Everyday Case

[Brian]

Since the last thread on creating natural dentures and the questions asked? I thought I would post an everyday case here in my lab. Perhaps someone can pick up a few things and in turn I might could pick up a few things.

I also (if time permits) will start photos of an immediate upper denture using Physioden teeth. This case will be a royal pain.

Well lets start off with this case. Upper CD replacing interim immediate denture. Opposing is yet to be determined. Pt. is waffling between a Valplast or a Cast..

 

[Brian]

Case is articulated with a Stratos 200, via horizontal guide.

The guide helps to assure me of the correct position
( a closer guess when a face bow is not used ) within the articulator and center of 108mm. ( Bonwill's Triangle) This will greatly increase the accuracy of the arc of closure.

 

[Brian]

Next I will continue with the articulation.

 

[Brian]

Prepping to start the set up following the rim.

 

[Brian]

Set the teeth and wax the contours... Teeth used were Blue Line from Ivoclar, A41 shade B2. I'm still having a small problem with my lighting.

 

[Brian]

And here is with the lower posteriors set... I will not wax this one up to complete.. As stated unsure of what the Doctor and the patient will decide.

 

[Brian]

I will document this all the way to finish. Investing, boil out and prep, colorizing, processing and finishing.

I will also show pictures with the patient as well. If there are any screw ups I will be sure to post as well.

 

[labdude]

Thanks Brian....
What this site is all about.

 

[DDDental]

Brian Very nice work, please tell me how you post photos, I was going to post some pictures of my work but I can't upload them.

 

[Travis]

The amount of photos you upload to this site is limited. I have to put limits on file sizes because I have to pay for the space we use. You can upload large files to various different sites and link them in your posts (ie Image hosting, free photo sharing & video sharing at Photobucket). Iam sorry but I have to limit the amount of space each user uses so I stay within my space the server allows. I will make a sticky on this
Travis

 

[labdude]

Nice time to mention.....anybody find anything of value here at the site???
It is a FREE site, but you can support it.
Just click on the "donate" tab in the top menu.

 

[Al.]

And here is with the lower posteriors set... I will not wax this one up to complete.. As stated unsure of what the Doctor and the patient will decide.

Brian why didnt you put the root contour above the laterals like you for the other teeth?

 

[Brian]

Al,
As in natural tissue, sometimes they are there and sometimes their not.
I let the tooth set up dictate my wax up.. I was also trying to reflect the lower...

 

[Denturist]

Perhaps it is jut the angle of your photos but I don't see any compensating curve in your setup.
Nice setup though.

 

[Brian]

There is, the lower posteriors were set with the 2D template.

 

[Brian]

Well, here we go..... I have just been forwarded the pictures and comentary will soon come with the lab slip. I should have the case tomorrow or early Tues.

I said I would post the good with the bad.. I personally think the tooth size should be reduced. Secondly I think she may be open a little.

I will turn #7 out a little, and I feel that the teeth need to be raised a little to follow the smile. Negative spaces could be a little better, however 12 and 13, are really where they need to be as in regards to occlusion.

I'm a little surprised by the results, normally with this client thing hit a little stronger.

Well now it's your turn.. Let me have it!

 

[TheLabGuy]

#10 grabs my eyes right away.....It's way to short in relation to everything else, which could be a good thing since 7,8,9 are long. In addition to #10, the distal is twisted in to much, needs to come out more labially, this will diminish the appearance of sharp cusp tip on #11 and that "dark" space. #9 appears to be going uphill due to #10's shortness. I agree with you that 8 and 9 are just to large, she's got a smile, she shows the the buccals of the molars. What about the shade?.......is that just the reflection of the flash on natural (mandible) vs. denture teeth (maxillary)?

 

[CYNOSURER]

I believe you are correct. The teeth need to be raised by closing the bite a cat's hair...which you can leave in as part of the characterization.

I wondered about that hole between 10 & 11 but couldn't tell if it was avoidable or not from the photo angles. It does look like some smaller teeth might help close that hole as the length of #11 looks right. Problem is compounded by her having three large lower incisors instead of four normal size.

You want to talk about mis-sizing I'll email mail you my latest nightmare. My attempt to post pic using Google's Picasa Web album haven't worked to date.

 

[Denturist]

Three things I would change.....
1. Close the bite about 2 mm by raising the maxillary teeth, this would improve the smile line, and insure adequate freeway space.
2. increase the buccle corridor by bringing posteriors in lingually.
3.I know the shade is from the Dr. but I would get him to take another shot at it (because he has clearly missed it) so you could change the shade from what appears to be A2 to a C2 or maybe D2 or D3, of course the shade is a bit harder to determine due to lighting and individual computer monitors, but it does need to be closer to the patients natural shade.
As to the set of the teeth..... personally I like a certain amount of irregularity instead of the picket fence..... gets rid of that denture look.

 

[Flipperlady]

I wouldn't fret anything. This is why we have wax tryins. I think the C2
shade selection might be a good alternative. although it's hard to tell as patient may have wanted a lighter shade than what she had and bigger
teeth to get the free facelift look. I would however ask for a new bite.
My 2 cents.

Michelle