #1 dental laser in the world
• More power – 3 watts
• New easy to use presets
• New treatment timers for perio treatment
• Wireless foot control
• Optional battery pack
• Perfect for first timers or hygienists
• Affordable
• Disposable tips or fibers
• Certification included
• MSRP: $4,495
• CE Price: $3,495
Use code
CESNYDER18
AMD Picasso Laser Tissue re-contouring
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Make cases easyIdentium for multiple teeth
Make cases easy, make your patients happy
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Make cases easy, make your patients happy
RESTORATION PLACEMENT?
• Bonded
• Margin placement
• Moisture Control
• Technique Sensitive
• Materials
• Self Adhesives
• Bonding agent (TE or SE) & luting resin
• Cemented
• Margin placement
• Moisture Tolerant
• Retention Required
• Materials
• RMGI
• Ceramir
Cement Selection
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RESIN CEMENT COSMETIC CASES….
COSMETIC CASES….
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COSMETIC CASES….
COSMETIC CASES….
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COSMETIC CASES….
COSMETIC CASES….
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COSMETIC CASES….
COSMETIC CASES….
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COSMETIC CASES….
COSMETIC CASES….
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PROVISONALS
PROVISIONALS
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CERAMIC TRY-IN
• Make sure it is etched properly from lab
• Ceramic Primer prior to try-in (unless using Ceramir)
• Ultrasonic with ethanol after try-in
BONDS WITH OR WITHOUT HF
ACID ETCHING
THE “NO-WATER” SILANE w/ MDP
INSTANT ACTIVATION
LESS DEGRADATION
(More Stable 2 Year Shelf-Life)
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Silanes
Universal Adhesives (w/MDP)
Silane Primer + MDP
Organo-Phosphate Monomer (MDP)
Silane Primers
A disadvantage of many other silane products is that they are pre-
hydrolyzed.
Another disadvantage is some require the use of Hydrofluric Acid
etching and sometimes in addition to Micro-Etching. The new
Monobond Plus requires HF and Micro-Etching as well as 60 minute
activation time period.
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TRYIN APPROVAL
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3 VITA® shades
2 chromatic shades
LITHIUM DISILICATE & SILICATE, LEUCITE AND FELDSPATHIC
RESTORATIONS
IS AN ADHESIVE CEMENTATION
SYSTEM THAT IS EASY-TO-USE,
EFFICIENT AND HIGHLY
EFFECTIVE
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FINAL RESTORATIONS
Veneer Finishing System
FREE SAMPLES AT BOOTH TODAY
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ContacEZ Restorative strip system
• NEW Gold Narrow Strip 0.10mm single sided medium diamond grit Sub Gingival Trimmer w/ Blank Clear Gateway
• Black Diamond Strip 0.06mm fine diamond single sided
• Orange Serrated Diamond Strip 0.05mm extra fine diamond single sided
• White Serrated Strip 0.035mm
• Blue Serrated Strip 0.065mm
• Gray Final Polishing Strip 0.05mm ultra fine diamond single sided
ContacEZ IPR Optional Strips
• Clear IPF Single Sided Opener 0.10mm med-fine diamond
• Cyan IPR Single Sided Widener 0.12mm med-coarse diamond
• Purple IPR Super Widener 0.25mm
coarse diamond
• Brown IPR Mega Widener 0.30mm coarse diamond
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• More efficient than Halogens
• Halogen produces light from 370 to 800 nm then filters out all
but blue light in 400-500 nm range
• Longer lasting / Cordless / Batteries
• Faster curing (5 seconds)
• Smaller in size/lighter
• Less heat
BENEFITS OF LED LIGHTS
Comparisons - Lights
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VALO DELIVERS
Access to the curing site = Energy to the resin
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Machined from Aerospace Aluminum
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• Design• Power• Durability• Access• Posterior tooth• Broad Light Output Range
– 395-480nm
• Cost• Weight
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IT’S ALL ABOUT THE LITTLE DETAILS
QUESTIONS?
THE POWEROF
ACTIONABLE METRICS
.
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Online Real Data
THE POWEROF
ACTIONABLE METRICS
.
TIP
TWO WAYS TO INCREASE PRODUCTION
PATIENT Visits PRODUCTION on Visits
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NEW PATIENTS
HOW MUCH DO WE REALLY LOVE THEM?
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RECAPTURED
PATIENTS
47 $65,114
345
Before AfterHygiene Re-Appointment
$167,400 increase through Actionable Metrics
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Hygiene Re-Appointment
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REAPPOINTMENT METRICS
How well is your staff
reappointing patients?
How many people are
past due?
You run a report?
How do you follow up on
the report?
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Slipping Through The Cracks
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Delivering Best Dentistry
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Accuracy, Consistency, Data
• Get an analysis of your company and see where you can make more money and be more efficient!
• Hard to make more when You have no idea what you are missing!
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Text “action” to: 77453
Text RaceData to 77453
TIP
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Cementation of Anterior
crowns
• Alkaline pH 8.5
• Moisture Tolerant
• Self Sealing
• Apatite Formation
• Insoluble/No Degredation
• Stronger with time
• Semi / Translucent
• Biocompatibility-Excellent
• Bioactivity-Apatite formation
• No silane, conditioning, bonding
CERAMIR ® CROWN & BRIDGE**
Cement Selection
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Bioactivity by Doxa
A reactive bioactive system that contributes to hydroxyapatite mineralization of hard tissue through ion release and alkaline
pH.**
Cement Selection
CEMENTATION TECHNIQUE
Cement Selection
Mix for 8-10 seconds
3-4 restorations
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LITHIUM DISILLICATE (EMAX) OR ZIRCONIA
• Silane is contraindicated
• Tooth etching or conditioning
is not necessary
• Bonding agent is not needed
Cement Selection
CROWN RETENTION• Results Zirconia crowns (Kg/F)
Material Result (Zirconia crowns) Kg/F
Ceramir Crown & Bridge 32.1 ± 6.3
RelyX Unicem (3M) 27.8 ± 11.3
Dyract Cem (Dentsply) 12.2 ± 3.1
Rely X Luting (3M) 10.9 ± 6.5
0
5
10
15
20
25
30
35
Ceramir Crown & Bridge RelyX Unicem (3M) Dyract Cem (Dentsply) Rely X Luting (3M)
Cement Selection
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Cement Selection
Cement Selection
Journal of Esthetic & Restorative Dentistry March 2015
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Case #11:
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Cement Selection
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Case Review
• Maintain Centric Occlusion
• Facebow & Wax Bites
• Beadline Provisionals
• Simplify Cementation
• Silane is contraindicated
• Tooth etching or conditioning
is not necessary
• Bonding agent is not needed
Technique Research/Literature**
• Moisture Tolerant
• No Sensitivity
• Alkaline pH
• Apatite Forming
• Insoluble
• Stronger With Time
• Self Sealing
Remember The Old Appointment Book?
How LONG Did It Take To Answer A Question About Balances, Forgotten
Appointments?
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TIP
• VOIP Phone System Integrates with your existing dental practice management software (DPMS)
• Dentrix
• Dentrix Ascend
• Eagle Soft
• Easy Dental• SoftDent
• Practice Works
• Mac Practice
• Open Dental
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Teamwork
• Auto confirms appointments and adds to the Practice Management Software
• Auto Birthday Messages
• Auto propagation of messages
• Easy to implement with minimal time to use.
• Improve business opportunities dramatically
• Cuts down on current employee time by streamlining many tasks
• Saves money on traditional procedures
– Less postage
– Less paper goods
– Less employee time
Online reviews• 2011 33% reported they did not trust online reviews.
• A recent study reported 88% of people trust online reviews
• 92% or internet users read product reviews
• 89% said it influences their purchases
• 74% of internet users said they would most likely not do business if there was a negative review
• Currently having one bad review is considered normal, but lots of bad reviews is not good.
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Reviews text message
Reviews text message
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Reviews text message
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Weave Reviews Via Cell phone message • Select Ratings to be sent to:
• Google• Yelp• Facebook
• Customize Order of Review Sites
• FYI-A dental/medical office can have more than one listing on Google, Yelp etc.. Because they typically employee more than one doctor as well as the business name (ie. Aesthetic Dental Designs and also Todd Snyder, DDS and my Associate can have a site too, just use different phone numbers and emails)
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Weave Mobile App
-Same functionality
-From anywhere you have a wifi or cell connection.
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WEAVE IS THE BEST SOFTWARE TOOL I OWN
• It lets me do more in less time than what it would take three people to do in an hour.
• It replaces your existing phone with a Voice Over Internet Phone that attaches to your practice management software.
• It gives you the ability to cut your phone bill and be replaced with a modern phone platform that allows you to.
• Text your patients
• Record all phone calls
• Automated appointment reminders, follow-ps, post-op notices, birthday greetings, and more
• Collect balances instantly via text
• See unscheduled patients and have the ability to instantly send automated text messages to fill gaps in the schedule
• Newsletters and promotions
• So much more….. YOU HAVE TO GET A DEMO IT IS AMAZING!!
• THE COST IS TYPICALLY THE SAME AS YOUR EXISITING PHONE BILL BUT YOU GET RID OF YOUR PHONE AND FOR THE SAME COST YOU REPLACE IT WITH SOMETHING BETTER THAT MAKES YOU MONEY!
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TODD SNYDER(949) 643-6733
www.aestheticdentaldesigns.comwww.drtoddsnyder.com
www.toddsnyderracing.com
97% of offices don’t train.
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Technology Online
• Efficiency 24/7
• Accountability
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Unit 1 Introduction Rapport
Unit 2 Foundation of Rapport
Unit 3Fundamental Techniques in Handling People
Unit 4 Six Ways to Make People Like You
Unit 5 Mirroring & Matching
Unit 6 Outcome of Calls
Unit 7 How to Build Rapport
Module 5 Rapport 2: Personality types
Unit 1 The Know-it-All
Unit 2 The Storyteller
Unit 3 The Easy Peasy
Unit 4 The Rusher
Unit 5 The Informationalist
Unit 6 The Nervous Nelly
Unit 7 The Indecisive
Unit 8 The Price Shopper
Module 6 Rapport 3: Advanced rapport
Unit 1 Empathy
Unit 2 How Long to Build Rapport
Unit 3 VIP Process
Unit 4 Positive Language
Unit 5 Elements of the Rapport Process
Unit 6 Phone Success Quiz #02
Module 7 Engage: Foundation
Unit 1 Introduction to the Engage
Unit 2 What is Engage
Unit 3 Proactive v. Reactive Scheduling
Unit 4 GREAT vs. EAGER Calls
Module 8 Engage: Elements of engaging the patient
• 14 Modules
• Quizes
• Exam
• 13 Modules
• Quizes
• Final Exam
Module 5 Working with Emergencies
Unit 1 Emergencies
Unit 2Scheduling Quiz #01
Module 6 Broken & Changed Appointments
Unit 1 Introduction
Unit 2Broken Appointment Policy
Unit 3Handling Broken Appointments
Unit 4Broken Appointments COSTS
Unit 5What patients must know
Unit 6Important Points
Module 7 Confirmations
Unit 1 Confirmations
Module 8 Early and Late Patients
Unit 1Early and Late Patients
Unit 2Scheduling Quiz #02
Module 9 Next Appointment Updates
Unit 1Next Appointment Updates
Module 10 Patient Reactivations
Developing
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1. Telephone Skills
2. Customer Care Protocols/Scheduling
3. Team’s Role/Training
4. Resource Library
5. 24/7
97% of offices don’t train.
(954) 323-2220
Inquire with “Heather” for a $200 Discount
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www.Chip-In.org
You don’t want to miss what I am going to present in the coming months!!
Watch these Social Media Channels. Watch the Instagram Stories or Facebook Posts