Dental Economics has brought so much into my life. It strengthened my relationship with our former editor, Dr. Chris Salierno. It introduced me to our current editor, Dr. Pamela Maragliano-Muniz. Most importantly, it gave me an opportunity to meet Dr. Michael DiTolla. Mike authored a column for DE called “Confessions from an average dentist” that ran next to my “Pearls” for a few years. Chris introduced me to Mike, and we’ve been best friends since. This truly is a wonderful profession and publication!
Mike DiTolla and I have spent a lot of time together over the past few years. We have lectured together. We have developed lecture content together. Throughout all of that, I have learned that he deeply believes in one of his main educational points—that we as an industry leave provisional restorations on for too long. Two weeks is the standard length of time that we as restorative dentists book out a crown delivery. In today’s digital world, that’s just too long. Bad things happen over two weeks—teeth move. Mesial drift happens. Supraeruption happens. Gingival inflammation happens. Pulpal inflammation happens. Traditionally, we can “work through” these problems. We can grind crowns into place. We anesthetize and use hemostatics on the gingiva. We do endos. But we shouldn’t have to do those things, especially with digital dentistry.
38 Smiles is a dental laboratory in Southern California that has dedicated their raison d’être to addressing this issue. With a digital scan, they promise a three-day turnaround for single-unit posterior zirconia crowns. Since these are the majority of the crowns we do, this can change your practice. It takes two days to ship from Southern California to Texas, so we book patients six days after their preparation for their crown seat.
This has changed the game for us. Patients don’t like being in provisionals, and minimizing that time is something they do really like. It has made our seat appointments much easier and faster. These crowns just drop in. They drop in because the tooth doesn’t have time to move. If you make a decent provisional and seat your final crown in four to six days, your life will become easier. We can anesthetize less. We have fewer complaints of sensitivity and lost or broken temps. Restorative dentistry becomes simpler and easier when you deliver crowns in four to six days. Of course, all of this hinges on having an intraoral scanner to submit digital impressions with. You won’t be able to deliver in those short windows with polyvinyl siloxane impression material. This is another great reason to go digital. In addition to the quick turnaround, 38 Smiles Dental Lab only polishes their posterior zirconia crown. No glaze—that means less opposing wear to enamel. Polishing zirconia is much kinder on opposing teeth than the glaze is. Most labs don’t do this because glazing is faster and easier. Polishing zirconia takes time and skill. 38 Smiles has the skill and takes the time to polish the zirconia instead of taking the easy way out.
38 Smiles and their three-day turnaround time have made my life easier and better. Just another thing I need to thank Michael DiTolla for. Two-run home run to center field for 38 Smiles and 3-day zirconia crowns!