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    When the bite's too tight..

    Discussion in 'Removable' started by JMN, Jun 18, 2017 at 10:34 PM.

    1. JMN
      Curious

      JMN Christian Member Donator Full Member

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      What do you do? This patient presents an interesting challenge, this is one of the worst one I've seen yet for lower anterior to palate contact.

      This is what I did, and I'm wondering what y'all do.

      Just leaving the wire passing through the gap, and attach the tooth and mutual undercut retention to either side. The wires are out of occlusion, and will pose no problem for mastication. This is the only gap and it wasn't even big enough for 18Ga wire, these are 20Ga ball clasps. The clasp wire is just being held with wax till the palatal side is done, then do the tooth side.

      Any better ideas?

      The models look dreadful because some moron decided to salt n pepper without checking clearance for the lower anteriors aside from the tooth setting labial enough to be out of their path.

      Er, hi. :rolleyes::oops:
      20170618_214807.jpg 20170618_215128.jpg
       
      Last edited: Jun 18, 2017 at 10:48 PM
    2. Doris A
      Innocent

      Doris A Well-Known Member Donator Full Member

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      Call the dr and tell him that he needs to reduce the opposing teeth so you have room for the partial to be made correctly.
       
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    3. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      or open the bite
       
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    4. JMN
      Curious

      JMN Christian Member Donator Full Member

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      I should have said it's for a single tooth flipper during/between either a bridge or implant -undecided pt. Would you still ask for enamelplasty for a temporary situation? I just don't feel that good about asking them to do a permanent change to the length of all 6 lower anterior teeth for an at most 7-8 month prosthetic.
      Am I too conservative about this?
       
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    5. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

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      maybe bond a pmma tooth to the adjacents.
       
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    6. Doris A
      Innocent

      Doris A Well-Known Member Donator Full Member

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      I would because otherwise you are going to repair it every time you turn around from the patient biting it in two, even with the wire. Or make an essix.
       
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    7. CoolHandLuke
      Fiendish

      CoolHandLuke Well-Known Member Full Member

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      this might be a really great opportunity for Peek. highly wear resistant, durable, tooth coloured (sorta) lightweight and cheap.

      but youd need to send it out to be milled.
       
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    8. Juko

      Juko Active Member Donator Full Member

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      For something like that I use glass fiber and basically make a Maryland bridge. Glass fibers for wings, composite over the fiber to create the composite wings and then I use acrylic to attach the tooth. Doc uses composite to attach to adjacent teeth and wallah a temporary Maryland bridge in place of a flipper. Last one I did is still in the patients mouth and it's been close to 7 months now.
       
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    9. Juko

      Juko Active Member Donator Full Member

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      Now that I've been thinking about it. The last one I did was all composite. I built a tooth using composite and the rest is the same.
      I've done it with acrylic tooth and attached using acrylic to the fiber too. either way works.
       
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    10. JMN
      Curious

      JMN Christian Member Donator Full Member

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      Thanks
       
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