Bisacryl and VPS

If you’ve ever had issues with the set of VPS impression materials, watch this video. Lee goes to the source – Germany – for answers on the correlation between bisacryl and the failure of VPS materials to set.

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Copyplast Flexibility: Pro or Con?


This is a copyplast former placed directly in the mouth to create provisionals – these happen to be crown preparations. Copyplast is a wonderful material for both direct and indirect provisional techniques BUT its greatest strength in this application is also its greatest weakness – its flexibility.

When pushed in over the preps, particularly when there are many preps, the copyplast tends to distort depending on where the force is applied. Because of this, many excellent clinicians use putty matrices to build provisionals. Their stiffness minimizes distortion and excess material. But they are not clear, and particularly in an intraoral environment I find them more difficult to work with.

The former above is 1.5 mm copyplast. Note the excellent adaptation to the teeth with a very thin layer of flash extending along the gingival. Actually even that thin amount is misleading; this former is tightly adapted and not distorted because it was seated with a custom tray created by the former itself.


Here you see the custom Biocryl tray partly removed on the patient’s right side. In my next blog, I’ll show you how it was created.

Here are the characterized provisionals made from the above.


An Hour Is an Hour, But All Weeks Are Not Created Equal

Calendar with MouseIn a recent post, I talked about how you can beat the overhead game when you realize that increasing the value of the time you put in (I gave an example of 200 days a year) increases your return exponentially. Now let’s examine another area that’s often overlooked: the flexibility you have in calendaring those hours.

Two hundred eight-hour days is 1,600 hours a year, no matter how you slice it. So why not slice it the way that suits you best? Life doesn’t come at us in neatly portioned daily servings, so why try to fit your work hours into an inflexible weekly template? Some months require more personal time than others. Some years have a different strategic focus than others. Once you get past the Monday to Thursday, eight-hour day mindset, you start to see how you can accumulate revenue time in creative combinations.

For instance, why not try working Tuesday to Friday one week, take two days off, work Monday to Thursday, then take four days off before starting the cycle again? With that four-day downtime stretch, every other weekend feels like a week off.

Let’s take it a step further. How about going to a five-day week, and adding half an hour to each work day?  Now you’re almost filling your monthly hourly input in three weeks, leaving your fourth week practically free. That’s almost 12 weeks a year of pure, life-enriching personal time or focused, stress-free time to work on the practice.

I realize this example is not realistic for everyone, and that while some of you will embrace the idea of extra work now for extra time later, others are simply not up for the idea of adding more time to the day, or another day to the week. Others might go for the five-day week idea—if they can use that extra day to do just the kind of deeply-immersive, high-value dentistry they can really get into. The point is, this is your practice, your life, your time, and one of the great benefits of being an entrepreneur is that you do have options. So set your revenue goals, then pull out a calendar and craft a timetable that works for you. That’s how to ensure that you really have the time of your life.

Set Time Frustrations? Try These Bisacryl Tips

See how directions and temperature can take the guesswork out of your materials usage.

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New in Dental Photography

Photo MedPhotography is equal in importance to the radiographic examination in terms of diagnosis, and much more important in terms of helping patients understand what they have in their mouth. We devote an entire afternoon to capturing patient images by doing it with partners at all of our Facially Generated Treatment Planning workshops and Sean Chappell from PhotoMed (pictured holding the new D90 system) attends all the workshops as a technical advisor to our faculty and participants.

PhotoMed has introduced a new SLR system based on the Nikon D90, featuring a lightweight wireless flash. Comparable in weight to the intraoral systems based on the Canon Rebel (or even lighter depending on the Rebel model), it meets all the needs of even the most demanding dental office photographer.

SLR cameras give us the most control over our photography, but there is a learning curve and some practitioners may find them heavy. Point-and-shoot cameras are lighter and easier to learn, but limit what we can do with the camera, particularly in regard to lab communication.

Spear Education and PhotoMed are always seeking equipment that exceed our participants’ expectations. Contact Sean at if you have questions.

Telling the Right Story

Right StoryWe are all master story-tellers. “I’m just not getting the right patients.” “My practice is just in a bad location.” “If only I could become insurance-free.” “I wish my team would ‘get it’.” We find all kinds of ways to rationalize behavior and explain away results. It’s a defense mechanism, a way of protecting our ego. But these aren’t the kind of stories that contribute to success.

If you want to grow and advance, you have to stop being a master of explaining what is, and become a master of explaining what can be. That is really at the heart of what it means to be a visionary, and it is a skill that anyone can develop. You are, after all, programming your life with your self-talk, for better or worse, so it makes sense to tell yourself the things you need to hear. Ask yourself if the story you’re telling yourself right now is creating the right context for what you need to do, and if it isn’t, change it.

Who Can You Help Rescue Today?

They’re all out.

Thirty-three men, entombed in a small space two thousand feet underground for more than two months. Let’s take a moment to think about what that means, and about the incredible resilience, fortitude and sacrifice these men showed.

Then take a moment to reflect on how their community, and the world community, rallied around them. First by drilling small delivery holes to send down food and other essentials—including the essential nourishment that comes with human contact and hope—then with the tireless work of engineering and construction, the inspired ingenuity, that went into creating the rescue channel and capsule that would ultimately set them free. It all came together this week with the thrilling, heart-lifting spectacle we all followed on TV, and which is captured magnificently in these pictures from The Boston Globe.

All of this reminds us here that the most meaningful thing we can do in life is to serve others to the best of our ability. It’s something we try to do every day at Spear, and it’s something you have the power to do every day in your practice.

Your patients, needless to say, are not in the same dramatic predicament those miners were in, trapped below ground. But you do have patients in your practice who are trapped in their own way, by enduring years of discomfort, pain, embarrassment, and loss of function in their dentition. They may not be openly praying for rescue, and in fact many of them are resigned to their situation. They get used to the pain, they unconsciously compensate by chewing differently, and after awhile it feels practically normal. They accept their condition until something occurs that wakes them up and they realize they can’t accept it anymore.

That’s where you need to create the situation that wakes them up. These patients undoubtedly need help, they need to be rescued, and you are in a position to do something about it. You have the opportunity to say something, or to do something that will awaken their hopes, inspire them to action, and start them on a treatment journey that will change their lives forever. It is an awesome and solemn responsibility. And as we just saw this week, people who take responsibility like that seriously are capable of producing some truly phenomenal results.

Off the Pedestal

Not too long ago, in one of my blogs, I was chastised by a responder for not doing what he thought I should have done. This was followed by the comment, “I would expect more from a prosthodontist.”

Let me set the record straight:  I am not a prosthodontist. Nor do I play one at work. I am a GP and I have worked pretty hard at the science and craft of dentistry for the past 33 years. I do some things really well and there are certainly areas where I have much to learn.

I get that teaching creates an expectation of expertise. I have also come to understand that we as dentists want heroes and we want them to be perfect.

Sighhhh. I promise I am neither. Mostly, I am an educator, who is pretty comfortable not being perfect and working hard at getting better. I am tenacious, persistent and perfectionistic, all characteristics that have served me well and have also caused me grief.

Do yourself and your heroes a favor:  Keep them off a pedestal. They very likely don’t want to be there and when they do fall off, it is painful for everyone. Isn’t it hard when you discover that your heroes aren’t perfect?

Rather, when you find those whom you would like to emulate, recognize they are just as human as you are, allow them to be imperfect and celebrate what you learn from them.

Most of us in this position welcome being accepted as people, friends and perpetual students.

Can the Tissue Be Trimmed? Results Are In!


Trimming the tissue to create symmetry at the time of a restorative procedure can create a great result. This tissue was trimmed using the Sirona Diode Laser during a Live Patient: Anterior Esthetic Restorations course at Spear Education. The admitted risk, of course, is that the tissue will return to its original position a few months following the procedure. As we discovered when the above photos were posted on my blog, many thought that the tissue would rebound rather quickly. If you’re like me, you have no doubt experienced that occurrence when you hoped for another outcome. And as the old saying goes, once burned, twice shy.


Here’s the result after 20 weeks of healing time. The probe shows tissue has indeed come back, with a sulcus measuring 1.5 mm at time of treatment and 2.5 mm after healing. Not illustrated is the initial measurement of a 3 mm sulcus on the unprepared tooth, meaning about .5 mm of change was effected with the trimming of the tissue. The change in morphology of the zenith toward the distal and a slight change in emergence profile of that portion of the tooth with the restoration completed by The Winter Lab have created a striking difference in symmetry and therefore in overall impact of this treatment.

The Unexpected

Frank talks about how he handled the unexpected in two current patients whose dentistry presented some surprises.

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