10 unit...

sidesh0wb0b

sidesh0wb0b

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CatamountRob

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Are those purple lab pans?!?
OMG......
 
TheLabGuy

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Nice lab work Bob...I'm not overjoyed at the implant selection (zimmer 3.5mm) or the idea of placing just four implants upstairs either. The late Dr. Misch pretty much beat it into our heads you have to go six implants upstairs...if and when something fails, you have no back up plan with just four. On the flip side though, your prosthesis looks like its rigid enough to help lateral and excursive forces. Any clinical photos?
 
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Props to you Mr. Sideboob. Lots of guys would fill their britches if confronted with doing that. Instead of just the pics, would you narrate just a bit so I could understand your work flow better? I know Im slow, but I don't understand the first pic. That's plastic? What, how, why.
Thanks
 
sidesh0wb0b

sidesh0wb0b

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Nice lab work Bob...I'm not overjoyed at the implant selection (zimmer 3.5mm) or the idea of placing just four implants upstairs either. The late Dr. Misch pretty much beat it into our heads you have to go six implants upstairs...if and when something fails, you have no back up plan with just four. On the flip side though, your prosthesis looks like its rigid enough to help lateral and excursive forces. Any clinical photos?
thanks, Rob. i am not uber thrilled about the 3.5s either but alas i dont have those three letters so ....
that being said, everything was super stable in occlusion and the pt didnt have any significant wear on the temp denture (so i was told) so i believe all will work out great. i leaned toward the zirconia for strength reasons too, just a bit stronger than the emax/lisi stuff but didnt comprimise much on the beauty side. (my phone pics dont show great detail but it looked nicer in person)
no intraoral pics yet, hopefully the Dr took some and i get them soon.
 
sidesh0wb0b

sidesh0wb0b

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Props to you Mr. Sideboob. Lots of guys would fill their britches if confronted with doing that. Instead of just the pics, would you narrate just a bit so I could understand your work flow better? I know Im slow, but I don't understand the first pic. That's plastic? What, how, why.
Thanks
yeah sorry. not used to posting via tapatalk....
nervous, yeah a bit. but been doing this now into my 20th year. not much makes me poo anymore. workflow....okay so
1. at receiving the impressions (and no temp denture imp/model) i was concerned about fit, and lining up midline/length/etc. so first step was that "plastic" thing. clear cured acrylic over temp abutments(non engaging) for the Dr to seat in the fixtures and make us both 100% certain of the accuracy of the impression. all went well and it seems no one makes verification jigs like this. this is how i always do it lol.
2. second image you can see the preop model from months ago before implant placement. aaaaand the lower teeth were broken off the model, so i had to wax those on.
3. next i mounted on the panadent and sent to a milling lab. got the titanium frame deisgn images, made some tweaks to it, and had them mill. surprisingly lightweight for how big it was. they milled a Ti frame for #4-13 preps and added a ~4mm flange on the facial and ~2mm flange on the lingual. (missing my pics of these, need to find them)
4. opaqued the ti preps with a correlating LC shade (GC Gradia) and opaqued the flange areas with a middle of the road tissue shade.
5. made a diagnostic screw retained over the ti frame and just had some baseplate wax over the tissue flange for presentation. Dr took a GC Gradia tissue shade at try in from the custom shade tabs i made him. Dr made a few length adjustments and otherwise said to proceed.
6. cleaned off the diagnostic wax and baseplate wax, opaqued the flange with the tissue shade and prepared the entire frame for crowns.
7. finalized each splinted segment and seated them as one. Then LC cemented them to the frame and cleaned out the access holes.
8. finished up with adding the Gradia tissue to flange areas on facial and lingual and applying LC glaze to those area.

huuuuuuuuuuge labor of love here. not a major profit maker but it was a lot of fun. looking forward to the next one, feel much better about tackling it! my images dont really show the detail in the crowns. sucks too. was pressed for delivery time so didnt get the Nikon out for good images. was nice pinks and blues in there and the zirc turned out gorgeous. really love playing with vericore. having a load of success with it!
that help some?

*edit*
pic 3 was right after applying the tissue and removing from model after light cure. pic 4 was just cleaned up and adjusted slightly then steamed. pic 5 was to show access holes and during glazing the gradia tissue areas. pic 6 (not sure why #10 looks so dark but it was a perfect match, prob a shadow) final glaze just before cleaning/disinfecting and shipping out he door.
 
JMN

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yeah sorry. not used to posting via tapatalk....
nervous, yeah a bit. but been doing this now into my 20th year. not much makes me poo anymore. workflow....okay so
1. at receiving the impressions (and no temp denture imp/model) i was concerned about fit, and lining up midline/length/etc. so first step was that "plastic" thing. clear cured acrylic over temp abutments(non engaging) for the Dr to seat in the fixtures and make us both 100% certain of the accuracy of the impression. all went well and it seems no one makes verification jigs like this. this is how i always do it lol.
2. second image you can see the preop model from months ago before implant placement. aaaaand the lower teeth were broken off the model, so i had to wax those on.
3. next i mounted on the panadent and sent to a milling lab. got the titanium frame deisgn images, made some tweaks to it, and had them mill. surprisingly lightweight for how big it was. they milled a Ti frame for #4-13 preps and added a ~4mm flange on the facial and ~2mm flange on the lingual. (missing my pics of these, need to find them)
4. opaqued the ti preps with a correlating LC shade (GC Gradia) and opaqued the flange areas with a middle of the road tissue shade.
5. made a diagnostic screw retained over the ti frame and just had some baseplate wax over the tissue flange for presentation. Dr took a GC Gradia tissue shade at try in from the custom shade tabs i made him. Dr made a few length adjustments and otherwise said to proceed.
6. cleaned off the diagnostic wax and baseplate wax, opaqued the flange with the tissue shade and prepared the entire frame for crowns.
7. finalized each splinted segment and seated them as one. Then LC cemented them to the frame and cleaned out the access holes.
8. finished up with adding the Gradia tissue to flange areas on facial and lingual and applying LC glaze to those area.

huuuuuuuuuuge labor of love here. not a major profit maker but it was a lot of fun. looking forward to the next one, feel much better about tackling it! my images dont really show the detail in the crowns. sucks too. was pressed for delivery time so didnt get the Nikon out for good images. was nice pinks and blues in there and the zirc turned out gorgeous. really love playing with vericore. having a load of success with it!
that help some?

*edit*
pic 3 was right after applying the tissue and removing from model after light cure. pic 4 was just cleaned up and adjusted slightly then steamed. pic 5 was to show access holes and during glazing the gradia tissue areas. pic 6 (not sure why #10 looks so dark but it was a perfect match, prob a shadow) final glaze just before cleaning/disinfecting and shipping out he door.
Thanks for the step by step! I was wondering about the clear jig too, never made mine that purty.
 
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