Implant Supported Bridge

[TheLabGuy]

None of my business, but for a case like that, I would think it
is suicidal not to insist the DDS make a new occlusal guard and
charge for it.
Just my 0.5 cent's worth.
LCM

I usually send one with it for delivery. Depending on the Doctor, most already have an idea in their head what they want to use (Tanner, NTI, Michigan Splint, etc...) I've worked for a few labs in the past that use to offer a 20% discount and include the discount card in with any case three units or more. I thought that was a good idea and they had success with it when I was working with them.

 

[disturbed]

around $150/200 per unit and $400+ for tissue I hope...much better looking case, typically the cuspids are the darkest tooth in the mouth....right? and maybe I cant see em but ..mammelons?? and why did you not match the occlusal anatomy of #2? the natural molar?? or wear facets of the other side?? those simple steps and would have been $300+ a unit.

 

[paulg100]

"I cant see em but ..mammelons??"

why should the case have memelons?

i see patients all the time without mamelons in their natural dentition, theres enough to think about on a case this size without over complicating it for the sake of it.

Another thing id say re darkening the canines - yes its natural, but theres plenty of patients that will freak if you do this on large cases, so you dont always have the artistic license.

 

[dmonwaxa]

None of my business, but for a case like that, I would think it
is suicidal not to insist the DDS make a new occlusal guard and
charge for it.
Just my 0.5 cent's worth.
LCM

Suicidal on whose behalf? he he he.... I always advise on that regard, but thats between doc and patient. However i'll say this, it makes sense (cents) ($$$$$) to factor this in ones treatment plan. I wouldnt want to be the one retrieving it and sending it to the lab for repairs, lost chairtime is expensive. Labs will and should charge for repairs in something like this. It's common practice for prosthondontist to provide a guard to all their FA and FMR patients.

 

[dmonwaxa]

around $150/200 per unit and $400+ for tissue I hope...much better looking case, typically the cuspids are the darkest tooth in the mouth....right? and maybe I cant see em but ..mammelons?? and why did you not match the occlusal anatomy of #2? the natural molar?? or wear facets of the other side?? those simple steps and would have been $300+ a unit.

I twear, I twear I did put mammemons in thar. Beweeve me I did. Look cwooser.

























See I told you I did

Now wook cwoser.....cwooseeer!!!

















Even cwooooooserrrrrrr. CCCCCCCCCCCCCC

I must say you have pwetty good eyes, I totally blew the anatomy with total disregard of #2. I'll twy better next time. Maybe I can get some wessons fwom you so I can duplicate the anatomy of an ajacent natural tooth when Im restoring one whose antagonist a poorly made crown on a supererupted tooth.


Beweeve me joke-ey I did build #3 in with anatomy as allowed by the antagonist.








But then again I'm a novice, what do I know,,, Thanks for having my back Paul. It takes a special person,,,It's only someone like yourself who has the working knowledge and understanding what it takes to take on a case like this.

BTW,,,,WTF ,,,wear facets? U R freaking "disturbed"

 

[Al.]

Putting effects in a large splint is very difficult. it dries so fast.
I usually don't do it much.

 

[Clear Precision Dental]

Nicely done !

 

[disturbed]

ok.. it's that kind of a place eh? well I guess I can be totally forward.. First, I am not insulting, I was critiquing which I Encourage when I start posting pics of MY work, so calm down.next.. in an attempt to teach someone who probably thinks he's top shelf Gucci now...answer me this mr. speech impediment, why did you drop the papilla down so far between the central and lateral but leave it up so high on the other side? as far as the centrals are concerned, do you know what an apex is? why does one cuspid have a tip and the other is softened? Is your bicuspid longer than your cuspid?? because it looks like you dont have cuspid rise, it looks like the tips of those bi's are longer than the cusp tip of the cuspid and they are going to.... well...i am just guessing now.. @ Al, sounds like you need to try a new buildup liquid, I stack d'sign and have no issues with drying on full arch bridges, effects, even just a few, can bring these cases to life.@ paul, teeth ARE complicated NOT monochromatic. show me a patient that thinks natural teeth look bad and I'll show you a tech that tried but failed. If no one critiques no one grows. If you all simply pat each other on the backs no one will strive to do better because you convince yourselves your doing good enough. your occlusion is completely controlled by you in this situation, disregard the crappy crown that super-erupted because some A'hole left it 2 mm out of occlusion,(it looks to NOT be erupted from your pics...it looks in line with the rest of that side..but anyways...) plan for its replacement which will happen soon especially if it is erupted much, it will more than likely break soon, if you are saying it is out of alignment with the surrounding teeth..which it looks like it is NOT.... plan for it and make your opposing accordingly. and YES..wear facets, a natural occurring process that makes teeth look natural. If they are not over done they look beautiful and patients hardly notice them because they look NATURAL, the incisal edge of the centrals is flat because of WEAR, the best occlusion in a worn mouth is worn occlusion.worn occlusion still has a central pit.... I never had anyone complain because the crown matched their other natural teeth.. have you?!? now with all that being said, it IS a decent job, I do realize peoples propensity for the hollywood smile, but, if you leave no room for improvement and label yourself hot **** before you truly master your craft you will never improve or learn.

 

[disturbed]

and no, I STILL don't see any mammelons...and your cuspids are LIGHTER(higher value) than the rest of the teeth in this case, at least the one on the patients right side is...very nice work.. defiantly not wallmart anymore, more like target now! but seriously, it's good work and I am sure that after seeing the first try this made the patient jump for joy.

 

[Hal2a]

Very nice work ! Not all dentition has visible mammelons and does not need to be reproduced on every anterior case to be successful. When I discuss esthetics to patients, many have not noticed that their canine is the darkest tooth in their mouth.
I'm sure you have made a profound difference in this persons life, elevating a persons' self image is no small thing.

 

[paulg100]

"@ paul, teeth ARE complicated NOT monochromatic"

Thanks for pointing that out to me

"If no one critiques no one grows. If you all simply pat each other on the backs no one will strive to do better because you convince yourselves your doing good enough."

Think you got this site confused with a CEREC forum.

 

[DMC]

Looks Great!

popcorn

 

[Al.]

ok.. it's that kind of a place eh? well I guess I can be totally forward.. First, I am not insulting, I was critiquing which I Encourage when I start posting pics of MY work, so calm down.next.. in an attempt to teach someone who probably thinks he's top shelf Gucci now...answer me this mr. speech impediment, why did you drop the papilla down so far between the central and lateral but leave it up so high on the other side? as far as the centrals are concerned, do you know what an apex is? why does one cuspid have a tip and the other is softened? Is your bicuspid longer than your cuspid?? because it looks like you dont have cuspid rise, it looks like the tips of those bi's are longer than the cusp tip of the cuspid and they are going to.... well...i am just guessing now.. @ Al, sounds like you need to try a new buildup liquid, I stack d'sign and have no issues with drying on full arch bridges, effects, even just a few, can bring these cases to life.@ paul, teeth ARE complicated NOT monochromatic. show me a patient that thinks natural teeth look bad and I'll show you a tech that tried but failed. If no one critiques no one grows. If you all simply pat each other on the backs no one will strive to do better because you convince yourselves your doing good enough. your occlusion is completely controlled by you in this situation, disregard the crappy crown that super-erupted because some A'hole left it 2 mm out of occlusion,(it looks to NOT be erupted from your pics...it looks in line with the rest of that side..but anyways...) plan for its replacement which will happen soon especially if it is erupted much, it will more than likely break soon, if you are saying it is out of alignment with the surrounding teeth..which it looks like it is NOT.... plan for it and make your opposing accordingly. and YES..wear facets, a natural occurring process that makes teeth look natural. If they are not over done they look beautiful and patients hardly notice them because they look NATURAL, the incisal edge of the centrals is flat because of WEAR, the best occlusion in a worn mouth is worn occlusion.worn occlusion still has a central pit.... I never had anyone complain because the crown matched their other natural teeth.. have you?!? now with all that being said, it IS a decent job, I do realize peoples propensity for the hollywood smile, but, if you leave no room for improvement and label yourself hot **** before you truly master your craft you will never improve or learn.

Im looking forward to seeing some of your cases. Youve for sure set your self up for some heavy peer rewiew.

 

[TheLabGuy]

ok.. it's that kind of a place eh?

Dude relax, nobody here stole your birthday. If you want douche bag status or just prefer to have everyone dislike you then you might have a good start going for you. If you can't see mammelons, then you're blind or don't know the definition, not sure there is much more to say about that. Now if you would like to see more defined mammelons, then say it that way. Personally, I loved the presentation and difference this made for the patient. The only thing I seen worth mentioning is I prefer a little deeper separation in my larger spans, whether that's cutting them or twisting the teeth very slightly to make them look individual but this wasn't the original posters wax up, it was a 'please save my ass Dental Tech" case. Once again, great job Troy, and don't let a internet troll tick you off, he'll find a new bridge to hang out under or become a little wiser that we are here to help each other out without being condescending.

 

[rkm rdt]

Just got back from holidays.

I sure missed the love around here.

Dmon,nice a$$ saver you did there!:top:

great pics.

Disturbed,

I'm not sure cuspid rise would be a good idea here,

2 reasons: 1) The original framework does not appear to be designed for it.
2) This is an implant retained bridge.

Why do you feel cuspid rise is required?

 

[disturbed]

yea! a question and less of an attack response. cuspid rise (and protrusive) is neccessary to protect the posteriors..always..unless you have build in an occlusally supported, multi unit, group function.(should probably be metal occlusal with a compramised case like this),but that would have ment new framework... If not, how do you know where the lateral forces go? why would you NOT want cuspid rise on ANY bridge?
TROY
It was a decent case, I stated that in my FIRST response, than I responded to attacks..maybe unappropriattly..sorry..build up RAGE!! occupational hazard. I hope it lasts 20 years....maybe should of told the dentist it would be in the patients BEST interestes to get new framework? glad you saved the DENTISTS ass on this one....

those blobs on the incisal of his 3rd bake? those mammelons? more defined mammelons won't work until you know what mammelons look like,..

 

[disturbed]

I am s little shamed to present my 3rd shofu layered to zirc case..It's not my best work.. 73 Y/O hence the lack of surface texture, intense color, and translucency,custom shade, doc did not send pics but they were seated..PFM's on the bi's the latereal is not quite seated and the model work over ditched..mammelons are VERY whispy,not inverted cones as they appear in pics, just didn't show up on photos as well as I had hoped,, I am taking some advice from al and taping paper on my flash.. I don't work there anymore. no more Zr!!. yes I am a hipocrate,if you all have read any of my other threads regarding zirc.. but I have learned.. working at a mostly implant lab now.. lots of full mouth reconstructs and lucky to be working with highly trained tech and perio's. a few Gp's.. will be taking pics soon. hopefully get a video eventually.

PLEASE bash away!!popcorn

 

[disturbed]

got your attention? good, now I'll shut up for a while..

 

[rkm rdt]

They look fake.

 

[DMC]

The Mamalons look like they are a little too obvious and symetrical. Like cookie-cutter teeth out of a mould.

Nice overall shape! Welcome to the forum!

Scott