Have any of you come across this?
I first heard the term five years ago in Las Vegas. With the wonder of Google, I have found that it was probably first referenced in 2008 by Dr Rella Christensen. Nothing more recent. Why?
In 2015 I was in Las Vegas for the Sironaworld Cerec conference along with 5000 other dentists. It was the 30th annual event, and the Omnicam was released superseding my Blue cam, which was preceded by a Red Cam.
The Omnicam was a massive improvement, and now there a Primescan which is capable of far more than I am prepared to attempt, or my employer to buy.
Volks was the term used as it was for the people. It means that it was affordable for the majority of the public as in Volkswagen, not Porche. Both are functional, but one could argue one is more aesthetic and innovative than the other as well as is a different pricing structure.
Dr Rella was extremely enthusiastic about the Volks crown. She had set up a non-profit organisation CRA employing 40 scientists and staff with a network of 400 clinicians.
The volkscrown was a hybrid material, in this case, 3Ms Lava Ultimate, which I was starting to have difficulty in the UK with supplies. The reason was apparent in the lecture, as there were failures!
I have only read the article from 2008 today, and it reports the "failures" I have experienced. But they are manageable and repairable as you haven't removed the usual amount of tooth structure. I spoke to Dr Christensen at the end of the lecture. The reason for failures was predominantly debonding, and with that clearly, some lawyers were sniffing around. The reason for debonding was an incorrect procedure carried out by dentists, probably male as they hadn't read the basic instructions. The outcome was possibly as 3M were anxious about getting sued, rather than the dentist, they withheld the product. The opposite of the other main digital technology of clear aligners where while the treatment plan is by distant AI using GANs, the responsibility of the outcome is with the dentist.
I fitted a few all-ceramic Dicor crowns in the past, and they did fail, and I quietly stopped making them as I thought it was my technique. If I went on Facebook, I would have known better, but it was twenty years ago. The crowns I have fitted more recently have had greater success with similar material to Dicor because they are milled, and not made in a furnace. The other obvious advantage is it's a single visit.
As with most technology, it will continue to advance and with new features. But there may be the alternative to get last years model at a reduced price which is still excellent, similar to electric toothbrushes. Think of your phone and your contract, perhaps intraoral scanners may be leased in the same way? For the vast majority of the public and dentists, the technology is good enough now. And concerning learning new technology, it's all online.
Volks crown Article 2008
DR Rella Christensen
I retired yesterday, and while I will no longer treat any patients, I hope to support both dentists and the public through some reflections on my years in practice.
Last month this patient reminded me of how I'd looked after her when she was anxious and unhappy with her previous dentist who had fitted some veneers. She then told me how I wouldn't replace the veneers until she cleaned her teeth better and had some outstanding work carried out.
These are her BWs from 1997. Below are my comprehensive notes of the period and an indication of how the majority of our record keeping. We had to keep them to a minimum; otherwise, the record card would explode.
There is far much to discuss, but the root filling LL6 had a fractured instrument was poor, but lasted longer than the root filling I did in the ll5. It is strange how variable the outcomes are for root fillings despite their radiographic appearance.
I was never confident enough to make a crown on the ll6. I repaired it with Dyract in 2002, as you can see here. She is not concerned with the appearance. In fact, none of the teeth since 1997 have failed apart from both lower second premolars.
below are her recent digital BWs with many original amalgam fillings from 1997.
Finally, I sent off for permission to replace the veneers. This is the current appearance in 2020. I removed the offending cosmetic restorations and did not attempt temporaries. Two weeks later she returned for the fitting but decided she liked the appearance as they were. She still has the veneers at home.
I saw this patient under the NHS, if you look how long she was booked in for and my notes, you can see how different it is today. If you had a few of these NHS patients in your chair, what would you do? Give them some cash, and ask them to go elsewhere?
In retrospect, avoid any RCT where you intended to get near the apical foramen? Simply extract may have been better, as seems the new norm in NHS dentistry. If I hadn't gained her confidence back then, I doubt if she would have any molar teeth now. As for the person who placed the veneers, they gave the profession a bad name.
After a while, when using an ultrasonic scaler, my mind drifts off. Sometimes I even wonder what I am doing, and why? In March 2016 Mrs Collins isolated premolar supporting her CoCr -/p was M2 and bleeding. Desperate measures were required, so I sent her a YouTube video form the excellent group Perio Courses. In July 2020 she still has no bleeding, no mobility, and a lower denture she likes-even more unusual. She was the tipping point for my teeth4life APP.