Anterior FCZ Disclaimer

[RJS8669]

Assuming most people here are fully capable of producing nice looking anterior FCZs - however, I would posit that most people here would agree that a well-done eMax or PFZ crown is probably going to be inherently more esthetic.

That being said, some dentists will attempt to use an FCZ in the anterior to save money. Sometimes they go well, and sometimes they require a bit of work to make them esthetically acceptable to the patient. I just had a conversation with a client regarding a patient's expectations because he had chosen to do a 4-unit anterior FCZ splint. I tried to get him to change to a PFZ after hearing that the patient wanted her restoration to look as good as possible. His replay - "We already have a financial arrangement with the patient based on the FCZ fees" So, I told him that had no such agreement and I wanted to make it clear that I would do the best job to my capabilites, but any additonal work to make the patient happy - layering or custom staining - would be at an additional charge. He accepted that, but not happily.

My question -

Has anyone developed a disclaimer for anterior restorations? Something that might head off such discussions?

 

[user name]

Yes. I wont do them.

 

[dmonwaxa]

Assuming most people here are fully capable of producing nice looking anterior FCZs - however, I would posit that most people here would agree that a well-done eMax or PFZ crown is probably going to be inherently more esthetic.

That being said, some dentists will attempt to use an FCZ in the anterior to save money. Sometimes they go well, and sometimes they require a bit of work to make them esthetically acceptable to the patient. I just had a conversation with a client regarding a patient's expectations because he had chosen to do a 4-unit anterior FCZ splint. I tried to get him to change to a PFZ after hearing that the patient wanted her restoration to look as good as possible. His replay - "We already have a financial arrangement with the patient based on the FCZ fees" So, I told him that had no such agreement and I wanted to make it clear that I would do the best job to my capabilites, but any additonal work to make the patient happy - layering or custom staining - would be at an additional charge. He accepted that, but not happily.

My question -

Has anyone developed a disclaimer for anterior restorations? Something that might head off such discussions?

Good for you... based on fcz fee my azzz!

 

[CoolHandLuke]

i went through this yesterday.

just tell them it is your policy to layer in the anterior from cuspid to cuspid for best shade match and esthetics.

 

[zero_zero]

We layer anything from canine to canine, period...made a few demo cases for our accounts with full contour anteriors next to a layered one to show their patients what they get if they choose to be cheap...everybody's fine with layered for an a extra fee...

 

[sidesh0wb0b]

Assuming most people here are fully capable of producing nice looking anterior FCZs - however, I would posit that most people here would agree that a well-done eMax or PFZ crown is probably going to be inherently more esthetic.

That being said, some dentists will attempt to use an FCZ in the anterior to save money. Sometimes they go well, and sometimes they require a bit of work to make them esthetically acceptable to the patient. I just had a conversation with a client regarding a patient's expectations because he had chosen to do a 4-unit anterior FCZ splint. I tried to get him to change to a PFZ after hearing that the patient wanted her restoration to look as good as possible. His replay - "We already have a financial arrangement with the patient based on the FCZ fees" So, I told him that had no such agreement and I wanted to make it clear that I would do the best job to my capabilites, but any additonal work to make the patient happy - layering or custom staining - would be at an additional charge. He accepted that, but not happily.

My question -

Has anyone developed a disclaimer for anterior restorations? Something that might head off such discussions?

i have 2 Drs that do a ton of full contour zirc....one finally decided that stacking/pressing ceramic on the frames looks better (he wont be doings FCZ for anteriors any longer). the other i am still working on.
its as simple as the phone call i always make......"hey doc, i cant guarantee this unless we do it this way". done deal. remakes on them, ill make it over and over for full price if they want. and ill make that phone call on every case.

 

[MasterCeramist]

We layer anything from canine to canine, period...made a few demo cases for our accounts with full contour anteriors next to a layered one to show their patients what they get if they choose to be cheap...everybody's fine with layered for an a extra fee...

Do your docs actually have a different fee they charge the patient based on whether the case is layered ? Or is it the docs trying to get by with a cheaper lab bill by going full contour on most cases? Just curious.

 

[zero_zero]

Do your docs actually have a different fee they charge the patient based on whether the case is layered ? Or is it the docs trying to get by with a cheaper lab bill by going full contour on most cases? Just curious.

AFAIK they pass the lab bill to the patient. ..PFM's and FG also varies in price given the different alloy weight...they can also explain to the patient that layering is more labor intensive vs. full contour...thus more expensive. ..

 

[Affinity]

I just had this discussion with the Drs wife last week. The fee I charge for anterior is so minimal its a joke, but they still complain. If I hand them a stained chalky bridge with no contours and huge embrasures, they would have a fit. Heres a case I just finished up, FCZ layered with .5mmgc initial. It looked a lot nicer than the photos, zirconia is not photogenic.. No light transmission, light just bounces back. Not to mention the doc changed the shade from a a2.5 to a1.5 after I already had it layered..

I wouldnt even attempt these without layering, that is my disclaimer. Although, Im sure you can make them nice with some lustre paste, I dont even try.. its not what I would want in my mouth.

 

[eyeloveteeth]

looks good!

 

[hammerhead]

Here is a possible solution-.If DR needs zirc occ.,just do three quarter crowns .Next buy a bottle of Shofu one shot..Material is the old opal T, which seems to take on the chroma from a internal core almost perfect.Esthetics have been very good with no complaints from drs or patients

 

[RJS8669]

Do your docs actually have a different fee they charge the patient based on whether the case is layered ? Or is it the docs trying to get by with a cheaper lab bill by going full contour on most cases? Just curious.

Trust me -he's pocketing the difference. Same guy actually considered using PMMA crowns as final restorations back during the early stages of the recession...

 

[user name]

Here is a possible solution-.If DR needs zirc occ.,just do three quarter crowns .Next buy a bottle of Shofu one shot..Material is the old opal T, which seems to take on the chroma from a internal core almost perfect.Esthetics have been very good with no complaints from drs or patients

I sent you a PM hammerhead, but anyone else please clue me in....Im not familiar with Shofu's product line. What do they use for a liner, and what is this 'one shot'?

 

[dmonwaxa]

Very nice Affinity

 

[Affinity]

thanks, I can get pics in the mouth in the next week or so and Ill post to see what it looks like. This is sagemax. Love this material.. It finishes great in the green state.. its a bit softer so easier to work with, so you need to be careful, but not brittle like the Zolid material.

 

[NicelyMKV]

Do you have a disclaimer for this?

Lol. Just a last second pic. Still has polish on it. Prep was out a mile as well.


Sent from my iPad using Tapatalk HD

 

[Affinity]

haha only in the dirty south!