a day in the life

[disturbed]

Let me start by stating that I do not own the lab, If I did I would do things a little different for a better outcome, I would leave a micro metal color on the crowns to get a better junction at the margin between the coping and the custom abutments as opaque is a bad thing to bury in tissue.. I would have extended the distal of 12 to include the cusp tip of the lower to the marginal ridge but it had no metal support. when working for someone else there are always differences in opinion.

opaqued and dusted with margin powder.Deep dentin on the occlusion and around the tissue A3.5/ A3 body

 

[disturbed]

effect 1 and incisals, check contour and overbuild where needed to compensate for shrinkage.

 

[disturbed]

live staining with vanilla, ribbon of E 3 on the incisal edge,overbuild margins to prevent to much tearing, lightly condense to remove any potential bubbles. fire

 

[disturbed]

I apply lots of ceramic sep. to help prevent porcelain sticking to the model during removal as the margin is often below the tissue level. good results, very little remains on the model. the other side will be screw retained with a metal occlusal on the distal of the upper, as the implants allow for it and it saves the doc a good deal of money, they love that, and I feel I get more control of the emergence profile this way.

 

[disturbed]

dentin is built slightly out of occlusion in CR,deep dentin is used around the screw hole to raise the occlusal level so the composite does not grey out when the hole is filled. Over built for shrinkage. Now lets try to get that darn screw out without disturbing my anatomy..

 

[disturbed]

Success! now I add to the gingival again, it's a good idea to add here first because you are close to the opaque and if you are drying out too much the wet porc., when added here first, will not draw any bubbles into the body of your crown, but again lightly condense to be sure no bubbles are trapped inside.

 

[disturbed]

remove the tissue and start your contacts, notice how the shrinkage was controlled nicely and I have very little work to do. I hate grinding, I prefer to remove the scale and be done with it,also I control where My effects end up better this way. I spend more time stacking but a LOT less time grinding, better on the old hands. I use a GOOD build up liquid, Long life.. Microscopes are a necessity when doing your best work, when you see everything nothing gets missed..hopefully...

 

[disturbed]

contours are checked and re checked, function creates my incisal edge and occlusion, I do this first in raw porcelain VERY CAREFULLY to get an idea of where the crown should be than refine it after firing. balanced occlusion is always important, as is making sure there are no interferences, ESPECIALLY with implants, nothing will kill an implant faster than mal-occlusion. out of contact won't cut it.. teeth will super-erupt to fill the space anywhere from a few years to a few weeks. cuspid rise is verified and made sure its a smooth pathway, not to steep or it will put to much stress on the implant, not to shallow or it will not clear the posteriors. I will have to ask the doc to fill his old partial rest on the marginal ridge to prevent a food trap.

 

[disturbed]

now after some surface texture, check them with occlusal tape and I am ready to glaze. I prefer to use very light paste, lower firing temp and hand polish to keep things crisp but I am at the mercy of the boss and he wants a natural glaze on everything. So i make my mix, 20% deep dentin, 30% dentin, and 50%+ correction powder, to fill the marginal tears, I vibrate the hell out of it to insure no pockets are left that might tear again and than slightly overbuild the margin area to prevent any more firings. A 50/50 mix incisal/correction for the contacts as I am firing them very close to the last bake (5-7 degrees less) and I do not want to lose my contacts. fire. 2 bake crowns.. rarely do i need a third for simple cases like this.

 

[disturbed]

I tapped in the contacts making sure everything was fully seated, screwed them in lightly, polished the metal occlusal, checked the occlusion, polished the marginal areas, they need to be as slick as ice around the tissue areas. used a rubber wheel to break up the light on the crown than lightly bristled.

crack lines are very difficult for me to photograph, I need practice. I subscribe to the less is more theory when it comes to things like check-lines anyways. i assure you, they are still there..
PLEASE critique these, I am not looking for a pat on the back, I am looking to improve my skills and the best way for me to do that is for you to give my your opinion on what I did wrong or what you would have approached differently. I will decide if I agree :banplease:

advice,slams,insults, all welcome

sorry about the thread format. I am new to forums and need to figure out how to make em look like Al's..

 

[disturbed]

this was on the side between firings. 3 powder build.

 

[DMC]

Thanks for adding to the site!
Looking good.

 

[charles007]

Disturbed and very impressed...........

Keep up the good work

Charles

 

[disturbed]

PLEASE CRITIQUE!!!

 

[rkm rdt]

If I was your boss I would hit the roof if I saw you use a metal hemostat on the abutment base....and then you vibrate it?

Either use plastic hemos or add a friggin' handle!

 

[wilkscm]

i really liked it please post more
thanks

 

[harry1]

'Disturbed'
Thank you, enjoyed for your contribution.

 

[CoolHandLuke]

looks pretty good man. i only have one thing i dont like so far, and thats your use of blue labstone. yuck. i can see you have glued back one dies to the model in your first few pics. harder stone (hell, even talladium's cheap blue stone would do) could have prevented that and left you not-guessing at the contacts.

personal stone preferences aside, your crowns look pretty good.

if your margins are consistently below the gumline, why do you want a micro metal collar? for plating?

 

[JohnWilson]

Thanks for taking the time to document this and share your work. It obvious that you are a good ceramist and like you stated you are not in control of everything so take this with a grain of salt. For the benefits of newer techs trying to mimic what you have shown I will state some common errors I see in implant cases.

Lack of metal support
Occ tables too wide, both M/D and B/L
Opp contact on incline planes
Occ contact in centric relation with non equilibrated models.

Implant restorations are subjected to more force than tooth borne restoration due to the fact there is not PDL to allow things to compress. Having a free end restoration with a thimble style coping as shown in the first set of pictures is a guarantee that the porcelain will fail.

Techs working with implants as stated should never ever use anything metal to hold onto the interface that goes into the implant, this can and does mar the non oxidizing gold alloy very easily. Along with that techs should understand that this interface should NEVER be blasted with anything including glass beads!

Framework design is super critical to make lasting implant restorations, we advocate waxing all restorations full contour and cutting back for ideal metal support. With the advent of cad cam and full contour design and cutback it has saved a ton of time with this design aspect.

Understanding how important an equilibrated model is to the success and lack of occlusion adjustments on these cases is critical as well. The majority of fixture level impression are not taken with the PDL compressed as the impression copings are extended beyond the hight of adjacent teeth necessitating a single arch impression. Mounting an equilibrating the model prior to fabrication will save your clients a ton of time. Just stacking your glass out of occlusion is not the answer, as premature off axis loads in excursive movements will not be replicated on your articulator this way.

OK thats enough for now,

 

[wilkscm]

How about some Ants please
thanks