Specialist in Prosthodontics · University of British Columbia
University of British Columbia · Royal College of Dentists of Canada · American College of Prosthodontists · Digital Dentistry Institute
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Dr. Faraj Edher is a Specialist in Prosthodontics. He received his specialization in Prosthodontics and Masters in Craniofacial Sciences at the University of British Columbia, after completing his dental training at the University of Sharjah. He is a Fellow of the Royal College of Dentists of Canada, and an active member of the American College of Prosthodontists, Association of Prosthodontists of Canada, and the Canadian Association of Restorative Dentistry and Prosthodontics. Dr. Edher is the Director of the Digital Dentistry Institute, a global educational organization that conducts comprehensive training programs in digital dentistry and implant dentistry. He regularly gives presentations, seminars, and workshops, both locally and globally, on a range of different topics such as generalized and specialized presentations focusing on digital dentistry, implant dentistry, treatment planning, and aesthetic rehabilitation. In addition to practicing full time in British Columbia - Canada, Dr. Edher is a Clinical Assistant Professor and guest lecturer at the University of British Columbia and has numerous publications in areas such as dental implants and digital dentistry.
How can digital workflows completely transform the predictability and accuracy of your complex restorative and implant cases? What AI tools are genuinely making a difference in clinical practice beyond the hype?
Dr. Faraj Edher is a Specialist in Prosthodontics who earned his specialization and Masters in Craniofacial Sciences from the University of British Columbia following his dental training at the University of Sharjah. He is a Fellow of the Royal College of Dentists of Canada and maintains active membership in the American College of Prosthodontists, Association of Prosthodontists of Canada, and the Canadian Association of Restorative Dentistry and Prosthodontics. Dr. Edher serves as Director of the Digital Dentistry Institute, a global educational organization conducting comprehensive training in digital dentistry and implant dentistry. As a Clinical Assistant Professor and guest lecturer at the University of British Columbia with numerous publications in dental implants and digital dentistry, he regularly presents internationally on digital workflows, implant dentistry, treatment planning, and aesthetic rehabilitation.
This episode reveals how digital dentistry creates unprecedented predictability in complex restorative and implant procedures. Dr. Edher explains how modern workflows minimize the variables that traditionally affected clinical outcomes, offering consistent excellence regardless of daily fluctuations in performance. The conversation explores practical implementation strategies for incorporating digital tools into routine practice while maintaining efficiency and profitability.
Episode Highlights:
Intraoral scanners enable real-time occlusal clearance assessment during crown preparations, eliminating callbacks from laboratories requesting additional reduction. This instant feedback allows clinicians to modify preparations in 10-20 seconds rather than scheduling additional appointments, fundamentally changing the treatment workflow.
Digital implant planning combining cone beam CT with intraoral scans creates a virtual practice run before surgery, solving problems in the planning phase rather than during the procedure. This approach represents the gold standard for implant dentistry, even when surgery is performed freehand rather than with guided protocols.
Immediate dentin sealing protocols maximize bond strength by treating freshly cut dentin before temporization. This technique involves selective etching, proper adhesive application, and often includes a flowable base layer to preserve tooth structure by managing undercuts additively rather than through over-preparation.
Virtual jaw tracking technology with artificial intelligence eliminates guesswork in full mouth reconstructions by providing accurate condylar settings and functional movements. This advancement reduces occlusal adjustments to nearly zero during prosthetic delivery, particularly beneficial for complex cases involving vertical dimension changes.
Modern veneer fabrication utilizes pressed lithium disilicate for restorations under 0.5mm thickness to achieve superior internal and marginal adaptation compared to milled alternatives. This evidence-based approach, combined with systematic bonding protocols, creates predictable aesthetic outcomes in challenging cases.
Perfect for: Prosthodontists, general dentists implementing digital workflows, clinicians performing complex restorative cases, and practitioners interested in evidence-based approaches to aesthetic dentistry and implant rehabilitation.
Discover how digital integration can eliminate the unpredictable variables in your most challenging cases while improving patient communication and treatment acceptance.
Transcript
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This transcript was automatically generated and may contain errors or inaccuracies. It is provided for reference and accessibility purposes and may not represent the exact words spoken.
What kind of AI tools are we talking about that really make a difference in your practice?
I'll give you a quick vague answer and then a more specific answer. The vague answer is, I believe
that the way we will ask ourself this question is the same way as if I were to ask you, how do you
use the internet in your practice? The specifics are going to be irrelevant because the answer will
be everything.
Welcome to Austin, Texas, and welcome to the Phil Klein Dental Podcast. Today we're joined by Dr.
Faraj Edher, a Vancouver-based prosthodontist and founder of Transcend Specialized Dentistry,
known for his work in advanced cosmetic dentistry, implant rehabilitation, and full-mouth
restorative care. In this conversation, we'll take a closer look at what digital dentistry actually
means in a day-to-day clinical practice for Dr. Edher, not just in theory, but in real workflows,
decision-making, and patient care. Dr. Edher will share how he integrates digital tools across his
practice, where he's seeing the biggest gains in efficiency and outcomes, and how these
technologies are changing the way complex restorative and implant cases are diagnosed and
delivered. We'll also explore the role of AI in modern dentistry, what's genuinely useful today,
what's still emerging, and how it's beginning to shape everything from diagnostics to treatment
planning and patient experience. So if you're looking to get into digital dentistry or expand what
you already have, I think you'll find this conversation extremely interesting. Before we bring in
our guest, I do want to say that if you're enjoying these episodes and want to support the show,
please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases
and our entire production team will really appreciate it. Dr. Edher, welcome to the show.
Thank you for having me. Yeah, we're very happy to have you. And you certainly work in a beautiful
part of the world, Vancouver. I plan to go up there this summer or even maybe not quite Vancouver,
but close to it on the U.S. side and see some beautiful territories and some national parks.
But hats off to you for building a great, successful practice in a really beautiful part of the
world. So I hope you're enjoying it. Before I throw some questions at you, Dr. Edher,
I do want to step back and look at what's happening with digital workflows in dentistry, because in
many ways, it feels a lot like a modern day version of the industrial revolution.
And I don't want to get too textbooky here, but the big change back then was that everything
shifted from slow manual craftsmanship to faster,
more efficient systems. powered by new technology at that time. And of course, it all began with
the steam engine back then. And in a similar way, we're watching dentistry move from messy
impressions, multiple appointments, heavy reliance on the artistic lab tech,
to something much more automated, streamlined, and in many ways, more precise.
And with tools like intraoral scanners, cone beam, CAD cam, and 3D printing,
plus integrated AI with all that, what used to take weeks can now happen in a day,
sometimes even in a single visit. And it's not just about speed, because just like the Industrial
Revolution changed how people worked and what skills they needed, digital dentistry is pushing all
of us to think differently, learn new systems, delegate differently among our team members.
and essentially redefine what high-level dentistry means and what clinical efficiency really looks
like in today's modern dental practice. So taking all of this into account, Dr. Edher,
through the lens of your high-tech digital practice, what does digital workflow really look like
for you in your day-to-day routine restorative cases, and where are you seeing the most impact?
Absolutely. Well, first again, thank you for having me on. And that was a very relevant
introduction to where we are when it comes to the world of digital dentistry and just the world of
dentistry in general. I used to say several years ago when I talk about digital workflows,
I'd say that today we focus on calling it digital dentistry. But really,
within probably a very short span of time, it's just going to be... It's like when we talked about
digital radiographs. And for some years, there was an emphasis on the digital aspect. And as it was
adopted more and more, when you say radiographs, you almost are routinely thinking of digital
radiographs. So that implementation just becomes more mainstream. And from my perspective,
as you said very, very well, the key is not necessarily the speed.
The key is not necessarily the efficiency. Those are cherries on top,
as I say, where we've really seen a revolution when it comes to how we practice dentistry is the
predictability of the clinical work that we can do. You know, I know that we've been doing
exceptionally excellent clinical work for 100 or more years,
utilizing traditional workflows, and we'll probably continue to see excellent clinical work.
for a long time to come using traditional workflows. The difference, I think, where we introduce
these digital technologies is the predictability of doing it consistently, not relying on,
you know, how do I feel on that given day? How's my lab technician doing on that given day? And
just having that ability to consistently produce really great quality work for our patients.
Right, so the variables, those variables that are always in front of us when we're... practicing
traditional dentistry are minimized. I mean, there's still variables out there that can affect
predictable outcomes and clinical success. But if you utilize, you're saying if you utilize the
digital tools that we have out there in an intelligent way, and you know what you're doing, you're
minimizing the risk of failures that don't necessarily have to happen if you maintain good digital
practice. So in your routine work, And we'll get into implants in a second.
Tell us what a dentist should really consider, one that is looking to get more into a digital
workflow in their practice for routine stuff. And talk about the relationship with the laboratory,
if there is a laboratory involved, or should some of these restorations be done in-house,
that kind of thing. And what are you doing in your practice for these routine restorations? Yeah,
so for routine restorative dentistry, I would say there's two must-haves if you really want to
take advantage of the digital workflows. The first being a intraoral scanner. So being able to
switch into the world of digital impressions has significant benefits.
And those benefits, I think... mind we have to shift away from the idea that digital impressions
are an alternative to pvs or whatever other traditional material we're utilizing it is but that's
not necessarily the benefit of it the benefit of it are all of the additional features that it
unlocks in how we can practice restorative dentistry so in addition to it not being messy and not
having the goop in the mouth and all those things that we can just logically figure out there are
certain things that are just not possible to do in our traditional world that you can only do if
you're taking advantage of these technologies. What are some examples of that? Modifying how you
take your impression. For me, as a prosthodontist, I do sometimes more complex restorative work.
So if I'm preparing, let's say, 10, 12, 14 teeth for crowns, if I was doing a traditional
impression, I'd have to try to capture them all with a tray. go about that workflow whereas with
digital impressions whether i'm doing 2 or 3 or 10 or 14 i can break them up into sequence because
i have now the ability to stop and start scanning again work my way around with the preps work my
way around with the retraction cords if i'm using retraction cords so it allows us to just to
rethink how that clinical workflow goes about things Another very day-to-day example is,
I remember when I used to work with a traditional workflow. One of the most common things, because
we like as dentists to, of course, be as conservative as possible in our preparations. I still
remember commonly getting the call back from the lab in the evening saying, hey, we got your
models. We poured the models. And, you know, for that crown you want, I need just a half millimeter
more space to be able to give you what you need. So what do you want? Do you want me to give you a
reduction guide or are you going to see the patient back? That no longer exists in the digital
workflow because when I scan my patient, for example, for a crown prep, I take the opposing, I take
the bite, I can within seconds know exactly what the occlusal clearance that's there is and
modifying it or changing it. doesn't require me to redo any of the work. It just requires me to
modify within 10 to 20 seconds. So it's things like that where we can think outside of the box and
just come up with new ways to do things based on working in the digital world that I think provide
the most benefit other than just thinking of it as replacing, you know, impression material.
Right. And that makes a lot of sense. Now, there are a lot of dentists that I talk to that say that
they have a scanner, but they're not. interested in designing anything in the office they don't
want to get involved with the software now i know there's new technology it's actually one push of
a button and your crown is designed in a minute and it's it's phenomenal stuff it's it's uh they're
partnering with a lot of scanning companies you may know who they are at this point um are you
familiar with circle one Yeah, I've heard of Circle. And then there's a few others, like Three
Shapes doing it, ExoCADs doing it, Sprintray are doing it. This AI design automation is definitely
the way things are headed. Right. And this particular design software is all cloud-based. So
there's nothing that is in the hardware at the site of the office. It's all done in the cloud.
It's very resource light on the client side. It's very interesting how this is going to be
developed. But a lot of the companies are partnering with this. with this basically a software AI
company that will really make a big impact on simplifying the design process. But the point is that
they're not really interested in being a laboratory is the mentality. That's the mindset that a lot
of dentists have. I didn't go to dental school. It would become a lab. So I'm going to use the
scanner as a replacement for a tray and a replacement for impression material.
And I don't need alginate anymore. I could do digital wax ups. What are your thoughts on that?
Absolutely. I mean, from my personal perspective, I'm also not in the game of wanting to become a
lab technician. Now, I'm lucky. Our practice, we have an in-house lab with CAD CAM designers and
ceramists. So you can think of them like a third-party lab, except they're in our same space.
And I delegate all the work to them, just like I think most dentists would do unless they want to
start to get into the design and manufacturing themselves. With that being said... The tools that
are unlocked with these digital workflows not only benefit the clinician,
but more importantly, they significantly change how we communicate with our lab. So my
communication with the lab now is completely 360 degrees different, and it's much, much more
efficient. And now they know exactly what it is that I'm referring to, because we're both looking
at the same digital file. Whether we're in the same building or not doesn't matter. We're both able
to look at the same digital file and be able to assess things. Again, back to the point of
intraoral scanners, if I prep a crown, I have the ability on the spot to zoom in.
you know 20x and really look at my margins and if i can't see where my margins are there's no
reason for me to press send because i'm not going to send it to the lab for them to only guess my
margin so it gives you that instant feedback and the ability to talk to the lab as to what things
you want them to pay more attention to um so yeah i i fully agree with that there's a lot of
dentists that don't want to take on the lab component but these digital workflows will help you
stay in line with your lab because whether we like it or not 90 plus percent of labs are switching
to a digital workflow because for them, it just makes no sense anymore not to,
just based off of the efficiencies that come with CAD CAM as opposed to the manual way of doing
things. And so even if a dentist is sending a PVS impression, they're scanning it or scanning the
model and then going into the CAD CAM workflow. And that actually introduces inaccuracies. The more
we bridge back and forth between the digital and physical workflow, the more we introduce errors in
that system. And so staying in a consistent workflow actually helps with that. Yeah, for sure.
So the intraoral scanner is a must-have at this point. We don't want to go from analog to digital
back to analog. I mean, that makes no sense whatsoever. And that's a very, very good point. So when
it comes to implant dentistry... How have digital applications improved your diagnosis,
your treatment planning, and your surgical and restorative outcomes compared to traditional analog
methods? Yeah, probably even more so than what we talked about for restorative dentistry.
Digital workflows, in my opinion, are probably safe to say the gold standard of how we should do
implant dentistry today. In other words, the utilization of cone beam CT, the ability to then
superimpose cone beam CT to some sort of digital scan of the patient, whether it's an intraoral
scan or like we said, the lab scanning your impression, superimposing and merging those two things
and then doing digital planning to me is the gold standard of implant dentistry. Even if you end up
doing the surgery freehand, by the way, so it's not necessarily the guided part, although of
course, is significantly beneficial but just the process of visualizing what it is that you're
about to do before you flap or do whatever you do surgically to the patient adds tremendous value
to how that procedure happens because you've almost done a digital practice run.
And now there's less trying to solve problems during a surgery. You've solved all those problems in
the planning phase. And now you're just trying to execute on that plan. So that takes us to the
second piece of technology. I mentioned there are two that are a must have. In my opinion, the
second must have in today's world is a 3D printer. Because with a 3D printer, nowadays,
the barrier to entry when it comes to cost has significantly reduced. The speed of printing has
significantly improved, and so it's less of a weighting issue. And the ability to utilize 3D
printers in particular with implant dentistry, where we can transfer that digital planning that we
talked about between a cone beam CT and a scan, doing all of our digital virtual implant planning,
and then transferring that by 3D printing a surgical guide to allow us to execute on that plan very
precisely is, in my opinion, a no-brainer, even if we think of it from an ROI perspective.
Once someone gets over the initial learning curve of utilizing... guides and digital workflows for
implant dentistry, just the share time that you save on its own during the procedures will probably
be a net positive in the ROI. And that's not accounting for patient experience,
recovery time, accuracy of procedure success, and all those other variables that will also improve.
Now, do you have specialists that place the implants in your practice or do you do that yourself? I
do place implants, so I'm a surgical prosthodontist, so I do the surgeries too, but our practice is
multi-specialty, so we have a periodontist as well that places implants, and then we have another
prosthodontist, and we also have an orthodontist. doesn't place implants and occasionally we'll
also work with oral surgeons in the community too for some larger zygoma implants or things like
that so in your opinion based on all the advantages of using these digital tools with the ai and
plus we didn't even talk about the case acceptance i mean that goes without saying right that when
you show these patients the case in front of them on a screen after scanning where they could be
taken to if they accept the treatment i mean that's got to boost case acceptance right um that's
kind of thing i'm just putting in there but there's no question that the uh digital aspect of this
creates an environment where you have much more predictable outcomes like you said now you do a lot
of work through the bc dental study club did you are you the founder of that group yes correct yeah
yeah congratulations on that because i hear that's very successful what are the most clinically
relevant topics or techniques that general dentists are consistently trying to master right now
based on the fact that you're so active with the bc dental study club yeah that's a great question
i think there's a range and it depends on where they are in their career trajectory um i mean
through the bc dental study club we do a variety of programs ranging from like one year implant
mini residency workshops on like porcelain veneers, we do composites,
we do endo, we do crown and bridge basics. And what I find is at least what I recommend normally to
our members is When they're earlier on in their career and just starting out,
it's really to focus on your bread and butter and try to get confident with the basics, whether
that be crown and bridge, maybe slightly more complex endo extractions, things like that. As you
start to be interested in developing more skills and more complex things, that's where we get into
things like veneers or implants or more advanced occlusion slash full mouth reconstruction cases.
So we offer a variety of things, and I find that it just depends on where they are. But what I do
find is common amongst all of the courses is their interest in the modern applications of how to
perform these procedures. Sometimes dental schools are outdated, or there's just not enough time to
go through every way of doing things. So what we find there's a lot of interest in is, okay,
even if I am doing this procedure on a day-to-day, how could I be doing it in a more modern way
using the tools that are available to me instead of just sticking to the textbook method that maybe
now there's a better way for? Yeah, when you say modern way, what does that mean, modern way, as
far as technique? The techniques or the workflow. So for example, digital technology is a more
modern way to have a workflow for how you do certain procedures. Bonding protocols,
right? There's a lot more modern science and a lot more modern evidence as to... what the right
bonding protocols are, how to prepare a tooth for bonding, how to prepare a restoration for
bonding. Systems have changed, biomaterials have changed. So updates on all of those aspects just
allow us to take in that information and perform the procedure in a probably different way than
what we learned 5, 10, 15, 20 years ago, and make those changes. And of course,
weighing that with evidence, because we also focus a lot on evidence-based decisions. So the last
thing anyone should do is change the way they practice based on me saying, hey, here's... modern
way of doing it. Without a doubt, evidence-based is the key. So these dentists that come to the BC
Dental Study Club may not have had a whole lot of continued education other than what was mandated
since they've been in dental school. So there's still a lot of them just by what they learned in
dental school continue to practice those techniques for 10 years, let's say. So when you say
modern, it doesn't necessarily mean digital modern. It means... proper technique for instance when
it comes to adhesion do you are you an advocate of selective etch for the enamel and then using a
universal adhesive for everything and obviously the dentin when when appropriate if there is dentin
that you're working with is that something that you're a proponent of Yeah, I like to work with a
selective etch technique. I also like to do immediate dentin sealing protocols for when there is
dentin that's exposed, especially if I'm doing bonded procedures, like if they're onlays or
veneers, as you mentioned. If my goal is to loot a restoration, because we often differentiate
between looting and bonding, if my goal is to loot a restoration and I've got adequate retention
form, then I'm not as concerned really about the overall.
bonding steps like I would be for a restoration that is non-retentive and dependent on that bond
strength. And when you do a dentin, immediate dentin seal, real quick in like one minute,
tell us how you do that with the adhesive. What do you use and what do you put on there? And
obviously you cure it. It sits there for a while before the final prosthesis is delivered.
So tell us what that immediate dentin seal actually means clinically. so in a nutshell without
getting into too many details the Concept of immediate dentin sealing is the idea that the best
time to bond to dentin is when it's freshly cut dentin. So if we think of our traditional way of
doing things, we're prepping a tooth, exposing dentin, putting a temporary on, and then maybe a
week or two later seeing the patient back. And now those dentinal tubules have been contaminated.
It's much harder to get into them with proper bonding protocols. So the concept of immediate dentin
sealing is if you're prepping for a non-retentive bonded... restoration like we said like a veneer
an inlay or an onlay or something similar you may want to utilize immediate dentin sealing which
means when you've exposed that dentin before you temporize or do anything else you go through the
bonding protocol related to the dentin which may include selective etching in some areas,
reduced etching times for dentin areas, and then utilizing a bonding agent, depending on the
bonding agent, whether it's one step or two step or depending on the bonding system you utilize,
but getting the most effective bond to the dentin immediately at the time of preparation and
preserving that. Do you incorporate a flowable into that cure? into your dent seal so so there
there are concepts of you know you can do immediate dent and sealing and not incorporate flowable.
At times, it is helpful to incorporate a base layer of flowable, particularly if the restoration is
going to seat in an inlay prep or an onlay prep design aspect. It also sometimes helps with
avoiding undercuts. So instead of over-preparing teeth, using flowable for that base layer will
help preserve tooth structure because you can get rid of undercuts additively instead of
subtractively. So yes, we do integrate that as well. Yeah. Now, regarding AI, real quick,
just in a few minutes, it's getting a lot of attention. It's built into equipment that dentists
buy. It's built into scanners. It's built into printers. What are you actually using today in
clinical practice? Because you have a very high-tech practice that goes beyond the hype and
genuinely improves. the things we're talking about, diagnosis, efficiency, patient care, what kind
of AI tools are we talking about that really make a difference in your practice? I'll give you a
quick vague answer and then a more specific answer. The vague answer is... I believe that the way
we will ask ourselves this question is the same way as if I were to ask you, how do you use the
internet in your practice? I think AI is that big of a game changer that the specifics are going to
be irrelevant because the answer will be everything. And we're not quite there yet, but that's
definitely where we're headed. I think the answer to that question will be everything. AI will just
improve everything. As of today, the specifics where we are utilizing it and seeing success beyond
the hype, because I think that's a great way to put it, a lot of it initially, just like with the
internet, right? There's a bubble initially, it's just a lot of excitement. And then that bubble
bursts and you end up with something that's... so what I think is currently solid is from a
clinical perspective how it's helped make tools more accurate so all of our intraoral scanners have
AI built into them that AI is what helps the scanner for example exclude a moving tongue exclude
your finger if you're scanning it so there's certain things that are just happening behind the
scenes that help radiographic interpretation I think is useful. Of course,
if we think of it from a profession perspective, very useful for insurance and things like that.
But if we talk about it clinically, where I find it to be the most useful is, of course, giving us
as clinicians some insight on things to look at. But more importantly, it's the patient
communication part. As you know, with patients, if you're meeting them for the first time, some
patients don't. necessarily immediately trust the clinician. When you're showing them technology
and saying, here, this is artificial intelligence that's showing, maybe there's something going on
here, maybe there's something going on there, let me investigate further. It removes the barrier
of, do I trust you and what you're telling me? And it's now more systemized. So I find that to be
helpful. And then we can get into more advanced AI things clinically, such as jaw tracking
technologies that can now utilize artificial intelligence to give you very, very accurate condylar
settings. functional relationship movements. So from that perspective,
it's also great. And for me, AI is a daily tool for the operational side of a practice.
As a practice owner, for me, that's been really the biggest game changer. We've implemented AI in
almost every aspect of our operations, where we just help our team be set up for success, being
able to minimize the routine things that they have to do repeatedly, and have them focus on the
things that actually need a human. interaction with the patient right i mean a dental practice is
no different than any other business from that standpoint it's very unique of course because it's a
dental practice but from the standpoint of utilizing ai to run your business to show the customer
in our case the patient what you're doing build trust i mean that's just universal right now and
you're absolutely correct about that analogy it's like saying you know what what is the internet
good for uh you mentioned jaw tracking what i've heard about jaw tracking is that when you use it
the benefit is so tremendous when it comes to the delivery of the prosthesis because they're
saying, the doctors that I'm talking to, the dentist that I'm talking to, and I'm so glad you
brought it up because I'd love to hear your opinion, is that they literally do almost no adjustment
when they deliver that crown or bridge because the jaw tracking handles all the movements that
occur between the two extremes. So when you put those little stickers on and you do the jaw
tracking, it basically builds all the possible movements for the laboratory to see in between the
two. extreme points. Exactly. And it's so significant that I say, I do a lot of full mouth
reconstructions on teeth, worn down dentitions, increasing vertical dimension and that sort of
thing. So I always say if I were to ever need a full mouth reconstruction in today's world,
I would refuse to have it done without virtual jaw tracking. It's just that much of a game changer
in terms of removing guesswork. No matter what we say, like without it, we're guessing a lot of
things. The source of air that comes from, that comes to us and we see it as occlusal adjustments
comes from two things guessing which means utilize utilizing average settings on an articulator
arbitrary hinge access opening all of those things introduce errors clinically that are reflected
as bite adjustments and then manufacturing errors so again the digital workflow helps reduce those
and then virtual jaw tracking completely removes the guesswork i'm no longer working with the
average setting articulator or no longer going through the steps of trying to fully adjust an
articulator and probably not doing it very accurately by the end of it. That's a game changer.
It's really a game changer. Yeah, I wish they would incorporate something like that in clear
aligner therapy because they're straightening teeth. And these patients say, wow, I love the way my
teeth look. They're beautiful, but I have no maximum intercuspation anymore. Like I can't chew like
I used to. I'm speaking, you know, firsthand here. So before we let you go,
Dr. Eder, I do want to touch on the training that you're providing. You offer a highly regarded
hands-on porcelain veneers curriculum, and you've partnered with Ivoclar to support that training.
So from a clinical standpoint, which materials and systems have truly earned your trust to a point
where they play a big role in your veneers training program? Yeah, the entire concept behind the
veneers program is that, as you probably know or have heard, there's very little structured
education on this procedure. Although it's a very common and very popular procedure,
there's very little structured education on the right way to utilize evidence-based techniques and
theories to do porcelain veneers in a way that's systematic and predictable. So that was the
concept behind doing this. In my practice, a lot of what we do is... redo veneer cases because
patients come, they've had them done, they're unhappy, and now we're redoing them. And I started to
think over the years, you know, those errors that took place that caused the patient to come and
have these veneers redone are very avoidable. And it's not that it's a bad dentist. It's probably
that they just didn't know any better regarding certain things. So we put together a two-day, very
comprehensive, hands-on program on everything that someone would need to know to implement
porcelain veneers. For all of my programs, what I think has allowed us to have good reception to
them is the fact that I genuinely just share what I do. I share what I do with my patients on a day
-to-day. And we partnered with Ivoclar on this because I'm a big fan of the Ivoclar system when it
comes to bonding and the cements that are utilized for, particularly for veneers,
but also for other things. They're light cured resin composites and they're bonding agents.
So we wanted to integrate that in a practical way into the practice because not only is it
important to have a partner that allows you to share the clinical knowledge, but also a partner
where... have their products supported with very high levels of evidence,
and that's what I think Ivoclar does very well. There's very good evidence to show here's when to
use this, and here's why, and here's what the benefit of using this, and so on and so forth. How do
you typically fabricate your veneers, given that you have a lab in your office? I know a lot of
dentists are doing chair-side milling, but does that also apply to your veneers? I don't do a lot
of chair-side milling. I don't do a lot of same-day dentistry for me because most of the cases
I'm working on are a little too complex, at least for me, to find a way to do this that fits with
our schedule. So we focus on a more traditional workflow. We utilize,
and by traditional, I still mean all the digital tools, all the digital technology, but sending it
to a lab, having the lab make your veneers. And interestingly that you said milling because... now
we mill, for me personally in my clinic, we mill almost all of our restorations. The only exception
is... thin porcelain veneers, we still like to press those because the evidence still shows up to
today, and I'm sure it'll change as milling technology improves, but as of today, the evidence
shows that very thin porcelain veneers, you get better internal adaptation and better marginal
adaptation when you press it compared to when you mill it if you're under half a millimeter in
thickness, which we try to have our veneers be. We try to have them around 0.3 to 0.5 millimeters
in thickness. And that's a laboratory process because that's a different material. Obviously, the
milling material is different than the pressing material. Yeah, and that's another reason why we
partnered with Ivachlor on this, because lithium disilicate Emax, very well studied, very well
bonded to tooth structure. And so it's also a natural ecosystem for us to be able to...
complete these porcelain veneer procedures. And we do them twice a year here in Vancouver.
We found so much interest, people traveling from all across North America for them, that we've
recently also launched them in Toronto, in Canada, but then also planning to do them in Scottsdale
and Miami, Dallas and Chicago. So we're doing a tour.
Fantastic. Now, when you're doing your, last question, when you're doing your restorative dentistry
and you seem like you're the kind of dentist that would prefer, like you just said, to actually do
an indirect restoration rather than a direct restoration in a deep class two,
right? You'd rather do it with your laboratory in-house. What do you do?
Do you mill some sort of hybrid block for a quick mill? Because let's say it doesn't...
require tremendous extra strength because it's it's just like a small onlay or something or do what
kind of block do you use and what do you what are you doing there yeah so i don't do a lot of like
class twos because normally we're referral based so they'll see their dents for that now
occasionally i'll get a case where there's limited mouth opening or something that just makes it um
more complex and I still like to do lithium disilicate. So we'll mill in that situation because
normally they're not ultra thin. We'll mill lithium disilicate for inlays or onlays. More recently,
we've been playing around with 3D printed resins as an alternative to direct.
composite resin i still think porcelain is superior than than resin but i do think that a 3d a well
-made 3d printed resin using the right resin material might be a superior option than a direct
composite without a doubt and and with with a patient that has limited resources,
that may not be able to go with the ideal situation, that those solutions can last a long time.
And 3D printing is just in the beginning of its evolution with the kind of materials that are going
to be able to be printed on a chair side. It's going to be amazing. And I'm not sure if you've come
across this yet, but the concept of pressed 3D printing.
where there's a company that's now come up with that to be able to press a 3D printed restoration
in under nine minutes is going to be a game changer for this type of thing.
And now it's a matter of just material technology and material science. And I know that Ivoclar,
for example, is one of the companies that's working really hard to come up with some very
innovative resins to allow us to push the envelope when it comes to 3D printing as well.
I think it's an exciting time to be in dentistry. Oh, absolutely. Absolutely. And with those
software applications that allow you to push a button and it automatically,
I mean, in less than 30, 40 seconds, it designs the thing perfectly based on all your scans.
And then you print the restoration. It's, yeah, it's an exciting time. Let's put it that way.
Compared to the days when they didn't even have a dental chair, when the patient would actually lay
on the floor and the dentist would do the dentistry with the patient's head between their legs.
With a cigarette in their hand. Yeah, with a cigarette in their hand. Yeah, we've made it. We've
certainly progressed there, Dr. Edher. All right, well, listen, thank you very much for your time.
You're a brilliant dentist. One day if I'm in Vancouver, I certainly want to see your operation out
there. It would be amazing. Yeah, anytime. We'd love to host you. Yeah, and hopefully we'll have
you on again on this show. And thank you so much for your time. Really appreciate it. I appreciate
it. Thank you for having me.