• Welcome to Dental Lab Network
    1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.

    When the bite's too tight..

    Discussion in 'Removable' started by JMN, Jun 18, 2017.

    1. JMN
      Curious

      JMN Christian Member Full Member

      Joined:
      Sep 2012
      Messages:
      6,195
      Likes Received:
      1,302
      Location:
      In a surprisingly solid sea of electrons
      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
    2. Doris A
      Angelic

      Doris A Well-Known Member Donator Full Member

      Joined:
      Jul 2011
      Messages:
      1,681
      Likes Received:
      812
      Location:
      Virginia Beach
      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.
       
      • Like Like x 1
      • Agree Agree x 1
    3. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

      Joined:
      Nov 2007
      Messages:
      14,069
      Likes Received:
      2,804
      Location:
      Ottawa, Canada
      or open the bite
       
      • Like Like x 2
    4. JMN
      Curious

      JMN Christian Member Full Member

      Joined:
      Sep 2012
      Messages:
      6,195
      Likes Received:
      1,302
      Location:
      In a surprisingly solid sea of electrons
      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?
       
      • Agree Agree x 1
    5. rkm rdt
      Artistic

      rkm rdt Well-Known Member Donator Full Member

      Joined:
      Nov 2007
      Messages:
      14,069
      Likes Received:
      2,804
      Location:
      Ottawa, Canada
      maybe bond a pmma tooth to the adjacents.
       
      • Like Like x 1
    6. Doris A
      Angelic

      Doris A Well-Known Member Donator Full Member

      Joined:
      Jul 2011
      Messages:
      1,681
      Likes Received:
      812
      Location:
      Virginia Beach
      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.
       
      • Informative Informative x 1
    7. CoolHandLuke
      Fiendish

      CoolHandLuke Well-Known Member Full Member

      Joined:
      Aug 2011
      Messages:
      6,714
      Likes Received:
      1,124
      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.
       
      • Informative Informative x 1
    8. Juko

      Juko Active Member Donator Full Member

      Joined:
      Aug 2015
      Messages:
      271
      Likes Received:
      94
      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.
       
      • Like Like x 1
      • Creative Creative x 1
    9. Juko

      Juko Active Member Donator Full Member

      Joined:
      Aug 2015
      Messages:
      271
      Likes Received:
      94
      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.
       
      • Informative Informative x 1
    10. JMN
      Curious

      JMN Christian Member Full Member

      Joined:
      Sep 2012
      Messages:
      6,195
      Likes Received:
      1,302
      Location:
      In a surprisingly solid sea of electrons
      Thanks
       
      • Like Like x 1
    11. budgenator

      budgenator Active Member Full Member

      Joined:
      Apr 2012
      Messages:
      111
      Likes Received:
      28
      If you can't get a wire in there, the Fixed lab is going to have clearance problems too. Even Bruxzirs need a 0.8 -1.25 mm on the anterior's lingual.
       
      • Informative Informative x 1
    12. artdlab
      Curious

      artdlab New Member Full Member

      Joined:
      Aug 2011
      Messages:
      7
      Likes Received:
      0
      Location:
      Virginia
      I would do BioHPP MD bridge (peek material)
       
      • Informative Informative x 1
    13. JMN
      Curious

      JMN Christian Member Full Member

      Joined:
      Sep 2012
      Messages:
      6,195
      Likes Received:
      1,302
      Location:
      In a surprisingly solid sea of electrons
      If they prep for a bridge it will be plenty thick since no support is coming from the palatal area, but from mesial and distal. or do an implant it could be screw retained and be fine.
      There was all kinds of room on this one labiopalatally, just severely closed bite.
       

    Share This Page