Framework............

[Tonkster]

Fabricated a framwork for try-in. Was returned with the instructions to add teeth, process and deliver. (we only added 3 teeth) When received did not fit patient.

1. fabbed and fit
2. processed and finished then fit back onto provided model.
3. doesn't fit at delivery.

What could have gone wrong. Second time this has happened in the last month.


Help !!!!

 

[Flipperlady]

Teeth shift all of the time, could be they shifted inbetween appointments and now make the framework snug. If the fit is just a little off the doc could have the pt. wear the partial and it should fit in a couple of days. If it's way off then he or she could spray on the green indicating spray and see where the issues are. They'll be able to tell if it's a tight spot or the frame is bent. A good high speed bur can take a small tight spot off the frame.

 

[lcmlabforum]

So many steps, so many variables.
Acrylic areas can lock into undercuts that are not present when metal framework alone
not have interference with. Stone model, after processing, would typically be abraded
or have teeth fractured. Person seating RPD may not know how to use 'rotational' path
or know where to relieve and give up readily.
Again, so many steps, so many variables.
LCM

 

[JohnWilson]

So many steps, so many variables.
Acrylic areas can lock into undercuts that are not present when metal framework alone
not have interference with. Stone model, after processing, would typically be abraded
or have teeth fractured. Person seating RPD may not know how to use 'rotational' path
or know where to relieve and give up readily.
Again, so many steps, so many variables.


LCM

All good info here,

Also the obvious, it didn't really fit great at try in and the the client missed it. A lot of times when there are only a few teeth like this when its just sent for frame try in the rest seats are close the frame almost fits and it appears that it will work to the client. Then you put teeth on and process and the client calls you saying the teeth are longer than the adjacent teeth and the frame isn't seating. Well duh it never seated flush in the first place.

I had a client, HAD being the key words, that liked to survey and design all of his partials. Yes yes there are a few clients that know their responsibility even if its not a benefit to the patient. Anyhow he had a basic understanding of the use of a surveyor from school but really did not understand rotational paths let alone the best clasp designs for the existing dentition. Just because a book says that a free end case should have an I-bar doesn't mean the undercut is in the right place. Anyhow I digress, he would have us pour mount and send his models to him to do the survey/design, we would block out to his markings and cast, he was so anal about fit that he did not want us to use an electric polishing unit and made us hand polish everything and leave the tissue bearing surface raw on Max cases. After all of the head aches he would then do his own bite rims on the frame and many times the wax would flow under the frame and keep the frame from seating properly. He would not allow any tissue stops on frames as " they were just an adjustment nightmare" So after working with this guy for about 6 months I just flat gave up as we had so many issues with his beliefs.

As for you situation, if you are pouring the master model make sure its just that, "a master model" and not something that the frame can abrade by being rough with it. I make a silicone mold that I can pour multiple models from and always have the first pour to verify after we have worked out all fitting on other casts.

OK after writing this out I realized this probably has no interest to anyone but it did make me feel better remembering how I cut him loose

 

[rkm rdt]

LOL, We're here for you big guy!!!

 

[Tonkster]

Thanks for the responses. I will have to sit down or email the dentist for more details . All models are provided to me.

Totally understand the patient saying it fits jut to move forward with her final product.

I'm thinking they may have some one new pouring there models and possibly not getting the proper stone to water ratio. Many variables here.

Thanks again!!

 

[ottawa]

Did you ask the dentist to take a new impression? If i can't get a framework/partial to fit chairside, ill take an alginate and pour it in die-stone and get it to fit in the lab.

 

[MasterCeramist]

If they are taking impression and fabricating the model there's not much you can do but make it fit the model. As posted earlier always dupe the master model for final fit.

 

[Tonkster]

I always duplicte master models when fabricating metal frames. Also, what would be the recommendation for billing purposes on remake that fit the model provided but not the patient????

If i have to remake the metal frame. I am usually provided a NEW model. I will charge a 1/2 price remake on new model fee. Do you think this is fair?? or am I short changing myself???

 

[XxJamesAxX]

If it fits the original master model then its a 1/2 charge for us. I think thats more then fair, and yes you are (we are) short changing ourselves, but hey thats what us labs do right?

 

[lcmlabforum]

My mentor from a long time ago. This is for single crowns.
First pour is for margination, etc. Finish lines/design are marked only with wax pencils.
Second pour is for in-house for fit check after labwork comes in - so there is no question of dies being abraded.
Third part is for solid models if needed for proximal contacts, etc by the lab.
Fourth pour is stand by for another lab fabricated provisional.
LCM