After spending several years as an Dental Assistant I decided to move into a career as a Dental Lab Technician. When I was working as an assistant in a practice my primary duty was designing CEREC restorations, and preparing them for seating by adjusting the contacts and glazing the restorations. Through my experience of working in an office I really began to understand the importance of a smooth crown seat. Our office seated many lab crowns also, and I saw firsthand both good and bad restorations. Generally crown seats would go smooth, but occasionally there would be one that took a lot of adjusting, or had to be remade.
When I attended a Dental Technician program I began to understand where some technicians struggled on fundamental concepts such as margins and contacts. During our program tooth anatomy was covered in depth, as well as metal finishing, porcelain techniques and all the other day to day things technicians do at a bench. One thing that was not covered well was how a Dentist preps a crown, and how the finished restoration is seated. Without this understanding many of my classmates had difficulty with vital tasks such as die trimming and understanding the need for a solid model. As our industry grows more technical with CAD/CAM and implants becoming standard, those fundamentals are still as important as ever.
Sometimes it is easy for labs and Dentists to get frustrated with one another. Technicians do not always have an awareness of how difficult it can be to work on a living patient as opposed to a model. Dentists sometimes get rushed by scheduling and miss the perfect impression, or do not see the need for a bite registration. As a former Dental Assistant I really appreciate a crown that seats with little to no adjustment. As a current Technician I really appreciate every extra piece of the puzzle a Dentist provides with their case. Photos, notes, bite registrations and solid impressions should all help make your restoration perfect. Impressions that capture more of the arch help a Technician judge the occlusion and the bite. Just like four legs on a chair help it balance, more teeth in an impression do the same for the model. Case planning that incorporates your lab will be an asset during the preparation of teeth, or implant placement. Diagnostic wax-ups and implant stents not only help the practitioner during the procedure, they also help during seats by providing appropriate clearances. Taking the quickest route through the case preparation will cost time and stress during the seating.
Encourage your Technician to come and see some of their own crowns seated, most people are interested in improving their abilities and it will help with your long term results. If your lab is not close to your practice you can always do some case reviews together online, show your technician photos and x-rays and find out what information they could use to enhance patient outcomes. If you would like to see what goes on in your lab most technicians would love to look over cases with you at the bench. Look at your models when cases come back, and pick out what you like about your prep and what you would improve. Seeing a prep on a model is much easier then seeing one in the back of someones mouth.
Technicians and Dentists who want to constantly improve upon their work can stay challenged. Boredom and frustration come from being stuck in a rut, and case analyzing with our partners is a free source of improvement. Use your Technician as a resource and offer your knowledge in return, the benefits are something your patients will appreciate.
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