I love using the Cerec for single unit crowns and a balanced bite. One or two crowns, especially in the posterior are great. The workflow is easy and I have full control over contour and occlusion.
But for more complex cases, where I am changing the occlusion or the position of the incisal edge, working with a skilled lab technician is critical. Without a lab partner who understands what we are doing and why we are doing it, there is no way to have a predictable outcome.
So what is the best way to find a lab that can help support the work we do?
Ask around. Talk to your friends and trust your mentors. Throw away the $29 crown mailings that land on your desk each week. Talk to other dentists who are practicing complete dentistry. Find out who they are using. Ask for an introduction to their favorite tech.
Then check our their credentials. It takes a significant amount of time, study, and testing to become a certified dental technician. And even more to become a master. I think that is a great place to start. These techs should be very capable of delivering high quality restorations. The next level of accreditation would be from the American Academy of Cosmetic Dentistry. Just like dentists, these lab techs have to pass an extremely rigorous evaluation process before achieving that coveted designation.
But what about occlusion? I don't think anyone teaches occlusion better than The Dawson Academy. So I have looked for a Dawson-qualified lab and a Dawson-credentialed technician. You can find a list on the Dawson Academy website under the "Find a ..." tab. These techs know what you do and understand your treatment planning process.
Once you find someone who has been recommended to you and has the right certification, you have to pick up the phone or visit the lab to open up a line of communication. Because any CDT, MDT, or AACD-accredited lab tech should be able to create beautiful restorations for you. Any Dawson-credentialed technician should be well-trained to follow your 2D and 3D treatment planning protocol. But even the greatest techs can only do their best if they are working in a lab that lets them do what they were trained to do. That is what you need to find out when you visit them and speak with them on the phone.
In this regard, they are a lot like dentists. Knowing how to do complete dentistry is great. But if you are in a practice that focuses on quantity over quality, you will never be able to do your best work. So we need to ask our friends and mentors to make a recommendation. We need to do our due diligence and discover what kind of certification and training they have achieved. And we need to communicate to find out how they work and to let them know how we I'll make it easy for them to make us look good.
Then do not skip any steps.
Send them a crisp and clear impressions of perfect preps with a facebow and an accurate bite. Follow-up with a full series of photos and the completed wizard treatment plan. Send impressions of the approved provisionals. A new set of photos for them to follow. Then when the case is finished, send another set of records so they can see the end result. Make them a part of treating a person, not just a disembodied set of teeth. They will love you for it and you will have found a new partner to help you do your best work.