Pin Point Occlusal Contacts

[Al.]

John this first case is the one I talked to you about, Thanks.

 

[Al.]

Heres some more PFMs

 

[Al.]

Emax

 

[Al.]

Here are some of the above seated.









This bi is too light and the incisal is too white. I definately think I need to start adding a layer of clear over the regular incisal on the incisal 1/4 on the facials of emax.

 

[charles007]

Al, great pin point contacts........ must be nice to work with doctors who don't use heatless stones for adjusting occlusion !......... I still remember those day.......Now docs want a no adjust, drop-in crown, A2 shade, for the cheap.....

Almost forgot........porcelain work is not half bad either !!

NICE STUFF AS USUAL

 

[TheLabGuy]

Al,
Nice work......are you using your ring flash on your pictures? ETTL setting?
I wanted to point something out to you and the other folks here. It pertains to custom abutments, in particular your two custom abutment implant case.......


I know hindsight is 20/20, but if you would of brought your custom abutment mesially more you wouldn't have all that unsupported porcelain in that area. Other than that, gorgeous anatomy brother, and not just occlusal, buccal as well.

 

[JohnWilson]

Really beautiful work Al

Glad I could be of some help.

Really well supported marginal ridges.

Rob what you are seeing in the xray is not an issue at all and if you look at where the bone is it appears that thats about as wide as the abutment could be with out issues.

What I like to see on xrays is the marginal ridge support and Al did a perfect job not hanging a ton of glass off of them.

Occlusion on Implants is a touchy subject since they do not move like normal teeth under function via the PDL. Point contact is great but can cause issues if it hits a marginal ridge the wrong way. Equilibrating models is an absolute must and we have found taking the units slightly out of contact so that when the normal teeth compress a bit we will have a more even occ contact.

Not sure what I like more, your skill with the camera or the brush.

 

[Al.]

John that one I asked you about was the first I had done.
I had more coverage at first but after you sent me those pics I cut the wax back so the abuttment had less tissue coverage and tried to keep it in the depressed areas of the tissue to make it look like it was coming out of the tissue to help reduce food traps.

I was told by a Dr I need to limit my occlusion to a 1 or mabey 2 contacts directly over the implant next time.

As far as metal support alot of high end Drs are conscience about it and will double check the support you build in their xrays.

Here is the metal support for that funky blue crown I posted above. It makes for a very heavy and expensive crown metal wise. Especially if it has a high au content. Its the upper 1st molar.





Rob, yeah Im using the exact same set up you are.
The dual flash is on my wish list though.

Your problem is you are using the Auto mode I use the Av mode and adjust my settings.

 

[TheLabGuy]

Rob, yeah Im using the exact same set up you are.
The dual flash is on my wish list though.

Your problem is you are using the Auto mode I use the Av mode and adjust my settings.

Thanks Al, I'll play with the Av mode some.......
It's weird, I can take some great shots clinically, but that light plays hell with me at the bench......I know, don't skim the book, read it right!!!!!!

John,
We're going to have to disagree on that.......
I agree the marginal ridge is great, but why not make your abutment extend more in that area (cervical) for crown support is my only point. Due to the metal marginal ridge support, it won't shear off, but if that wasn't there he would of been in trouble on this one.

 

[JohnWilson]

Thanks Al, I'll play with the Av mode some.......
It's weird, I can take some great shots clinically, but that light plays hell with me at the bench......I know, don't skim the book, read it right!!!!!!

John,
We're going to have to disagree on that.......
I agree the marginal ridge is great, but why not make your abutment extend more in that area (cervical) for crown support is my only point. Due to the metal marginal ridge support, it won't shear off, but if that wasn't there he would of been in trouble on this one.

Hi Rob this is what makes this site great its a learning convo not argumentative.

Perhaps I am reading the film wrong but it appears the mesial/distal width is maxed out based on where the bone is. If Al was to extend it to the mesial where you drew your red line box it would run had into the bone.

Your right the porc will no sheer in that spot and it saved some alloy but I agree if it was waxed perfectly full contour and then cut back and even 2 mm it would be text book.

The new nobel software allows me to do just that and I love it.

 

[TheLabGuy]

Hi Rob this is what makes this site great its a learning convo not argumentative.

Perhaps I am reading the film wrong but it appears the mesial/distal width is maxed out based on where the bone is. If Al was to extend it to the mesial where you drew your red line box it would run had into the bone.

Your right the porc will no sheer in that spot and it saved some alloy but I agree if it was waxed perfectly full contour and then cut back and even 2 mm it would be text book.

The new nobel software allows me to do just that and I love it.

I hear ya John, we are all pals here, no reason to get into an argument, which isn't the same as talking shlt......

Okay, I see what you mean with my dash lines (over exaggerated)....you're right, that would be in the bone, but look at the arrow picture.....the metal could of had a ledge right there and not effect the bone at all and had support for porcelain (see picture below),that's why you do a custom abutment. Like you eluded too before, it doesn't really matter because the marginal ridge was built out so much, but my d.Sign porcelain isn't as forgiving and that's where it would shrunk at.

 

[JeffT]

Hi Al, are you waxing your emax occlusals or hand building?
Once again lovely work.
You sure your not Wili Gellars love child ))

 

[Al.]

For emax I do alot of press and stain but often I wax a 80% full contour crown and do layering in the non functional,

I still need to work on my tooth form on posteriors sometimes they come out kind of funky looking not as natural as they should be.

 

[Affinity]

Do you find most Drs want occlusal contacts on implant crowns? My understanding is that any occlusal load on an implant is a bad thing.. at least how its been explained to me.. Because there are no perio. ligaments attatching the tooth, it is direct bone contact. In other words, no give. Just wondering?

 

[Al.]

I had a Dr tell me the other day he wants only one contact and he wants it directly over the implant.

 

[amadent]

AL-
Thanks for posting all of the great pics of your work
They are a spark to the fire that has been missing in my own work for a few months now
Thanks you
Greg Amendola MDT

 

[molarmaker]

Lovely work,. implants are a area I need to work on Pictures of emergence and proper contour for hygiene would be most helpful to me . I'm new here,where were you 30 yrs ago when I really needed you. Thanks Stan.