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The color of money

Oct. 5, 2009
Joshua Polansky, BS, MDC, explains how the consistency and predictability of pressed ceramics can transform a complex task into a relatively simple one, and end up being the best alternative for all concerned.
By Joshua Polansky, BS, MDCI love the title of the old Paul Newman movie: "The Color of Money." It seems that those two items are what most patients are interested in these days: color and money. When consulting with many patients, they speak only about color. “I want brighter teeth” and “I want a Hollywood smile” are two of the more common requests coming through my lab. And of course, after explaining what I can do for them, many patients bring up the great equalizer — money. Technicians know that color is not the most important factor in a successful restoration; it is form. This is sometimes hard to explain to patients, and many of our attempts at education may fall upon deaf ears when cost is involved. It is in times like these that I tell technicians their verbal skills can be just as important as their technical skills.It has always been my dream since entering the field of dentistry to become a master dental technician ... a true artist. I will always be passionate about doing complex build-ups and highly characterized restorations, but as we know these take time and I lack in the area of speed. In my hands, at least, it’s true that “speed kills.” This sometimes becomes a problem for patients when they hear my fees for feldspathic restorations. This is not something I take personally because the patient is the client, and my job is not necessarily to make teeth that only satisfy my needs, but the patient’s as well. Today, in every field, people are making choices and much decision making about dentistry comes down to price. My job is to bring a simple solution to people whose daily lives are already overtaxed and overstressed. That is how I help my doctors and patients. For many technicians without the proper training, feldspathic restorations are quite complex with many variables determining the success or failure within each case. The technician must not only have a full understanding of form, but also a full understanding of layering principles, color selection, correct firing temperatures, moisture control, and a full understanding of handling the medium. This is truly an art based on the science of the physical properties of porcelain. This could become very tedious and time consuming without the proper training. All things considered, utilization of press technology can transform a complex task into a relatively simple one, and end up being the best alternative for all concerned.When using press technology, all the technician must master is form, which also leads to another positive about pressing and that is consistency and predictability.

Utilizing the press technique for esthetics and strengthAlan M. Webber, the co-founder of Fast Company magazine, writes about simplicity: “Mastering the art of simplicity gives you a valuable edge. It means you’ve rejected the siren song of complexity, which often masquerades as sophistication or erudition. Instead you’ve practiced the hard work of finding the essence of your idea.”Webber is not suggesting that simple is easy. Simplicity still requires us to perfect form. In an article I wrote titled "Made by hand," I make this very same point that by endless repetition of copying natural teeth, we can perfect very meaningful results for our clients ... without suffering through the complexity. You can request a copy of "Made by hand" by sending me an e-mail at [email protected].

Pressing for the best marginal fit and colorRemember, our clients want things that work and look good. Our job is to relieve their stress and make everyone’s life easier. This can be done with pressed ceramics. Once we create an approved wax-up, we can take control of the entire case including the occlusion. The beauty of pressing lies in its predictability. Once the patient accepts his or her wax-up and the provisionals are made, creating the final restorations is nothing more then injecting your matrix with wax and pressing. It's as simple as that. With all the new and improved ingot selections coming to the market and metal oxides that mimic most shades, it becomes less of a headache to fabricate beautiful work. The beauty of pressing also allows creative technicians the opportunity to cut back and layer whatever desired effects they see. But form must still be mastered.
Pressing with the capabilities of ceramic creativity with a cut-backAll-ceramic systems provide better esthetic results for a wider range of patients than metal-ceramic systems. Few technicians can match the beauty of an all-ceramic system when using ceramo-metal. The higher the glass content, the better the mimicking of enamel. By adding filler particles to the base glass composition, we improve mechanical properties such as strength and thermal expansion and contraction. A third class of ceramic contains no glass at all. Polycrystalline ceramics are even tougher and stronger than the glass-based ceramics. These ceramics have grown in popularity since the advent of computer-aided technology. Today, technicians have a varying assortment of choices in materials and processes to satisfy their clients. I believe that pressing the particle-filled ceramics can provide consistent and predictable results. To reduce rework and, therefore, precious time, I've found that the Ceravety investment from Shofu works the best for any pressing situation. This investment never cracks and gives me a choice of different applications in addition to an excellent fit consistently. There is a story about a multilingual Chinese salesman who had a phenomenal track record. He consistently had the highest sales of anyone in his group. And it wasn’t just in China. He was the top producer in Korea, Japan, Australia, and in America. During their annual sales kickoff meeting, one of the vice presidents asked him, “What do you think is the best language to do business in?” The salesman replied, “The language of my customer.” The language of our customer is color and money; for the dentist, it’s precision fit and accuracy. For me, it’s pressing for ultimate success.
Joshua Polansky, BS, MDC, earned his Bachelor of Arts degree, summa cum laude, from Rutgers University in 2004. While working part time at a dental laboratory, he took advantage of an opportunity to apprentice with distinguished master technician, Olivier Tric. Mr. Tric opened Joshua's eyes to a whole new world of possibilities. He made the decision to become a master dental technician following the path that Tric had forged. He continued to acquire technical skills by studying in Europe with other mentors and experts in the field. Joshua currently resides in Los Angeles, Calif., where he is earning his master’s degree in dental ceramics at the UCLA Center for Esthetic Dentistry under Dr. Edward Mclaren. Joshua is the owner and operator of Niche Dental Arts, a collaborative boutique Dental Laboratory with his father, Dr. Barry Polansky. Contact Joshua at his blog http://nichedentalarts.blogspot.com/.