Facepalm cases

JonnyLathe

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OK need some help your fellas and ladies

Case arrived from local account that she sent to a big house lab in mid west

recently completed flexi combo that's a doctor forgot about the housings she now picked up the housings caps in duralay resin

I should be OK if I can get the housings caps to sit on the model and strip redo the Set up and flexi process

Do i have this correct
What.

So cast frame, flexible acrylic, on locators. What a mess. Completely agree with Bigj1972.
 
TheLabGuy

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So many things wrong with this I don't know where to begin.

Obviously doctor isn't a genius in removables. And the way you're describing and showing this case sounds like you're not very experienced... Maybe mid-level? No offense.


You need to put the brakes on this and give everyone involved a paradigm shift. You're thinking is sort of correct but there is a lot of potential here to go sideways.

Outside of some kind of extra stability, being processed in thermoplastic does not do anything except jeopardize the longevity of this appliance. This was either processed in nylon or a polyolefin. The partial does not look like it fits the 3D cast you have.

The flexible clasps have no real retentive value over the attachments alone. The attachments embedded in a flexible at that location compromises the durability of the partial.

My advice is to consult with the doctor about reprocessing in acrylic. If everything is good as is, you need to place analogs and make a cast out of the partial. Flask it, then take all the teeth out put back in The matrix and process in denture acrylic. If you experienced in fluid resin technique go that route with putty.

That 3D cast is practically useless. You're thinking is correct about solving the problem but you're not going to be able to solve it by going back into thermoplastic and because of the 3d cast involved you're going to go sideways with this and then it'll be an even bigger hole that you fell into.

So don't overcomplicate it, matrix and reprocess everything into an acrylic just as is, don't use the cast. If you can't do that, don't touch it.
I agree with this, instead of going analog route, you could have her scan with scanbodies, create a master model that way. If she supplied a 3d model, then she has a scanner. However, at this point, a custom tray to pick up the locators might be an easier option for everyone involved but get that thing in acrylic.
 
bigj1972

bigj1972

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TheLabGuy is right.... The more I think on it, start over. Forget matrix convert. I don't think this dentist exactly knows what they did wrong, but there's too many variables.

I can't get a good shot of the framework but it actually looks like it was made post implant placement. So you don't know if big lab lifted framework when they injected thermoplastic, you don't know if dentist lifted framework with the attachment pickup,

Yeah don't be the hero on this. Start over with new cast, analogs, original frame and teeth, or don't get involved.

Otherwise, Dentist wanted $199 lab, let her send it back to them. Those premolars are coming off anyway, so her decision to remake will be made for her.
 
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D

Denture Dude

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I’d love to know what the pt bill was.
 
GG - J

GG - J

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So many things wrong with this I don't know where to begin.

Obviously doctor isn't a genius in removables. And the way you're describing and showing this case sounds like you're not very experienced... Maybe mid-level? No offense.


You need to put the brakes on this and give everyone involved a paradigm shift. You're thinking is sort of correct but there is a lot of potential here to go sideways.

Outside of some kind of extra stability, being processed in thermoplastic does not do anything except jeopardize the longevity of this appliance. This was either processed in nylon or a polyolefin. The partial does not look like it fits the 3D cast you have.

The flexible clasps have no real retentive value over the attachments alone. The attachments embedded in a flexible at that location compromises the durability of the partial.

My advice is to consult with the doctor about reprocessing in acrylic. If everything is good as is, you need to place analogs and make a cast out of the partial. Flask it, then take all the teeth out put back in The matrix and process in denture acrylic. If you experienced in fluid resin technique go that route with putty.

That 3D cast is practically useless. You're thinking is correct about solving the problem but you're not going to be able to solve it by going back into thermoplastic and because of the 3d cast involved you're going to go sideways with this and then it'll be an even bigger hole that you fell into.

So don't overcomplicate it, matrix and reprocess everything into an acrylic just as is, don't use the cast. If you can't do that, don't touch it.
absolutely zero offense taken but extremely grateful for the advice and suggestions
 
JonnyLathe

JonnyLathe

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TheLabGuy is right.... The more I think on it, start over. Forget matrix convert. I don't think this dentist exactly knows what they did wrong, but there's too many variables.

I can't get a good shot of the framework but it actually looks like it was made post implant placement. So you don't know if big lab lifted framework when they injected thermoplastic, you don't know if dentist lifted framework with the attachment pickup,

Yeah don't be the hero on this. Start over with new cast, analogs, original frame and teeth, or don't get involved.

Otherwise, Dentist wanted $199 lab, let her send it back to them. Those premolars are coming off anyway, so her decision to remake will be made for her.
Agreed, the only thing that we know fits in the mouth at best are the locators housings as they were picked up in the mouth. The rest is probably junk.
 
GG - J

GG - J

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TheLabGuy is right.... The more I think on it, start over. Forget matrix convert. I don't think this dentist exactly knows what they did wrong, but there's too many variables.

I can't get a good shot of the framework but it actually looks like it was made post implant placement. So you don't know if big lab lifted framework when they injected thermoplastic, you don't know if dentist lifted framework with the attachment pickup,

Yeah don't be the hero on this. Start over with new cast, analogs, original frame and teeth, or don't get involved.

Otherwise, Dentist wanted $199 lab, let her send it back to them. Those premolars are coming off anyway, so her decision to remake will be made for her.
I actually just got off phone with her told her all the concerns and issues and suggested we start fresh or i cant be have any responsibly for this case

after a little back and forth

we are starting from square 1 -

thanks
 
Doris A

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Another one. #4 isn’t being added to new P/. #15 isn’t being extracted. We are making a flipper to replace #’s 9&10 with gold teeth.
Edit: This Dr is doing this pt a disservice, the least he could have done is add #4 at no charge. 15 doesn't oppose anything, it wouldn't take 2 seconds to take it out. We even offered to add #4, and were told no!
A65E81A7-3877-44FE-824C-4D86CDB3C4D1.jpeg
 
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Doris A

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Same “Dr” as yesterday. Just add #7!!! 0B573731-EB69-4495-A10B-D5533C5F91DA.jpeg
 
bigj1972

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Another one. #4 isn’t being added to new P/. #15 isn’t being extracted. We are making a flipper to replace #’s 9&10 with gold teeth.
Edit: This Dr is doing this pt a disservice, the least he could have done is add #4 at no charge. 15 doesn't oppose anything, it wouldn't take 2 seconds to take it out. We even offered to add #4, and were told no!
View attachment 41766
Probably engineered obsolescence. You make too nice of a flipper, and they won't come back in 9 months for that new bridge.
 
Doris A

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Probably engineered obsolescence. You make too nice of a flipper, and they won't come back in 9 months for that new bridge.
Yup, a bridge with 1 open face gold, and 1 solid pontic is going to cost a pretty penny.
 
doug

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This happened the other day when the abutment and crown were to be seated.
FB249236-B4EC-426B-AB7B-E1D0E2ECCA97_1_201_a.jpeg
 

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