What do you think?

Edy

Edy

Active Member
Full Member
Messages
550
Reaction score
6
Lately my Doc's are bringing me crowns which are missing some of their tissue borders , they always after they prepare the tooth or even before , they take me an impression so i build for them temporary acrylic crowns , after they receive the temporaries , they grind/prepare the teeth / take impression for me the metal / and they glue the temporary crowns , after 7 days sometimes a bit more due to lot of work in lab .. i send them the metal crowns to check them ... the metals sit perfect in the mouth, they send back to lab and after 7 more days i send porcelain check before they send again back to lab for glazing . . .

The problem starts when i receive the crown for glazing .. after metal check was ok , the crowns with porcelain on them while doc is checking in mouth are missing in some places , it looks like the tissue moved away upwards and left space and the natural tooth is visible , or the abutment .. in most cases i redo the work , other times in minor problems like these i add porcelain in the missing spot .. You think the temporary crowns are playing a bad part here ? that why the tissue is changing in two weeks since the first impression for the crowns was made ? i know that the tissue is not welcoming the temporary crowns very well, a friend of mine recommended me to do temporaries with no contact with tissue even that the natural tooth/or the metal abutments remain visible during this two weeks period while the temporaries are in the mouth . .
 
Tayebdental

Tayebdental

Tayeb S. CDT
Donator
Full Member
Messages
3,238
Reaction score
470
Dose the doc do sub-gingival prep with gum retraction cord and a visible margin prep line?, if not you are just guessing and working in the dark. Temporaries should not be that antagonist to the gum and cause such gum shrinkage. It is probably healing of the gum after tissue trauma from the bur during tooth preparation. I hope this help!!.
 
Last edited:
Edy

Edy

Active Member
Full Member
Messages
550
Reaction score
6
The most of doctors are not using the cord and when i tried to convince them to work this way they did not like the idea at all , it takes too much time for them to work with the cord so .... i cant really force them to do that , around here only very few doctors use it , but i dont think its only that which causes the tissue to change so much in 2 weeks , maybe like u said the healing process may cause that , and if we wait for the tissue to heal and only then take the impression its a problem again , patients wont wait so long
 
R

rookiee

Active Member
Full Member
Messages
191
Reaction score
12
Patient will wait, maybe not all of them but majority for sure! That is if you have right approach! I found a young doc and we made nice business relationship, he listens to me and the other way! Problem is that docs are afraid that if you don't do it fast they'll go somewhere else and they want to get their hands on money asap! Smart doc is "soft", with the right strategy he can be educated which is good for everybody, him, you, patient! With this doc I'm a lot of times present when he's preping, I take photos, talk to him, talk to patient like a normal human and a lot of times when patient is asking when it'll be finished he points directly his finger towards me and says there's your guy! And then I say when can be done! If patient is still trying to win I say ok, we'll do it faster but if you want to have job done as it should be done then it's going to be done when I told you! Then maybe I show some real pics of our patient cases and so far I think nobody insisted of having his teeth done early!

All you need is right approach no matter who you are, doc or tech but of course you have to be solid and stand behind promises you make and not make patient wait longer for crappy work!
 
TheLabGuy

TheLabGuy

Just a Member
Full Member
Messages
6,223
Reaction score
817
Some expanded functions allow assistants to place the cord in some states/countries...is this an avenue of approach? That or buy him/her a laser...
 
Top Bottom