What are your New Year predictions for dentistry?

 


First an update on our practice's new schedule for 2026 . David is seeing patients at our office on Thursdays and some Wednesdays. My schedule is Monday, Tuesday, and Thursdays as well. Friday I am an attending our Mount Sinai's general dental practice Residency.

As the new year approaches and the office is closed until January 5th, I have had time to reflect on how things are going in our practice and I am looking forward to the new year and starting my 46 sixth year in dentistry. Its been a long and fascinating journey!

When I started, some dentists were still taking copper band impressions for crowns, but most dentists had adopted elastomeric impression materials to accurately capture the details of their preparations. I had been trained in both techniques, but clearly taking elastomeric impressions was easier and allowed fewer steps in crown fabrication. 

Now dentists coming out of school are trained in elastomeric and digital impressions. Now my son works in another office that has a milling machine and he has the capability of fabricating a same day crown, so digital techniques now are slowly supplanting the analog techniques that I prefer. We currently have a 3d scanner in our office and if I felt that same day crowns offered were truly superior to those made by my lab, I certainly would consider purchasing a milling machine, but for the present, it is not the case.

Truth be told 3D milling of crowns has its limitations and as 3D printing improves, it will most likely will eventually become the preferred way to fabricate indirect restorations, since it can create better fitting restorations for our somewhat less than perfect tooth preparations. Even if a dentist spends significant time and effort in his or her preparations, most preps have minor imperfections that can present problems using the present day milling machines.

Please don't get the wrong message. At the moment most of the Zirconium crowns are made using  commercial labs and they are excellent restorations that I am certain will stand the test of time. Digitally produced full zirconium crowns can be both esthetic, strong and durable restorations, but really require a very smooth shoulder or chamfer finishing line. This can be time consuming to properly produce for many dentists. Beveled preparations that were used for all metal or ceramometal restorations , were more forgiving and were in my opinion faster and easier to prepare. 

I suspect that in the future some sort of 3d printed crowns made of some sort of composite material will become more and more popular... Already one of my collegues is using this technique in her office for most indirect restorations and she is very pleased with the results. As a youngish 72 year old, I am looking forward to seeing how things evolve in dentistry, and I am optimistic that our results will get better and better, especially for those dentists who are passionate about producing excellent and long lasting restorations!




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2025/12/what-are-you-new-year-predictions-for.html - http://lspindelnycdds.blogspot.com/

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