by Dr. Tony Soileau
Sleep apnea is pervasive in our adult community, with many people needing devices to help get a good full night of sleep. We see at least 30-40 sleep patients each month and at least 80-90% are referred by a medical doctor. I’ve found that both doctors and patients truly appreciate a single visit for the treatment of sleep apnea.
When I initially started treating these cases, a lot of doctors and patients were very interested. However, when I told them that they first needed dental work because if we did it afterwards the appliance is not going to fit, both parties lost trust in me and we lost a lot of patients and referrals. I understand how frustrating it is when a patient seeks help for their sleep apnea condition and I’m pitching a full mouth reconstruction. It’s important that if the patient comes in for sleep apnea that you treat the sleep apnea first.
I developed a remedy for this common dilemma using LuxaCrown (DMG America). Now, the patient comes to see me for sleep apnea, we talk about how crucial it is to get the dental work done first in order for the appliance to fit correctly, and the dental work is completed immediately before fabricating the appliance that same day.
The biggest advantage of using LuxaCrown is that we can create and place all of our crowns in a single appointment. Instead of taking two hours to fabricate a CAD/CAM crown, it takes a mere 30 minutes for ¼ of the cost. It’s profitable, I’m saving the patient money, and I am able to start their sleep apnea treatment the same day.
So, how do I ensure that LuxaCrown will fit the sleep appliance? I actually use the appliance as a stent, and this guarantees a great fit. Even if it’s slightly too big, it’s so easy to shave LuxaCrown back versus working with porcelain.
LuxaCrown is semi-permanent but lasts for up to five years. If the occlusion and bite are done correctly, I’ve found that it can last even longer. With LuxaCrown, I went from having to send my cases to a lab to milling right in-office. I’m basically making a stent, seating, polishing, cementing, and I’m done.
Because LuxaCrown restorations are most likely going to be worn for several years, I spend a little more time with finishing. If you leave it rough, plaque is going to be collected. If there are small voids in it, it’s going to create fractures. So, I take a little time to perfect it but it’s not hard to do.
I’m fabricating LuxaCrown crowns that are approximately 2mm thick, so fractures are really not an issue. Because it’s a flowable material any little voids are filled. To polish, I use a diamond paste just like I would for a porcelain crown. I use a soft brush with light pressure, then a rag wheel to buff for a beautiful polish that’s not going to collect plaque. The margins are super smooth, and now I have a crown that’s equal to porcelain as far as fit and polish.
What’s more, because LuxaCrown does not require isolation, I cement it with a resin modified glass ionomer (RMGI). If you carefully polish it, use diamond paste and the ragwheel to really get it smooth, the RMGI is so easy to remove that it peels right off.
LuxaCrown is truly a game-changer. If you take a little time with finishing and polishing, you can make gorgeous, reliable long-lasting crowns that will last for years and fit sleeping appliances perfectly.