Season 1 Episode 19: Conversation with Don Bell from Ivoclar Vivadent

Full Episode Transcript

With Your Host

Dr. Tarun Agarwal

Welcome to T-Bone Speaks with Dr. Tarun Agarwal where our goal is to change the way you practice dentistry by helping you achieve clinical, financial, and personal balance. Now, here’s your host, T-Bone.

T-BONE:   Hello everyone and welcome to another episode of T-Bone Speaks, I’m your gracious host today, T-Bone.

And today I have a wonderful guest I wanted to bring in industry a person and one of the things I like to do maybe differently in our podcast is I want to bring in lots of guest and certainly Chuck and I like to talk about various things that we see going on in practice but I want to bring in guest.

A lot of times  I guest people that you don’t meet and  really I don’t want to bring the same guest that you hear in other podcast and I know that  I believe that there is a great synergy between our profession and between our manufacturers and too many of us have an adversarial relationship and I think It’s sometimes good to hear things from the manufacturer and because it gives us insight into what they’re thinking where things are going and it’s always helpful to know what’s coming down the pipe. So I have Mr. Don Bell from Ivoclar Vivadent on today.

Don, how are you doing?

DON:                    I am doing very well this evening.  How are you doing?

T-BONE:    I can’t complaint. I know life is good in the Chicago office of Ivoclar Vivadent

DON:          It is very good.  I’m enjoying. I’ve been here maybe about a year and a half now and I like the city a lot. I actually love the city a lot, I love the place I’m in so it’s going very well.

T-BONE:     Well you know just in case Mr. Ganley is visiting or listening we want to let him know that the investment in the Chicago office is paying off quite well and Don is working all the time and keeping people in check.

DON:          Very good. I appreciate that.

T-BONE:    So I still don’t understand why you’d go from Buffalo or Amherst to Sunny Chicago. It’s not like you made a big weather update there?

DON:          No but there were other factors for me. As you know because we’ve spoken we got a chance to work together on events and symposiums. I travel quite a bit and the travel of schedule in getting anywhere from Buffalo, New York to really anywhere in the country is always multiple stops. So I was going out to even say to Arizona to the West Coast or even these, it’s always connect, connect right so every trip was two legs off, two legs back and multiply that times a lot of trips, it really becomes a lot of wear and tear and it was – it became difficult. You know weather delays in the flight [crosstalk]

T-BONE:    Especially in Buffalo.

DON:          Yes, or even I connected a lot to like Chicago or Philly, you know connecting to other parts of the country so that became a bit of a challenge and I also had some opportunities and different changes in my personal life that I really want to get to Chicago so that along with the change and or dealing with the travel schedule that was becoming it was challenging, it was a challenge.

So now I get a chance to work out my home office here. I’m in Buffalo consistently, usually a couple of times a month for our open house program and other meetings and sessions that we have and I use the technology which is really even great to connect stay connected to our office and stay connected to our field reps.

I still travel a fair amount but as you know being in a hub city like Chicago it’s one trip out one trip back so the amount of my trips have gone or shorter because of the location and also quicker because of less legs per trip so..

T-BONE:    And from Chicago you can be anywhere in the world

DON:          Yes, personally I have to say it’s been really dramatically better from a to do what I do in to my job stay connected to our company while also be able to be mobile. It’s been – it worked out and has worked out so far extremely well.   I think for me and…

T-BONE:     Oh you have to say that too by the way.

DON:          Yes, [Laughs]

T-BONE:    So Don, let our listeners, know I mean who are you, what you do, what’s your role in Ivoclar I mean give us this clue on who is Don Bell?

DON:          Sure, I should say my name is Don Bell. I’m a director in Marketing for Cad/Cam for Ivoclar Vivadent and our company is a small relatively small privately held firm based in Schaan Liechtenstein. We have global facilities all around the world and for almost fourteen and a half years I was based in Amherst location which was the North American headquarters that’s where our president Bob Ganley resides. He’s also the global CEO.

We have a beautiful training facility, the test facility in Amherst  to test materials, we’re focused dental company focusing  on dental and I spend now July will  be sixteen years I’m in the dental industry and I’ve had a real growing up period in this industry where I came in.

My first categories of products that I manage were Pro/Cad blocks and barreling two cement and  that evolved in securing lates then I get a chance and  opportunity with Dr. Michael Gagley to develop and launch our first Diode laser which led to the second and third and the fourth and eventually we got  out of that category, do a really change in distribution and a change in philosophy in the market and the industry and it’s afforded me opportunities to stay really to get involved in digital field right away. And when I first got in the industry I’m really stay in at my entire time so I got a chance to see the evolution Cad/Cam technology, how the materials are evolved working out when. You know for us it’s been a development of entire process of developing products like blocks cement furnaces, characterization tools – all these to make it, make the Cad/Cam process in one visit very efficient.

I think as a company we’ve done very well and I think part of it is because we’ve had people that have been ingrained in our organization like myself I’m going on sixteen years and I’m not the only one, there are you know literally probably a dozen people in our organization that are in that I say probably twelve to eighteen-year range of experience in the dental market some more and it really gives you a great knowledge based to full from.

I think we worked together extremely well I think it gives us the huge advantage of a knowledge of what’s worked in the past and maybe what hasn’t but also the ability to kind of look forward and you know knock at you lock in to what it was.

I think we’re a little conservative in some aspect but I think we kind of think a little bit beyond that most of the times.

So my background besides this I was actually an accounting under grad from a small school call Biometry University [   ] Masters in Marketing and I worked for the first four years in accounting cost accounting from manufacturing company in the clothing industry and industrial bow business to business products and then transition to dentistry. So they’ve all been good really, really good experiences for different reasons.  You know my first job afforded me the ability to see and experience a really large company with multiple divisions and that was publicly traded and that was difficult as my first two job were actually publicly traded companies and that is a tough environment to be in sometimes and transitioning in a dental became a little bit a mix of trying to reach to dentist almost  like a consumer in terms of influencing communication but also a lot of education and knowledge based information and how products work and why they work and also being private I think I’ve enjoyed much more.  It gives you a different perspective as a private organization.

T-BONE:    Well there is more flexibility in private companies I believe.

DON:         Yes, you have the ability to do things really at your own discretion to some extent but also on your own time line.  So you choose the right hour situation you write it out and it’s you want to make a move, you make a move and there’s not really pressure from investors.  We have a good family in company so we have one investor and one owner and I think he’s done, I think he’s generally  extremely pleased with our organization how we’ve grown over the last twenty years especially. So I’m really glad to be a part of it, digital has been a huge part of our growth in the last ten years especially and it’s been really fun to be a part of it and I’m really grateful for that opportunity I have when I first started and [unclear] involved in it today.

T-BONE:    You know my first experience with Ivoclar in a meaningful way was at an event called Smillenium, I don’t think you guys do it anymore there in Orlando. To date it’s still one of the best events and I think a lot of it has to do with the time in my career that I want to say that was probably 2005 or so you know I was about four five years out of school and I was quite out of my elementary and say me and Samir came representing the young guys.  I think we’’re probably the only digital owners there at that time too.

DON:          Yes, we used to run and now it’s interesting we’ve done a Euro part and that we did earlier this year which is more I guess theoretical in nature what we’re trying to get and understand how a digital work process works in our office to where we might be heading to.

In the past when I first started Cad/Cam was you know the red head is set trial to our organization. We’re a lab company. We’re able to make some blocks for the machines and you know the machines were in I was in CEREC 2 when I first started so CEREC 2 was you know it was wire framed designs.

T-BONE:    CEREC 2 wasn’t very good.

DON:          Trying to imagine I used to remember the line you have to imagine that in 3D or three dimensional like I don’t know about that. [Laughs] so it’s funny but it’s finally looking back now then you see how it advance to 3D. Today it’s just incredible when you’re involved that early in you get a much I think people perspective for how fast it’s grown. But now it’s fully digital fully integrated in our organization as a mainstay of how we grow and how we run our business.

When we run events on summer just completely Cad/Cam events now more of our speakers and us wise, because that’s the predominant strategy that we’re developing and it’s not that we don’t work with doctors or groups that don’t digital but lab is predominantly digital in some respects whether it’s receiving files or design work or milling and chair sides growing extremely fast as well so I think we’ve been positioned well.

It is pretty amazing how exchange. I’ll tell you a really funny story if I can I’ll try to make it brief. When I first started I could have been in the company more in the year two and we’re at the Chicago midwinter meeting we we’re hosting a dinner and it was almost like a combination lab doctor appreciation dinner and they brought in I think if I remember correctly they brought in cases that you know doctors that work in certain labs on and it was a celebration, it was a celebration of the lab and dentists partnership and how that affect and it was really Empress at that time. It was Empress at that time, it was our Empress material that was a flagship product for us.  I was sitting in a table in the lab as a host and we had you know I don’t know how many tables we had so we’re all spread out as employees and I was hosting a table and I remember I’m not going to use any names but I was hosting a lab, the lab owner was at the lab at the table asked me you know oh you know I introduced myself and he said so what do you prior [unclear]. I work as a marketing that’s cool and what area you’re working? I work in the lab side I don’t think we’ve dealt with you in the past. Well, I actually work in the clinical side of a business I said alright that’s good and I told him I managed blocks and cements and our conversation turns abruptly from that’s pretty neat to why are you?

T-BONE:   I hate you.

DON:          Yes why are you at my table you’re taking business from us and it was one of those really awkward moments where you look at – what ran to my head was you got to be kidding me like you’re going to be, everyone is going to be doing digital restoration whether they’re doing designs, scans, sending files milling them in labs. Like this is –  it’s crazy but I say it was very provincial. The lab is very provincial back in the day and they saw Cad/Cam as a direct competitor and now it’s completely different for us.

T-BONE:    I would, you would know better than me but I would say from a pure business perspective labs represent a bigger business than chair side do for a company, is that probably true?

DON:                   Yes, although that gap is closing dramatically.

T-BONE:   Is it really, so you’re saying chair side is catching up to at least in Ivoclar’s eyes?

DON:          Yes, in our world it’s closing the gap now we’re going to be I mean as machines continue to grow there will be a point most likely where we’ll have more materials and again I’m assuming nothing dramatic changes in the industry but if that continues we will probably pass in a not too distant future our lab revenue that we generate our business from our lab side and that includes [unclear]

T-BONE:     Oh that includes.

DON:          No, yes right now we don’t do a lot of millable product in our lab side because mostly…

T-BONE:    other than E-Max?

DON:          We’re pressing a lot of E-max. [Unclear] back to pressing and the millings are [Unclear] flux so our business is ok in that category where other lab businesses are doing much better or much higher growth and net [unclear] so.

T-BONE:    Well you said the Z word let’s – before we get to Z word so basically if for any of our listeners who are CEREC or even E4D owners or any Cad/Cam owners, Don would you say that you are essentially the direct contact at Ivoclar for anybody that has digital question, digital you know material issues and stuff like that?

DON:          Yes, particularly chairside because our group, myself and my group manage our relationships and partnerships with our approved milling partners.  Right now we only have two chairside, we have Sirona Dentsply and Planmeca that makes Planmeca fit machine.

T-BONE:    So what is it called now?

DON:          Planmeca fit

T-BONE:    It’s not E 4D anymore?

DON:          E4D is now the manufacturing entity down in Dallas, Planmeca is when they brought in to the partnership now manufactures and sells a system under their brand name.

T-BONE:    Ok, interesting

DON:          Yes, so our relationship really go deep with our milling partners and our distributor partners that work with those whole system so it’s very – you know in our world our Cad/Cam world answer your question yes everything runs to myself and my team and it’s a very small pool right now, people that we work with.

T-BONE:     Alright so let’s get to the Z word now, ok. It’s Zirconia, so let me ask you this is Ivoclar in this Zirconia business, how does Zirconia affect E-Max and where is Ivoclar’s position on Zirconia?

DON:          Ok so question one,  we are in the  Zirconia business, we purchase the company called  [Vland] I might be off on the year. It’s a couple of years ago to essentially capture and purchase their brand of Secunia Zenostar and since we’ve developed Zenostar brand a little bit more we find it added an empty medium translucency to this Zirconia we just launched this past year in [unclear] form for the Vland mill and that business is going pretty well, it’s not growing as fast  as Broxcillewell but it’s going pretty well. It’s an aesthetic.  We try to translate or should I say advance the original Zirconia Zenostar that was nice you know maybe a little bit more traditionally opaque not super aesthetic and is something that’s more that fits with our core values and our brand so it’s going to be high performance but also very aesthetic material. Zenostar is our brand that’s considered as doing pretty well within the system that we currently sell to labs. The Vland milling systems.

How do we see affect the E-max?  It’s directly affecting E-Max every day; there’s no two ways around it.  If I’m a doctor today let’s say a doctor who doesn’t own a machine, I’m making a decision everyday I want material on running prescription for and six out of ten, seven out of ten, are writing prescriptions for full contour Zirconia.

T-BONE:     Is it that big now?

DON:          It’s big and we kind of guess there’s not like a lot or really super credible lab data’s you have to kind of piece together what we think is going on but it’s very, very high. It’s very high.

T-BONE:   Is [PFM?] found dead now, finally?

DON:          [PFM] still exists, it’s declining and is probably declining much faster than even we can track but I think there’s still a fit for it.

T-BONE:     Like what? [Laughs]

DON:          I think one of the things I like about it is it currently exists is that I think it gives you some flexibility with the alloy that you use and the ceramic to create an anatomically supported ceramic restoration which is going to avoid the chipping that you saw maybe with layered Zirconia that’s going to look pretty aesthetic.

I can make the argument you know if I put one next to a Zirconia restoration which will look better I guess it all depends on the material on the shade you’re matching and what Zirconia you’re using.  But I think it has some flexibility to it and I also think frankly some doctors are just very comfortable and they don’t want to change.  [PFM’s?] work, I’ve been using [PFM’s] for twenty years in my practice, they look great. You know they’re functionally very sound, yes occasionally maybe it caused chip over time. you know you either replace it or repair it but I’m pretty happy but I think what’s happened is and so I think it’s becoming more and more habit that the people are using I think where it’s really translated to or migrated to is people making decisions between I’m getting out of  Zirconia metal base I’m sorry not Zirconia I’m getting out of metal base restorations to something so I want to  go to something that’s strong, that won’t break, looks good, for a while a lot of people jump on the  E-Max bandwagon and  jumped on because I think the durability and the aesthetics, I think Zirconia took its place  with everyone else who had moved from [PFM] so there are a lot of people who’ve move right  jumped out of the [PFM] market and  Zirconia I think is fitting now people that are looking to change and really want something that won’t break. It’s like a weight metal that’s not going to fracture so I think based on your criteria as a clinician and what you’re looking for, Zirconia is a really, really good solution because it’s extraordinarily durable and it doesn’t break really virtually ever.

T-BONE:    Okay, so then let me ask you this why Ivoclar is not in the Zirconia business share side?

DON:          We have a plan for it, I think Sirona was a little bit faster and so now we’re trying to adapt our plan to make sure that whatever we do create if possible will work in their furnace.

We also realized they developed a really cool technology to fasten into Zirconia and soon enough we’ll be able to send E-Max or crystalized E-Max so what we want do now is that’s going to become a baseline furnace technology that people going to get for a couple units at a time then we need to make sure our stuff will work in their furnace.

T-BONE:    That’s great by the way you know I always say that about some of the good I say good companies and I consider I require one of them is instead of saying instead of popoing and say that didn’t work you’re saying listen if that’s where the market going we want to survive and we want to thrive in that market so we should make our product and make sure that our product works in that furnace. So what’s Dan talking about is a Sirona released speed fire oven probably in the last three or four months and what it does is it allows you to do Zirconia Chairside in approximately let’s call it thirty minutes from start to finish out of the milling unit to finish and that oven should and we want it to be able to do the E-Max crystallization as well so it sounds like you guys are already developing that or testing that or getting close to releasing that program what’s you call it.

DON:          Yes, that will be step one and then because we need to get that in the furnace sooner than later just because it becomes a real headache if you can imagine if you’re a new owner today.

T-BONE:    I don’t buy furnaces.

DON:          Yes, like what’s the message it gets confusing and it’s not it’s very unstable it sends a bad message. Partners can’t or the partners, our working partners can’t get on the same page it looks clunky right so we’ll get that nailed down I think probably I’m not exactly sure when but I know we’re getting close with some challenges we’d overcome with the size of the muffler and few other accessories that didn’t fit it the firing technology but I think we’re getting close and then the plan would be our Zirconia developments hopefully we’ll be able to work in that furnace.

That will be interesting to see if that actually works because we are realizing that when we release and again their technology furnace is different so it may work but when we release our medium translucent Zenostar it is a longer, it’s a long centering process it’s more traditional centering time to get better translucent cyano aesthetics and I think, we think there might be a co-relation a little bit between time and translucency maybe a direct co-relation and we don’t know if we can overcome it by just raising the temperature faster.  So that’s what we’re working out on our technology for us to try to figure out, is there way to do a medium translucency Zirconia that really looks like hopefully looks like E-Max and their furnace a very short time period as well or is it going to take longer and if so how much longer to get the aesthetics.

T-BONE:    Yes, it’s interesting you say that because that’s where I long to see and we’ve had faster firing Zirconia but it’s always come at what seems to be the compromise of aesthetics, so for our listeners traditional Zirconia, solid Zirconia is typically fired or crystal sorry centered for eight hours in most laboratories. In the laboratory process  they can put you know twenty, thirty restoration in a big furnace and you know they can set it and forget it whereas in the chair side process we don’t what’s the benefit – if we have to have the patient come back for a second visit it doesn’t matter if it’s one day or two weeks at that point so Chairside is to get things down to you know five, ten, fifteen minutes or you know in a perfect world we would love to have milling units that essentially milled things in their final state.

DON:          Right and I agree I think and really believed that when we talked about strategies after Chicago so we first launch our furnace in Chicago and we had a chance to see it and they were really great because we sat down on Thursday at Chicago with their team when they released it. We went through their demos how it works. It’s impressive I mean it’s really to watch that workflow in that technology furnace is pretty impressive to watch how simple it is to use.  So I think it’s extremely important for new owners an adoption of new technology and when we came back we were talking about you know what we think the next is just exactly what you said it’s no restoration right complete right out of the mill. I said this for a while I always I used to get  a look now I don’t get to look anymore but their  first statement was no one ever wants, no doctor wants a furnace in their office and people kind of look you funny, I’m like, no, no think about it, no one wants a furnace in their office they want – if they want  to finish their restoration, they like to be ideally taken out of the mill maybe polish it and seethe it and that’s it and the furnace has become for us unnecessary requirement to get from Part A to Part B in a very efficient time period but no one wants that so if  you can get E-Max coming out of the mill maybe multi layered by layered  to some translucency toward transition to it right out of the mill that can be polished and if you end up doing a case where you want to do something more you know it’s multiple unit and you tried to match eight to nine on  a central maybe you end up having you know $1500, $2000 glazed furnace because that’s all you need.

The products will be centered of and crystalized all you need to do is apply some stain out if you’re trying to match in fire and eight minutes will be done and most of these fire won’t even need to do that necessarily so I think that’s the ultimate goal I think Sirona took a big step to try to get something faster and more efficient and open up Zirconia Chairside and I think you know the real big jump then and this is going to be furnace free how you’re going to say it I think furnace free is ultimately the goal I think for everyone. It’s how you get there and what technology do you have to get there well.

T-BONE:    So I would say when you say furnace free I would say that ultimately this is out of a material issue these is more of a manufacturing issue or a milling issue because the material Zirconic can be made pre-centered and E-Max certainly can be done post crystalized which is what your pressing product is essentially so yes as I think about that I think about that, that is more as we get milling technology that’s better.

DON:          Yes and I do think one of the things that’s you know if you follow that track a little bit what that allows you to do then in a case for us like E-Max if that could actually work and come out of the mill complete you can know, we could then could make a multi layered block.

T-BONE:   Sure I mean that would be much easier in fact you have a multi layered block in your pressing?

DON:          Yes we can make the ink that’s power packed. We can actually make that so you can actually make a you can make a block that’s layered, you can do an implant right out of mill that’s then shaded and just seethed it, you don’t have to go to open fire. It really when you start following the path it’s like wow that would be really cool and it would really change dramatically I think change how new owners especially people looking at the technology said, wow these is really simple and pretty much what I’m getting from the lab it’s multi layered and I just drop it in complete right out of the mill.

T-BONE:    Yes you know it’s interesting you say that you know I have PPO office and one of the things I love doing is using some of the multi layered CEREC watch, whether it be  Empress or Beta Tri Lab or the CEREC block which is actually the Beta block but you know I like using those and just polishing them because they sometimes come out looking  pretty darn good and you know when you go and only get paid six, seven hundred bucks for a restoration you know it makes logical sense sometimes to do those you know the question then becomes or the challenge that I face was who wants to deal with fracturing restoration so that’s why you know many of us made a move to  E-Max. But before we talk about E-Max you know I wanted to ask you know why would somebody choose you know what is the need for Zirconia, what is the fascination for Zirconia because if you look at NYU study at this stage almost ten years of work with E-Max I mean what is the real benefit to Zirconia when we have a material that holds up unbelievably well and looks pretty damm awesome.

DON:          I would say if I was – I’m trying to be as subjective as possible which is not always easy but try to put yourself in somebody else’s shoes looking at from a clinical perspective.  I think Zirconia offers a couple of things that E-Max doesn’t well. E-Max does a lot of things well I think it shown to be very durable over time it does require though there are some limitations to what you can do as far as reduction with E-Max because of the structure of the material and the strength in fracture toughness to [unclear] disilicate and if you go thinner you really need to bond it. I would say with Zirconia it gives you the opportunity at least to be in the situation where I could do a posterior crown, I probably can reduce it last and conventionally cement it and have that restoration not fail being fractured or break so that I think there’s a and I go step further I also think there’s a question a little bit of you know there are offices I still think they’re are transitioning office a percentage office,  they’re still using a fair amount of consistently doing  PFM’s that are transitioning out so they’re looking for something that they know they can put in that’s conventionally cementable that’s really strong that’s not going to break and maybe looks like a white metal and Zirconia I think for a lot of people transitioning out fit that requirement as a material that’s not necessarily  fail even if I you know really fit in spots it’s probably still going to be pretty tough to hold up  longer term. That’s what I think my perception is it feels like there’s an element sort of creating  you know very tough material, it’s got flexibility, can go really thin and it’s you know conventionally cementable really all the time to take replacement and you know many go into this debate on aesthetics, what’s good enough and what’s better and am I putting in something now that looks better  than what I was doing before, I mean that’s become very subjective.

T-BONE:    That’s about the hands of person that’s making it.

DON:          Right and I do think but I think from a technical standpoint there are some things that Zirconia offers that E-Max – that address some E-Max limitations.

T-BONE:    Interesting, it’s unbelievable to hear you say this I mean that’s… [Crosstalk]

DON:         I mean, I could say well why would you ever do but I also think I know practically speaking from all our experience Chairside what we know is we recommend one and a half millimeters of reduction and we know that bonding really supports the restoration better and cement bonds really well the glass [     ] great material of the bond to two structure.

So when you go thinner and you bond it pretty much as you know Chairside doctors virtually have a 100% success rate with E-Max because E-Max they know they go thin they bond it they’re using one of probably three cements on the market. They’re all they’re all very good and have great clinical results. Now, if you take out of that realm into a general market they may say I was using a lot of PFM’s I’m transitioning something else I’m going with Zirconia because I can do a similar drop. I can drop it in with conventional cement I’m done with a weight metal.  If I go with E-Max then I’m going to change my props and need to get more production, I do have to bond which I didn’t have to do before and that’s where I see the differences.  Some of it could be construed as a weakness and some could just be – this is what the market is you know you got segments at the market that want to move in a certain direction and have a solution that fits what they want.

T-BONE:    You know I think of it maybe this is the cynical side of me. I think that Zirconia is taking off for two main reasons and I call it following the money. 1) It feeds into the laziness of most dentists that they don’t want to change anything that they’re doing so they want to do their feather preps, they want to do you know the minimal reduction; they want to cement with zinc phosphate or whatever in the world they’re using with it. and then I also look at it from the lab side I think there are significant reasons that labs have moved to Zirconia over PFM and I think with Zirconia there is significantly, there’s I mean I couldn’t even imagine how many Zirconia products that are out there, hundreds and hundreds Zirconia products they’re inexpensive to fabricate because  you can buy a puck and probably the average you can get twenty to twenty five restorations in there so you know that the cost factor for the lab give them a real reason to want to use Zirconia.

DON:          I definitely agree with that because we see that in the lab side of our business. It’s a very – the one thing that’s Zirconia does to in a puck form is it’s extraordinarily efficient to mill, to process overnight in bulk because you can mill in bulk and the puck you can fire in bulk overnight and it’s very economical to process and they don’t typically come back because they don’t break.

So from a standpoint of from those criteria I think I agree with you, that’s probably the big reason why It’s taking off  I would say I was watching a commercial, I saw a commercial today that I thought was interesting and Bob has said this by a doctor or Mr. Ganley from our company our CEO has said this in the past that you know something is good and then it becomes, it doesn’t become bad necessarily but something else become better so and then that eventually becomes good because something else becomes better to that and I agree if you look at you know any industries with the development of technology and materials or products or whatever there’s always you know good becomes there’s a better and then there’s something better than that and that’s kind of  process of advancement of materials and you know the cynical part of me looks at it and like I said it’s difficult for me to be objective because I work at Ivoclar and we sell a lot of E-Max. I look at it and think ok are what we’re doing is what happening now better than you know high strained glass ceramics like E-Max or any of the equivalent  material that are now coming to market so some of the E-max are looking  [unclear]

Is what we’re doing now better and what defines better now at this point. Now, that’s where it gets a little fussy because there’s the aesthetic component of better there might be the functional [   ] restoration that never break is that make it better because you know it never fracture or  is easy to seethe because you can always cement it and that’s where it gets a little fussy I think if you’re going back to Cerec, Cerec for two days and go from Cerec to the Cerec 3D you would say this is clearly better, right?  The interaction, the software the not where you can do where you can see or you can design that’s better I think this category is a little fussy on what’s better right now.

That’s more of a personal opinion than anything but I always heard that things eventually would become good and then there’s a better.

T-BONE:    I mean everything good is replaced by better.

DON:          Sure,

T-BONE:    Blackberry, who would have thought that blackberry would essentially be dead?

DON:          Right I mean that was the coolest thing ever when blackberry came out that was the best technology to receive, retrieve messages and communicate by e-mail by far.  There wasn’t any remotely close competitor that. The Blackberry was it and I don’t even think they exist anymore.

T-BONE:    They actually sell Android phones now. [laughs]

DON:          There ye go. Oh that’s great.

T-BONE:    So speaking of our cake being cut out by newer and Blackberry being cut out by Android and iPhone I remember when I started with Cerec it was all Vida.  I mean Vida I don’t know the exact percentages but Vida owned 99% of the block market.

DON:          Yes, we have like 5%.

T-BONE:    Yes, so 95% of the block market and then in fact you have a product called Procad which we call Empress on a stick which may not have been – I don’t know formulation wise if that’s actually true or not, but then I think really we saw the block market for Ivoclar turn when you   guys came up with the Empress Cad.  How did you guys go from having 5% of the market to I don’t know if you guys are allowed to say what percentage you have now or which you have a tie is but I would – the assumption was from my end that you have 80 to 85% of the market at one point in time.

DON:          Yes, I think we’re pretty close to that we’re on the I say around the 80ish range which is very high. I mean it’s really sometimes it borders on absurdly high in terms of what the block market share is and I tell you though the why and how did we get up there.

ProCad was very similar chemistry with Empress it wasn’t exact and we’re very hesitant and to really blur the line between the Ingot and the block that was our first [crosstalk]

T-BONE:     Was that about the lab not wanting you to do that?

DON:          Yes, yes it was very touchy and remember, we we’re a lab business first like predominantly and that was a big, there was always a big controversy and from our perspective I think we look at it on the clinical side of the business where I was in the digital side in Cad/Cam early on was this is going to take off and it is what it is like the Empress brand will carry into the Chairside market and really  benefit us tremendously and I think there was a concern was well, there’s not enough upside down, to upset the lab being upset, right  those are the kind of concerns and the chemistry weren’t exactly the same so what was happening was we launched Empress/Cad.  There was actually modifications to the Empress aesthetic became the new ingot so we launch – for those people who actually remember that Empress became an Empress aesthetic line that was released that chemistry that match exactly to our what became our Empress Cad bock.  So there was almost there was a merging of technologies to optimize the aesthetics and the strength as much as we could with the [unclear] crystals to get a really aesthetic restoration whether it was pressed or milled. And we launch it there was pretty much we were getting from the lab you’re going to get a on a mandrill at that point.

I think the industry started to take off of what was what precipitate or what preceded that was something a lot more important that was no one necessarily knew about we just started to see the result.

As we start to grow a little bit in Cad/Cam and the market start to move a little bit our CEO had made a definitive statement at a strategy session and said we are going to develop technologies, materials technologies whatever for digital technology. That is our objective going forward that is what we’re going to be involved and that’s how we grow our company. This goes back I don’t know 2003, 2004 it was really early on and from that point what we started to see was the development of translation of the transfer of the migration of the technologies to the Empress block. We came up with really a process so we came out with a Chairside furnace, we came out with the first version of multi mix cement which was super-fast and very high bond strength to support the restorations, the Bluephase at that time, the Bluephase curing light was the first one, like everything was advance and kind of sequence of a digital workflow including a Chairside furnace and all those pieces started to fall because they’re all being sort of worked on and were developed  and driven into the market place.

And that’s when that’s started and also the focus from our rep to say you all were going to work with the office and we’re going to help support that office if you really successful with the machine because we’ll be going to essentially provide service along the entire process from the block to the cement to the characterization material whether you polish it or glaze it, a furnace and then cement to finish it and we also have laser technology to modify and handle trotting around crowns to get better and more accurate digital impressions so all that workflow all happened at the same time.

He made a decision that we’re going to develop on a digital and everything else in our focus and our reps change and what you see now is you know our reps are so engaged with their Cad/Cam offices, they are the best expert most of our offices have.  Our reps are can be the best support mechanism by far to that office because they can answer questions on any material especially restorative material how it works, what it is, how it functions, what we think of it.

I’m going to give you a really good case and point when recent materials have launch going back to lab ultimate and then to cell tract and of city in.  We would get calls our reps would get call and say what is this material? What do you guys think of it from our offices directly that would, I don’t know how many times it happens in any industry where the office actually calls you know company A about company B’s product and what we tried to do was align our reps as good as we could for being experts in the workflow to help an office but also understanding materials and I still  can tell now I think they know more about everybody else’s materials and anybody else in the country right now and it yes it shows if we have webinars we talk about updates and material updates on things. They ask extraordinarily pointed and questions are very on point with their content how they communicate it. They’re very accurate with what they communicate.  We tried to get them as many tools as possible so they can speak like a digital workflow expert, restorative experts and I think they do and that as much as anything the materials kind of follow suit because our first Cad came out then E-Max came out after that all the indications for E-Max and Chairside applications put  our reps and our focuses on the company where you know steps one building block one and two that really set the tone for where we were gone and the rest of it kind of fall into place but we follow the same model and our reps really do a phenomenal job.

T-BONE:    Ok so I want to get in to talk about the birth of E-Max but before I get into that so we talked about I would say E-Max you know the commitment to certainly go digital let’s call it four side because we’re talking ten twelve years ago I mean Chairside Cad/Cam was nothing compared to what it is today.

So you know how does Ivoclar prevent itself from becoming the next Blackberry where you own just like somebody else own 90% of the market and then you took essentially all of it. How do you make sure that doesn’t happen?

DON:          I’m going to give you the benefit of experience by being in this industry for a while. I’ll give you a short story and also perspective.  I started when we have five percent and I saw what happened to Vida from and Vida’s still a very good private company very similar from ours I say lack of development of staying ahead of the curve in terms of material development and the reduction of support forces, support people and personnel in the market and what kind of reflect they had in terms of their position in market place.

The other perspective I have and that was those are I’ll say decisions that were probably made along the way, right?  The other perspective of the competitor who was really dominant and has essentially disappeared was when we introduce the laser into the marketplace and we were introduced the Diode laser specifically to get involved with improving digital impressions. That was the prominent reason we thought this was a great strategy to improve impression taking a general but specifically digital impressions and it was fast, it was efficient, it worked you know, our proven technology there didn’t seem to be any magic to it and no one was doing it.

When we entered the market because I was involved with the development and the launch of the product, Biolase, I went to a Biolase booth and was essentially mocked like you’re coming to our booth to learn how to sell lasers. That was said verbatim like right to my face and I was actually going there to meet someone about an industry where we have some kind of laser committee meeting I have to meet somebody there and it was some other I don’t know if it was the rep or some multiple reps or whatever it was very condescending comment.  And then a year later, a very similar circumstance happened  I was meeting this person at a then we would go to a meeting together and  I walked into the booth and It was like night and day and the comment was you guys cleaned our clock and a dial [unclear]  and what I realized was part of it is decisions that you make you have to maintain a strong position in your material development, your product development whether it be workflow, whether it be materials whatever it is and the other part of it is not letting yourself think that you are more than you are and you can become very arrogant as a market leader and that’s the biggest downfall of the company have I think is – you become we’re really great, no one ever going to pass why would I want to do something different than what we’re doing today. I  mean we all know E-Max is going to be replaced, we talked about it all the time, there will be another product that will replace E-Max and that’s just the way it is that’s the cycle of product development and we’re going to work in a  race right now to make sure we get there first.

T-BONE:    You want to be a replacement for E-Max?

DON:          Absolutely, absolutely we don’t want to be channel like we can make the argument I will say today, I can make the argument there are bigger concern on the lab side of the business is proctor is taken a lot of business and has become a replacement to a large extent for E-Max as a result of materials especially in the posterior.  Chairside we’re a risk could be happening as well and some way shape or form so for us is what is our next development that gets us to jump the current product in the lab side of the business where it’s being milled in puck form to labs or chairside.  What is the product that gets us that leapfrogs everybody and keeps us ahead because if we don’t do that even though we’re not arrogant and we want to stay as market leaders you know if your product falls behind you’re in trouble so it becomes product development and the race to stay head out and having unique development that works and stick to our core values of performance and statics and also a real persistence to be, I say humble and not arrogant about where we are. Like I don’t like necessarily talk about market share not because it’s proprietary information or anybody can’t figure it out it’s more I don’t want to make it sound like wow we own the market we can do whatever we want because I really don’t believe that.  I’ve seen two companies in my span of time at Ivoclar had the tables turned on them. In a short period of time by us. So I know what it’s like, I’ve seen the other side I don’t want to be on the other side.  I notice that I [crosstalk]

T-BONE:    That’s not good for your job isn’t it Dan?

DON:          I know I’ve seen it firsthand I have no desire to see that. So you know for me and I think for our organization it’s not we don’t really have to talk about it but I think we act and convey the idea that we’re going to keep pushing, and keep pushing and keep growing and advancing and stay ahead and continue to do what we do in the field really well which are I say this before about our reps. The reps become an extension of us as an organization to not settle.  We don’t want anyone to look at it and go wow we own the market and then we’re going to switch, no, no, no this is how do we help the office to be successful continue to do what you do best which is service to the office we’re going to generate great products that work and if we both do that we work together really well we’re going to continue to be a head of everybody else maybe not in the same market share levels that we are now but we’ll still we’ll be ahead of this category.

T-BONE:   Yes and at the end of the day for pure business perspective you can afford to lose market share as long as the market is growing because then ultimately you’re selling  the same volume at the end of the day so.

DON:          Yes, and  I think for us you know, if we were, the way I look at it is I’ve said this to our team before inside  our organization that set the people outside, I have or I don’t like the conversation of saying of anyone saying inside  our building that well we drop five percent it’s not a big deal, my perspective is, we will fight, scratch and claw for every percent to keep it and if somebody earns it and if they have a really great product that has a niche works good for them, but once you concede one point, one point becomes five, one five becomes ten and I really do believe that I think you strive to not lose and continue to grow your business we tried to figure out ways how to grow our share we sounds almost little ludicrous to say but if you’re not doing that you’re inevitably you’ll going backwards and of course  you’re going to start losing.

T-BONE:   You know listen I like Vida I think they made great products but to me the icing was when they  invited twelve of us over to Germany and they literally tried to argue with me about how Mark 2 doesn’t break and I’m like you’re right It doesn’t break in certain situations but on posterior teeth on molars and second molars it has a good chance of breaking just like Empress has a good chance of breaking, molars I’m like, so you can’t fight the market you know  if the market says we want faster, we want cheaper, we want better and ultimately that’s what you have to deliver.

DON:         Yes, and I think you know that’s a losing battle.  I mean you can’t convince someone that as a market especially if that’s head after fingers on the market, like yourself and others that train and speak in the market place you guys know what’s going on you see what’s going on from dentist everyday way more than we do and directly you see it because we’re going to tell talk to you on classes and programs and tell you what’s going on.  You know that’s not made up information it’s just what it is you got to take it ok these is where the market is going do we want to try to influence the market in another direction or do we manage to go with the flow so to speak and try to develop things that fit that and those are choices you have to make, usually that’s a losing, it’s a losing battle to try to convince someone that they’re not right and very seldom, very seldom works, very seldom.

T-BONE:     So how did E-Max come about what, where did E-Max get born from?

DON:          E-max was a successor to Empress and the intent was it’s time that it’s going to be an encompassing brand called Empress II that was going encompass higher strength materials either have traditional glass ceramics who would have a sub structural material that was Lithium Dissilicate and then layered material to be opened on top the universal layering material and…

T-BONE:    That didn’t work out so well.

DON:          When I first started there were some challenges with from what I recall that was very, very new to the industry as well as the company with co efficient of thermal expansion of lithium disilicate as a substructure material and a layered strata and it wasn’t so much that it didn’t work but it was the way it was described to me is the pretty window for success.

T-BONE:    Yes in other word it’s so hard to do that.

DON:          Yes it became if you really, really you know if you could  really nail the parameter of it at work if you didn’t there’s a good chance that it wouldn’t and going back to reformulation when that was going on we realized that lithium disilicate could be modified a little bit to look more aesthetic and more translucent that became MO became DOT and DOT works you know reasonably good as a  monolithic material and when we got restorations done we start doing some evaluation to what are the basic premise then became wow one piece crown that’s going to be pretty durable that should hold up much better than a layered restoration and that was – it made logical sense but from that point it wasn’t really strong, very durable monolithic restoration and I don’t think people were saying monolithic back then, but.

T-BONE:   No, no, we were, I remember Smilennium  was the first time we saw E-Max I think that’s when you guys we’re bringing it to us but it was not even E-Max has a block it was like E-max for the lab?

DON:          Yes it was a family with a sub structure material and it was the same idea E-Max was then recalibrated to be a sub structure material [unclear] ceramic and then also a traditional layering ceramics that we use which was designed for appetite, a layering ceramics and then there’s also the lithium disilicate and what end up happening was those are all components they’re like colors of the house.

T-BONE:   Yes, it was the most confusing thing I ever saw in my life by the way.

DON:          It ended up having pieces of all the stuff and what actually as Zirconia component that was Zirconia sub structure and what end up happening was the lithium disilicate version really took off because labs started to realize this looks nice i can press it and be done with it in one press, it looks really good and it’s durable so it fit in all of a sudden they need some stronger than Empress that looks better than a PFM and in these case it was – end up being proved out to being durable and then we went Chairside, the Chairside block, we never really anticipated, exasperate because of the firing times were thirty six minutes.  Yes, if we knew going in that’s going to be a challenge and what end up happening was back to your point about say Empress or Mark II, people we’re having failures with their machines and  posterior restorations have gone to a PFM or Zirconia restoration on molar and then little by little started to try with lithium disilicate or try E-Max  and say wow I can mill this and fire it takes a little bit longer but then I don’t have to send it out so I can still kind of make this  work  I think out of some necessity and some convenience to do one visit dentistry it started to work in the posterior and then you know thirty six became thirty two and then became  twenty six and you know get the time down to something.

T-BONE:    Fourteen to fifteen minutes now.

DON:          So it was, it’s been an evolution, we’ve learned you know I say this to our reps, I say to people outside our organization we learned about materials almost every day just like everybody else does. We’re just in it every day and we were about physical properties and chemistries and things that we learn about materials even our own materials so I think the benefit of being a dental compre having a real focus on restorative materials as your, you’re all in with what’s going on on the material explanation side, how things function and we learned something all the time about materials and what’s important and what constitutes clinical success to working in the key clinical success long term.

T-BONE:    I remember Arman [unclear] was the first one I knew that did a E-Max monolithic restoration with CEREC it was I think it was the H.O block at that time.

DON:          It might have been, yes.

T-BONE:    It was so ugly and I remember he made a statement which I laughed at at that time, he said this will change CEREC dentistry in this material as soon as they it making better looking will change everything and I laughed at because that’s, that’s crazy right. It’s ugly and it takes 36 minutes to do and all of those things and look what it went through I mean now we’re talking about high translucency material, the medium translucency material, I mean truthfully the only thing in missing E-Max is the multi translucent you know and that’s more not obviously not desire that’s more from a you know complexity of manufacturing

DON:          Yes, [unclear] could see what it did as a product whether it was perfect or not when we launch it.

T-BONE:    Luckily he doesn’t’ care how things look sometimes.

DON:          Yes, but I also think he got the whole point of the biggest headache I have was a fractured restoration and if this tops that, oh my God this is great and you know to a large extent I can probably say the same thing about Zirconia today.

That’s probably why a lot of people are gravitating toward because the odds are, I’d say it’s probably never going to break I’m sure it could under circumstances. The odds are pretty slim that you’re going to have an apps fracture.

T-BONE:     But I think people are moving to Empress I don’t have anything against Zirconia per se but I think they move to Zirconia to follow the money it’s $59, $69 restoration $79 restoration that you simply can’t you can’t even you know in theory, you really can’t do E-max at that price point as a lab because the cost of the material is so much and the labor that goes with it because you can say well I can do the pressing but the human being doing the pressing cost more than the material itself so you know, so and I want to know who made the decision to buy Pentron laboratories?

DON:          That had to have been above Mr. Ganley and George Thesausky who is the head of our RND, Vice President of RND in North America and Pentron was an interesting fit for us in terms of the pans that we purchased. That they have pans, we have pans on lithium disilicate sort of today who is also become our manufacturing facility for us now. It’s evolved quite a bit from what it was to what it is today.  And we manufacture a big chunk of our blocks in Parksnow [Crosstalk]

T-BONE:     New Jersey

DON:          New Jersey, yes, and it’s become, it really help us with a lot of things.  We have, we feel like we have really good second facility to manufacture blocks and you know the way the world is today, if something ever happened to Europe you can get a blocks here for any period of time.  It’s critical to be

T-BONE:     Our patients will be gumming it.

DON:          Yes, it’s a [unclear] think about, think about things that can happened you know just because of terrorism or threats of [crosstalk]

T-BONE:     How about the volcano ashes in the air and your stuff can’t come over.

DON:         Yes, I think that really precipitate a lot of it we’re shut down from shipping.

T-BONE:     Yes.

DON:          And then there’s a period of time where most dealers now and you know electronic orders that are pretty tight you know there’s not a lot of

T-BONE:    They have to make money.

DON:          Yes so that really, that acquisition I think tied up some probably loose ends and gave us some access to pans and not only on glass but also on Zirconia that we’re actually still utilizing or beginning to utilize more now. So there was a lot of value on it and the organization facility wise became really grown dramatically and something that’s really pretty cool and great.

T-BONE:   I don’t know what you guys paid for but I think it’s probably one of the better buying decisions ever because it allowed you to own lithium disilicate from A to Z essentially because I remember when you guys were doing Empress II which is the original lithium disilicate I was doing OPC 3G which was Pentrons’ Lithium disilicate or their competing you know Pentron’s is always known as a copycat company or whatever it may be and they actually a good products and so I know when you guys got that to essentially own E-Max from that point on and obviously all these  other stuff that I don’t even understand has been unbelievably helpful to you there as well.

DON:         Yes, it was a really good it was one of those under the radar type things that when it happens it was like what are we doing how does this makes sense and in the long run it really played out and paid out well for us.

T-BONE:    But you guys didn’t get the Pentron clinical side?

DON:          No, I think you know I always wondered if that was around the table because.

T-BONE:     It turned out the lab side is probably more valuable than the clinical side.

DON:          Yes, I know that clinical side was way more valuable that we actually got at that time now I think that’s a different perspective because the markets moved so much to glass Chairside glass and now Zirconia which like I said we actually got some access to technology to head on Zirconia as well so it’s been it was a good – it ended up being a really good fit. I think we would have taken the clinical business for sure  if we could have got it but I’m  sure the price tag was probably too much.

T-BONE:    it’s interesting so as we are talking about the clinical side do you guys see I mean do you see a lot of excitement or growth on the clinical side of Ivoclar business I mean what you and I probably refer to was the analog side you know – bonding agents component. That bores me.

DON:          Yes, I think what I was saying earlier is that there are incremental changes you know like you and I think that can be – that’s not necessarily bad but I give you a really simple example.  We had I met a doctor lab after just recently that actually migrated toward adhesive pan.  The adhesive pan that we use and the heat was good I mean it’s not I don’t know it’s [unclear] was great but it’s really good adhesive and it’s delivered in really fast, simple efficient, clean mechanism now in the pan and people really love it and they think alright you know I get it but it’s not – I look at  still from the perspective of three years ago we launch the ability to do a mill at Chairside bridge and now it’s [unclear] like those are giants.

To me those are giant leaps in technology between the milling the scanning the design or the material to me the pan doesn’t seem that way but in the category that you run I think you see I still see you know dramatic or somewhat significant improvement so making easier, faster, better so instead of having two bottle system that you dispense next you have something that super-efficient that doesn’t waste material on and works and give you a great bond.

So I think you end up seeing I would consider them more incremental changes but everyday whether it’s depth of cure or better aesthetics with the depth of cure or better ware polish even on noble or on place rest and restoration there’s always going to be an improvement because you know we want to make things that look better, perform better or both whether it’s clean out or durability whatever the case maybe is so I think the excitement like your point if you’re in the digital world look at the analog world of thing what’s the big deal? If you didn’t have a machine and you were dealing with you know posteral bunny agents and press material on temporary material you probably have different perspective on wow this is pretty cool.  You know your cool factor will be a different scale based on what you’re in.

T-BONE:    I mean no offense but that’s a crazy talk. [Laughs] listen you know in all seriousness, you know how hard it is for somebody to change her bonding agent like there’s nothing in my life I’m using that’s five or seven years old other than my bonding agent, I mean that to get me to change bonding agent you would have to have some kind of dramatic improvement.  You can’t count on me with I’ll vouch it’s ten percent higher I’m like and so what you know it doesn’t matter right but changing on material you know changing a block material say, say hey you know how quick was I to change from say Empress to E-Max because the stuff stops breaking I mean ultimately.

DON:          Oh yes.

T-BONE:    Alright last couple of things here and then I’m going to let you go.  We’ve talk about since you’re so open and talk about competitors what’s your take on these hybrid ceramic materials?

DON:          I like, this is how I love certain things about them. One, I’ll speak specific to enamic.  I really love the fact that they are able to weave a sponge like ceramic with resin in a bowl between it.  I just think it’s pretty cool.  Dr. Tom Haile, a PhD that works for us and I’ve talked about him a lot, it is really interesting technology they figured out how to make these blocks because it’s not easy to do that, it’s not easy to melt three different completely different materials together and then also have it malleable.

T-BONE:     And mill them really good.

DON:          They mill really fast, the margins very clean so I think there are some really big advantages to it in that regard.  Performance wise I think good, I even heard really a ton of negative in terms of you know I hear I don’t really like the way it looks. It looks

T-BONE:   It doesn’t look that great.

DON:          It’s not translucent but it dulls out I think some of that is a functional it’s to chemistry, there are two different materials so you have a ceramic and a resin.  Yes you would polish resin it goes on resin material or you would handle it different way you would polish it certain way you maintain a luster.  Ceramic would be just the opposite, you might even glaze it or do a different type of diamond polisher on it and I think the challenge is when you have a hyper like that, it’s how do you get that or even the bond like how is the bond surface work when you got three different substrates.

I think the technical aspect is cool but it also pride some challenges form.  I like the idea a lot I mean frankly the idea that we would love the most it’s not like everybody is not trying to figure out how to do this is you have a resin and you make a crown or you make a block that has a resin core with E-Max as the enamel that it’s fused together then when you mill it you get a crown that’s [unclear] on the inside and enamel on the outside and that’s your crown, that would be [Crosstalk]

T-BONE:    Or maybe you have lithium disilicate as the sponge and resin woven into it.

DON:          Yes, perhaps yes as long as we can mill the completely sliced version yes so that’s the I think the challenge, I love the technology.

T-BONE:   Why aren’t you guys in that business?  Why aren’t you guys in that block segment?

DON:          We are in the process of trying to overcome pans that apparently maybe other people will overcome or

T-BONE:     Ignored.

DON:          Yes that could be as well.  We would never do that so for us there’s at least one company that has a process pan on resin based materials and I’ll say that’s all resin. Not necessarily resin hybrid but  resin based blocks so we even try to use our work through it or around it we’ve been having some challenges and we’re also trying to work through it and it’s just one of those things where I don’t think we’re going to get license for it  just based on the relationship with the company and we got to figure out ourselves or you know we made some blocks we’ve actually milled some we got some really good results but we still have the challenge of how do we get around the patent so we’re still working on it it’s just a function of you know?

T-BONE:    You don’t think they’re bad materials.

DON:          No, actually I will tell you this, if I was if you would ask me point blank as a new owner what I should have in my office I think I have a multi-layered blocks whether it’s Smart two Empress obviously I’m going to slam myself to Empress more.

T-BONE:     Well, Empress looks better, quite [crosstalk]

Dan:           A forte or an Empress Cad Multi are two beautiful layered materials for certain cases in the anterior, E-Max is a great posterior application for restorations, for partial coverage especially in lace, i would never pack a composite unless they absolutely had to.  I would take a scan and mill it and drop it in a resin restoration as many times I could especially where there is a content I’ll let the machine melt the content all day long and those restorations will be in there forever because it got protection from the existing post that remains they’re not going to be under flex forces like a crown would I think their tremendous application I’m surprised more companies don’t focus all their time and attention on that but I think it’s a great fit. I really do think it’s a great application I think it would make composite placement very, very fast and very efficient and I say very efficient it would be less manual labor for connection to cement a milled restoration and composite then it would be the pack composite in any way shape or form.

T-BONE:    So you consider ceramics and resin restoration?

DON:          That’s actually in our world it’s a separate category because the resin hybrid, we consider the resin hybrid because of the category of material, the way we will describe is there’s a lot of ceramics in the Empress and so the other materials are pure resin.

T-BONE:     What about [unclear] what’s you’re take on that material?

DON:          I actually like the fact that they’ve got some, they’ve made some modifications to the filler which logically seem to make sense.  I think it mills just like a lot of materials mills, super clean at the margin it’s like really nice, very smooth

T-BONE:    But unlike lava material it actually sticks to teeth as crowns.

DON:          Well, I tell you what’s been interesting so I would say yes based on what we’ve seen so far, I don’t know how many people are doing crowns with it per se but the modules is actually lower than lava which means in theory it’s going to have more flux so I don’t know like if,  this is my guess what happens since lava pull the indications  maybe have issues with the bonding as a crown indication I would say most people they’re going to use a Cerec Smart or lab ultimate or probably milling partial coverage and they probably milling crowns out of other materials because they know it won’t flex.  I think the general consensus is if it’s all resin it’s going to flex it, It has a likelihood to debond and you know then what I’m going to replace it so I don’t want to do that.

T-BONE:    And you consider enamics different from that?

DON:          Enamics a little bit, yes, it is different I mean the chemistry is really a lot more percentage wise a lot more ceramics so that’s to me I don’t think, they don’t have a flex from what I can tell we tells the company flex issue as much as they have a sub straight surface issue like if they were, if something if somebody  had an  enamic crown the bond I would probably assumed ok how did you treat it because the surface area is either it’s resin and ceramics so we, you know we add ceramics you the same blast resin or modified to be able to get to  bond to it  no, I don’t know maybe you do some  hybrid combination of bulk or one or  the other I don’t know if it’s going to give you the optima; bonding surface.  Just based on the chemistry of the material, I think mixing the two materials is tough to get the finish to look nice and to get a good surface bond like glass bonds who really well to two structure whether it’s Vida, arch, Empress, E-Max it just bonds great to glass, Zirconia doesn’t or two structure resin well but resin in big wrap bigger indication may flux so I think the hybrid version is difficult to bond to from what it appears.

T-BONE:    And then the issue of the resin also is if it is manufactured or milled it’s too dense for there to be in a free bond available so…

DON:         Yes, you really need to activate the surface in some way shape or form to be able to get a bond to it and that’s you know a little bit of the downside of that material I think for an inlay applications especially it’s you know you’ll going to get a really good surface, you’re going to get a really surface you’re going to get any flux that you get  in some portion in to  the flux not push it away from the margin so I don’t – I haven’t heard a lot in  the market of partial coverage restoration debonding or coming out I don’t think that will happen,  I haven’t really heard a lot of that  happening anyway but I don’t really anticipate that happening going forward either so I think  if I go back to my original premise of a new owner I definitely would go resin for partial coverage. I would look at multi- layered materials or specifically you know like laterals we try to get a good match  and a blend or an anterior and now we’re trying to match with pre-molar forward and then something of higher strength like E-Max with the Zirconia material comes strong and that was a posterior application because you need to strengthen the toughness of the material to hold up long term.

T-BONE:    Well, Don, I don’t want to keep you too long I know you have lots of things going on in the Chicago office there but I got to be honest with you this has been the most interesting conversation from a pure perspective of I have talked about every other product out there.

DON:          Yes, you want to get my perspective on things I give you my perspective.

T-BONE:    Yes, that’s what I love about you I mean and I think you probably roll your eyes every time we see each other because I’m straight up like why aren’t you doing this, where we at with this why are you sucking at that you know?

DON:          Some things we are doing believe me so you bring out that I get frustrated because I’m like when I’m out there or we’re getting  closer.

T-BONE:    I’m kind of like the [bab] block I’m like how am I going take to come up right what are my concept you know what you need a tie based that’s like made out of peak material or something so you don’t have to.

DON:          And there are things that we like as much as [   ] in the pipeline there are other things in the pipeline as well, so it’s not I think you’re in some cases we hear things from yourself or from other people especially in these digital area that are I wish I had this and they are really good ideas and we may have just started or on process of starting them, and then it’s navigating production and FDA and everybody else so.

T-BONE:    I’m going to give you another idea and I may have mentioned this to you before you know how you put nail polish on you have that little thing that you shake and then it has a brush built into it, you need a Pc pen with like one of those magnets or something in it and that needs to be my glazed or my stain for my ceramics so I don’t have, I hate mixing that crap I absolutely hate mixing it.

DON:           Oh ok that’s a really good idea.

T-BONE:    I love to just sit there and shake like shake the Pc pen and then you know that would mix up whatever was in there and then I can have like a nail polish brush on there and I can just paint my glazed on so I never had to mix my glazed so I never got that sandy look to it or something like that. I don’t know what it would take to do it.

DON:          That’s a good idea. See I just learned something today. I got a new idea today.

T-BONE:    Yes, I think that would be a great product because it makes my assistant’s life easier and my life easier and you know the other thing it would do for me something like that is I could literally actually stain and glaze in the mouth.

Dan:           Oh yes, yes you have better control over it.

T-BONE:    I have way better control over it and then I can take it out and stick it right in the oven you know so that would be really nice certainly and so, so Don how can our listeners get in touch with you?

DON:          Easiest way I give you the best priority way if I get a text there’s a really good chance that I will answer pretty quickly.  My cellphone 716 465 4425; my e-mail address is probably one o one is e-mails and issue in dentistry where I give it to you anyway. It’s Donald.Bell@Ivoclarvivadent.com Ivoclarvivadent is all  one word and it is my full first name it’s not Dan it’s Donald by the way i don’t know where it goes it doesn’t go with names so.

T-BONE:   Do you think Ivoclar will just go ahead and make you a second e-mail address that automatically goes to you?

DON:          And a few people e-mail me like I send it to DonBell ah yes, I don’t know where that’s going?

T-BONE:    I think my favorite story is one time I gave out your cellphone I was angry and I require for something who knows I gave out your cellphone and e-mail address and I had my whole audience text you so I can’t remember what it was its probably like why don’t we have bob and block and I’m like text this guy and ask him, what does it take to get this done?  But Don, it’s been awesome I mean literally you know to literally work for Ivoclar and you’ve talk about so many other products.

DON:          I appreciate this is fun that we’re able to talk about things that are going this is the digital dentistry though it’s everything that’s going on right now so.

T-BONE:    It’s amazing by the way and for those you know, for those of us who want to learn more about Ivoclar products one thing we got to mention this, you guys allowed dentist to come to Ivoclar correct?

DON:          Yes, we actually we’ve been doing what’s called the open house program in Ivoclar we’ve been doing for over a year now and we bring once a month, we bring doctors into our facility and it’s a pretty small group. You’ll end up working with our rep. We try to organize it through our sales team that kind of balance out who gets access to the building and participate. But you get basically two days in the building to meet everyone to spend time using materials testing, cements working on ceramics and the case now we do [unclear] start to finish like we do all kinds of things and it’s a very intensive interactive program that’s meant to do short introduction of products in categories and then we do a lot of hands on and it gives – doctors bring their staff or key person on their staff to learn more about how to handle products, get questions answered.  It’s very, very interactive and for us it’s a really good way to learn from owners because we consider our organization I have no idea what’s going on in the field when you had people in front of you for two days you learn about what they’re doing in their office and I think it did a tremendous, it’s a tremendous value for us I don’t know how many people realize that when they come in our building I tell them that all the time.

T-BONE:   You guys should be paying them to come there.

DON:         Yes, they learn a ton I mean they’re basically they have to get to our building; they need to get to Amherst and everything else we pick up from hotel and food and all we ask is that they be interactive and they learn and be open because we learn a lot from them they learn a lot from us, they get interaction to all our testing people and testing materials and Dr. [Tom Howes?] a PhD in ceramics  and there’s so much shared information I think It’s been really phenomenal. It’s very aggressive like you learn so much from people in two days.  It’s been a lot of fun we still do it and people…

T-BONE:     Are you guys still doing the testing of all the different products?

DON:          Yes, we actually, we tweaked that a little bit we do- we still do we select certain materials that are current, we try to select like the current materials in the market or current topics to discuss because you know it cover like for us I don’t know the version of somebody else’s cement that’s five years old doesn’t do us any good anymore.

We try to address up the current from a testing standpoint but also on the material science side. We don’t really cover material science per se we cover what’s current topics in dentistry so whatever you know current either it’s new products or new you can hear this phrase all the time about you know some test that’s being done that’s supposed to evaluate materials better rumors on the street or whatever we try to pick topics that are just current today and address some there in the open house.

T-BONE:    I’ve been to that it’s fun you actually like I’ll come in and say for example I’m using XYZ bonding agent and will literally test my technique of that bonding agent against yours in my own hand and you’ll see whether it’s better or not I mean sometimes it is better sometimes it is not better and it’s quite interesting, again it goes back to our  conversation in the overall conversation of your company all the way down for meeting the CEO. Mr. Ganley is unbelievably down to earth person. It’s that ability to say no this is when the bigger picture of dentistry and it’s not about us owning every single share that we can by you know by cheating or putting misinformation out there, we want to earn it and you know would recognized other companies that had great products and you know that will just make us work harder to get better there

DON:          Yes, believe it or not so.

T-BONE:   I look forward to seeing you in August at CEREC World and the other thing I should also mention you guys do this symposium throughout the country for CEREC owners?

DON:          Yes, we run one day events that are really I will best describe them as very good regional education programs and you’re participating in some of them with us.

We try to bring education to local areas, local regions and it seems to work out really well, we get a lot of owners that come we try to bring in really top notch speakers to go over topics of materials and applications and indications how to do things and I always find people who learn a lot during the symposium and they also,  we also get prospects that usually come in spend the day learning about the digital workflow on Sirona system and using our materials and it gives them the ability to really meet owners that haven’t a lot in the past or to that point and they also get a chance to learn from really good speakers that are delivered to them you know in their backyard, they don’t have to go fly to the cross country to go and see a lecture so I think it’s been very valuable for us again we learn so much. Our reps get really engaged at the grassroots level in the regions with the branches and specialist and the owners and it builds really good relationships, we share a lot, we learn a lot about what people want to do what they’re doing, what they’re struggling with like it’s really good and great inside what’s going on and in return I think we give back a lot of really good education from top flight speakers.

T-BONE:    That’s awesome, thank you Don, I’m going to – it was great having you on and I would love to have you because we didn’t even talk about [  ] or bridges.

DON:          Yes, like I say if you ever want to do a part two of this.

T-BONE:    I do because, if anything, I’m the implant guy and I didn’t even use the word implant the whole for God’s sakes.

DON:                   [crosstalk]… implants, there’s the rumor of who’s going to be carrying what machines, how does that affect the market, what’s going to happen.

T-BONE:   We didn’t even talk about the Dentsply Sirona merger [laughs]

DON:         There’s a whole bunch of stuff we could [unclear] a version of that.

T-BONE:    Holy smokes and we went an hour and 15 minutes. That was pretty awesome.

                                                                                        

Thanks so much for listening to T-Bone Speaks with Dr. Tarun Agarwal. Remember to keep striving for excellence and we’ll catch you on the next episode.

Thank you everybody and I appreciate your time.

Thanks so much for listening to T-Bone Speaks with Dr. Tarun Agarwal. Remember to keep striving for excellence and we’ll catch you on the next episode.

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