Internal Frame

[prodigy1]

I have been doing metal internal frames over implants and was wondering if anyone else is doing this over implants for strength. They are inexpensive but is this something other labs do?

 

[amadent]

not really sure what you are talking about?
do you have any photos, that would give me some better insite ?
thank you

 

[CYNOSURER]

I can see the advantage to having a cast reinforcing frame around implants (Locators, O-ring's, hader clips etc.). And I've made them when requested. Simple to do and very profitable. I don't push them as I'm on the fence as to the overall benefit. Stress causes fractures. If you reinforce the denture so that the stress doesn't fracture the denture then that stress has to go somewhere. It would be nice if it all stayed with the denture but chances are it will manifest itself somewhere else. Of all the things in the mouth that I would rather have to fix; it would be the denture. Granted there are cases where attachment selection and acrylic thickness makes a strengthening bar almost mandatory (lowers more often than uppers) but, I guess it's like the guys who complain about how quickly nylon attachments wear out. Chances are they are wearing out because something is wrong (occlusion, attachment placement, tissue support, etc.). Instead of recognizing this built in warning system they just continue to replace the nylon till something else 'breaks'. (implant, denture, patients' pocketbook, etc.)

 

[prodigy1]

Here is what I am talking about.

 

[prodigy1]

I charge between 50-75$ is this a fair price.

 

[JohnWilson]

Who designed this and why?

From the look of the flat ridge there should be plenty of inter occlusion space. The bulk of that bar with the over casting is going to make setting the ant. teeth very difficult. Also if the client is going to use a Hybrid tooth it may be very difficult not to grind all the way through the PMMA which will complicate the bonding.

If the bar wasn't blocked out and the over casting sits right on top of it you have made it a rigid appliance that is not tissue supported anymore as well. With the AP spread that is not correct. Perhaps the frame is floating and the bar will be blocked out when the acrylic is processed.

When we make an over casting for an attachment case it floats, it does not touch the bar. This allows the appliance to be tissue supported. Only time we make a rigid frame is when the AP spread allows us to make the case implant retained/supported.

 

[kcdt]

From the look of the flat ridge there should be plenty of inter occlusion space. The bulk of that bar with the over casting is going to make setting the ant. teeth very difficult. Also if the client is going to use a Hybrid tooth it may be very difficult not to grind all the way through the PMMA which will complicate the bonding.

.

At that stage, I would hope the teeth were set and tried, and that an index of the set up, hopefully with the teeth accompanying, was accomplished before the bar was ever fabricated, hell, if I had my way a guide derived from same would've guided placement (but sometimes...).

I think you make great points about functional resilience/rigidity and A/P spread. The design as I see it, even with a blocked out bar, isn't going to allow for much downward hingeing- that is one think a rotational clip in the anterior is good for.

But in concept, I do like an overcasting on a bar. You just really have to design that way early.

 

[kcdt]

I charge between 50-75$ is this a fair price.

Your pricing is reasonable to me, is the range because charge by unit?

 

[droberts]

Here is what I am talking about.

The width of the bar is too wide for the size of the arch, and as for the metal supra structure, overkill. Be careful putting 4 Locators that close together, and also make sure you have the denture extended back to the retro molar pads. What can happen when the Locators are too close together using 4? The denture will rock off the distal two and cause premature wear to the most anterior two. The best design on this would have been 1 placed in the area of #24 & 25 tri-podding the denture. Think of a chair, its easier t stabilize 3 legs instead of 4. JMO

 

[araucaria]

Thats a strong beam, if you turn the model round and view carefully from the other side you'll see this - you may need some loupes or optics




Albert, respondants don't know the dimensions and we can only guess. We don't know the dimensions and extensions of the base or of the occlusal table. We don't know the height available anteriorly or the inclination. The locator caps give us a starting point from which to make known our observations. We don't know what's opposing either.
Comments are just a knee-jerk reaction to immediate impressions. If the job is going to carry only one premolar and one molar on each side then rotational stress isn't going to be a real issue. Will the doctor and the patient be satisfied with the end result, and will it stand the test of time - that's what matters most. We're making the patient a smiling and eating device after all - not a spaceship!
ps - the price is too cheap

 

[dmonwaxa]

Ditto,,,I could not agree more overall. Though, from the distal extension of the FMK looks like 2 premolars and a molar is the intent. Again Ditto on the small print.

Thats a strong beam, if you turn the model round and view carefully from the other side you'll see this - you may need some loupes or optics




Albert, respondants don't know the dimensions and we can only guess. We don't know the dimensions and extensions of the base or of the occlusal table. We don't know the height available anteriorly or the inclination. The locator caps give us a starting point from which to make known our observations. We don't know what's opposing either.
Comments are just a knee-jerk reaction to immediate impressions. If the job is going to carry only one premolar and one molar on each side then rotational stress isn't going to be a real issue. Will the doctor and the patient be satisfied with the end result, and will it stand the test of time - that's what matters most. We're making the patient a smiling and eating device after all - not a spaceship!
ps - the price is too cheap

 

[prodigy1]

Yes the more metal you use the higher the price.

 

[prodigy1]

Thanks for the advice and this will help me fabricate a better prosthesis.

1. The doctor has the implant made so I have no involvement with how many locators or what type of attachment are use and the frame design is primarily his.

2. What you do not see is that usually the doctor or the lab who sends the case to me does a quick setup so I know approximately where the teeth will need to be set.

3. I blockout over implant bar and use the thinnest pattern I have to go over it (about .35 mm),so the frame is very thin and light.

4. I check on articulator and make sure there are no occlusal problems.

Thanks again for the questions and advice.

 

[CYNOSURER]

What I normally do on a case like this is to make a lingual plate with a finish line (as shown in blue) and then meshwork everywhere else. The 'T' factor will give me all the strngth I need across the anterior and that it's all metal in this lingual area insures that tha area is as thin as it needs to be. With your solid covers over the locators are you doing what amounts to a pick up impression in the lab with cold cure???

 

[prodigy1]

Good advice Tim and I have actually made a frame similar to that and yes you just cold cure locators on.