Maxillary Implant Bridge

[TheLabGuy]

Here is one from start to finish that posed some problems but ended up working out great in the end. I snapped quite a few pictures throughout the process if you want to see anything just chime in. The main issue was esthetics, putting three teeth where two were and that those hexes were both engaging so parallelism showed it's hand and the dreaded matching of the pink tissue. Overall, I'm very pleased with the gingiva (matching a dark green patient) but wished I would of focused more on the natural teeth and adding a little more characteristics.....next time

 

[rkm rdt]

Nice job Rob!

The pt obviously had a large diastema between the centrals originally.You created a more natural looking restoration than 2 wide centrals with an incisive embrassure.

Are they Nobel Active rps?

 

[amadent]

Rob,
Kudos on a good well done, teeth look great and the tissue match is spot on
never would anyone know that the case has metal linguals

Greg Amendola MDT

 

[Gdentallab]

nice case.
the small diameter of the implants makes it more difficult to make a good aesthetic out of it. but this case you made it very nice.

 

[TheLabGuy]

Thanks Gents......
rkm, those were BlueSkyBio. Which brings up a question and something that happened (very frustrating) with this case. I ordered the blue sky bio ucla type of abutments, waxed them, casted them, and guess what? The titanium part that holds the plastic sleeve melted too and contaminated the hell out of that metal, and prevented it from casting all the way out. I snapped some pics and got in touch with their VP, very nice Gent, and went with all plastic from Attachment International and got the case to cast out.

 

[rkm rdt]

I sense your relief of the completed case.

 

[Tunajoe]

Spectacular!

Well done!

 

[Al.]

Thanks Gents......
rkm, those were BlueSkyBio. Which brings up a question and something that happened (very frustrating) with this case. I ordered the blue sky bio ucla type of abutments, waxed them, casted them, and guess what? The titanium part that holds the plastic sleeve melted too and contaminated the hell out of that metal, and prevented it from casting all the way out. I snapped some pics and got in touch with their VP, very nice Gent, and went with all plastic from Attachment International and got the case to cast out.

Difficult case, nice results Rob. It looks like 3 laterials now?

All plastic you mean the interface or the hex is cast?

I hate it when Drs take pics of a nice case but take it from that angle low looking up at the incisal edge. The patient must have been laying back when he took the pic.

 

[JohnWilson]

Really nice case Rob how did you get the units to draw and completely seat using the engaging parts?

I love your tissue match did you stain the hell out of it or did the glass actually match the acrylic tabs?

Very good result with a very tough case.

 

[dmonwaxa]

Great Job Killer Rob. Well done, glad to see you posting again... I got a question for you... do pfm metal cast to Titanium.... Whats your secret? Gingiva shading is awesome what material did you use? Well done my friend!

 

[charles007]

Great job Rob.. sweet......I keep having nightmares about loosing my two centrals, You are the go to LabGuy should that come to pass..........

 

[dmonwaxa]

Great job Rob.. sweet......I keep having nightmares about loosing my two centrals, You are the go to LabGuy should that come to pass..........

We can arrange it I'm sure.popcorn JK

 

[TheLabGuy]

LOL Troy......Thanks Gents, much appreciated.
Al - I had to go with all plastic, even the hex because the ones from BlueSkyBio, they had a titanium bottom with a plastic sleeve, and normally that titanium bottom never melts (since Ti melting temp is around 3000F) but it did and fubar'd the first attempt. Hence why I had to go all plastic.

John-I sent along a gingiva shade guide (frickie-12 dollars) to have the Dentist snap an assortment of pictures. From there I was able to opaque accordingly. What I did to really match the shade because d.Sign only has 5 different pinks to work with, while the pink porcelain was still in the wet stage (built, but not baked it yet) I stained it and it soaked in. None of that gingiva is externally stained. It takes practice and at first it's a bit of a guess but after doing a few there is nothing to it. Seeing it upside down (as a reflection) helps too.

 

[dmonwaxa]

Rob, as far as the gingiva goes you mentioned staining during the build. What stain did you use for that intense red/crimsom effect? Never used anything that red. BTW I've never been successful at casting to Ti either...

 

[TheLabGuy]

I mixed d.Sign violet and brown with some of the white for varying degrees of pink shades. The darker crimson shade you are referring to was G5 - Pink porcelain with the darker stain mixture and the porcelain around necks are G3 with a lighter staining....only used two shades of porcelain for this, the rest was stained as mentioned. Hope that helps.....and that was weird about the casting issue, crazy that it did that and had no issues with the all plastic...picture below.

 

[dmonwaxa]

Rob, I usually mix brown to get that darker effect also but from the pics, they sure look a lot deeper red,,, must be the violet,,,DUH. Why didnt think about that, blue an brown makes black/dark grey. Their dark blue will really take that down a notch. Casting to Ti has me baffled. My alloys melt at a lower temp ^600 deg; not even close......

 

[Al.]

Rob thanks for sharing about your gin porc.

So you used the G5 for your darker shade. Thats toward the violet.

Inline and Dsign are the same shades. I havent really been to happy that they dont have a more red shade.

Have you tried the Intensive Gum shades. They have 4 of them.
IG 2 on the tab seems to be a deeper red.
They look like an DD or Opacious dentin in opacity.
Mabey have to put that down first then lay a regular gum shade on top ot it?

I was thinking about ordering the IG powders but really dont know how to use them.
I really dont want to experiment on real cases.
The G3 and 4 seem to come out kind of light or peachy compared to the red of gums.

 

[dmonwaxa]

Rob thanks for sharing about your gin porc.

So you used the G5 for your darker shade. Thats toward the violet.

Inline and Dsign are the same shades. I havent really been to happy that they dont have a more red shade.

Have you tried the Intensive Gum shades. They have 4 of them.
IG 2 on the tab seems to be a deeper red.
They look like an DD or Opacious dentin in opacity.
Mabey have to put that down first then lay a regular gum shade on top ot it?

I was thinking about ordering the IG powders but really dont know how to use them.
I really dont want to experiment on real cases.
The G3 and 4 seem to come out kind of light or peachy compared to the red of gums.

Al. you're a master, and masters don't get scared. Go ahead experiment a little you have the green light, treat itthe same crack lines ; try em the in the posteriors....and that doesn't sound right. I know.

 

[TheLabGuy]

Rob thanks for sharing about your gin porc.

So you used the G5 for your darker shade. Thats toward the violet.

Inline and Dsign are the same shades. I havent really been to happy that they dont have a more red shade.

Have you tried the Intensive Gum shades. They have 4 of them.
IG 2 on the tab seems to be a deeper red.
They look like an DD or Opacious dentin in opacity.
Mabey have to put that down first then lay a regular gum shade on top ot it?

I was thinking about ordering the IG powders but really dont know how to use them.
I really dont want to experiment on real cases.
The G3 and 4 seem to come out kind of light or peachy compared to the red of gums.

I've never used the IG's either and that may be the cats meow right there. I don't do a ton of pink porcelain cases, maybe one every couple months but I do get them so anything would be helpful. I'll ask the ivoclar guru's in Chicago about them when I'm there in a few weeks.

 

[DeVreugd]

Rob,

Nice result on a tough case !!

Russ