How would u handle this case

[JohnWilson]

See John, diet not necessary. People here appreciate you carrying weight.

You're an ass, a funny ass, thats why I get along with you

 

[prestige.dental]

Hello Cadfan

What did u mean by

"Two steps more"

 

[cadfan]

Hello Cadfan

What did u mean by

"Two steps more"

for a cement retained version you need the internal index so you need another impression its step one can be done without but thats like suizid and because of the high angles you need a second step fixing the angulated abutments in a verification jig with additional impression because of the high angles and deep rotation index the first impression is never ever 100 % ok.

 

[prestige.dental]

for a cement retained version you need the internal index so you need another impression its step one can be done without but thats like suizid and because of the high angles you need a second step fixing the angulated abutments in a verification jig with additional impression because of the high angles and deep rotation index the first impression is never ever 100 % ok.

Thank for the reply.

Sorry I could not totally get you.

Do u mean:

Close tray impression getting the hex

Then making parallel custom tit abutments

Then placing them into mouth and take crown and bridge impression

Or a open tray non engaging impression

 

[cdtwade]

Pop quiz: " Sloppy model and preparatory work is not indicative of over all poor craftsmanship, it's proof."

Who am I quoting? The winner gets to drink wine with John Wilson!!!

Also please do not misconstrue this post as an attack, I am just trying to emphasize the importance of clean, precise model and preparatory work.

 

[2thm8kr]

Pete Dawson

 

[Rick Sonntag]

Pop quiz: " Sloppy model and preparatory work is not indicative of over all poor craftsmanship, it's proof."

Who am I quoting? The winner gets to drink wine with John Wilson!!!

Also please do not misconstrue this post as an attack, I am just trying to emphasize the importance of clean, precise model and preparatory work.

Dr. Clyde Schuyler. I've heard that 2013 was a fantastic year for Napa and Sonoma Cabs.

 

[2thm8kr]

Dr. Clyde Schuyler. I've heard that 2013 was a fantastic year for Napa and Sonoma Cabs.

You are correct, I just remember Dawson quoting him at the courses I took.

 

[JohnWilson]

I have been crediting the wrong person too

 

[dmonwaxa]

Sorry John, taking credit all this time,.mmmm..
.....busted!

 

[cadfan]

@ prestige dental Yes impression from the hex with open or closed tray , maybe a little advantage for a closed tray in this case , than parallel versus 2 degrees conical ti or any other abutment than fixing the abutments in the mouth with a transfer jig and closed tray impression over all. A closed impression only is not accurate enough in my experience , and thats the difficult part not every doc is able to handle it.

 

[prestige.dental]

Pop quiz: " Sloppy model and preparatory work is not indicative of over all poor craftsmanship, it's proof."

Who am I quoting? The winner gets to drink wine with John Wilson!!!

Also please do not misconstrue this post as an attack, I am just trying to emphasize the importance of clean, precise model and preparatory work.

Hello Wade:

I know u are not attacking. Your intention is to encourage good craftsmen ship.

Could u please share some thoughts on the case. Would u mind sharing some knowledge.

 

[2thm8kr]

Cut the impression copings for 6 & 11 to establish a seating path for the custom open tray you are going to make. Connect all of the impression copings on the model with PMMA or pattern resin etc for a verification jig and try it in. Cut the jig in situ were necessary to get a passive fit of the jig and use the custom tray to take a new open tray impression with the jig in place. Verify the accuracy of the model. Once you have a verified model discuss the restorative options with the prescribing doc.

If this case were on my bench I would be leaning toward a screw retained bar using Hader clips or similar for retention of a removable appliance. I would also be looking closely at an x-ray of the central anterior implant to see how much space, if any is between the posterior wall of the implant chassis and the incisive canal as well as how the buccal plate looks. There will be a lot of lateral force on that implant so take it into consideration for the design.

 

[gallagerdental]

Ok- I know I'm gonna catch a lot of flak. On this, but yea the plaster work isn't good ( but it's mounted correctly, I hope). I personally wouldn't do work like this, but I for one want to see the end result, that's what counts. Cut this guy some slack. Give him a chance to make good.


Sent from my iPhone using Tapatalk.

 

[cdtwade]

Hello Wade:

I know u are not attacking. Your intention is to encourage good craftsmen ship.

Could u please share some thoughts on the case. Would u mind sharing some knowledge.

I'm trying to.

 

[dmonwaxa]

That's exactly what we're encouraging. Maybe he'll post new pics showing some pride in the mounting. John gave too much credit by saying $5 worth of care .... More like $0(zero). If that much care went into the mounting, how much care is going to be taken with the prosthesis. Guess we should all be proud to show this type of work....and not say squat ...after all were all peers right? I wonder how dentists would view us if we sent out a case like this. And its not just the mounting ... The model work has a lot to be desired. I would have been the first to respond to the OP but witheld my opinion for fear of being judgemental, but since others shared the same viewpoint I decided to chime in. Sure the OP should be encouraged but certainly not be let off the hook for sub par workmanship. Probably not be right person for the job....seems like he might be in over his head.

 

[prestige.dental]

Well after some thinking and keeping px's desire for a fixed presthesis in mind

1) we are gonna take (trios/intraoral NT trading-scan body) scan for all the seven implants

2) we will also take the scan (stl file) of the existing temporary bridge in mouth with trios


3) stitch the two scans using pink tissue landmarks

4) design the titanium abutments within the temporary bridge envelope
and make seven parallel custom titanium abutments from premilled blanks.

5)cut away the hexes of all 7 abutments

6) screw abutments (by eye balling or from primo pattern zig made intra orally over the abutments) on the master cast which was made from open tray non engaging imp copings

6) make the zirconium bridge over parallel abutments with gingiva in multiFZ from CAP

7) cement on the cast


This would a combination of digital and analog methods. May be I would make it in pmma first.

Guys how much much should I taper the abutments for a easier fit.

 

[2thm8kr]

How are you going to verify that the scan or the cast are accurate?

 

[prestige.dental]

How are you going to verify that the scan or the cast are accurate?

The jig was made inside the mouth by splinting the non engaging impression copings with primopattern resin and then a open tray impression was taken.

So this jig fits the model and was made in the mouth. I can try the jig again in the mouth to verify seating, it's right now lying in the open tray PVS impression material.

The trios scan and 3shape will will give me parallel tit abutments which will be placed on master cast and then scanned again. So the trios stitching error( error of stitching the seven scan bodies using gum as the common reference , if any, will be eliminated this way.

 

[dmonwaxa]

2 to 4 degrees of taper on abutments would ideal but on a case like this you may require a bit more.