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dmonwaxa

dmonwaxa

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So here goes, my first post. I'llt ry to make it short and sweet. Max implant supported FDP the lower to be restored next month. As you can see the angles of the implants this was gonna be a challenge and with stock abutments to boot. They were customized and a framework was made.The ceramic work was finished on a resin die model. Nothing fancy, just down and dirty.
1.jpg 2.jpg 3.jpg 4.jpg 5.jpg 6.jpg 7.jpg 8.jpg 9.jpg 6_.jpg 6__.jpg
 
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TheLabGuy

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I'm curious, did you do a full contour wax up to figure out your golden proportions or when you did the framework?

Any clinical shots back yet?
 
DMC

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That's a mouthful! Surgon had a great time I guess.

Looks great. I wish I got cases like this often.

Scott
 
dmonwaxa

dmonwaxa

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Hey "TheLabGuy" thanks for viewing. Yes, i did do a waxup and fabricated radica provisionals prior. "Golden proportion", whats that? I had to do a "spacial" analysis using the vectors off #7 and by using a derivitive of the Fibonaci principle multplied by Pi. That gave me the proportions. No I didn't use the Golden Proportion here, but a somewhat "calibrated" eye. The challenge here was the path of draw. When using a stock abutment the amount of modification one can achieve may be limited without compromising their integrity. Here there were 7. The humdinger was getting the position of #10 just right. ( See pic #1) As in most cases the implant is situated ridght where the interproximal embrasure needs to be. So you just have to work around it the best you can. I'll try to add photos.
 
TheLabGuy

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Thanks......this is one of them 'big-em's'....lol
I'm not a fan of the implant placement, almost made your job impossible. Plus, the main issue, is there is no implant in #14 area, where you'd expect to have one because of all the occlusal forces.......I will digress, great job miracle worker.
 
dmonwaxa

dmonwaxa

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***, thanks for viewing and your kind words. You think the surgeon had fun, that was the easy part, just ask the tech that worked on this one. As an aside, the doc sent me a personal note with this case " arent you tired of thes full arch cases yet" Funny! When I seperated the impression all I could say was " OMG".So you really think you want to do these. Be careful what you asked for.
 
dmonwaxa

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Miracle workers

Thanks......this is one of them 'big-em's'....lol I will digress, great job miracle worker.


Thanks TheLabGuy, this is an example of what we all do, and do almost every day.

BTW, just added pics of waxup and provisionals.
 
TheLabGuy

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Here is something I noticed in the final, that's why I asked if you had a wax up.....the way the smileline correlates with the mandibular is canted, and the midline appears askew.......as I tried to show in the photo. This is what my eyes went too right away when you posted your photo's. What I'm getting at is, I'm such a tard that I would went with the mandibular as guidance versus what the soft tissue looked like (assuming this is why it appears different). I think this is why stick bites and the stick bite photography is so important when doing cases like this.......because how else are you going to know? awww.patriotdentallab.com_images_here.jpg
awww.patriotdentallab.com_images_here.jpg
 
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charles007

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Talk about a Nightmare on your side of the street.... wow... I think I would want to call in sick on this one... BUT I can't in a 2 man show.
I noticed the cant also....Also see the embrasure are closed which makes the crowns look wide....
This will be an easy fix to just deepen the embrasures to tilt the canted look, SHOULD it come back to haunt you....boo
This is the very reason labs should have an extra charge on larger cases... I charge an extra 10% on 5 units or more....If I did implant cases like this, I would probably charge myself out of the market.... and for good reason... like this case.
Great job with the tools you were given...

Welcome to DLN dmonwaxa.... great to have another great tech we can learn from, and bitch at....hehe
What alloy did you use?

Charles
 
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dmonwaxa

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HEY! I SAID TAKE IT EASY GUYS!!! jk thanks for the "freedback". Good eyes guys, a lot of times I analyse things better in pictures. Part of what you see might be camera angle and lens distortion?????? LOL. Rob compare the wax up and the final, midline more perpendicular. Also the pic of waxup was not the final I think. Boy I'm starting to feel the heat, but I'm thick skinned.
 
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charles007

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HEY Hey....I did say you're a Great Tech to learn from.....

dmonwaxa, I'm right scary looking when I'm blown up on my 22'' computer monitor.. just ask Rob.....
 
dmonwaxa

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scary

Thanks Charles, I was really talking to Rob, Ha HA. I will post a new pic for his expert evaluation ;D)). btw the alloy is Pd. Argen. And please dont blow it up, it scares me to hear you say that
gp.jpg
 
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paulg100

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No stick bite, no photos , no hope! lol

Just finished a full upper case like this. Multi emax crowns on implants for the Dr's wife and had no information what so ever.

The guy just blasted into and didnt even know how to take a face bow. Didnt want to take the temps off to get the correct info either!

About 4 days work, if it comesback im gonna hit the roof!

How do you turn the work away and still make a living.

Oh yeah and he wanted it back in 2 1/2 days ...which he didnt get.

Dmonwaxa: constructive comment - your contacts should be at the lingual/palatal. Whilst they are labial it makes everything look like a block. I used to do this until i learned and it will TOTALLY change the way your cases look for the better.

also you are WAY over glazing/firing to the point of marbles. what ceramic are you using and have you checked your temps/hold time and calibrated lately?. You should be able to fire 10 times if need be and still have a homogenous, colour stable and vital result.

Sorry to be harsh. Give the info and we will help loads.
 
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TheLabGuy

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Hey dmonwaxa......
I truly hope you don't take any of this as criticism at all........95% of us on here don't even get cases like this, let alone know where to begin with them, and here you were kind enough to post it on here so we could pick your brain, and pick this case apart to pieces....THANK YOU!!!!!!! Now i'm anxious to see the clinical picture of it in the mouth.......We could pick this to death until we see it in the mouth, so keep up the hard work and thanks again for sharing. If it makes you feel better, it's a good thing that so many people are posting making suggestions and comments, if it was bad work, we ALL wouldn't even say a word....:)
 
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charles007

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Hey dmonwaxa

We're all a bunch of Ace holes who are bottom feeders who eat their young, and get off on spending hours on DLN......Many of us actually PM alot and call each other late at night and weekends for help. Great group of guys here that add up to hundreds of years of experience, abuse, and who get no respect, who will bend over backward to help anyone here. Take advantage of this great site and use it to the fullest.

Enjoy DLN, just keep the tissue box near back if we get to tough.........you probably made to much money this week and are a little sensitive........haha

Now back to my 16 hour days in my dental lab dungeon.

Check out Dentaltown.com for some good old fashion word trashing and harsh criticism in a technical way.
Some of the same good old boys from DLN ... and another great learning forum.

Charles
 
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dmonwaxa

dmonwaxa

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Guys, guys,guys. No hard feelings, I knew I was gonna bear my soul. As for Rob, I was just gonna say you sure talk a lot, and I havent seen any of your work posted. LOL. But then again I'm new, and just might have missed it. Still learning my way around the site learning how to load and post and edit and stuff; so bear with me. PaulG. Thanks, you're right. I recently had to recalibrate, plus I polish with diamond paste after glaze firing. As for contacts I assume you're speaking interproximal, right? Something I need to work on. First from a prosthodontic standpoint, function. I dont skimp on metal, and for a case like this you dont want to. My connectors are. what i consider minimal to where I'm comfortable to avoid distortion from firing. Second,I could leave the connectors th same and build the porcelain out, giving me more room to deepen embrasures but making it bulky for patient. A delima when trying to maximize esthetics. Did the best I could at the time though. Thanks again you guys. It helps to see what other folks are seeing
 
dmonwaxa

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Thanks,,,,, thanks,,,, thanks for the warm welcome so far. No tissue needed here. Also regarding my commentary, I'm not making excuses, just sharing my rationale, and the considerations one has to make when doing a case like this.
CIAO
 
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paulg100

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yeah its not easy. One of the best things i can say with bridge work is cut through the porc to the connector on the first build then fill in with the second/third.

If you try and build in the contact point and cut in after firing you will always struggle to get full seperation with bridge work as you are constantly worried about hitting metal.

Maby you are already doing this but its much easier to create units that look like single teeth if you do it in ceramic, dont cut it.

Its less productive but the resluts speak for them selves.

Infact cutting in anything always leads to artificial results. Just takes a damn load of experience and practice to do it in ceramic.

Re the surface glaze, the best middle ground i have found on natural teeth is a kind of plastic finish/luster. I rubber wheel units, glaze with paste then buff with lave/pumice to acheive this. Also results in an ULTRA smooth finish for less plaque adhesion.

At the very least you could use a rubber wheel and knock down the luster of the mesial/distal line angles. This would make a big difference stright away. Imagine the lips and how they erode prominent points of the tooth then replicate this in the surface finish.

I cant imagine that you would ever need to use diamond paste on a stright glaze fire unless you are underfiring your glaze cyle to preserve micro texture or it is an elderly very worn tooth perhaps. Normally a paste glaze is to much on its own.

I constantly pick my own work to peices under close up photography, its the only way to keep improving ;) the day you say your work is great is the day you stop improving.
 
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TheLabGuy

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As for Rob, I was just gonna say you sure talk a lot, and I havent seen any of your work posted. LOL. But then again I'm new, and just might have missed it.

Keep looking, try DentalTown, try L.V.I, IDF, or ACE forums :)
You just want to give me a hard time don't you.....lol It's all good, you'll fit right in with us dinosaurs.....oops, I mean dynamo's here at DLN....lol
 
dmonwaxa

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Re Analyses

This is much better.
Picture4.jpg
 

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