Implant Supported Bridge

[dmonwaxa]

This is a case that had to be reworked. The patient was very unhappy with the esthetics,,,,just cant understand why! " These look like they came from Walmart!" is what the patient said. I documented the steps involved with its restoration. Hopefully we succeeded in giving him something along the line of "Gucci." Keep in mind that this case is already completed and in service.


FPD as Presented



Impression of existing abutments



Fabricating Resin Dies



Solid Model



Mounted Models



Existing FDP Articulated.

 

[dmonwaxa]

Thanks for the help John...Please PM me with instructions... LOL

 

[dmonwaxa]

Now the fun begins. The patient did not want a new bridge, ie. no FMK remake so I had to use existing FMK. This is what it looked like after stripping, including a lot of grinding and heatless stones. And this is the good photo, cause junk kept coming out,,,eeew!



FMK Refinished, all cleaned up

 

[Al.]

Oh my goodness, you are just rebaking porc on their frame. I wondered why you didnt section the dies.

Whats on the lingual of the lateral.

 

[dmonwaxa]

LOL,,, Al. I think I sharded in ....no sH!TT3d in my pants when I first saw it. Since we were reusing the FMK there was no need to section the dies. Whatever was there is what I had to go with. I was provided with an abutment level impression, but a pickup impression would have been better IMHO. As for that thingamajiggy I'm not too sure it could have been a metal dik for handling and or cooling the FPD, thats my guess. BTW while you've been having fun with all thos nice cases I've been having my own fun with these kinda cases...

This FMK was purged about 6 times before it got to this stage.

Couldnt see you having all the fun by your self... LOL popcorn

 

[dmonwaxa]

After stripping the porcelain it was like opening up Pandora's Box; I really didnt know what to expect. Some careful refinishing was done using carbide instruments and the bridge was prepared to receive new ceramic material.


Opaqued

[/IMG]
Dentin/Body Build

[/IMG]
Bridge after 1st firing.

[/IMG]
Enamel build and start of gingival build.


Ready to be fired.


Fired and seated on cast.

 

[desertfox384]

Lookin good, your brave to re-use that frame...

 

[dmonwaxa]

Thanks desertfox.Bravery or ignorance, its a matter of perspective I guess. I informed the doc there would be no guaranty provided since we were reusing a FMK was made by someone else. The goal was to improve the esthetics by decreasing the apparent crown length, and reducing the splayed effect if the long axes. This can be seen at this point.

 

[Al.]

Everytime a big case comes out of the oven, I feel the stress, are there any cracks, are there any bubbles, did it move?

 

[Slipstream]

Was the original case made out of country? I hope you billled enough for your time - looks like the remake is as much work a new job.

 

[araucaria]

Thanks desertfox.Bravery or ignorance, its a matter of perspective I guess. I informed the doc there would be no guaranty provided since we were reusing a FMK was made by someone else. The goal was to improve the esthetics by decreasing the apparent crown length, and reducing the splayed effect if the long axes. This can be seen at this point.

If there's any doubt about the success of the task, would it help if composite was used instead? Eliminate the risk? And the job could be modified further if necessary. That's a big job you've got there - and a lot of work hours too.

 

[dmonwaxa]

Al., I know you know the stress levels that are experienced with large cases like this. Sinc the bridge was stripped manually; ie. the material was ground away and sandblasted no warpage was observed. The fmk went through about 6 purge cycles before all that muck disappeared. I believe the careful and time consuming preparation of the FMK paid off, I experienced no cracking or bubbling of the porcelain during it's processing. As you stated in one of your posts any pitting in the metal had to be removed to avoid bubbling. I also slow cooled the bakes to avoid any cracking.

Colin, its funny you should ask if it was made out of country, what would make you ask that? I believe it was done by a foreign tech though. This was the first case I did for the practice and the associate doc thought I charged too much. I think it would have been easier remaking than the reworking.

araucaria, composite was out of the question for the patient.

 

[dmonwaxa]

So here it is all finished.


Finished FDP on Model.


Wide View

 

[patmo141]

Very cool case dmon. Did the doc say why no pickup/transfer imp? I guess as long as it seats on the model, no big deal.

"the associate doc thought I charged too much" Ha ha. Ehh it's in our nature. You should point them to this thread so they can appreciate all the steps involved.

 

[TheLabGuy]

Man, that looks so much better than what you started with. Pat yourself on the back on this one Troy, great stuff. Hopefully, you get to do the bottom now

 

[dmonwaxa]

Pat, yes ths was a cool case; and this is the succint version, I have a lot more photos...heh heh heh.

Thanks for the kudos Rob.

 

[dmonwaxa]

Rightt lateral view.


Left lateral view


Lingual


Labial view

 

[TheLabGuy]

What did the patient say?

 

[dmonwaxa]

What do you think he said? Gucci ! Off course! Seperate yourself for a moment, if you had that picketfence and end up with this; which would you prefer. I know what I would choose. Sorry for being so philosophical, but the Crown Black Label Is talking....he he he

 

[Alistar]

Awesome work man. Hope you don't get skimp'd by the doc.