Fundamental Principles

Executive Editor Daniel Alter, MSc, MDT, CDT | dalter@aegiscomm.com

The dental laboratory technology space has experienced a significant paradigm shift in its restorative fabrication modalities through digital means as of late, and this shift continues to evolve and expand the way we fabricate dental prosthetics. Very sophisticated processes are available now to achieve robust complexities, and new materials that were once unimaginable are now at our disposal; however, the importance of fundamental principles has never been more critical. The technologies available provide for tools to achieve truly remarkable outcomes, but those cannot be achieved without keenly and intimately understanding the foundation of the oral environment and all of its contributing factors to allow for prosthetic success. Those key factors are the basis of what will ultimately succeed in the oral environment; not observing those principles may introduce unintended consequences to the dental patient and, perhaps ultimately, the dental laboratory. Much like building a house, if there is no sound foundation, the house may be attractive but it will eventually fail due to a multitude of forces.

So, what are the foundational principles of dental technology? Whether it be fixed, removable, or a combination of both—including implant-supported restorations—understanding from macro and micro perspectives how the entire oral environment works will help you navigate the functionality of the oral environment and the prosthesis you are aiming to achieve. Those perspectives include the human being and their face, musculature, tooth arrangement, and occlusion, as well as biomechanics, tooth morphology, inclinations, and height of contours, just to name a few.

One core principle that trumps all others and must be adhered to is that "Form MUST follow Function." You must first achieve proper function in the patient's oral situation, and only then focus on the form or esthetics and so on; similar to the example of building a house, if the prosthetic is visually appealing but does not function properly, the prosthesis is meaningless and will quickly fail. With regard to biomechanics, restorative material selection can make or break the success of the case, and its most simplistic example is the location, as well as the hardness of a material, which can affect the outcome of the case. Will it function well with the oral mechanism or create issues caused by material selection, and so on?

There are ample opportunities to learn these fundamental principles from formal educational courses that are available in person or online, as well as journal articles, books, and seminars; equally important is for laboratory owners and managers to strongly encourage their technician talent to immerse themselves further and emphasize the importance of doing so. Similarly, it would behoove the laboratory to provide mechanisms within the building to learn and review these principles on an ongoing basis with all involved in the form of lunch-and-learns, junior technicians shadowing more seasoned technicians, dental fun trivia challenges, and more. At the end of the day, these efforts will lead to better outcomes, making the laboratory's clients and their patients happy, and thereby leading to the laboratory's success.

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