Full Upper Implant Bridge

[JohnWilson]

A great way we found is to fabricate a screw retained denture set-up for the dr. to try in and the patient to approve before proceeding

Just curious,Screw retained to what substructure? Triad?..or do you just do a wax tryin with the uclas and denture teeth in the wax?[/QUOTE]

I have done this technique many times.

After having the master model mounted ...

1) I make a verification jig for our master model out of the uclas/pattern resin that I will be using in a later step. I index the occ with wax for a bite registration on my articulator

2) AFTER the model has been verified and the bite has been double checked I choose the cheapest PMMA denture teeth I can find and do an anatomical set up including any gingival contours that will be replicated when the definitive restoration is fabricated.

3) After approval I make a matrix and remove the wax up from the cast, I then screw on analogs to the UCLA's block out the access hole with putty and make a model out of low expansion die stone. I then flask and boil out the case and eliminate the denture teeth from the flask and pack pattern resin in a cold flask.

3) I devest and remove soft tissue from master model and check for pattern passivity. Once I have the pattern passive (sometimes you may have to section and relute) I make plunge cuts to a uniform reduction of 2.5mm to the entire pattern. This is verified with the matrix I made in step 3.

4) I again recheck the pattern for a passive fit as sometimes when you grind on pattern resin it will heat up and distort if your not careful.

5) Now I take up to .5mm of wax and cover the entire frame prior to investing. This smooths out any rough spots in the resin and allows for an easier burn out of all that plastic as it creates less stress on the mold.

6) Sprue, invest, burnout at a very slow rate staging at least 2 times. Cast and devest. EDIT I forgot to add that you should NOT blast the UCLA interface you should leave the investment there and strip the remaining investment with a chemicle devester,

Now the moment of truth, check to see if you have a frame that is passive. Now this doesn't mean that when you screw both ends of the frame to your master model that it seats It means that when you take one screw any where on the model and screw that down and the frame does not move then you have it passive. If not disk and laser-weld till it is.

Now all of this work you have a perfectly supported frame that is guaranteed to fit in the mouth if the client took the time to verify the jig properly in the first place.

This definitely takes more time than waxing but I like the control I have using the resin instead.

 

[CRWNMKR]

RKM,We usually use temp. cylinders and a light cured base for the denture set-up without any kind of a flange so its an easy in and out

 

[Al.]

Ok it fit very,very nice.







I want predictable, no coming back for changes after the porc build.

So I added some preformed wax veneers on the front 6 for the metal tryin.
It took me about an hour but may save me alot of time and grief later.

 

[araucaria]

AWOA = Al's Work Of Art

And I thought it was Elmer Fudd saying Hiya in Hawaiian

I agree though about the art, it's nice to see the passion that Al puts into his work. The step by step posts are always a pleasure to see.

 

[dmonwaxa]

And I thought it was Elmer Fudd saying Hiya in Hawaiian

I agree though about the art, it's nice to see the passion that Al puts into his work. The step by step posts are always a pleasure to see.

Then it would be AWOHA..

I agree always a pleasure.

 

[Daniela]

Al, are you making any changes to the frame after the try in and before starting the porcelain?

 

[Al.]

Hi Daniela,
Yes is need to shorten the front 4 and taper them M and D.
Its safe to leave them long now in case they want the teeth lengthened.

I would like to bring the frame in on the front and left side but Im getting close the the access holes.

 

[dmonwaxa]

Hi Daniela,
Yes is need to shorten the front 4 and taper them M and D.
Its safe to leave them long now in case they want the teeth lengthened.

I would like to bring the frame in on the front and left side but Im getting close the the access holes.

Al. how thick is the metal on the buccal access holes?

 

[doug]

Al, what was the final weight of the casting?

 

[JohnWilson]

Lets have a guess ...

If its HN I will say that in its current condition it is 27.5 dwt

 

[Al.]

WOW, you are good.

It weighed 27.5 and I added .1 for each sprue cut , so it came out to 28.7.
Thats about $1000 my cost.

FYI I charge the cost of one extra unit per bridge for the tissue porc, I figure it takes about the same amount of time, I really dont know any other to put a price on it.

The whole case is going bill between 4500 and $5000.
The Dr did all the model work and supplied the abuttments.

Last week I did all singles, not one bridge. Around 45 units. Thats alot of case pans and models. 80 contacts to grind in and 45 units to seat n the solid models, packing up 45 cases for delivery etc.

I told my wife I would rather do work for 4 or 5 productive prosthodontists rather than 20 + gps. Do 2 or 3 large cases a week.

Same thing with cosmetic dentistry, I would much rather do a 20 unit veneer case than 20 singles.

There is probably more money pumping out the singles fast and cheap but the pace is hard to maintain.

 

[Al.]

Don't forget the handles

Guess what, I forgot them on one side.
And the first thing I thought about was you.

 

[amadent]

I want predictable, no coming back for changes after the porc build.

So I added some preformed wax veneers on the front 6 for the metal tryin.
It took me about an hour but may save me alot of time and grief later.

Great idea AL

 

[dmonwaxa]

It weighed 27.5 and I added .1 for each sprue cut , so it came out to 28.7.
Thats about $1000 my cost.

Was this the weight prior to metal finishing, and how much did you grind away metal finishing?

FYI I charge the cost of one extra unit per bridge for the tissue porc, I figure it takes about the same amount of time, I really dont know any other to put a price on it.

The whole case is going bill between 4500 and $5000.
The Dr did all the model work and supplied the abuttments.


"Dont underestimate your skills mister", plus you have more time and money tied up in metal than those doggone plastic patterns

Last week I did all singles, not one bridge. Around 45 units. Thats alot of case pans and models. 80 contacts to grind in and 45 units to seat n the solid models, packing up 45 cases for delivery etc.

Thats a lot of units for 1 man.

Al.; As always, I cant wait to see the results.

 

[paulg100]

"Last week I did all singles, not one bridge. Around 45 units."

If thats from start to finish (frames through to finish) then i seriously need to get my butt in gear!

Maybe ill just sell me cad/cam kit and buy an AL, ill get the one that runs 24/7 though :laugh:

 

[rkm rdt]

Guess what, I forgot them on one side.
And the first thing I thought about was you.

You'll have to handle the buildup like a baby robin.

 

[dmonwaxa]

"Last week I did all singles, not one bridge. Around 45 units."

If thats from start to finish (frames through to finish) then i seriously need to get my butt in gear!

Shhh! not so loud...then they'll know we're all slackers....

Maybe ill just sell me cad/cam kit and buy an AL, ill get the one that runs 24/7 though :laugh:

He's already running 24/7; so you might have to clone him....*** could probably scan him and print you a prototype,,,,,it's probably gonna be kind stiff, but a little KY Whiskey will do the trick.....

 

[Al.]

"Last week I did all singles, not one bridge. Around 45 units."

If thats from start to finish (frames through to finish) then i seriously need to get my butt in gear!

Maybe ill just sell me cad/cam kit and buy an AL, ill get the one that runs 24/7 though :laugh:

My wife does all the model work and local pu.

Its not that difficult or stressful. Really been doing it for years.

Just have to work by the week. IMO its impossible for 1 person to do 10 or 15 a day start to finish. Have to ware too many hats in one day.

Its possible though when I do it in groups. Trim and prepare 50 dies takes how long? Same with waxing 50 units then finishing the copings or pressings.

My wife delivers or mails all the Drs work for the week on Mon. Nobody calls "when is mr Xs crown going to be here", which was 80% of calls.

Frankly 50 units a week with this system guarantees I have to work 1/2 the day on Sun, but it is stress free because everything goes smoothly.
For now, I am busting my as@ off while I am able. to pay off my house. My goal is 4 years then I am cutting back.
30 units a week would be loafing working on a weekly basis.
With monotrac the model work is really part time for my wife. She figures 15 hours a week.

 

[stevo]

looking forward to outcome

I was very interested in this case presentation and looking foward to the out come, As there has been no posts for several days I was wonder what had become of this case

 

[JohnWilson]

I am sure its still in the metal try in stage and has not come back but thats just my guess