Honest opinions....

[Brett Hansen CDT]

What do you think of the buccal design on the bicuspid?

 

[Affinity]

The buccal design or the overall design? Honestly its way overcontoured, anatomy is ugly, wrong axis, wrong height of contour, occlusal table to wide, but maybe its like that because of the opposing, hard to say without seeing that. Is it an implant?

 

[charles007]

Brett, show pictures of the preps and the closed bite

 

[Brett Hansen CDT]

Not an implant. orginal tooth was twisted. I should have included pics of the model without the crowns and with the opposing. I designed the first go round at it and was told the buccal needed to be brought out. Now it looks like a marble and a food trap to me. But what I do know? the person who finishes the emax made the changes you see. The margin on 4 is supragingival so I just followed that countour originally. I just needed to get some outside opinions to justify my frustration.

 

[Brett Hansen CDT]

Brett, show pictures of the preps and the closed bite

Let me wait until some people go home so I don't stir up a **** show.

 

[cadfan]

normaly the grow under the earth called potatoes

 

[charles007]

Are the teeth in crossbite, on the bicuspid in particular ?...... if so bring it way back lingually, as though the bicuspid is a lower. If I'm right flip
the articulated model upside down as though your designing lower crowns rather than very bulky buccals.

 

[PDC]

A lot of times the patient will complain if they aren't able to see the buccal surface of the tooth. They don't want it to look like they are missing a tooth when they smile. Maybe they just to be able "to see" what they just paid a $1000+ for.

 

[charles007]

I bit my cheeks and tong for years until I made my first crown... sparkling gold crown...

 

[Brett Hansen CDT]

I pulled my original design. I will mill them out and take more pics later.

 

[CoolHandLuke]

this is one of those cases you need to NOT design it in the correct arch position and rotation because further harm will befall the patient.

if the correct arch position is desireable, considerations must be made to avoid food traps, which clearly have not been made.

restore the case in xbite.

 

[charles007]

Function comes first, forget about beauty... beauty comes with ortho lol

 

[Car 54]

A lot of times the patient will complain if they aren't able to see the buccal surface of the tooth. They don't want it to look like they are missing a tooth when they smile. Maybe they just to be able "to see" what they just paid a $1000+ for.

Or some Drs will complain about black holes (cp to triangles),negative buccal corridor spaces.

 

[Car 54]

What do you think of the buccal design on the bicuspid? View attachment 29872 View attachment 29873 View attachment 29874

Sending that image to your account and asking their opinion may impress them, as far as your thoughts and concerns, and a CAD image?

 

[Kaiser7100]

Don’t even need to see prep or opposing based on designs. Tooth is very rotated and out of alignment. If your charging 200 then spend all night on that. Mill it send it. Looks fine

 

[TheLabGuy]

Really depends if your Doc/patient want the tooth in the curve of Wilson, or what they obviously had before...I'd probably design both and send screenshots to the Doc and have him pick which one before I milled it out.

 

[Getoothachopper]

More than once iv'e heard Labs who don't want to design their own work say they won't pay more than $5 for a design ,,,,,,, "Is this possibly one of those ?"

 

[sndmn2]

...sometimes we all get stuff like this and we try to twist it, warp it into shape and no matter what ,we never get the outcome we are looking for..

 

[charles007]

Really depends if your Doc/patient want the tooth in the curve of Wilson, or what they obviously had before...I'd probably design both and send screenshots to the Doc and have him pick which one before I milled it out.

Agree with Rob, in the digital age sending screen shots should be used routinely if there are any questions on the design.

 

[Brett Hansen CDT]

I was highly irritated about this case on Friday. It was due out this morning. I do text SS's of cases when issues arise to get my doctors input. I didn't see a reason to do that on this case. I followed the contours of the tooth under the margin and used the information from the opposing to design two crowns that would function properly and look better than what they had before. The person finishing the crowns thought they needed to be brought out buccally so you could see them. She took them to my uncle, the lab owner, and he approved the change. I thought this was wrong and against all the knowledge I have acquired in the last fifteen years. If a doc requested it, fine, but that was not the case. Also, the case was due out this morning and my mill was already backed up with other jobs. So I brought my frustrations here because I needed some outside affirmation that my position on how these crowns should have been restored wasn't incorrect. Thanks for all your input. It is nice to see the suggestions that were posted are practices I am already following. Maybe that is because I learned it from watching you!!! Happy Monday!