SHOW YOUR FULL A.........rch Zi

[Al.]

It's the small things that eat away so much time. Organizing the parts, screwing and unscrewing. Taking the soft tissue on and off, just the time you pend staring at it and thinking or analyzing.

I could do 3 full arch emax cases for probably 3x or more the profit with zero stress while I'm still a full arch implant case is still in process.

 

[NicelyMKV]

My doctor asked me why Oral Arts was 2700 and I was 6000. I said send to them and see....

 

[Affinity]

it will be interesting to see these in about 10 years.. This huge hunk of zirconia is hanging on a few cemented bases.. bases that in fact, have no retention, most are cone shaped. The cool factor is high with these cases, but I dont think they are as indesctrucable as everyone thinks.. Its always the thing you dont pay attention to. The zirconia will probably be fine forever.. but I can only imagine the nightmare of getting one back after 6-7 years in the mouth, and having to add to it because of resorption.. Redo the model, burn out all bases, put on gas mask, refire, recement.. and I hate to sound like disturbed, but I can only imagine what this behemoth does to the opposing teeth over time. Theres just not enough time yet to judge whether these are practical in the long run.

 

[NicelyMKV]

Add in the high cost of a 25mm reputable Zr material and the possibility of fractures and chipping during milling, uneven shrinkage during sintering, something happening during ceramic overlay and having to remill..... Crazy expensive risk.....

 

[Al.]

Those 3 cases I sent back I figured I would have had almost $6,000 In parts alone.

Plus the frames. That's ALOT of $ to spend up front for cases that will take a couple months to complete.
One screw up like a bad bite that was perfect and ??????

I found my regular production or gravy cases stopped for these cases. My profits went way down.
There is some excitement or cool factor with these at first ESP when they bill out high.
But that wares off as quick as the new car smell does the first time you lite a smoke in it.

 

[NicelyMKV]

They will break. In seeing ZZ prettau bridges fracture after a few years. These were fabricated by a ZZ lab.

 

[NicelyMKV]

I'm more interested in the Ti ceramics. Milled subs with ceramic overlay.

 

[Affinity]

True that! Do you go through 5 disks before you realize, you either cant mill it, or the loss of money on material doesnt justify what you will make? Then the frustration factor. Then what do you do? Give it back? Send it to GW? One crack or chip and youre redoing it all, doesnt fit, redo. Broken tools.. wear and tear...

 

[Affinity]

I think in 5 years, these will all be done with peek or pekk frames, hybrid acrylic, and a cherry on top. These cases need shock absorption.

 

[Al.]

I think in 5 years, these will all be done with peek or pekk frames, hybrid acrylic, and a cherry on top. These cases need shock absorption.

Yes and with individual emax crowns on top I'm seeing a ton of these cases from Phil Reddington in the UK

 

[2thm8kr]

These cases need shock absorption.

Roger that Houston!

 

[dmonwaxa]

What ti base did you use? or did you modify temp cylinders? Looks great.

Thanks for the kind words, it was 2 connect.

 

[charles007]

Very nice case Troy,
I admire all the long hours it takes to do cases like this, , buy no thanks, to much work and learning curve for me ... Already earned all my grey hair years ago on RH cases and learned how to solder bridges with my eyes closed lol
Enjoyed the late night tel call....... btw the wife did ask this morning who called late last night... lol

All labs capable doing this kind of work should charge top dollar ! and I mean over 6k. + I remember back in the 80's the doctor I worked for inhouse spent over 30k on CE learning how to do implants and the reason why docs charge so much for implants. Those of you doing zirconia implant cases are in the Elite group of labs... meaning your in a sellers market, and highly experience techs in this new field are in high demand. If you have the experience, training, and spent $$ you should charge appropriately and forget about following GW coat-tail prices.. It take a lot pre-scheduling, lot of parts, materials, remills, back and forth/telephone calls, office visits " Extra Stress " etc.
I would like to think that even the worst doctors aren't going to want to use the cheapest lab knowing remakes would be a nightmare. Also very few doctors are doing cases like this and very few labs are doing cases like this,,,, meaning, very little competition from other labs
There was a day when doctors marked up lab work 3x to the patient ! Who's to say you can't charge 1/4 to 1/5 +- the patients cost ?
I like Al's 10k as a starting point............just saying

 

[Affinity]

I disagree charles, I think more Drs ARE doing (or trying) these type of bridges... and anyone with a 5 axis mill, thinks they can manufacture them. GW will get more and more of these cases, because thats just what GW does, suck up market share with rock bottom pricing. GW can remake the case almost 3x before a Dr pays another lab for the 'same' bridge..

Here in spokane, the leading prosthodontist charges over $50k for these, per arch. A lot of other Drs think they can offer the same treatment, because they can place 4 implants! I had a Dr, quote a pt. $10k for this treatment, (his charge).. when I told him it would be over $5k for the bridge, he didnt know what to think. Of course he gave the pt the estimate (and placed implants) before ever consulting with any lab on what the fee would be on a case like this. No plan=no bueno. No concept of what is involved. Never even asked what would be involved. Some Drs think they can just take an impression and a bridge will magically appear. No concern of placement, tissue management, VDO, bite verification. In fact VDO was never even discussed, who knows if there is even room for a case like this.. ugh end rant.

 

[rkm rdt]

I disagree charles, I think more Drs ARE doing (or trying) these type of bridges... and anyone with a 5 axis mill, thinks they can manufacture them. GW will get more and more of these cases, because thats just what GW does, suck up market share with rock bottom pricing. GW can remake the case almost 3x before a Dr pays another lab for the 'same' bridge..

Here in spokane, the leading prosthodontist charges over $50k for these, per arch. A lot of other Drs think they can offer the same treatment, because they can place 4 implants! I had a Dr, quote a pt. $10k for this treatment, (his charge).. when I told him it would be over $5k for the bridge, he didnt know what to think. Of course he gave the pt the estimate (and placed implants) before ever consulting with any lab on what the fee would be on a case like this. No plan=no bueno. No concept of what is involved. Never even asked what would be involved. Some Drs think they can just take an impression and a bridge will magically appear. No concern of placement, tissue management, VDO, bite verification. In fact VDO was never even discussed, who knows if there is even room for a case like this.. ugh end rant.

At least they gave you 2 weeks to do the case.

 

[Drizzt]

I agree with all of you . Now that I think about it , I will stick to PEEK frames and e.max or zirconia single copings with composite gum !! The 25mm disc milling kinda scared me !

 

[NicelyMKV]

Anybody have photos of these peek frames?

 

[Al.]

Yes these are getting very popular. Had a doc tell me his goal was to do one of these a week.

And the ones Glidewell are advertising look like Dog Sh*t

 

[Tayebdental]

 

[2thm8kr]

Anybody have photos of these peek frames?

I've only seen photos of overdenture frames covering Ti or Zr substructures and implant chassis.
I think there are some examples on Panthera's site.