Very Dental Extra: Really Strong AND Really Pretty Zirconia with Dr. David Rice

[00:00:00] This is a production of the Very Dental Podcast Network.

[00:00:05] Sometimes you just can't get enough Very Dental.

[00:00:14] Sometimes you need a little bit more.

[00:00:16] Now is one of those times.

[00:00:18] Welcome to the Very Dental Extra.

[00:00:22] A Very Dental People Welcome to another episode of the very dental extra.

[00:00:27] You hear that the extra.

[00:00:29] Our extra today is brought to you by our friends

[00:00:32] over at Iva Clarn.

[00:00:33] And today I'm talking with someone who you've heard

[00:00:35] from before, Dr. David Rice.

[00:00:37] David, how you doing?

[00:00:38] I'm great. How are you, Ellen?

[00:00:39] I'm good.

[00:00:40] So David and I saw each other last week at this time.

[00:00:44] We were in Chicago at the midwinter.

[00:00:47] Did you actually go over to the midwinter? Like I saw you over at the where lab day is the high

[00:00:52] at, but did you go to the midwinter? I did. I spent two and a half days midwinter and then a day on

[00:00:57] the lab side. Okay. Okay. So you were there. Wow. You were there for like the whole time.

[00:01:03] That's kind of cool. Okay. So one of the highlights of Chicago for me,

[00:01:07] I've been going to the mid-winner since I was in dental school

[00:01:11] because my dad used to,

[00:01:12] my dad actually one year paid to have like 15 of my friends

[00:01:16] come down from Minneapolis to the mid-winner.

[00:01:20] And interestingly, vendors don't want to talk

[00:01:24] to dental students.

[00:01:25] Can you imagine that?

[00:01:27] Shocking.

[00:01:29] The trick was, and they had, we had like a little,

[00:01:30] I don't remember what color their stripe was,

[00:01:32] but there was a certain stripe that told them

[00:01:34] they were dental students,

[00:01:35] and they just didn't have a lot of time for us, imagine.

[00:01:38] You know, it's good to feel like an outcast

[00:01:40] right out of the gate as a dental student.

[00:01:42] Let's just give you a stripe so everybody knows.

[00:01:46] I know right. And but I still was I was amazed by the place. I

[00:01:50] was a man and I still am. And that said, I mean, I like that

[00:01:56] meeting. It's been a highlight of my dental career over the years.

[00:01:58] It's kind of like comes around once a year, sort of like

[00:02:00] Christmas like dental Christmas a little bit except you go to a

[00:02:03] ton of meetings. You I mean, you go to a ton of these bigger meetings, you know greater New York

[00:02:07] Which I've been to a couple times to Chicago, Hinman down south. What are some I think one of the California ones is particularly big

[00:02:15] What do you see? I mean because you go to all these things. What do you see in?

[00:02:19] You know in general

[00:02:21] They're shrinking by and large. They're shrinking. I would say meetings like Chicago that we were just at,

[00:02:27] they've done a really good job of maintaining.

[00:02:30] In fact, I think this year they probably grew a little bit.

[00:02:32] This might be the biggest midwinter they had in four years.

[00:02:35] So that's cool.

[00:02:36] But you know, young dentists, they have a different perspective

[00:02:40] on meetings, you know, different than you and I.

[00:02:42] We've gone as much for the camaraderie

[00:02:44] and the community as we have the CE and that's not their thing.

[00:02:49] I've told this story about a million times,

[00:02:51] but and you graduated around when I did.

[00:02:53] So you remember, they didn't really have.

[00:02:56] You couldn't look at every product you might be interested

[00:02:58] on the internet and watch 10 YouTube videos

[00:03:01] and talk to 50 people in a Facebook group.

[00:03:03] You couldn't do that.

[00:03:04] When you went to the exhibit floor at mid-winner,

[00:03:08] you were seeing a lot of this stuff for the very first time.

[00:03:11] I was weak and I bought things.

[00:03:14] I bought lots of things that I didn't need.

[00:03:17] I was talking to David Hormbruck last week and basically the shelf that every practice owner,

[00:03:23] every dentist has of stuff that they

[00:03:27] bought with all the good intentions, but ended up not using that shelf gets smaller for me.

[00:03:33] I think the Internet has helped me a little bit.

[00:03:36] I don't make the dumb meeting purchase as often.

[00:03:40] I'm not saying I'm immune, but I don't do that as often.

[00:03:44] Are you familiar with that?

[00:03:45] Has that ever happened to you?

[00:03:47] I'd like to say no, but absolutely.

[00:03:49] And yeah, I still make a lot of dumb mistakes,

[00:03:52] but that might not be one of them anymore

[00:03:54] with the way things have evolved.

[00:03:56] Yeah, yeah, I agree.

[00:03:58] It's getting better, anyhow.

[00:04:00] So mid-winter was cool.

[00:04:03] Lab day is cool.

[00:04:04] Lab day is really cool.

[00:04:05] Like lab day is probably something everyone should go see

[00:04:08] just cause it's a whole different animal

[00:04:11] than the kind of meetings that we're talking about

[00:04:13] like the mid-winter.

[00:04:16] I don't know what's up.

[00:04:17] Do you have a mill in your office?

[00:04:20] I do, see, I do in my office,

[00:04:22] but we kind of cheat right behind our back wall in our practice is

[00:04:26] Our lab and you know Tony and his team they rent the space they have their own business

[00:04:30] But you know we've got multiple mills and multiple printers and all all the things

[00:04:37] At our disposal so I do some chair side stuff, but I do a lot of stuff with Tony's team because you know, they're amazing

[00:04:44] What's what's interesting to me? I literally have a lab. My lab guy bought the other side of

[00:04:50] my building just late last year. He's just finished moving in and which is cool, which

[00:04:56] is really cool. And yes, we're getting printers in mills and he's a pretty small Nonetheless, he's he's got some cool stuff going on there

[00:05:06] And it's fun to see the lab side of it and have access to the lab side of it

[00:05:11] Right like it's fun to be able to see how your stuff is being made and all that stuff

[00:05:16] Yeah, they've it you know

[00:05:17] They have it just a really cool perspective and and they know things that you know every dentist should know should care about

[00:05:23] But sometimes maybe we rely a little too heavily on them.

[00:05:26] Yeah.

[00:05:27] And I guess on the other hand, they know things that we don't actually have to know.

[00:05:34] Right?

[00:05:35] Like we can go and ask them about it and see how they, but they actually have to know

[00:05:38] things that we don't know.

[00:05:40] They have to know settings of their mill.

[00:05:42] They have to know the birds.

[00:05:44] They have to know all the stuff and they have to know the birds. They have to know all the stuff.

[00:05:45] And they have to know the materials,

[00:05:46] which is a really good segue.

[00:05:49] See, in the podcasting business, we call that a segue.

[00:05:52] That was a really good segue into what we're talking about.

[00:05:54] Okay.

[00:05:56] So we're actually here.

[00:05:57] David has an article coming out probably around the time

[00:06:01] this episode comes out.

[00:06:02] I'm not exactly sure.

[00:06:04] And it's gonna be in dental economics, isn't it?

[00:06:06] It is. Yes. Okay. Okay. It has a very clever title. So give us the title, David. I'm very I'm very clever.

[00:06:13] It's the wise and wise of z. Wise and wise. Got it. So, okay,

[00:06:28] the first Y is like, why? And then the second Y is the different, the wise or the itrias,

[00:06:35] yitrias. How do you say, how do you like to say it? You know, I like, you know, your first

[00:06:39] pronunciation felt very European to me. So I don't join that. Yeah. I, cause is the why silent or is it there?

[00:06:46] In any case, that's an important, it's an important thing that, okay, so I'm going to

[00:06:50] just put this right out there.

[00:06:51] Yeah.

[00:06:52] We put it out there or I'm put it right out there.

[00:06:56] Listeners, you probably don't know what kind of zirconia your lab is giving you because

[00:07:01] you probably didn't ask because you probably didn't think you needed to because a zirconia crown is a zirconia crown.

[00:07:08] Now some of you that are paying attention to the materials a little more know that's

[00:07:12] probably not exactly true but David's point is that we need to be paying more attention

[00:07:18] to these things.

[00:07:19] Would you, is that kind of the point of the article a little bit?

[00:07:22] Absolutely, it's the point, you know, because most, you know, I would argue like most people

[00:07:27] jumped into Zirconia because we're like, oh, we want a tooth-colored crown that's crazy

[00:07:31] strong. And that's one type of why. But there are plenty of others out there that just aren't

[00:07:38] as strong as everybody thinks they are. So you think you're putting in something that's

[00:07:42] bulletproof and it's not.

[00:07:44] And it is funny. You wrote another article. I just read. I'll link both these in the show notes,

[00:07:49] but basically what you noticed and I totally noticed this too. The first zirconia crowns we put

[00:07:55] in fit really well. They were hard as a rock. They were opaque, beyond opaque. They looked barely better than your temporary.

[00:08:06] Some of them maybe not as good as your temporary.

[00:08:08] And you could deflect bullets off them if you want.

[00:08:12] And this was the first introduced, you know,

[00:08:16] three-wide material.

[00:08:20] And there is opaque, strong as hell, but opaque,

[00:08:22] like really opaque.

[00:08:24] And then tell us a little bit about how did they evolve this and then describe the fact

[00:08:30] that some people noticed that it started looking prettier and they didn't ask a lot of questions.

[00:08:36] Yeah, so I mean we did as humans do, we're like, oh that fits really great and it's crazy

[00:08:41] strong but it's ugly.

[00:08:43] Yeah.

[00:08:44] Do a better job lab.

[00:08:46] So labs and manufacturers went out and just made something that's really pretty that turns

[00:08:51] out is half as strong.

[00:08:54] But nobody, like you just said, no one asked the question.

[00:08:57] We just said, well, why didn't you do it that way the first time?

[00:09:00] Yeah.

[00:09:01] That would have been better.

[00:09:02] So then they came out with, you know, five wiser

[00:09:05] conia, which is indeed really pretty. It's still not as pretty as, you know,

[00:09:09] lithium disilicate and other ceramics because of the way it reflects light,

[00:09:12] but much, much, much prettier. But no one, no one talked about the strength

[00:09:18] factor and that it's, you know, it's by and large weaker than e-max. So smart

[00:09:24] people then came around and said, all right, well, if that's one extreme and

[00:09:27] that's another, maybe we ought to figure out how to hybridize this stuff so it can be strong

[00:09:31] and pretty.

[00:09:32] And that's a very select group of zirconia out there that can accomplish both of those

[00:09:37] things.

[00:09:38] But to your point, if we're not asking, our lab's not telling because they're not buying

[00:09:42] tens or conia systems, they're buying one.

[00:09:44] They're going to work with the one they have.

[00:09:47] And if that happens to be the pretty one because you and I got mad at them, then maybe

[00:09:52] we need to change our props if that's what we're going to do or at least ask some questions.

[00:09:57] Well, tell them, okay, so there's the lot in there actually.

[00:10:00] So tell me, first off, what's the conversation with your lab?

[00:10:07] Sometimes you want to be as easy as checking a box.

[00:10:10] You want zirconia, but the reality is you should probably be asking about the system.

[00:10:14] What questions do you ask these lab people?

[00:10:16] You know, I think the most basic one everyone should ask is, hey, what type of zirconia

[00:10:22] am I getting?

[00:10:23] Who makes it?

[00:10:24] And is it 3Y, 4Y, 5Y, some hybrid-Y? What type of zirconium I getting? Who makes it?

[00:10:25] And is it three Y, four Y, five Y?

[00:10:28] Some hybrid Y, what is it?

[00:10:30] And if you hear any more than like a three second pause,

[00:10:33] there's a decent chance your lab is mixing their own zirconium by hand in the back

[00:10:38] and even they don't know what it is.

[00:10:40] That's dangerous.

[00:10:41] Run.

[00:10:42] I don't care how long you've been working with your lab.

[00:10:44] They should know what it is. They're telling me tell me about this mixing this sounds very exotic David

[00:10:50] It's it's quite exotic, but zirconia is like one

[00:10:53] It's it's weird right cuz you if you if you ask for a gold crown you get this little certificate if you ask for lithium

[00:10:58] To sell it you get a certificate

[00:11:00] Zirconia that's not necessary yet. So, there are manufacturers making some legit stuff.

[00:11:07] And then there's some people literally, you know, home cooking in the lab because it costs

[00:11:12] them less money, less money.

[00:11:14] And they don't know if it's three, four, five, why or some hybrid.

[00:11:18] They really don't know which means you and I can't count on the strength.

[00:11:21] I mean, the pretty we can look at and assess, but the strength, we're not going to know

[00:11:24] if something breaks. And then, you know, usually look at and assess, but the strength we're not gonna know to something breaks.

[00:11:26] And then, usually we're by ourself with our patient

[00:11:28] and nobody answers that phone call.

[00:11:30] Yeah.

[00:11:32] And that's when you blame it on,

[00:11:34] obviously the lab did something wrong,

[00:11:35] but the reality is you probably paid less maybe

[00:11:38] or you didn't ask your lab or whatever.

[00:11:42] And yeah, what's interesting about that is,

[00:11:44] okay, so you're talking about,

[00:11:46] so if you want your lab to be able to tell you, like you said, the three second pauses,

[00:11:51] the giveaway, you want your lab to be able to tell you that this is what they're using,

[00:11:55] they are using a particular brand or a particular style. And that's helpful. That's step one. And

[00:12:01] that is actually a legitimate question that lab should not really have a problem with that's kind of where I'm coming from

[00:12:07] Totally agree and then you know beyond there as a dentist. I think you just need to decide how strong does this restoration need to be?

[00:12:14] And I'll pretty doesn't need to be and then make your choice

[00:12:17] Based on that if it's going on a

[00:12:20] You know an upper second molar on a 99 year old patient

[00:12:23] They probably don't care if it's

[00:12:25] the most beautiful zirconia crown.

[00:12:27] They just want something that's going to fit and last.

[00:12:30] If it's going to go on somebody who wants to be on the cover of a magazine on a central

[00:12:34] and sizer, then it better be really pretty and everything in between.

[00:12:37] Yeah.

[00:12:38] Well, but the other thing is, like you said, the how strong does it need to be is a good

[00:12:42] question.

[00:12:50] And because the original, like, I remember we talked to Mike to Tola, the original Bruxer, that was the selling point,

[00:12:54] like the Glidewells, Glidewells, Zirconia, you know, they,

[00:12:58] they would, you know, the, the party trick was they'd take the crown

[00:13:01] and they'd hit it with a hammer into a board, you know, that's how strong it was. And of course, it didn't look like much. And they

[00:13:06] actually didn't even pretend that it was a pretty crown, you know. They started out with strong

[00:13:12] and not pretty. They moved to pretty. But the story is like a lot of times a better

[00:13:16] lot of dentists feel like, okay, I kind of want something in the middle. Like, I want something

[00:13:20] that's going to be strong on a first molar. I'd like to be able to prepare a tooth

[00:13:25] like I used to like I used to prepare gold. You know that's true. You know that's because I mean

[00:13:30] the one thing I can say is I'll see all see gold crowns that I've done in the past and they finally

[00:13:36] have decay at the margin or something like that. You take a gold crown off and usually there's just

[00:13:40] a ton of tooth structure to work with. So it's like hey if I don't have to prepare that much in the

[00:13:43] beginning that's awesome. My dad a lot of the you know poor with. So it's like, hey, if I don't have to prepare that much in the beginning, that's awesome.

[00:13:45] My dad, a lot of the, you know,

[00:13:47] poor some fused and metal crowns that he did,

[00:13:49] he probably, by any standard, was probably under prepped,

[00:13:53] but on a lower first molar nose, really seeing it, you know,

[00:13:56] it's a, you go back in there,

[00:13:57] there's a lot of tooth structure there left.

[00:13:58] So you didn't prep the snot out of the tooth.

[00:14:00] And you want, you'd love to be able to do that for Zirconia.

[00:14:03] I think on some level, maybe if you're on leaning towards that 3y with it's not very pretty you might be able to get away with a prep like that

[00:14:10] But then you said okay if you're going to the prettier perhaps you might or the prettier the prettier

[00:14:15] Zirconia you might have to change your prep tell me more about that

[00:14:19] Yeah, so if you want to go to like all the way to 5y

[00:14:23] It's you know from a compressive strength not to, it's, you know, from a compressive

[00:14:25] strength, not to totally geek out, you know, it's still pretty strong.

[00:14:28] It can be like 700 mega pascals depending on who it is.

[00:14:32] But from a sheer toughness, which is essentially what we do to our teeth, it's weaker than

[00:14:40] e-max, which means you think you're moving to a stronger material.

[00:14:43] You're really, really not.

[00:14:45] Which is why I think, you know,

[00:14:46] I have a car got pretty sharp,

[00:14:48] and they built, you know, their whole primes

[00:14:50] or conia family of materials,

[00:14:53] because they start 3Y at the tissue

[00:14:56] where we actually need the strength,

[00:14:57] and then they transition to get to 5Y

[00:15:01] by the occlusal table in size of the ledge

[00:15:02] where we want pretty.

[00:15:04] And it's really, it's super techy.

[00:15:06] It's really cool how they gradient things out, but we get the best of both worlds.

[00:15:11] But if you don't even know which is their cornea you're getting, then, then you, like

[00:15:15] you said, you either have to over prep if you want the prettiest stuff or accept

[00:15:19] the fact that it's not going to be that pretty.

[00:15:21] So knowing which is your cornea you're working with and why it's pretty and why it's trying is kind of helpful.

[00:15:27] So you're saying basically that the zirconia, give us the name of the zirconia and then

[00:15:33] we're talking about pucks here. So this is what your lab is going to use.

[00:15:37] Yeah. So I mean in true of a claw fashion it's got a 14-syllable name. But if you remember, you know, Zerk had to do it.

[00:15:47] How did they do it in Europe?

[00:15:49] I'm saying.

[00:15:50] I was just going to say that.

[00:15:51] It's like IPS, Emacs, Zerk had prime.

[00:15:54] Yeah.

[00:15:55] So I mean, Zerk had prime is what you need to remember

[00:15:57] when you're talking about it.

[00:15:58] Yeah, remember Zerk had prime.

[00:15:59] And no, the coolness of it is it's really strong

[00:16:03] and really pretty based on the chemistry

[00:16:06] and the physics and how they laid it all out. It's awesome.

[00:16:10] I love it.

[00:16:11] What's interesting, I've seen some labs show me how they use this particular material.

[00:16:16] They will literally, in the CAD software, depending on how translucent or how strong,

[00:16:23] they will literally mill it out of a certain height height of the puck like there's the three y is on basically the bottom and the five y's it's all like.

[00:16:33] This continuum so depending on strength and like aesthetic needs they'll literally mill it in a different part of the park which is freaking freaking crazy to me. That's a lot of thought.

[00:16:45] It's more thought than I actually, as a dentist, am putting into it.

[00:16:48] But I love the fact that the labs understand this.

[00:16:51] So they can, if it's a second molar, maybe you go a little closer to the three-wire end.

[00:16:56] If it's a premolar that's going to show, maybe you go a little...

[00:17:01] The different strengths that are necessary, you can kind of pick, is that, do I have that right?

[00:17:07] You do, you do have it right.

[00:17:08] And what's really, I guess maybe a differentiator is,

[00:17:12] there's some manufacturers that actually make it,

[00:17:14] and it's like bands, right?

[00:17:15] And you've probably seen the pucks,

[00:17:17] or if you're a chair side miller,

[00:17:18] and you're listening, and you've probably seen the blocks,

[00:17:21] where it's like a band, a band, a band.

[00:17:22] Like, this is like somebody took sand

[00:17:26] and they poured it in a glass

[00:17:28] and they put all the strong stuff at the bottom

[00:17:30] and all the really pretty stuff at the top.

[00:17:31] And then the whole middle of it is just,

[00:17:34] they poured from both sands in the middle.

[00:17:36] So it's truly like one integrated piece.

[00:17:39] And I've done, I mean, I've put those on second molars,

[00:17:42] first molars and central incisors.

[00:17:44] And to

[00:17:45] your point, you can work with your lab, kind of shuffle around where in the block it should

[00:17:50] go and they can be spectacular when done well.

[00:17:53] Yeah. That opens up a whole different animal for zircones. There's a lot of people that

[00:17:58] are never going to do. They're thinking, well, I'm always going to do lithium bicilicate

[00:18:02] in the front. I mean, if it's an aesthetic thing, I'm always going to do that. I need

[00:18:04] the translucence. But I mean, literally the five going to do that. I need the translucence.

[00:18:05] But I mean, literally the five Y part allows for quite a bit

[00:18:08] of translucence.

[00:18:10] I'm going to tell you this.

[00:18:11] I'm old enough.

[00:18:12] I don't know.

[00:18:12] You probably don't feel this way, but I'm old enough.

[00:18:14] I like to plonk my crown.

[00:18:16] I like to cement them.

[00:18:18] I like to use the cement that I've

[00:18:20] been using since dental school or something to that level.

[00:18:23] And that's one of the reasons I like zirconia, particularly the further posterior back,

[00:18:27] the more I like that.

[00:18:29] And I mean, so one of the reasons zirconia has been such a good fit for me is because

[00:18:32] of that.

[00:18:33] And so how do you feel about that when I say you've got a lot of options for sticking

[00:18:37] these on teeth though, I think.

[00:18:38] Is that right?

[00:18:39] You do.

[00:18:40] And I love that about zirconia too.

[00:18:42] I love it for myself because let's be honest, it's my favorite GV black principle. It's convenience form. We want it to be easy. Why

[00:18:48] should it be difficult if it doesn't need to be difficult? And then for my patients,

[00:18:52] sometimes Alan, I'll have an aesthetic case where I'm doing a bunch of in years, but

[00:18:56] then I'm getting back to the bicuspids and I'm doing crowns because I took old crowns

[00:19:00] off and I'm like, yeah, you know what the patient wants? They want simple too. So they

[00:19:04] don't want a 14 hour insertion.

[00:19:06] So when I can transition to something that I can loot instead of bond, I'm winning their

[00:19:12] patient experiences as much better and once the practice wins and they win.

[00:19:16] No, that's really cool.

[00:19:18] That's really cool.

[00:19:19] So I told you that my lab, the lab that I use local guy, bought the building, bought the other side

[00:19:26] of the building that I'm in.

[00:19:27] So it's really nice.

[00:19:28] I literally have a lab I can just walk over to and talk with him.

[00:19:31] I do all the time.

[00:19:32] And he got his own mill recently.

[00:19:35] He had been outsourcing for a while.

[00:19:37] Now he's not outsourcing, which is really great.

[00:19:40] And lo and behold, I walk into his mill and imagine my surprise and delight.

[00:19:47] He only has one kind of puck.

[00:19:50] And it just so happens to be the puck we're talking about.

[00:19:53] And I asked him why.

[00:19:54] I asked him why.

[00:19:55] I said, well, because I got all that I need with one puck, because it simplifies that

[00:20:00] end of it for them too.

[00:20:01] I mean, when you're talking about someone who's got a really high aesthetic need or someone

[00:20:05] who's got a real serious strength need, the ability to do whatever you need to do is

[00:20:10] very cool.

[00:20:11] So I literally, and I could tell when he started milling his own versus what he, I could tell

[00:20:16] the difference immediately.

[00:20:17] Like you could tell is really cool.

[00:20:19] Because especially when I was doing premolars, I'm like, I can see some serious translucent.

[00:20:22] So it's, I mean, I've seen this stuff in person too.

[00:20:24] It's really, it's an interesting change.

[00:20:26] And I don't know that I've seen it in anything else.

[00:20:28] Have you seen, I mean, outside of lithium disilicate, I mean, outside of a

[00:20:32] different material, this is really, this is really next level.

[00:20:35] It is.

[00:20:35] It's game changing.

[00:20:36] And I mean, and I'm an, and I'm an lithium disilicate guy.

[00:20:40] I mean, I can't tell you how many thousands of restorations I have in there with it.

[00:20:44] I love it. And I was the first person to push back and I have a climber. I mean, I can't tell you how many thousands of restorations I have in there with it. I love it.

[00:20:45] And I was the first person to push back

[00:20:48] and I have a client be like, hey, wait a second.

[00:20:50] Don't take my child away from me.

[00:20:52] I love this kid.

[00:20:53] And then I started test driving it myself.

[00:20:56] I'm like, oh, okay.

[00:20:57] So there's a place for this.

[00:21:00] And it's a big and most dental practices to your point.

[00:21:02] It's probably the lion's share

[00:21:05] of what most dentists will do.

[00:21:07] So why not use a material that's like you said,

[00:21:09] second, more, first, more, anterior teeth,

[00:21:11] anywhere between, make your life easy.

[00:21:13] It is, it's simple and it's a simpler ask of them,

[00:21:18] of the lab, honestly, it might be less expensive

[00:21:20] in some cases if you're not having to press it

[00:21:23] and stuff like this.

[00:21:24] There's a lot of, there's a lot of upside. What are their cases that you have surprised

[00:21:29] yourself using this material? In other words, at what point do you say, okay, I'm going

[00:21:32] to try it in the interior. Tell me about that.

[00:21:36] Yeah. So I had a patient and there was two centrals. They were both full coverage, like

[00:21:41] retreating full coverage crowns and I am a geek at heart. So I had two lithium disillicric crowns for eight and nine.

[00:21:48] And then I had two zirch head prime crowns.

[00:21:50] Oh, you did an AB test.

[00:21:52] I love it.

[00:21:53] I did an AB test and I, then I'm like, I'll be damned.

[00:21:56] Those things looked just as spectacular in this patient

[00:22:00] scenario is lithium disillicant.

[00:22:02] And at that point, I'm like, okay, I can no longer just poo poo,

[00:22:08] that this stuff is gonna be amazing

[00:22:10] and it's time for me to really assess it

[00:22:12] and calibrate my team to figure out,

[00:22:14] you know, when we're gonna use it,

[00:22:15] why we're gonna use it and on who,

[00:22:16] but it blew me away, I was really surprised.

[00:22:19] Yeah, so what we're really saying is that

[00:22:22] there's a change in materials and like always, I have

[00:22:26] a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a

[00:22:30] clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a

[00:22:34] clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a

[00:22:36] clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a

[00:22:39] clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a

[00:22:42] clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, I have a clique, this is like I said, this is kind of on the lab side, but again, it's worth a conversation with your lab

[00:22:45] to know exactly what they're milling out there for you,

[00:22:47] that sort of thing.

[00:22:48] It's pretty exciting.

[00:22:51] It is, and if you are a lab listener

[00:22:53] and you're hanging out here to understand

[00:22:55] how we dentist think,

[00:22:59] don't get locked in the box with something

[00:23:01] that can't deliver all the things that we want,

[00:23:03] because at some point,

[00:23:04] once dentist figure out the wise and wise because we will slow

[00:23:07] learners, but we'll get there.

[00:23:09] People are making different choices.

[00:23:10] And, you know, we want to be in the sandbox playing well together as opposed to saying,

[00:23:15] like, Hey, I can't work with you anymore because you're just not bringing what you need to bring.

[00:23:19] Yeah, it's interesting.

[00:23:20] And also honestly, I mean, I don't know in the lab.

[00:23:23] So I don't, I can't say, but But it's not like they're giving these things away.

[00:23:27] So the simplicity of having kind of less inventory of this stuff might be.

[00:23:35] And apparently the big joke is every time you walk into a lab meeting, you've got 20

[00:23:40] people telling you that they've got their material is cheaper. You should hear tri-free

[00:23:45] puck of this or whatever. But the reality is you got to look your dentist in the face

[00:23:51] over time. That's sort of the thing. So it's interesting. It's kind of like every dentist gets

[00:23:57] how many this lab can deliver a much cheaper unit per unit crown. You should give us a tri

[00:24:03] kind of thing. I mean, it's the same analogy between labs and dentists.

[00:24:08] We kind of have to be, you got to remember

[00:24:10] that there's patience on the end of those things

[00:24:12] and you have to be able to deliver on all cases.

[00:24:15] So it's just interesting.

[00:24:16] Not a type of out over there.

[00:24:19] Yeah, exactly.

[00:24:20] So one last thing before we go, I want to ask you.

[00:24:23] So you and Pam, your partner

[00:24:26] in crime over there, are relatively new podcasters. I don't know how long you've been, not quite a

[00:24:33] year maybe, has it been a year since? No, not yet. So I mean, not like you guys are pretty

[00:24:40] comfortable with the whole concept of content creation, putting it out there, all that stuff between dentistry IQ and dental economics and stuff like that.

[00:24:48] I'm curious about your experience. First off, the podcast is called Dentistry Unmasked,

[00:24:53] and you guys have a very clever photo shoot where you're both kind of right now.

[00:24:59] What do you think? You like podcasting? What do you think?

[00:25:03] I love it. I feel like you get to have very real conversations with people. You get to meet

[00:25:08] like a higher frequency of people and spend a little bit more time with them in smaller doses,

[00:25:12] which I like. Bite-sized content is great. Pam is just one of the gems of dentistry that I

[00:25:19] really appreciate because she always walks her talk. She's got a ton of integrity, and she's not afraid to push back, which I appreciate.

[00:25:28] There's a level of professionalism I think we all want to maintain, but sometimes a part

[00:25:32] of that is letting people know what the truth is, whether they want to talk about it or

[00:25:39] not.

[00:25:40] Sure.

[00:25:41] Sure.

[00:25:42] Sure.

[00:25:43] You guys have, your sound quality is good.

[00:25:44] Your topics are wide ranging, and it's been kind of fun to see you guys happen but and actually I think I'm

[00:25:49] gonna be on later this week or something like that. Yeah. It's a we'll make sure to put

[00:25:53] the link in the show notes for listeners more pod more dental podcasts to listen to. So

[00:25:58] and I guess before I go after now you're not even home right now you're you're out west

[00:26:03] I understand because you're a Florida guy and you're out west.

[00:26:05] So where in the world is David ending up in the next couple of weeks?

[00:26:11] Man, okay.

[00:26:13] Vegas presently, I'll be in Charlotte, North Carolina next.

[00:26:16] I'll hit home for a couple of days and then I'm off to Dallas, Texas.

[00:26:23] You're not home very often.

[00:26:24] That's what I'm hearing. Not enough. I mean, I love what I do. I love the people I get to do it with, but yeah, be nice to be home a little bit more. That's a 2025.

[00:26:34] Is that right? Oh, interesting, interesting. So the truth comes out here. That's interesting. So, yeah, what's the next big Chicago Midwinter-esque meeting that you're going to be going to?

[00:26:46] Man, you know, that one kind of culminates the season for me.

[00:26:50] So I guess the next one will be...

[00:26:53] Yeah, yeah, CDA.

[00:26:54] So out West West.

[00:26:57] Okay.

[00:26:57] It will be the next one, but it's got a little bit of breathing room, so to speak.

[00:27:01] Sure.

[00:27:02] Well, you're traveling all over anywhere.

[00:27:03] But those meetings have to take it out because you'd be i mean

[00:27:06] the funny thing is is you happen to see david on the floor

[00:27:09] that was probably a miracle because he has he has meetings

[00:27:12] that's i learned this when i became a podcaster what it really what i used to

[00:27:16] think is people just go on the floor and and they look at stuff and vice

[00:27:19] thought

[00:27:20] those everyone's having meetings with everyone else all over the place

[00:27:24] they're all like it's because everyone's in the same place at once.

[00:27:27] It's just easy to have in person meetings.

[00:27:29] I never realized that until I became a podcaster in there.

[00:27:33] So you probably don't get to just walk the floor very much.

[00:27:35] My guess is they've got you running around doing stuff all the time at these meetings.

[00:27:40] Yeah, I mean, between the dentistry IQ team and the Ignite stuff and it's my days, my

[00:27:46] typical day at a Chicago meeting is, as you said, probably 10 meetings in a day.

[00:27:52] And then you do a dinner meeting, which is a lot more fun.

[00:27:56] But now that I'm older, I do my best to, I get to nap time earlier as opposed to trying

[00:28:01] to stay out all night with the youngsters like I used

[00:28:05] to. I'm pretty happy to go home FaceTime. I better have and go to sleep.

[00:28:08] I tell you, yeah. So I, I, they had the podcast booth or brother. It's not booth. It was,

[00:28:14] it was like a, it was awesome at the Chicago Midwinter. And I talked to the woman who kind

[00:28:18] of put it together. She has a, they have a podcast for the mid or for the Chicago dental

[00:28:22] society. And if any other meetings are listening,

[00:28:26] you should just do that as fantastic. Now it's easier for me to say, because I just

[00:28:29] showed up and sat my gear down and started podcasting as fantastic. I basically went

[00:28:34] the whole time. I create a whole bunch of content there. And it kept me from buying stuff.

[00:28:39] So I'll say that. That was a good thing. I did not hit the floor like I normally do

[00:28:42] in the credit card, stayed relatively cool at that point. I really not hit the floor like I normally do in the credit card stayed relatively cool

[00:28:45] at that point. I really, really liked that a lot. But then both nights, this is, I can

[00:28:50] say this now, both nights, I went out to dinner alone. It was beautiful. It was so good. It

[00:28:56] was so quiet. And I didn't have to talk at all for those, oh, it's fantastic. So it's

[00:29:01] great. It is, it is. and that's very selfish of me,

[00:29:05] but I guess I had shared enough of myself that day.

[00:29:07] So I was glad to do that.

[00:29:11] All right, David, one last thing.

[00:29:13] What was the, when people are saying,

[00:29:15] okay, they're talking about this thing.

[00:29:16] It's from Iva-Clar.

[00:29:18] What are the things you need,

[00:29:19] they need to remember to talk to their lab about.

[00:29:20] It's Iva-Clar and it's Zur-CAD.

[00:29:23] Give me the thing again.

[00:29:24] What do they need to remember? Yeah, so remember's I have a clarin, it's zurkat, give me the whole thing, give me the thing again, what do they need to remember?

[00:29:25] Yeah, so remember zurkat prime and remember, you know, unbranded, just totally objective,

[00:29:32] just three Y, really strong, not pretty, five Y, really pretty, not that strong.

[00:29:38] Some of the hybrids in the middle, zurkat prime in my humble opinion and some data to

[00:29:42] back that up for sure is the best guy on the market right now. So just know what you're putting in a patient's mouth and then know

[00:29:49] if you want really, really, really pretty, you might need to prep a little bit more and

[00:29:53] maybe bond and stud elute.

[00:29:56] So for the for the chair side CAD, can people I have a is not what we're supposed to talk about, but I did talk about

[00:30:06] they released a block for Chairside Cat Camp and I had a chance to talk to talk to

[00:30:14] a couple folks from I have a car. That episode will be coming out relatively soon too. So if

[00:30:19] you're mad because we're talking about pucks, I got you covered in a few episodes you'll be hearing about

[00:30:26] that too. Again thanks to our friends from Iva Climb for bringing this to you and David thank you

[00:30:31] for a little bit of time and this was very informative I appreciate it. Hey always good hanging out you