options for treatment...

JMN

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you gonna charge for all those dupes?
If it gets done, it gets paid for. The wise dentist sees it as a sales tool.
He looks pretty awesome to the patient for having those available to show the difference.
 
2thm8kr

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If it gets done, it gets paid for. The wise dentist sees it as a sales tool.
He looks pretty awesome to the patient for having those available to show the difference.
On the flip side that is a lot of DX work if the patient ops for something else. Been there, done that.
 
JMN

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On the flip side that is a lot of DX work if the patient ops for something else. Been there, done that.
As long as they pay the bill, and come up with something that's realistic. But I know exactly what you mean.
 
Affinity

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As a Dr, which Im not, but since were treatment planning here, if the Pt refuses the treatment the Dr thinks is best, then the Pt can find someone else to try and make a miracle. Guess whos fault it is when the Pt doesnt like how it looks when its finished because what they want is next to impossible? After all their enamel is gone..
Giving a pt what they want isnt always in their best interest, pts dont know jack sht about their teeth.
 
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I will also say, without dealing with the crowding issue, and depending on Pts age, theres no guarantee the crowns wont relapse to the same misalignment in the future. Wheres the other wisdom tooth? If it comes out it could wreak havoc.
 
2thm8kr

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Making returns on a home made copper investment?Hmmmm2
 
sidesh0wb0b

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If the patient wants to look like their teeth have always been normal, you have no option if ortho is refused. Aside from a year's pay of whole mouth plan.

Since they want fast, my initial thought would be a MD bridge. You'll have plenty of tooth to bond against with the space being so small that you can't fit it between 9/11 properly, it will be still looking different, but could possibly get it fairly similar to 7 with overrotation and incisal tilt.

A MDI type solution with a single tooth cemented on could be a candidate as well if they have the bone for it. The implant path would be different from the root path, allowing a very firm grasp by the threads. Yeah, it stinks, but I have a 5unit bridge out there on 4 of them and it's still going 7 years later. Only option that patient could afford.

If it were my case, I'd dupe the model 2-3-4 times and try various permutations. Deliver with a note outlining steps required for each variant and let the pt and doc choose. I'm also highly averse to clinical decision making. I'll offer options, and even suggest the one I like, but I always make them make the call, on paper.
i would need to charge for that time and mock ups. right now its just in the eval stage and im putting a load of time into it as is! though if i had the go-ahead, i think thats a solid idea.
 
sidesh0wb0b

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I will also say, without dealing with the crowding issue, and depending on Pts age, theres no guarantee the crowns wont relapse to the same misalignment in the future. Wheres the other wisdom tooth? If it comes out it could wreak havoc.
i agree completely. i think this is an ongoing crowing issue. not something that just popped up last year. so without either tying all the esthetic zone together in a bridge, or ortho for the crowding....we might just be here again in 5-10 years. which i guess is about the avg life expected from a crown anyway, but i would prefer a much better result.
 
2thm8kr

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no, no they arent.
Sure? The scan is the original. Right click, save scene as stl. Now do other digital dx and save.
Present to Dr. or Pt. as 3d pdf with as many different scenarios as needed.
 
sidesh0wb0b

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Sure? The scan is the original. Right click, save scene as stl. Now do other digital dx and save.
Present to Dr. or Pt. as 3d pdf with as many different scenarios as needed.
being that i have models, i would have to scan. time. time=money.
than i have to have the digital capability to populate the scan, and adjust it multiple times. equipment+time=moneymoneymoney.

even if i got a digital scan to begin with, the second option still stands. at the end of the day what i am doing with my time is whats most important.
 
2thm8kr

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I agree that time is money. I get paid by the hour for DX work. Digital is way cheaper with time and money. So maybe not free, but way less costly than analog.
 
Affinity

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The new hypocratical oath: First do no harm, until the bill is paid.
 
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If the patient is not motivated, why should you? This patient seems to suffer the "magic wand syndrom".
Do not start this project!


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