Implant Supported Bridge

[NicelyMKV]

Nice job! Wow!

 

[dmonwaxa]

Thanks guys, the doc is a great account because of this.

 

[paulg100]

yep huge improvement.

Your a braver man than me though! the thought of doing all that lovely ceramic work on that old frame and then getting blows and stuff right near the end

Must have taken a ton of work and time to strip, cut down, degass multiple times etc. I think i would have had to say to the Dr new frame or no go.

Theres no way you would have been compensated for all your time if you ran into problems near the end of the ceramic work due to the frame, so i hope the dr has some concept or appreciation for what youve done there.

 

[dmonwaxa]

Paul, you are absolutely correct on so many levels. I shared the same concerns as you indicated; what if it bubbled up in the end? The numerous purge cycles continued to draw out contaminants from the FMK until I was satisfied. I believe, that by completely refinishing the FMK with carbide burs to expose virgin metal contributed to it's success. Documenting the case gave me some leverage just in case I needed to justify on my end, . The doc however is much more classier than that, and I had also informed them there was no guarantee on the success of the case. Thanks for sharing with your vote of confidence and support and insight.

 

[JohnWilson]

Troy,

Very nice glass work.

I have one question for ya, was the reason for the redo more to fix the porc. fracture on the canine or the fact that it was fugly?

Does the patients smile line dictate this treatment? Love to see before and after shots in the mouth to compare. I am sure you made this client and patient very happy with what you have accomplished, regardless on if the CEJ never shows.

Now lets just pray that the function and metal support hold that glass without fracturing. Hope you have a disclaimer on that.

 

[dmonwaxa]

John,,, Thanks for the compliments,,, much appreciated. And yes, yes and yes; on all counts. Bottom line it was "FUGGLY", Patient said they look like they came from Walmart. He wanted something along the line of Gucci,,,,

And quit being so impatient,,"dang",,,LOL, Just kidding wit cha.
Just for you ................


Intraoral try-in.


Before Retracted


After retracted


Before


After 1


After 2

 

[Al.]

Wow big difference! Nice case.
It's really nice to have Drs that give you pics. Not too many do.

 

[Bobby Orr ceramics]

Very Nice Work !!! The game in natural looking ceramics is not colour. It's value and contrast. You nailed the contrast beautifully !! Orr4

 

[JohnWilson]

Huge difference! Again great to have the pictures to back up top notch work, this is going in your portfolio of success for sure!

 

[Badgerdental]

Hey great job by dmonwaxa! Awesome to see. I'm here in New Zealand dealing with a full upper arch bridge on Intralock fixtures, I have no experience with these, I'm hoping you guys over there stateside can reccomend the best way to restore i.e cast framework, or milled framework, porcelain, or composite. Look forward to hearing from you guys

 

[grabo]

What porcelain u use on this case and how did you know if the CTE was the same with old metal u are using ?

 

[paulg100]

the doc should send these after photos to the lab that made the previous bridge, might be a wake up call for em.

Great job.

 

[dmonwaxa]

Thanks you guys, I appreciate all the positive feedback, especially the big guns; Rob John, Al., Orr and Paul. (in no specific order) Not forgetting the younger guys. I'm not quite sure if this case was originally done by this client, we seem to get a lot of patients who have had their work done in the past by other practices. This is a classic case of making lemonade when given lemons. I showed this case for two reasons:

Making lemonade....When I saw the script it stated the patients comments about his teeth coming from Walmart. That gave me a good chuckle and then I saw the bridge I laughed even harder, I understood why. Second to show the resin die technique. A lot of younger guys may not be familiar with it. It's another tool in the toolbox, especially when parts arent available and stone models would be susceptible to breaking.

@ Badgerdental....implants are implants IMO, only the designs are different.
Meaning the basic parts are the same in concept and function. The major difference in the similarities is the connection. They all must have some type of connection to hold everthing together. Intra lock has a few different designs whether the connection provides for being screw retained, cemented or being connected to a resilient attachment like an "ball".

@grabo...The porcelain used was GC Initial MC, with a CTE of 13.1. You want a ceramic material slightly lower in CTE than the alloy, that way it's in a state of compression; its strongest state. From my experience I deduced the alloy used was a high content Pd alloy, from it's weight, the way it felt when metal finishing and the oxide it produced when was treated. CTEs for these Noble and HN alloys are usually in the mid to high 13's to mid 14s.ex: 13.8 - 14.3.

Hope this helps

 

[dmonwaxa]

I stand corrected, The porcelain used above was dSIGN Ivoclar, CTE 12.0 - 12.6. The principle still remains the same.

 

[Badgerdental]

@ Badgerdental....implants are implants IMO, only the designs are different.
Meaning the basic parts are the same in concept and function. The major difference in the similarities is the connection. They all must have some type of connection to hold everthing together. Intra lock has a few different designs whether the connection provides for being screw retained, cemented or being connected to a resilient attachment like an "ball".

cheers, the manual appears to state specifically that that composite should be used over a cast CrCo framework. I don't have a composite system, I guess I could build up in porcelain then cement the titanium cylinders at the end?

 

[Badgerdental]

We want screw retained by the way

 

[dmonwaxa]

If it's a full arch then I'd go milled Ti, if you go milled then you'd go directly to the implant eliminating the need for an abutment connection. Snce you dont have a composite system you may opt for a conventional hybrid, screw retained denture. Basically a denture processed to a bar. Horseshoe shaped and with no palate. I would not consider NP, its a PITA to work with plus it may cause the patient to experience galvanic reaction with the Ti implant.

 

[Badgerdental]

Hey thanks for your replies, its opposing natural dentition so hybrid would be fine I think actually. I need to find a CADCAM milling system that will recognise or deal with this platform! A bit limited down here in our corner of the world.

 

[dmonwaxa]

You'll have to find a milling that supports that system, try Preat, Compartis, Nobel, or Biomet. You can always contact the implant manufacturer or sales rep for support info.

 

[lcmlabforum]

None of my business, but for a case like that, I would think it
is suicidal not to insist the DDS make a new occlusal guard and
charge for it.
Just my 0.5 cent's worth.
LCM