Help with screw retained bridge

[Care Dental Lab]

Help with full Maxillary screw retained bridge


I was given a case with 6 bio horizon multi-unit abutments in which the dentist wants a screw-retained restoration. The implants are placed lingual to the mandibular arch and there is not much vertical. The case can be done in cross bite. Is it possible to do in zirconia? Anyone have any suggestions? I attached some pics.

Thanks

http://s836.photobucket.com/user/caredentallab/slideshow/

 

[CoolHandLuke]

maybe you should try posting those pics again. i can't see them.

 

[Cbite Dental Products]

Help with full Maxillary screw retained bridge


I was given a case with 6 bio horizon multi-unit abutments in which the dentist wants a screw-retained restoration. The implants are placed lingual to the mandibular arch and there is not much vertical. The case can be done in cross bite. Is it possible to do in zirconia? Anyone have any suggestions? I attached some pics.

Thanks

Don't see the pics.

 

[Care Dental Lab]

Here is a link to the photos


http://s836.photobucket.com/user/caredentallab/slideshow/

 

[CoolHandLuke]

well, those are some interesting photos. it is certainly possible to do in zirconia, but you need to determine how much porcelain cutback you would want, because i suspect placing more than 1mm of porcelain occlusally would make the frame pretty thin in some areas. maybe place a thick lingual bar almost overtop of the screws. maybe place an apron. just a small one.

as-is, over those implants will be pretty weak. more material around them, will re-enforce it.

 

[Jo Chen]

First mount the case on a real articulator like a SAM, Panadent or Whip Mix.
I would ask the Dr to take the multi unit abutments off and go directly to the fixture. You have limited interocclusal space to begin with and the multi unit abutments reduce the limited space you have further. If you can open the bite a little that would help to give you more room too.

 

[rkm rdt]

I agree with Jo.

Can a temp bridge be made?

 

[k2 Ceramic Studio]

I'm with RMK, This thing is really big and if the patient is not happy with the end result and you have made it from Zr then that is alot of cash down the drain. Get a provisional milled from pmma in the design that you think would look best and let them get use to it for a few weeks.

 

[Marcusthegladiator CDT]

Nice case. Mount that puppy ona semi adjustable art and have your way with it. I like the idea of building the temps first. Build some temps, keep your matrixs' (matri?) and indexes. If the temps look great in the mouth, start building the finil restoration. Zirc is of course the way to go. But theres no reason you cant have some cobalt milled, would be much stronger. Waxup some framwork and send it off to be milled just as your waxup...
Then stack, and have fun with it. Looks like a mess but you'll love it when your done. Have you smashed your duralay build up into pieces yet with that matal articulator? You're gonna..
PS, no reason for building anything but a class 1 bite. Your already bringing them out so damn far, whats another few mm?

 

[thondaki]

Do you have access to a scanner .. If you load it up I would be happy to help out--digitally

 

[Al.]

First mount the case on a real articulator like a SAM, Panadent or Whip Mix.
I would ask the Dr to take the multi unit abutments off and go directly to the fixture. You have limited interocclusal space to begin with and the multi unit abutments reduce the limited space you have further. If you can open the bite a little that would help to give you more room too.

Jo can you make scerw retained splints without the multi unit abutments with biohorizons ?

I think if you go with zir than it is I going to be very bulky and impossible to clean at home.

 

[Marcusthegladiator CDT]

Do you have access to a scanner .. If you load it up I would be happy to help out--digitally

He'll mill some temps for ya...

 

[dmonwaxa]

Agreed with all that has been said so far. Articulator choices, material choices CrCo, sequence and staging with temps. As was said save your matricies. The Lower occlusion needs some help also especially on the incisal of the anteriors. See if Doc can equilibrate.

 

[Jo Chen]

Jo can you make scerw retained splints without the multi unit abutments with biohorizons ?

I think if you go with zir than it is I going to be very bulky and impossible to clean at home.

Al
Nobel or maybe Scott should be able to do this in zirconia if it is the BioHorizons implant with the Zimmer interface. A lot of people on here like zirconia but I personally would prefer a metal substructure and bake porcelain to it because you can keep the frame more gracile.

 

[ter01475]

I was inable to see your photos, but this is what I would and the way i do a case like this. First mount the models on a good articulator, and make the models removeable. Next do a diagnostic setup with some cheap denture teeth to illustrate the position of where the crowns would be in the final. Use a horseshoe base plate that will be attached with two waxing sleeves. This will also verify the bite! From there make a temp and scan your setup for the position of your crowns. If everything goes well then go the final. Don't use base metal for the final....there are many studies that show base metal on titanium will start an electrolitic reaction and damage the implants.