TODD C. SNYDER, DDS, FAACD The Nuts & Bolts of …...FOR OPTIMAL SHADE MATCHING 5/16/2018 18...

transcript

5/16/2018

The Nuts & Bolts of Veneers

TODD C. SNYDER, DDS, FAACD

Accredited Fellow, American Academy of Cosmetic Dentistry

Fellow, International Academy for Dental Facial Esthetics

Member of The American Society For Dental Aesthetics

Former Faculty, UCLA Center For Esthetic Dentistry

Todd Snyder, DDS, FAACD, FIADFE, ASDALaguna Niguel, CA

Aesthetic Dental Designs®

doc@tcsdental.com

5/16/2018

To Learn:• Preparation Designs• Tips & Materials• Provisional Techniques• Cementation Protocols• Technology

• a d d fadf jas

Why Are YOU Here?

• a d d fadf jas

What Do YOU Want?

• Advertising

• Staff Training?

• Office Appearance

• Expertise

• Emotion and Value

• Financing?

• Follow up?

Will That Get You What You Want?

More Patients, Money etc…

Better Outcomes?

5/16/2018

According to the American Academy of Cosmetic Dentistry 50% of patients are

unhappy with their smiles and 3 out of 5 people will invest in their smiles.

How Do You Get More Cases?

Consumer/Patient Impression

• Do they know what a Cosmetic Dentist is?

• Do they perceive you are one?

• Will they go somewhere else because they think you are a family dentist?

• Do they think you are capable of providing a great smile for them?

• How can you alter their perception?

• What is your brand image?• Your office appearance?• Website?• Your ads?• Your social media?

5/16/2018

Invest in technology.

-Office iPad (Large)

-35mm Digital Camera

-Big Lobby Television

-Software Systems

Personal Case Books

Office Displays

Referral Cards

Gift Cards

Custom Smocks & Bleach Kits

Modern Tools**

5/16/2018

One of the most powerful & fastest tools you own to create cosmetic opportunities??

5/16/2018

WHITENING

Immediate Call to Action Motivator

Start Here

Over-the-Counter Teeth

Whiteners: $1.4 billion

(MSNBC) ...

(Consumer Reports).

5/16/2018

Over The Counter Whitening

Whitening

5/16/2018

Opalescence GO!• Fast, Easy, Effective, Better

Experience• Convenient & affordable

professional whitening to GO• Pre-loaded, disposable UltraFit™

tray for a custom-like fit• Molar-to-molar coverage• No chair time

5/16/2018

Reduce or Eliminate Sensitivity

• Potassium Nitrate & Fluoride

5/16/2018

Opalescence Go Sample Tower

“Total annual revenue in the teeth whitening industry topped $11 billion at the beginning of

2015, with $1.4 billion spent on teeth whitening products. These figures suggest a steady annual increase in the teeth whitening market industry, which is expected to continually climb over the

next 10 years” AACD Research

5/16/2018

So why are people willing to pay top dollar for a beautiful smile

5/16/2018

Cosmetic Alterations

• How many of you want to buy something sight unseen?

• How many of you want to experience something first before investing?

• Your patients are no different!

• They are concerned about how it will look and feel. They want to be excited and happy!

• Don’t Just Tell…..Show & Tell!

5/16/2018

The Key to Success:

VisualizationWhat is the patient’s perception or desired outcome in their mind to create the EMOTION and DESIRE?

5/16/2018

YOU NEED CAMERAS

EYESPECIAL C-III (SHOFU)

5/16/2018

• Designed for dentistry

• 8 modes

• 12 Megapixels

• Dental cropping and grid lines

• Large LCD touchscreen

• Water and chemical proof

• Durable rugged Exterior***

• Fast autofocusing & anti-shake capabilities

• Held with one hand – weighs only 1lb

• Compatible with the Eye-Fi X2 card –

Immediately upload images onto PC, iPad,

Tablet or Smartphone

EYESPECIAL C-II (SHOFU)

MAGNIFICATION RANGE• Chose the magnification ratio/range by rotating the dial key

• Icons to help you determine and select the range properly

5/16/2018

STANDARD MODE

EDIT & DRAW FUNCTION ON THE

EYESPECIAL C-II

• Edit functions are ideal for

patient education

• Under the Menu key you can:

• Draw on images to show

areas of focus

• Rotate the image

• Protect the image against

being deleted

5/16/2018

WHITENING MODEFOR SHADE COMPARISON BETWEEN BEFORE AND AFTER WHITENING

• Similar to “Low-glare” mode but with lower light intensity

• Reduces glare and emphasizes the surface texture and shade

• Delegated Whitening & Imaging Assistant

Upper arch whitened

Lower arch not whitened

ISOLATE SHADE MODEFOR OPTIMAL SHADE MATCHING

5/16/2018

EyeSpecial C-III

Quadrant Dentistry

35mm Pro

EyeSpecial C-III35mm Pro

Cosmetic Dentistry

5/16/2018

EyeSpecial C-IIIKodak DCS-N

Cosmetic Dentistry

What do they want or envision?

Look at books or your cases.

Bring in examples of smiles.

5/16/2018

Everyone has an opinion & priorities

How WHITE?

Translucency?

What Texture?

Color Transitions

What about example

pictures?

◆ Are they relevant and

realistic?

5/16/2018

REALISTIC

Photographic Manipulation

• Cosmetic “Imaging” Software• SmileFy app• PreVue app• SmileVision• DentalGPS• DSD

• Digital Agents• Virtual Smiles ($125/image)• DreamSmiles (<$4000 a year?)

• Ivoclar/Kapanu?

5/16/2018

Why Does this Work?

✓Creates awareness

✓Suggests the possibility

✓Promotes discussion

✓Provides bridge to clinical evaluation and

presentation of options

✓Creates EMOTION and DESIRE

Digital Smile Mockup

-is a proven practice building program that can:

Dramatically increase your patient’s interest in a smile

transformation

Remember, 50% of your patients want to improve their

The goal is to help them visualize themselves with an

improved smile

5/16/2018

When you hand a Digital Simulation to your patient, you plant a seed of what is possible, a constant reminder of what their potential new smile can be. They can show it to their friends and family, you can put a copy in their chart for follow-up, have them hang it on their refrigerator...!

VIRTUAL SMILES©

• Tooth shape

• Length, width, & style #

• Tooth color

• Translucency, effects

• File Format

• Paper

• CD

• Email

• Flash

• Logo & Office Info

• Smile Simulations

5/16/2018

SMILE DESIGN SOFTWARE VS DRAG AND DROP SMILE GALLERY?

Overall Feel

Appearance…what is it? who decides, Dentist? Ceramist? Patient? Combined effort?

THEIR DECISION √

BUT YOU HAVE TO GUIDE THEM

5/16/2018

The Key to Success:

Traditional Veneers

Diagnosis & Treatment Planning

The Key to Success:

5/16/2018

Traditional Veneers

5/16/2018

You are selling the Emotion…

Do you know “THEIR” desired outcome?

5/16/2018

MARKETING

5/16/2018

Advertising Evolution- Internet & Social Media

• Traditionally Marketing was Expensive• Internet is very Inexpensive comparitavely• Website (SEO Management/Quality Code/Page Speed)• Reviews• Social Media (need to claim them all with same name)

• YouTube• Facebook• Twitter• Flickr• Instagram-no cost High Return

• Cosmetic Imaging• In Office • OUTSIDE OFFICE?

Google Website Speed, Responsive Design and Build Issues/Code

5/16/2018

WEBSITE PAGE SPEED IS VERY IMPORANT (and so is relevant content too)

https://www.wordstream.com/blog/ws/2018/01/22/google-speed-update

Jan. 22 2018

https://webmasters.googleblog.com/2018/01/using-page-speed-in-mobile-search.html

Jan. 27 2018

https://www.forbes.com/sites/jaysondemers/2018/01/29/will-googles-new-page-speed-criteria-affect-your-site/#6c3dbe8f6a8f

Jan. 29 2018

July 2018

CHECK YOUR PAGE SPEED

https://developers.google.com/speed/pagespeed/insights/

CHECK YOUR PAGE SPEED

MOBILE FRIENDLY?

https://search.google.com/test/mobile-friendly?id=De1nibkdCgXmmSqhS04nzw

https://validator.w3.org/nu/?doc=https%3A%2F%2Fwww.blux.com%2F

5/16/2018

NGenys

Pronounced Ingenious

Websites, Photography, Brand, Social Media and More

www.NGenys.com

Proof of Work / Transparency

5/16/2018

• There never seems to be enough of it…

• It has to be built into the schedule or out source to employee

• Take the time to huge profit

• Know what the case is going to entail ahead of time

• What is the patients Chief Complaints?• Pick 3 to address

• Why do they have these problems?

• Are they going to drive you crazy?

• Immediate Smile Change Consultation?

• Can they come back in a week?

Time (CONSULTATION)

5/16/2018

-Patient wants to fix the small

lateral incisor

-No tooth reduction

OPPORTUNITY

5/16/2018

Beadline Provisional Mockup

Beadline Provisional MockupBeadline Provisional Mockup

Diagnostic Models with a waxup are duplicated. Special over impression is created and used to deliver temporary mockup

5/16/2018

LISTEN For Yourself

5/16/2018

Show & Sell Possibilities..

COSMETICChanges

3 out of 5 • Patient came in to fix small lateral incisors

• Wants “Absolutely” no tooth reduction

• What drives him?• Appearance

• No Tooth Reduction

• Emotion

• Desired Outcome…. Feel Better, more confident?

5/16/2018

Results

Confidence, Dating,Work,Emotional Goals

Cosmetic Dentistry

• Do YOU WANT more Cosmetic Cases?

• Patients desire a change• But don’t know what they want (typically)

• What are their Chief Complaints (pick 3)

• Why?

• And What will that accomplish? Reasoning behind Tx.

• Always look at the big picture

• Take photos

• Write down where they can see their Chief Complaints• Signature on waxup

• Signature on provisionals

• Signature for final cementation approval

5/16/2018

Free TIPS on my Instagram Story

2 New Smile TIPS coming soon!!

How Do We Create The

Intraoral Mockup?

• First take an impression of teeth with a material that allows you multiple repours.

• Want one original model

• One model for laboratory

• Extra model if you need bleach trays or practice preparations

• Photos

• Facebow

• Horizontal Plane Indicator

• Teeth that are too far facial will remain untouched. When photos are taken they will be less obvious.

5/16/2018

Final Impression

• Pack #00 ReCord

• Take final impression with light body PVS (Affinity) and heavy body PVS (Affinity) tray material

• Use a custom HeatWave Tray

Final Impression

5/16/2018

Final Impression

5/16/2018

Final Impression

REVIEW

• Existing In Office Patients (3 out of 5) want to fix their SMILES!

• Shade Evaluation every exam & everyone in Hygiene Department

• Website, Social Media Accounts all setup and posting RELEVANT content

• Photos of everyone to send home (possibly with imaging) GET A CAMERA

• Take a photo and do a Cosmetic Simulation/Mockup

• Instant visualization through software on an iPad or possibly internet

• Instant Composite Mockup in the dental chair

• Take an impression and have lab do a waxup to facilitate a Beadline

Provisional Mockup (reduced fee or no fee agreement with lab)

5/16/2018

Diagnostic Models & Records

Silginat - Kettenbach

Counter FIT- Multipurpose Replication Silicone

(Clinician’s Choice)

5/16/2018

Counter FIT- Multipurpose Replication Silicone

(Clinician’s Choice)

Silginat - Kettenbach

Wear Facets & Interferences

3 Sets of Models-One is untouched for legal documentation-Second to practice preparations (It will be waxed up)-Third is a spare to practice on or make bleach trays

5/16/2018

Mounted and Equilibrated

—MEG BIRAM

5/16/2018

Are you confident in creating beautiful outcomes on anterior teeth quickly &

easily? IF NOT, PRACTICE!

Tooth Size Averages

2nd Premolar 1st Premolar Canine Lateral Incisor Central Incisor

6.6mm 7.1mm 7.6mm 6.6mm 8.6mm

7.7mm 8.6mm 10.6mm 9.8mm 11.2mm

Length

5/16/2018

0.6-1-1.68

Golden Proportion Measurement.

SculptPad (Ivoclar)

5/16/2018

• Practice Preparations

• Waxup

ADDITIONAL TOOLS

◆ Panadent: Multi Purpose Ruler

5/16/2018

◆ Erskine: Dentagauge 1 & 2

ADDITIONAL TOOLS

What Records & WhenDiagnostic & Prep Reduction Models

5/16/2018

Diagnostic Guides

5/16/2018

No Preparation Veneers

No Prep Veneers• Do a waxup

• Duplicate into a stone model

• Over impression of stone model w/ PVS BEADLINE TECHNIQUE or Siltech Putty

• Intraoral mockup using the over impression filled with temporary acrylic**

• Is thickness and appearance okay?• Depth cuts through over impression if necessary.

• Typically no provisionals are necessary

• No undercuts

• Color change varies based on tooth position/color

5/16/2018

Tooth Preparation Conservative Preparations

Mockup & prep

5/16/2018

No Prep Case: 1

• Angulation of teeth

• Spaces

• Lingually positioned

• Lack of lip support

• Thinned enamel

• Fuller smile

• Microdontia

• Chairside Mockup**

5/16/2018

Mockup & prep-Minimally invasive

5/16/2018

Mockup & prep

5/16/2018

Mockup & prep

5/16/2018

Mockup & prep

Preparations

5/16/2018

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

• Retention Form (Line of Draw)

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

5/16/2018

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

Veneer Preparations-Feldspathic Porcelain

Depth cuts of 0.2mm-0.8mm*

1.0mm-1.5mm incisal reduction*

5/16/2018

Veneer Preparations-Pressed Ceramics

Modern Ceramics

• Stand Alone Strength Properties

• Feldspathic (80-120 mpa)

• Lithium disilicates (360-500mpa)

• Lithium silicate (373 mpa)

• Zirconia (Monolithic 640-1200 mpa+)• Layered Zirconia Feldspathic (80-120mpa)

5/16/2018

Incisal edge preparations

a) No incisal lengthening

b) Changing color or wear

c) Lengthening tooth

Veneer Preparations

labial reduction options Depth Limiting Burs - Brasseler USA

Average enamel thickness

At CEJ .3-.4 mmMiddle third .8-1.0 mmIncisal third 1.1-1.3 mm

Veneer Preparations

5/16/2018

Preparation Reduction• Depth reduction burs

• Safe reduction

• Lasco

Veneer Preparations

Independent Depth Cuts (Lasco Burs)

▪ Depth Cuts▪ Tooth Reduction▪ Interproximal & Margins▪ Retention Form (Line of Draw)

5/16/2018

Burs• Organization

• Diamonds

• Carbides

◼ K0096 Finishing Kit $126.47 each

◼ K0095 Preparation Kit

$125.47 each

Preparation

Aesthetics

Function

Bonding to Enamel

Material Options

Minimal Prep Case: 2

5/16/2018

Minimal Prep Case:

Wax-up Case:

5/16/2018

Preparation Guides:

5/16/2018

Disposable Single Use Diamonds-medium or coarse grit

5/16/2018

• NeoDrys

• NeoDiamonds

• Bite-Check 18um

Offer not valid for previous purchases or in conjunction with any other offer.

Free Pack of NEODiamonds

5/16/2018

• Photomed (818) 908-5369

SHADE SELECTION

5/16/2018

Shade Assumptions

BW, B1, B2, A1, A2

Provisional Techniques

-Free hand

-Beadline Provisionals

-Putty over impression of waxup

-Premade temps?

5/16/2018

Review-Chief Complaint

-Occlusion

-Photographs/Imaging?

-Whiten first

-Waxup/BeadLine Provisional

-Material Selection

-Practice Preps

-Photograph Prep Shade

5/16/2018

EMOTIONFocus on overall appearance

Stay away from little details

“Going to look & feel great”

Instant Ortho/Un-Rotating Teeth

• Do initial workup

• Diagnostic preps

• Diagnostic waxup

◼ Sequence

– Reduce all excess tooth structure

– Ideal reduction

– Margin placement

5/16/2018

Cementation**

5/16/2018

Selection Process

◦ Open Bite Trays

Plastic-full or quadrant

Metal-full or quadrant

Custom Trays

Non-perforated or perforated (metal or plastic)

Rigidity can eliminate tray distortion and rebound

Spring back after impression is possible with plastic

Cross arch stabilization

Ideal occlusal stops for proper model articulation

Able to recreate excursive movements if mounted on a

semi or fully adjustable articulator.

Potential for errors & adjustments are low

Impression Trays

Custom trays create more

ideal placement

Thinner material creates

less distortion

USE TRAY ADHESIVES for

all open bite trays, not just

custom trays.

Only negative is time

Impression Trays Selection Process

Custom Tray

5/16/2018

▪ 4 upper & lower trays

▪ 60 sec. @ 158°F

▪ Fast, efficient

▪ Virtually custom

▪ 30% less impression

material used

Impression Trays

HeatWave by Clinician’s Choice

5/16/2018

Impression Trays

5/16/2018

Impression Trays

Dry all teeth in arch

Place tip in most difficult area first

Keep tip on margin and immersed in material

Go around entire margin first

Next go to adjacent teeth

Then do coronal aspect of teeth

Double Mix Single Impression is the most accurate

Syringe Placement

5/16/2018

Ultradent’s NEW Thermo Clone VPS

5/16/2018

Simplified Provisionals**

Siltech Putty Matrix

Bead Line Veneer Provisional Restorations. Pract Proced Aesthet Dent 2009;21(3):E1-E7.

Duplicate waxup model in stone

Scribe a 0.5-1mm line with a sharp instrument into the

model where the tissue and tooth come together.

Provisionals (Bead Line Technique)

5/16/2018

Duplicate model with a fast setting polyvinyl impression material.

I have used light and medium body washes with a heavy body tray

material.

The scribed line creates the Bead Line in the over impression of the cast.

5/16/2018

The Bead Line in the over impression creates pressure along the tissue

and preparation margin. This causes a thin cut or separation of the

acrylic flash from the provisionals for easier clean up.

Typically the excess acrylic can be removed with fingers, a spoon or discoid instrument. Minimal

to no effort is required to remove excess flash. If a void or a margin is exposed simply fill the

void with a flowable. Etching and a bonding agent are not required as the flowable will adhere to

the air inhibition layer of the temporary acrylic and you do not want to adhere to the tooth.

5/16/2018

The Bead Line Provisional Technique creates less work and risk of damaging tissues and tooth

structure. Typically the process takes 5-10 minutes to make provisionals. Consepsis (Ultradent)

can be placed on the teeth and dried prior to fabricating provisionals.

-Visalys (Kettenbach)

-TempSmart (GC America)

-Inspire (Clinician’s Choice)

-ExperTemp (Ultradent)

Provisionals

5/16/2018

Cling 2 (Clinician’s Choice) for all my full crowns & bridges,

retentive inlays & onlays.

My Favorite Temporary Cements

ClearTemp LC (Ultradent)

For either veneers or thin

anterior cosmetic restorations

-Aesthetics

-Function

-Gingival Embrasures

-Excess cement

-Patient homework & questions

Post-Op Check

5/16/2018

From Imaging & Diagnostic Wax-up the entire case was duplicated

Case #4: Single Tooth Aesthetics

Veneers

Function

Gingival Bonding

5/16/2018

Remove old restorations & repair abfraction lesions on cervicals

• Stump Shade (dehydration factor)

Base Shade

5/16/2018

• Contact lens effect

• At or above gingiva

• Masking tooth or color changes

• At gingiva, then place cord and

reduce another 0.3-0.5 mm

Veneer & Crown Margin Placement

5/16/2018

Impressions

Facebow & Wax Bite Registration

5/16/2018

Provisionals

ULTRADENT• Nanohybrid

• Superior handling

• High polishability & gloss retention

• Exceptional wear

• Unique syringe design

• Intuitive shade offering

5/16/2018

Three Shades of Mosaic

5/16/2018

Free Hand Provisionals

Free Hand Provisionals Example

5/16/2018

• Materials

• Rigid Bite Registration

• Light and Heavy Body

Prefabricated Over Impression

AESTHETIC RESIN TEMPORARY CEMENTS

• Materials

• Bifix Temp-VOCO

• TempBond Clear-Kerr

• ClearTemp LC-Ultradent

5/16/2018

Before & After Photos

Mixed Provisionals

5/16/2018

Waxup, Reduction Guides &

Temporaries (Case 6)

5/16/2018

Preparation Guides

A-TYPE PREP

5/16/2018

Removing provisionals that are locked on.

5/16/2018

Nine Years Later

QUESTIONS?

Red Blood Cells 2 – 5um

200-500nm

Human Hair 60 –120um

6,000 – 12,000nm

5/16/2018

Shimstock & Articulating Paper

What do you use…..

.…and why?

Parkell Accufilm II is 21µm for

dentistry

Great Lakes articulating

ribbon 12µm

8µm Almore Shimstock foil

8µm articulating paper??

Shimstock & Articulating Paper

5/16/2018

What do you use…..

.…and why?

8µm articulating paper

Available in blue

And red too!

TrollDental-8µm Articulating Paper

Booth # 573

5/16/2018

What Percent of Impressions per

Laboratories have visible

errors?

1-Samet N, Shofat M, Livny A, Weiss EI. A clinical evaluation of fixed partial denture

impressions. J Prosthet Dent 2005; 94:112-117.

And the key to remember, routinely, it’s voids, bubbles, and tears

“Approximately 90% of impressions have defects” G. Christensen

▪ Superoxol

Epinephrine

Ferric Sulfate

ViscoStat 20%

Astringent 15.5%

▪ Aluminum Chloride

Viscostat Clear 25%

Expa-syl

Hemostasyl

▪ Aluminum Sulfate

Tissue Goo 25%

▪ Various Cords

Astringents Enhancing Moisture Control

Fluid/Tissue Management

5/16/2018

Lasers (Diodes) Fast

Hemostasis

No crevicular fluid

No cord

Better healing

Enhancing Moisture Control

5/16/2018

Aesthetic Contouring

5/16/2018

Time??

Aesthetic Contouring & ExperTemp Provisional

5/16/2018

Features

• Number #1 dental laser in the world

• More power – 3 watts

• New easy to use presets

• New treatment timers for perio treatment

• Wireless foot control

• Optional battery pack

• Perfect for first timers or hygienists

• Affordable

• Disposable tips or fibers

• Certification included

• MSRP: $4,495

• CE Price: $3,495

Use code

CESNYDER18

AMD Picasso Laser Tissue re-contouring

5/16/2018

Make cases easyIdentium for multiple teeth

Make cases easy, make your patients happy

5/16/2018

Make cases easy, make your patients happy

RESTORATION PLACEMENT?

• Bonded

• Margin placement

• Moisture Control

• Technique Sensitive

• Materials

• Self Adhesives

• Bonding agent (TE or SE) & luting resin

• Cemented

• Margin placement

• Moisture Tolerant

• Retention Required

• Materials

• RMGI

• Ceramir

Cement Selection

5/16/2018

RESIN CEMENT COSMETIC CASES….

COSMETIC CASES….

5/16/2018

COSMETIC CASES….

5/16/2018

COSMETIC CASES….

5/16/2018

COSMETIC CASES….

5/16/2018

COSMETIC CASES….

5/16/2018

PROVISONALS

PROVISIONALS

5/16/2018

CERAMIC TRY-IN

• Make sure it is etched properly from lab

• Ceramic Primer prior to try-in (unless using Ceramir)

• Ultrasonic with ethanol after try-in

BONDS WITH OR WITHOUT HF

ACID ETCHING

THE “NO-WATER” SILANE w/ MDP

INSTANT ACTIVATION

LESS DEGRADATION

(More Stable 2 Year Shelf-Life)

5/16/2018

Silanes

Universal Adhesives (w/MDP)

Silane Primer + MDP

Organo-Phosphate Monomer (MDP)

Silane Primers

A disadvantage of many other silane products is that they are pre-

hydrolyzed.

Another disadvantage is some require the use of Hydrofluric Acid

etching and sometimes in addition to Micro-Etching. The new

Monobond Plus requires HF and Micro-Etching as well as 60 minute

activation time period.

5/16/2018

TRYIN APPROVAL

5/16/2018

3 VITA® shades

2 chromatic shades

LITHIUM DISILICATE & SILICATE, LEUCITE AND FELDSPATHIC

RESTORATIONS

IS AN ADHESIVE CEMENTATION

SYSTEM THAT IS EASY-TO-USE,

EFFICIENT AND HIGHLY

EFFECTIVE

5/16/2018

FINAL RESTORATIONS

Veneer Finishing System

FREE SAMPLES AT BOOTH TODAY

5/16/2018

ContacEZ Restorative strip system

• NEW Gold Narrow Strip 0.10mm single sided medium diamond grit Sub Gingival Trimmer w/ Blank Clear Gateway

• Black Diamond Strip 0.06mm fine diamond single sided

• Orange Serrated Diamond Strip 0.05mm extra fine diamond single sided

• White Serrated Strip 0.035mm

• Blue Serrated Strip 0.065mm

• Gray Final Polishing Strip 0.05mm ultra fine diamond single sided

ContacEZ IPR Optional Strips

• Clear IPF Single Sided Opener 0.10mm med-fine diamond

• Cyan IPR Single Sided Widener 0.12mm med-coarse diamond

• Purple IPR Super Widener 0.25mm

coarse diamond

• Brown IPR Mega Widener 0.30mm coarse diamond

5/16/2018

• More efficient than Halogens

• Halogen produces light from 370 to 800 nm then filters out all

but blue light in 400-500 nm range

• Longer lasting / Cordless / Batteries

• Faster curing (5 seconds)

• Smaller in size/lighter

• Less heat

BENEFITS OF LED LIGHTS

Comparisons - Lights

5/16/2018

VALO DELIVERS

Access to the curing site = Energy to the resin

5/16/2018

Machined from Aerospace Aluminum

5/16/2018

• Design• Power• Durability• Access• Posterior tooth• Broad Light Output Range

– 395-480nm

• Cost• Weight

5/16/2018

IT’S ALL ABOUT THE LITTLE DETAILS

QUESTIONS?

THE POWEROF

ACTIONABLE METRICS

5/16/2018

Online Real Data

THE POWEROF

ACTIONABLE METRICS

TWO WAYS TO INCREASE PRODUCTION

PATIENT Visits PRODUCTION on Visits

5/16/2018

NEW PATIENTS

HOW MUCH DO WE REALLY LOVE THEM?

5/16/2018

RECAPTURED

PATIENTS

47 $65,114

Before AfterHygiene Re-Appointment

$167,400 increase through Actionable Metrics

5/16/2018

Hygiene Re-Appointment

5/16/2018

REAPPOINTMENT METRICS

How well is your staff

reappointing patients?

How many people are

past due?

You run a report?

How do you follow up on

the report?

5/16/2018

Slipping Through The Cracks

5/16/2018

Delivering Best Dentistry

5/16/2018

Accuracy, Consistency, Data

• Get an analysis of your company and see where you can make more money and be more efficient!

• Hard to make more when You have no idea what you are missing!

5/16/2018

Text “action” to: 77453

Text RaceData to 77453

5/16/2018

Cementation of Anterior

crowns

• Alkaline pH 8.5

• Self Sealing

• Apatite Formation

• Insoluble/No Degredation

• Stronger with time

• Semi / Translucent

• Biocompatibility-Excellent

• Bioactivity-Apatite formation

• No silane, conditioning, bonding

CERAMIR ® CROWN & BRIDGE**

Cement Selection

5/16/2018

Bioactivity by Doxa

A reactive bioactive system that contributes to hydroxyapatite mineralization of hard tissue through ion release and alkaline

Cement Selection

CEMENTATION TECHNIQUE

Cement Selection

Mix for 8-10 seconds

3-4 restorations

5/16/2018

LITHIUM DISILLICATE (EMAX) OR ZIRCONIA

• Silane is contraindicated

• Tooth etching or conditioning

is not necessary

• Bonding agent is not needed

Cement Selection

CROWN RETENTION• Results Zirconia crowns (Kg/F)

Material Result (Zirconia crowns) Kg/F

Ceramir Crown & Bridge 32.1 ± 6.3

RelyX Unicem (3M) 27.8 ± 11.3

Dyract Cem (Dentsply) 12.2 ± 3.1

Rely X Luting (3M) 10.9 ± 6.5

Ceramir Crown & Bridge RelyX Unicem (3M) Dyract Cem (Dentsply) Rely X Luting (3M)

Cement Selection

5/16/2018

Cement Selection

Journal of Esthetic & Restorative Dentistry March 2015

5/16/2018

Case #11:

5/16/2018

Cement Selection

5/16/2018

Case Review

• Maintain Centric Occlusion

• Facebow & Wax Bites

• Beadline Provisionals

• Simplify Cementation

• Silane is contraindicated

• Tooth etching or conditioning

is not necessary

• Bonding agent is not needed

Technique Research/Literature**

• No Sensitivity

• Alkaline pH

• Apatite Forming

• Insoluble

• Stronger With Time

• Self Sealing

Remember The Old Appointment Book?

How LONG Did It Take To Answer A Question About Balances, Forgotten

Appointments?

5/16/2018

• VOIP Phone System Integrates with your existing dental practice management software (DPMS)

• Dentrix

• Dentrix Ascend

• Eagle Soft

• Easy Dental• SoftDent

• Practice Works

• Mac Practice

• Open Dental

5/16/2018

Teamwork

• Auto confirms appointments and adds to the Practice Management Software

• Auto Birthday Messages

• Auto propagation of messages

• Easy to implement with minimal time to use.

• Improve business opportunities dramatically

• Cuts down on current employee time by streamlining many tasks

• Saves money on traditional procedures

– Less postage

– Less paper goods

– Less employee time

Online reviews• 2011 33% reported they did not trust online reviews.

• A recent study reported 88% of people trust online reviews

• 92% or internet users read product reviews

• 89% said it influences their purchases

• 74% of internet users said they would most likely not do business if there was a negative review

• Currently having one bad review is considered normal, but lots of bad reviews is not good.

5/16/2018

Reviews text message

5/16/2018

Reviews text message

5/16/2018

Weave Reviews Via Cell phone message • Select Ratings to be sent to:

• Google• Yelp• Facebook

• Customize Order of Review Sites

• FYI-A dental/medical office can have more than one listing on Google, Yelp etc.. Because they typically employee more than one doctor as well as the business name (ie. Aesthetic Dental Designs and also Todd Snyder, DDS and my Associate can have a site too, just use different phone numbers and emails)

5/16/2018

Weave Mobile App

-Same functionality

-From anywhere you have a wifi or cell connection.

5/16/2018

WEAVE IS THE BEST SOFTWARE TOOL I OWN

• It lets me do more in less time than what it would take three people to do in an hour.

• It replaces your existing phone with a Voice Over Internet Phone that attaches to your practice management software.

• It gives you the ability to cut your phone bill and be replaced with a modern phone platform that allows you to.

• Text your patients

• Record all phone calls

• Automated appointment reminders, follow-ps, post-op notices, birthday greetings, and more

• Collect balances instantly via text

• See unscheduled patients and have the ability to instantly send automated text messages to fill gaps in the schedule

• Newsletters and promotions

• So much more….. YOU HAVE TO GET A DEMO IT IS AMAZING!!

• THE COST IS TYPICALLY THE SAME AS YOUR EXISITING PHONE BILL BUT YOU GET RID OF YOUR PHONE AND FOR THE SAME COST YOU REPLACE IT WITH SOMETHING BETTER THAT MAKES YOU MONEY!

5/16/2018

TODD SNYDER(949) 643-6733

doc@tcsdental.com

www.aestheticdentaldesigns.comwww.drtoddsnyder.com

www.toddsnyderracing.com

97% of offices don’t train.

5/16/2018

Technology Online

• Efficiency 24/7

• Accountability

5/16/2018

Unit 1 Introduction Rapport

Unit 2 Foundation of Rapport

Unit 3Fundamental Techniques in Handling People

Unit 4 Six Ways to Make People Like You

Unit 5 Mirroring & Matching

Unit 6 Outcome of Calls

Unit 7 How to Build Rapport

Module 5 Rapport 2: Personality types

Unit 1 The Know-it-All

Unit 2 The Storyteller

Unit 3 The Easy Peasy

Unit 4 The Rusher

Unit 5 The Informationalist

Unit 6 The Nervous Nelly

Unit 7 The Indecisive

Unit 8 The Price Shopper

Module 6 Rapport 3: Advanced rapport

Unit 1 Empathy

Unit 2 How Long to Build Rapport

Unit 3 VIP Process

Unit 4 Positive Language

Unit 5 Elements of the Rapport Process

Unit 6 Phone Success Quiz #02

Module 7 Engage: Foundation

Unit 1 Introduction to the Engage

Unit 2 What is Engage

Unit 3 Proactive v. Reactive Scheduling

Unit 4 GREAT vs. EAGER Calls

Module 8 Engage: Elements of engaging the patient

• 14 Modules

• Quizes

• Exam

• 13 Modules

• Quizes

• Final Exam

Module 5 Working with Emergencies

Unit 1 Emergencies

Unit 2Scheduling Quiz #01

Module 6 Broken & Changed Appointments

Unit 1 Introduction

Unit 2Broken Appointment Policy

Unit 3Handling Broken Appointments

Unit 4Broken Appointments COSTS

Unit 5What patients must know

Unit 6Important Points

Module 7 Confirmations

Unit 1 Confirmations

Module 8 Early and Late Patients

Unit 1Early and Late Patients

Unit 2Scheduling Quiz #02

Module 9 Next Appointment Updates

Unit 1Next Appointment Updates

Module 10 Patient Reactivations

Developing

5/16/2018

1. Telephone Skills

2. Customer Care Protocols/Scheduling

3. Team’s Role/Training

4. Resource Library

5. 24/7

97% of offices don’t train.

(954) 323-2220

Inquire with “Heather” for a $200 Discount

5/16/2018

www.Chip-In.org

You don’t want to miss what I am going to present in the coming months!!

Watch these Social Media Channels. Watch the Instagram Stories or Facebook Posts

TODD C. SNYDER, DDS, FAACD The Nuts & Bolts of …...FOR OPTIMAL SHADE MATCHING 5/16/2018 18...

Documents