Ambridge Ceramics produce digitally planned implant stent8 September 2014 Categories: Uncategorized
The team were fortunate enough to be asked to contribute their knowledge of Digital Dentistry and CAD/CAM restorations to a challenging case that Dr Mark Willings carried out using the immediate loading technique with his team at Dental Excellence Harewood.
It’s always very satisfying to see such great result when working with new implant systems and techniques.
We’ve been working with the Dental Wings system for many years now to create digital scans of our implant cases, and it’s a fantastic system that just gets better year on year.
The case was planned and produced here in the UK, which is a great example of a British Bite Mark laboratory always pushing forward and using the latest technology for our surgeons and their patients.
You can read the full print article using the link below
Ambridge Ceramics joined world class speaking lineup for ADi Focus on Digital Implant Dentistry 20144 September 2014 Categories: Uncategorized
Ambridge Ceramics was among the lecturers that discussed the latest technology and techniques at the ADi Focus Meeting on the 14th November 2014
This Focus meeting covered
Focus on Digital Implant Dentistry :
The Present – The Future
Using the years of experience and knowledge gained along with our surgeons and spanning many different digital systems and milling partners along the way, Steve will be sharing some of the key points that will make the use of digital tools and CADCAM for making your implant restorations a success.
As a British Bite Mark laboratory we are very proud that one of our technicians has been asked to share his experience along with a lineup of speaker who are leaders in their field from all over the world, including the founder of the Atlantis abutments system, which Ambridge Ceramics have been a pioneer of in the UK as a Beta tester before the official launch when it was acquired by Dentsply implants (at the time Astra Tech) and continued to use this market leading technology to provide our surgeons and their patients with unique restorative solutions as the range of CADCAM abutments and substructures provided by Dentsply implants continued to expand.
Dentsply Atlantis launches Conus Syncone Solution for implant overdentures in UK with Ambridge Ceramics5 August 2014 Categories: Uncategorized
A sneak preview of some exciting work we are doing with Dentsply Atlantis on a great custom solution for providing a secure stable option on removable implant dentition.
Atlantis Titanium Screw Retained Crowns are available to our clients prior to official UK launch30 June 2014 Categories: Uncategorized
In the recent months many of our surgeons have been benefitting from the biological advantages of our porcelain fused to titanium implant crowns.
Together we have catalogued many of these cases and they will be released after the official UK launch later this year but can give sneak preview of some of our work here.
One of the cases was this one we produced for Dr Papadopoulos where he had created the emergence profile that he wanted copying and captured that using a custom pickup which we could copy when producing the final crown.
In addition to the clinical benefits there is a significant cost saving to using these clinically superior crowns, for example you could be wasting well over £100 per fixture compared to a traditional cast screw retained crown, as shown below.
Traditional cast gold methods
Or much more on larger molar cases where more metal is needed to support the porcelain work.
But with Atlantis CAD/CAM Screw Retained Implant Crowns you have the benefit of consistent cost effective pricing, regardless of the size of the crown.
Steve Campbell is Lecturing for the ADi on CADCAM on the 2nd July26 June 2014 Categories: Uncategorized
Steve is Talking for the ADi at East Grinstead on Wednesday the 2nd July.
To see more about the latest CAD/CAM in implantology you can find more information or book here
Saving implant surgeons money and delivering better results21 March 2014 Categories: Uncategorized
Have you looked at the total cost of your implant restorations lately?
By that I mean the TRUE cost, both components and lab bills?
On our many Roadshow tours of the UK it was always surprising to see how many surgeons were wasting money and getting clinically inferior results.
So today I am going to share the slides form a short presentation we give that explains exactly how many surgeons are losing money without realising it.
How much does bad advice and support on restoring dental implants cost you?
That’s a lot of money, so how do we get to such a high figure? We start with showing the true cost of restoring your dental implants.
We use a true average costs which includes the cost of the components from the implant supplier and an average lab cost.
These component prices are including VAT and are correct as of 14/03/14
So on a like for like comparison of a cement retained implant option the clinically superior Atlantis custom titanium abutment not only avoids an compromise as it is completely custom designed for each patient. It also saves you £42.21. A win/win.
But that doesn’t get us to our £5995 over 50 implants does it?
To see where the real genius of using Atlantis titanium custom abutments comes in we need to look at the latest solution.
Ceramic bonded to titanium screw retained implant crowns from Ambridge Ceramics
Even with the cost saving of an Atlantis abutment over a stock we still have the cost of a crown on top to finish the restoration.
On average the cost of a bonded implant crown or all inclusive cost of a traditional cast screw retained crown including components and alloy is anywhere from £100 – £200
Case study – CAD/CAM Implant bridge with removable individual crowns19 March 2014 Categories: Uncategorized
Once complex and very expensive restorations such as the Woreley (also know as the Paulo Malo bridge) are now incredibly cost effective due to modern CAD/CAM technology. This type of bridge is simply a full arch implant structure that caries individual crowns.
So before we look at this case in detail we will cover how new technology has changed this and made the individual crown bridge (ICB) a much more attractive option for restoring a full arch.
Why use a CAD/CAM implant Individual Crown Bridge? (ICB)
What’s different on an ICB to a traditional screw retained bridge?
Effectively the ICB is just a platform for 12 individual crowns, which means we are liberated to use whichever material we feel is best for any particular region of the mouth. Why be locked to just one material for the whole restorative arch when we can take our pick of the best material for each quadrant?
As with our Visio.lign implant structures the key is to ensure we are offering a clinical benefit over traditional restorative implant solutions.
Rather than layer pink ceramic onto a chrome framework which may crack and would need to be re fired in a furnace to restore to it’s original state at some point, we prefer to make the CAD/CAM milled substructure out of titanium and layer Crea.lign composite onto it, which means that it is easy to repair and maintain should any of the gumwork in situ should it need this in future.
We choose crea.lign composite because it is shown to resist plaque adhesion and staining to a very high level, similar to ceramic as show in the table below.
This also allows us to do a whole refurbishment of the structure many years down the line if needed, all without the structure ever needing to be exposed to the heat and stresses of a porcelain furnace.
Average tendency to discoloration of composite materials compared to HeraCeram ceramic after storage in coffee, tea, tobacco, red wine and methylene blue.
Research report from the university of Jena on material testing of veneering materials, July 15, 2010, by Dr. A. Rzanny and Dr. R. Göbel
Using an ICB style implant bridge we will conceal the access holes in the primary structure, the final crowns do not need any access holes filling, which although not a particularly tricky problem for our experienced implant surgeons, it is still something we have to consider on a screw retained bridge such as the one shown below.
Not all CAD/CAM is the same
Astra Tech launch EV implant system in the UK21 February 2014 Categories: Uncategorized
Today we are in London for the Official UK launch of the Astra EV implant system!
This will be completely new for most of those attending the exclusive event in London today, but for almost a year now we have been secretly working with Dr Mark Willings and Dentsply in restoring the EV implants that he has been working with as part of the Ambassador program.
The design philosophy of ASTRA TECH Implant System™ EV is based on the natural dentition utilizing a site-specific, crown-down approach supported by an intuitive surgical protocol and a simple prosthetic workflow.
The EV system is an evolution of the already very successful Astra implant system, and now incorporates new design features that improve upon an already class leading and clinically proven implant system.
From a laboratory point of view there is nothing tricky about switching to this system but there are some nice touches, such as a unique index system that will only allow custom made abutments to seat in one position. This is also obviously a huge benefit for the surgeon as they don’t have to worry about them seating in one of several possible positions as we do with existing implant systems.
If anything Dentsply have managed to simply improve the user friendly appeal of the already successful Astra system, and build upon the strength and clinically proven results they already provide with the existing implant and restorative range.
It’s been really difficult for us to keep this under our hat as we have naturally been very excited and keen to share the work we have done with the EV implant system. The whole team are honoured to be included in the Ambassador phase of this implant system’s worldwide pre launch roll out and as today is the official launch, we can finally share it with you (although we’re not going to share too many details on the systems specifics, we’ll leave that to Dentsply)
Here are a few of the many cases we have restored under prescription and guidance of Dr Mark Willings, who was selected from a handful of surgeons worldwide to work with the EV implant system during the pre launch phase.
It’s obviously a huge honour to be trusted to work on a confidential project such as this one, especially as we have had early access to some of the nice touches that this system brings to the lab when restoring implants, but more importantly for us was the opportunity to feedback on the experience from the lab.
As you would expect we have only used the very best restorative solutions and avoided all potential compromise when dealing with these new EV cases. This has been the Atlantis system for single units and Atlantis ISUS system for multiple unit cases (which is our protocol on all Dentsply implant systems)
The requirement for these cases was that they should be screw retained crowns or bridges, although we do have 1 cement retained case and a couple that were screw retained using lateral fixing screws.
Here is a sneak preview of some selected shots that were taken from the large variety of cases that Dr Willings and others will be presenting today in London. We will also have the final fitted pictures to show after Mark has presented them at the launch today. For now we have the images of the lab work we produced on the new system.
Case 1 – 2 Atlantis abutments with a 3 unit bridge, retained with lateral fixing screws
First we designed 2 Atlantis abutments and then Lee tapped them both to accept Bredent Lateral Fixing Screws. Abutment design and framework by Lee Nichols.
Case 2 – Screw retained molar crown
The final crown that was layered with e.max ceramics by Mark Ambridge
With this case the patient requested a screw retained zirconia crown abutment, so we used the Atlantis system to design a zirconia sub structure that we could layer the ceramic directly onto.
The final abutment was designed and adjusted by Steve Campbell using the Atlantis Web-order Editor interface.
You can see from the image below that we used the Atlantis crown proposal to ensure we provided optimal support for the ceramic on the final crown.
Case 3 – Full arch Atlantis ISUS milled chrome and ceramic layered bridge
This case was a full arch that was scanned and designed from an immediate denture made by Mark Price, which was later converted to an immediate fixed restoration during the patients transition from temporary denture and guide to our final restoration. An effective way of working back from great prosthetic planning, which perfectly matches the EV crown down philosophy.
The final bridge that was layered with Creation ceramic by Jack Gleave.
CAD design stages that show how we used a copy of the immediate restoration which was modified for a more natural tooth emergence by Iain Baldwin, because the immediate had a flange that the patient did not want on the final restoration.
The patient wanted the overall appearance and function copying, so this became our guide. We have made the final guide transparent so that you can see the CAD framework design within.
Here is the CAD proposition of the final framework we received from Atlantis ISUS.
By using Atlantis ISUS we ensure we get a perfect framework to support our final frameworks, we prefer to offer a framework that is clinically proven to offer a superior level of fit which in turn leads to successful long term restorations.
You can see from this image that the new multi unit abutments have a wider diameter implant screw.
I know we’ve only shared a select few images and cases from all the work we have done here, but I wanted to keep this as brief as possible and just share the experiences and benefits we have had using the new EV system. However after the launch event we will get the final images from Mark and upload the full set and more detailed case write ups in a separate blog
SUMMARY FROM A LAB
Many of the modifications made in the EV system are just nice little adjustments that make the system very easy and predictable to work with and we found no issues at all in the cases we restored.
The biggest noticeable change is a completely new index system that moves from a hex to a spline and allows for easy seating and positive single position only engagement of all Atlantis CAD/CAM restorations, as shown in the image below.
All the components are now colour coded, from pickups and analogues right through to screws, which makes it easy to quickly visually verify you are using the correct components for the EV implant system. Also all the screws have the same 25 Ncm torque value to keep the system simple and user friendly.
The reason that we as a lab are so excited and have come to love this system so much is the simple fact that most of the improvements incorporated into this system are technically driven. Therefore designed to eliminate mistakes or mis information that can cause a case we’ve worked so hard on to either not be fitted or not have the result we would have wanted because the information in the impression was inaccurate in some way, either implant or soft tissue site.
Astra Tech stated that this was a crown down philosophy driven design change and they are absolutely good to their word. We’ve greatly enjoyed working with this system for a year and look forward to seeing many more come into the lab.
Finally, thank you to the whole lab team who have kept this quiet for so long and worked so hard on all stages of the many cases we have restored over the last year. There were many more ceramic cases by Marc Tocher and Rachelle Webb that we have not shown, along with plenty of work from the team behind the scenes that makes it possible to work on projects like this. Finally we’d also like to thank Dr Willings and Dentsply for choosing us to work with them on a project this big and exciting.
There’s more news to come
I’m not about to let the cat out of the bag just yet, but we do have a few more very exciting market leading projects still ongoing. Watch this space!
Want to know more about Astra Tech EV? Here is a link to the pdf
Nominated for Aesthetic Dentistry Awards 201419 February 2014 Categories: Uncategorized
It’s been almost a year since we won an award at The Aesthetic Dentistry Awards 2013, and thanks to a nomination by Dr Andy Denny we’re going to the awards again and hoping to make it 2 years running!
Back in 2013 we were surprised and delighted to be nominated by Andy, and overjoyed when we won, as you can see from the picture below.
(Mark Ambridge – Centre, Andy Denny – Right)
And here was the case.
So what are we up for this year?
The categories we are nominated in for 2014 are:
Restorative case – single arch
Mark Ambridge (technician)
Conservative Ceramic – Smile Makeover
Mark Ambridge (technician)
We think these awards are a welcome recognition of the hard work and beautiful smiles that are created by the surgical and laboratory team working closely to ensure the best restorative outcome and care for the patient.
This year, just as last we will be flying the British Bite Mark Flag. The British Bite Mark shows that a lab is using skilled General Dental Council (GDC) registered professionals to produce world class dental restorations which are produced in a laboratory that fully complies with strict MHRA and MDD regulation.
The work is anonymously assessed by a well respected panel of judges, each of whom is recognised for their skill and contribution to great dentistry, so the recognition of our work in 2013 was very much appreciated by the whole team.
We are in great company at this years awards, a full list of surgeons and technicians that have been nominated this year is available to download as a pdf here
We look forward to seeing all the nominees for a great night at the awards on the 21st March.
The benefits of CAD/CAM technology for the patient6 February 2014 Categories: Uncategorized
We’re very proud of the fact that we have worked with many pro active surgeons, which has allowed us to become known as a cutting edge CAD/CAM dental laboratory, with all the benefits this brings to our surgeons and their patients.
Over the years we have been involved in many Beta trials with some of the worlds biggest dental companies, which has given us a great insight into some of the benefits and potential weak points in some of the current materials and systems available today. The companies that we work on the Beta testing with are looking to overcome any potential weak points they see and improve the restorative options by heavily investing in research, and testing using the latest materials and technology.
For us as a laboratory one of the biggest leaps forward was definitely the use of CAD/CAM systems such as Atlantis and Isus to produce our titanium, chrome and zirconia sub structures (and even whole crowns in some case) as this allowed us to move away from some of the inconsistency, inaccuracy and wasted expense that the old traditional wax and cast or manual milling methods had.
But recently we have seen a very exciting shift away from focussing on the machining of the custom component parts and sub structures, and a focus on the materials which we use to deliver the final prosthesis to our patients.
What’s wrong with what we have?
Realistically with many cases there’s absolutely nothing wrong with the Porcelain, composite or acrylics we have successfully used for many years to restore our implant cases, but if we have an implant restoration on a posterior tooth where the patient has shown a history of destroying restorations then maybe we can look to the new hybrid materials that are now available? These mix the higher aesthetics we want from ceramics with the qualities that we would ideally want on an implant restoration such as shock absorbency and chip resistance.
One of the main characteristics of new Hybrid ceramics like Vita Enamic or 3M ultimate is the fact that they actually absorb shock from the opposing dentition.
Due to the fact that these materials are produced using CAD/CAM technology, they are a monolithic structure which greatly reduces the risk of delamination, further more these new engineered materials have been specifically designed to prevent crack propagation as shown in this pdf
What does this mean for us?
Thanks to our knowledge of CAD/CAM and depth of experience in using this with the new materials such as Visio.lign (which we use on full arch cases) and Vita Enamic we have been able to produce a screw retained CAD/CAM Hybrid Ceramic crown that offers the benefits mentioned above.
Below is a Vita enamic screw retained crown which has been milled and is awaiting final staining.
Further to being an ideal posterior restoration, this crown is also vastly more cost effective than a traditional screw retained ceramic layered implant crown (although if you do prefer ceramic for the very best aesthetics, we can now produce ceramic bonded to titanium implant crowns for maximum biocompatibility)
Thanks to our partnership with Atlantis we are also able to offer a restoration that has a custom titanium contour against the tissue and then transitions to these new Hybrid Ceramics in the rest of the screw retained crown restoration, think of it as a custom link abutment +
This is not a one size fits all solution, in fact we still produce many porcelain bonded screw retained units where aesthetics are absolutely critical, but it’s always great to have another solution that we can mix and match into our restorative toolkit when we are looking at the needs of our patients.
We have used monolithic crowns on cement retained restorations for many years, starting initially with full zirconia and then moving on to the new Hybrid Ceramics such as Vita Enamic purely because of the improvements in aesthetics and functionality they offer.
No patient you see is exactly the same, which is why we want to ensure we have the widest range of restorative solutions available to match their specific restorative requirements.
These materials can be used for cement retained, screw retained or even angle corrected screw retained implant cases. We have more information on both of these over on our website