Cautionary Tale

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RJS8669

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I posted this on Facebook as well -

This is a cautionary tale - not necessarily 3Shape related.

I recently completed a case with 3 single Nobel ASC FCZ restorations. We used this product to reposition the screw channels.

One little quirk with regards to these restorations is that the Ti bases feature a mechanical lock that affixes the zirconia crown to the Ti base without the use of cement.

When the case was delivered, the doctor called to tell me that the crowns were about 1mm out of occlusion. She took a new bite and returned them to have some ceramic added. Maybe I should have realized what had happened when after the remount the crowns appeared to be in occlusion. Nevertheless, I added very small amounts of glass to the centric stops and returned the case.

Again, I get a phone call that the crowns are out of occlusion. Xrays were sent showing the crowns screwed into the mouth and yes - about 1mm out of occlusion.

The patient is moving out the area, so the doctor - feeling horrible about the situation - torqued the restorations into place, rebated the patient's entire fee, and advised that he see a new dentist as soon as possible in his new location.

Two weeks go by. Last night I got an email from the doctor - . With a picture - and a
question, "What are these small gold components that are resting atop the implant analogs on the model?

Oh, no...

You guessed it. When the doctor removed the crowns from the model, the Ti bases had stayed affixed to the analogs, but weren't visible because of the soft tissue.

I've since advised the client to contact the patient immediately as I have no idea what is holding the crowns in place.

Just wanted to share in case a similar situation arises in someone else's laboratory. I feel kinda dumb for not figuring it out, but - then again - my hindsight is always 20/20...
 
CatamountRob

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So why did they stay on the model? What "locks" them into place?
 
Sevan P

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Replied to you fb post, but to add to it. The doctor took an xray but dis it capture the base to the top of the implant? she would ofseen it right away.

Sent from my SM-G920V using Tapatalk
 
rkm rdt

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nothing surprises me anymore
 
Contraluz

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a cautionary tale

I try to label all the different parts that go with an implant case. Which screw goes with which implant, etc. Especially on bigger case and 'firsts', like it was probably with this Dr.

M
 
doug

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This is another reason that the dentist needs to have a COMPLETE understanding of the systems they are working with. This is not something that should be handed off to an assistant
 
CoolHandLuke

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another reason you should be there to assist in seating, given its the first use of this system.
 
victormasi

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Its just people doing things without paying attention. Similar story, I fabricate a #10 Zr crown over a SD hybrid zirconia abutment. The doc. calls me and cannot understand why the crown keeps coming off the abutment after repeated cementations (twice re-cemented)
So I show up, ask for the models, and notice that the custom abutment is still on the model. WTF I said to the asst. why would you cement the crown ON THE HEALING ABUTMENT??? Makes no sense.
 
kcdt

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I posted this on Facebook as well -

This is a cautionary tale - not necessarily 3Shape related.

I recently completed a case with 3 single Nobel ASC FCZ restorations. We used this product to reposition the screw channels.

One little quirk with regards to these restorations is that the Ti bases feature a mechanical lock that affixes the zirconia crown to the Ti base without the use of cement.

When the case was delivered, the doctor called to tell me that the crowns were about 1mm out of occlusion. She took a new bite and returned them to have some ceramic added. Maybe I should have realized what had happened when after the remount the crowns appeared to be in occlusion. Nevertheless, I added very small amounts of glass to the centric stops and returned the case.

Again, I get a phone call that the crowns are out of occlusion. Xrays were sent showing the crowns screwed into the mouth and yes - about 1mm out of occlusion.

The patient is moving out the area, so the doctor - feeling horrible about the situation - torqued the restorations into place, rebated the patient's entire fee, and advised that he see a new dentist as soon as possible in his new location.

Two weeks go by. Last night I got an email from the doctor - . With a picture - and a
question, "What are these small gold components that are resting atop the implant analogs on the model?

Oh, no...

You guessed it. When the doctor removed the crowns from the model, the Ti bases had stayed affixed to the analogs, but weren't visible because of the soft tissue.

I've since advised the client to contact the patient immediately as I have no idea what is holding the crowns in place.

Just wanted to share in case a similar situation arises in someone else's laboratory. I feel kinda dumb for not figuring it out, but - then again - my hindsight is always 20/20...
What's dumb is drs surgically implanting things in patients without even a cursory grasp of the components.
Too common.
 
kcdt

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This is another reason that the dentist needs to have a COMPLETE understanding of the systems they are working with. This is not something that should be handed off to an assistant
One of my BIG pet peeves
 
2thm8kr

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This is another reason that the dentist needs to have a COMPLETE understanding of the systems they are working with. This is not something that should be handed off to an assistant
But, they need to catch up with FB.:rolleyes:
 
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So why did they stay on the model? What "locks" them into place?
I've noticed in the lab that they can be difficult to dislodge from the model analog. They are a snug fit and not much height so hard to get a purcahse...
 
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Its just people doing things without paying attention. Similar story, I fabricate a #10 Zr crown over a SD hybrid zirconia abutment. The doc. calls me and cannot understand why the crown keeps coming off the abutment after repeated cementations (twice re-cemented)
So I show up, ask for the models, and notice that the custom abutment is still on the model. WTF I said to the asst. why would you cement the crown ON THE HEALING ABUTMENT??? Makes no sense.
Whoa - and I thought this was bad...
 
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Here's an image of #30...View media item 165
Yes - I should have noticed the lack of the ti base, but it looks like its seated flush to the top of the fixture and it just never dawned on me that the doctor wouldn't notice the crowns had no Ti base during seating.
 
J

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Its just people doing things without paying attention. Similar story, I fabricate a #10 Zr crown over a SD hybrid zirconia abutment. The doc. calls me and cannot understand why the crown keeps coming off the abutment after repeated cementations (twice re-cemented)
So I show up, ask for the models, and notice that the custom abutment is still on the model. WTF I said to the asst. why would you cement the crown ON THE HEALING ABUTMENT??? Makes no sense.
Things that make you say Huh?
 

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