who said it is impossible to do EMax full press 4unit br.??? )))

[user name]

Dentist did a poor job. Should have been a full arch.
Ivoclar says dont do a bridge with more than 3 units.
Ivoclar says dont do a bridge that posterior. Too much occlusal force.
You have no right to experiment on a patient.
Should Ivoclar find out who you are and what youre doing with their product, they should refuse to sell you ingots.
You are giving e.max and yourself a bad name. You dont 'own' e.max. Youre a franchiser and everyone else that uses the product correctly should be angry at this miss use.
There are products and techniques well suited to fabricating this bridge...why not use them?

 

[Ryan Gottlieb]

Hey ed3, I really didn't mean any harm. I was not judging you or your work when I said the bite would be off because of the impression. Like me, you have to work with what the doctor gives you.
Like I said in my previous post, I hope it works out.
The reason I said I wouldn't have tried it is because I have had smaller emax bridges fail. I just don't do them anymore.
Some people may be posting some harsh comments about your case. I KNOW we have ALL pushed the limits of some cases at some time in our careers. Sometimes it comes back to bite us and some times it works out.
I hope you continue to post your work and contribute to this forum. Don't let this thread turn you away.

 

[paulg100]

theres pushing the limits and pushing the limits, doing posterior bridge work like that in emax is just silly.

good luck, hope the doc and patient realise that theres a very high chance that will fail prematurely.

Like already said, theres plenty of other material choices to do this case properly, so why even push this to the extreme like that.

Next you will be telling us the doc conventionally cemented as well. just silly.

 

[Affinity]

In addition to being a 4 unit posterior bridge, its free-end, so you have no adjacent posterior stop.. Think nutcracker covered in 1mm glass... Its only a matter of time.. Many Drs request metal occlusion for bridges like this.. I get it! Its a new era with new materials but they have their limits.. Im about 30 min from ivoclars HQ in liechtenstein, and i can tell you that company and the people spend far more time and money on research and making QUALITY materials with strict swiss standards. Everyone has a reputation to protect and thats why a company like ivoclar limits its products.. After all they develop them for you to use..

 

[Scotts studio]

Can't We All Just Get Along!!:reddy:

 

[KentPWalton]

It's not worth my time nor the risk in a remake of a bridge that isn't suggested to be done by the manufacturer of the product. Sure, it can physically be pressed, but is it what's right for the patient? Ethics and morals come in to play every day in the lab business. Everyone knows that there are products done that shouldn't be done at all on some preps that we get. Including PFM's. To me, it's all about patient care. I want what's best for the patient. I think of it as if it were my mouth. Would I want a test in my mouth? Compromise in my natural teeth, that by the way DO NOT grow back! So in my opinion, I would never even try these cases. It's just not worth the compromise in patient care. We turn Dr's requests down all the time for anything larger than a 3 unit Emax bridge. Other products can be placed here that have been effective for years with no compromise. You do what you want, I'm not doing these!

 

[cheadlemick]

Yet labs will make a bridge on an imp that is no good?

 

[KentPWalton]

Yet labs will make a bridge on an imp that is no good?

I like to call them and request a new impression or suggest a different product that may work with what they sent. Trust me, not all impressions can be used, I've seen it plenty of times. I've actually called and requested a new impression. He said, "Just go with it, do the best you can." I told him I couldn't guarantee the work and we would have to charge him I'd we had to remake the crown in the future. He re-impressed and we were able to use the next one. That's my answer to poor impression techniques.

 

[paulg100]

Thats exactly how i deal with imp problems Kent, works for me to.

 

[TheLabGuy]

Here is one I did awhile back. You can do 4 unit e.max posteriors...but that is only half the story. This patient wasn't opposing anything (edentulous),only wanted something for the high lip line when they smiled. Still though, you document that this is outside the manufacturer guidelines and that any/all responsibility from failure and then the liability rests on the Docs hand.

 

[KentPWalton]

Here is one I did awhile back. You can do 4 unit e.max posteriors...but that is only half the story. This patient wasn't opposing anything (edentulous),only wanted something for the high lip line when they smiled. Still though, you document that this is outside the manufacturer guidelines and that any/all responsibility from failure and then the liability rests on the Docs hand.

Man!! I didn't say it wasn't possible to actually press one out at all. I said that the manufacturer suggests that you only do 3 unit bridges with them and not in the posterior. But if you want to be "that guy", then go ahead. Geez. You can get better aesthetics with a stacked porcelain here anyway. You're just being selfish and wanting to press everything. Not do any work. There is no reason a metal or Zr framework wouldn't work here. Either would end up stronger and last longer than the Emax. Might as well call your 4 unit bridges ECracks!

 

[KentPWalton]

And personally here I would have done a single on the cuspid, then the bridge and would have not guaranteed the bridge. If the Dr. insisted of using Emax. But I would have tried to talk him/her out of it.

 

[TheLabGuy]

I'm being selfish???? You know what Kent, I don't even know you so I'm not even going to go there with you. My comments were for the original poster, when I talk to you I will make sure to address specifically you...now it's up to you how you want to be addressed!!!

 

[KentPWalton]

Sorry Rob. I let my emotions get the best of me. You're right. It's your and your Dr's choice. I'm just gonna stay out of it now. My apologies!!

 

[TheLabGuy]

Sorry Rob. I let my emotions get the best of me. You're right. It's your and your Dr's choice. I'm just gonna stay out of it now. My apologies!!

It's all good Kent, trust me, I love the passion...it comes across in your posts. As for this specific case, that bicuspid is compromised, hence why the Doctor wanted to use the cuspid and wanted something to easily remove if he has to extract that second bicuspid in the near future. It was a unique situation, but normally, you're right, no fricken way!!!

 

[ed 3]

Here is one I did awhile back. You can do 4 unit e.max posteriors...but that is only half the story. This patient wasn't opposing anything (edentulous),only wanted something for the high lip line when they smiled. Still though, you document that this is outside the manufacturer guidelines and that any/all responsibility from failure and then the liability rests on the Docs hand.

I know TheLabGuy,thank you, everything been done by dentist approval and acknowledgement, so far for a long time non of my frames came back as a remake or repair. That's all....
eep:

 

[ed 3]

OMG You are really lucky that you got away with that for so long. One day it will bite you in the .....
Hopefully soone than later.

ignore button :blah::blah:

 

[subrisi]

Haha, did I piss you off? At least you might remember when you get the next case and communicate with the dentist and make an EDUCATED decision.

 

[ed 3]

Haha, did I piss you off? At least you might remember when you get the next case and communicate with the dentist and make an EDUCATED decision.

you wish, who ta hell are you, so you can piss me off? another *******?:bootyshake:

 

[user name]

Here is one I did awhile back. You can do 4 unit e.max posteriors...but that is only half the story. This patient wasn't opposing anything (edentulous),only wanted something for the high lip line when they smiled. Still though, you document that this is outside the manufacturer guidelines and that any/all responsibility from failure and then the liability rests on the Docs hand.

This is a perfect example of a technician using his education and reason, and expanding on the instructions provided my Ivoclar...not deviating from them. In the e.max manual, the span of a bridge is described as three units, but more importantly, it gives the max distance that a pontic should span depending on where its located. LabGuy did make a three unit bridge. There is one pontic. The fact that he and the Doctor chose to splint an adjacent crown to strengthen a less than ideal tooth is simple engineering. This still falls within the material providers qualifications and is in no way a contraindication.

Its easy to be tempted to go beyond what Ivoclar suggests when using e.max. Its a beautiful easy to use material. Not to mention...give a man a hammer, everything becomes a nail. Its true, ed 3, that just like in rope or chain manufacturing, tensil strength is stated at less than 50% on breakage, Ivoclar isnt stating in the manual at what point the material will break. They are guiding us to stay well within its known parameters, because they know we are going to be pushing its limits.

e.max isnt going to hold up better because YOU blessed the bridge with your magic and talents. We've all got a stake in e.maxs' success. We,re your brothers in this business. Im not saying I have the answers, but when some of the 'elders' on this site grace us with their knowledge and experience, we need to sit down and learn. Not just keep defending what we've done in the past.