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Introduction and Speaker Credentials
00:00 - 01:10
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1
Why the Lab–Clinician Relationship Matters
01:10 - 04:30
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2
Treatment Planning: The Key Rule
04:30 - 10:00
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3
Prosthetic and Biological Profile: Face Bow and Articulator
10:00 - 20:30
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4
Vertical Dimension and Occlusal Plane Orientation
20:30 - 27:00
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5
The Digital Patient Concept
27:00 - 43:00
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6
Materials, Finishing, and Q&A
43:00 - 57:45
- 7 Community questions
Dental Lab: Friend or Foe?
Video highlights
- Why the lab–clinician relationship is the foundation of implant success
- How to start from the end: treatment planning backwards from the final prosthesis
- The role of face bow, articulator, and occlusal plane in prosthetic design
- Vertical dimension of occlusion: how to determine and communicate it to the lab
- The Digital Patient concept: integrating digital workflows with Nobel Biocare solutions
- Material selection for implant-supported restorations: zirconia, PMMA, and composite
- Practical Q&A: real-world cases and communication strategies between lab and clinic
In this insightful webinar, Dr. Francesco Mintrone, a distinguished prosthodontist and master dental technician, delves into the intricate and often challenging relationship between the dental laboratory and the clinician. He argues that this partnership is not merely a transactional one, but a deeply collaborative process that is fundamental to achieving predictable, functional, and aesthetically superior outcomes in implant dentistry. The central theme of his lecture revolves around the concept that the dental technician is not just a service provider, but an indispensable member of the treatment team who can be either a powerful ally or a significant obstacle to success. Dr. Mintrone emphasises that a successful partnership is built on a foundation of mutual respect, clear communication, and a shared understanding of the final prosthetic goal. He posits that by embracing a truly collaborative mindset, clinicians can unlock the full potential of their laboratory partners, leading to enhanced patient satisfaction and a more streamlined and efficient workflow.
One of the cornerstones of Dr. Mintrone's philosophy is the principle of "starting from the end." He advocates for a treatment planning process that is driven by the desired prosthetic outcome, rather than being dictated by the initial clinical situation. This requires a paradigm shift for many clinicians, who are often trained to focus on the surgical aspects of implant placement. Dr. Mintrone argues that by first envisioning the final restoration, clinicians can make more informed decisions about implant position, abutment selection, and soft tissue management. This "prosthetically driven" approach ensures that the final restoration is not only functional and aesthetic, but also biologically compatible and easy to maintain. He introduces the concept of the Digital Patient, a virtual representation of the patient's anatomy that integrates data from various sources, including CBCT scans, intraoral scans, and digital photographs. This comprehensive digital model allows for a more accurate and predictable treatment planning process, as it enables the clinician and technician to visualise the final outcome before any treatment is initiated. The Digital Patient concept facilitates a more seamless and efficient workflow, as it eliminates the need for traditional impressions and physical models, which can be time-consuming and prone to inaccuracies.
Dr. Mintrone also provides a detailed overview of the critical role of the face bow and articulator in establishing the correct vertical dimension of occlusion and occlusal plane orientation. He explains that these traditional tools, when used in conjunction with digital technologies, can provide a more accurate and predictable outcome. He demonstrates how the face bow is used to transfer the spatial relationship of the maxillary arch to the articulator, which then allows the technician to simulate the patient's jaw movements. This information is crucial for creating a restoration that is not only aesthetically pleasing, but also functional and comfortable for the patient. He emphasises that a thorough understanding of occlusion is essential for long-term implant success, as improper occlusal forces can lead to a host of complications, including screw loosening, abutment fracture, and bone loss around Nobel Biocare implants and other systems. He also discusses the importance of material selection in implant dentistry, highlighting the various options available, from traditional porcelain-fused-to-metal (PFM) restorations to modern all-ceramic materials such as zirconia and lithium disilicate. He provides practical guidance on how to select the most appropriate material for each clinical situation, taking into account factors such as aesthetics, strength, and biocompatibility.
The webinar concludes with a lively Q&A session, where Dr. Mintrone addresses a wide range of questions from the audience, moderated by James Chow. He provides practical advice on how to find and build a strong relationship with a dental laboratory, emphasising the importance of looking for a partner who shares your clinical philosophy and is committed to quality. He also discusses the future of implant dentistry, expressing his excitement about the potential of artificial intelligence (AI) to further enhance the digital workflow. He believes that AI will play an increasingly important role in treatment planning, design, and even fabrication of implant restorations. However, he cautions that AI is not a substitute for clinical judgment and the artistic skill of the clinician and technician. He concludes by reiterating the central message of his lecture: that the key to success in implant dentistry lies in the power of collaboration and communication between the clinician and the dental laboratory. By working together as a team, they can achieve outcomes that are truly transformative for their patients.
References
References
[2] Wittneben JG, Buser D, Belser UC, Brägger U. Peri-implant Soft Tissue Conditioning with Provisional Restorations in the Esthetic Zone: The Dynamic Compression Technique. International Journal of Periodontics & Restorative Dentistry. 2013;33(4 ):447–455. https://doi.org/10.11607/prd.1705
[3] Joda T, Zarone F, Ferrari M. The complete digital workflow in fixed prosthodontics: a systematic review. BMC Oral Health. 2017;17(1 ):124. https://doi.org/10.1186/s12903-017-0415-0
[4] Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Australian Dental Journal. 2012;57(1 ):2–10. https://doi.org/10.1111/j.1834-7819.2011.01640.x
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Question
How are you accurately digitally assessing the occlusion and mandibular movements for the digital articulator when the patient has no posterior support and is overclosed?
How are you accurately digitally assessing the occlusion and mandibular movements for the digital articulator when the patient has no posterior support and is overclosed?