nobel active, ideas???

[thewhitelab]

I have just received this case and would like to know what my different options are i.e angulation of upper 6?
They are both nobel active RP the clinician wants to have a temp bridge for a few months before moving to the final bridge, he also doesn't want to remove the abutments once placed at temp stage so will use duralay bonnets.
over to you guys....
cheers

 

[k2 Ceramic Studio]

Please tell me this is photo shop. WTF if the guy has not made life hard enough by placing it using the Stevie Wonder technique on the 6, he also wants to remove a temp br and fit the final without removing the abutments. Sorry I cant see for tears........

 

[JohnWilson]

The case looks tough but it may be easier than you imagine.

30* angel multiunit abutment on the distal fixture to upright, cad cam ant abutment to parallel to the MUA. Screw-mentable long term temp to sleeve the ant custom abutment and then use an occ screw to secure a MUA ti cycl to the distal abutment.

Make a master die of the ant abutment so when he is ready to do the definitive restoration all he has to do is take a MUA impression coping over the distal abutment, and standard impression over the ant abutment. This allows the dr to not capture sub g facial margin on the ant abutment as you have a master die and fills his requirement not to have to take the abutments out.

 

[paulg100]

first thing im thinking is fixture level cad/cam frame (so no abutments) with a multi unit on 6 and standard on 4.

Atlantis should be able to do that for ya in chrome cobolt so you can layer.
quick wax up for tooth position, send model and wax-up to em, wait for frame to return, and focus on the ceramics.
at least thats what id be looking at.

we like to bash the docs, but maybe the 6 had to be placed at that angle due to the sinus. just saying...

 

[thewhitelab]

Yes Paul I the implantologist is very good, my thoughts were the same avoiding sinus lift

 

[k2 Ceramic Studio]

OK same as John and Paul said Multi unit off of the 6 and a straight off the 4, cast or milled abutments then a pmma temp for the provisional and a Ti/Zr reduced mode sub structure from the original scan files(made at the same time and sent with the temp to check passivity),buy an extra set of replicas for the final restoration model or do a silicone pouring with the abutments in place so you have an exact replica of what you returned to the doc.

Hi Paul we like to bash the docs, but maybe the 6 had to be placed at that angle due to the sinus. just saying... I know where you are coming from but a 30* angle on a three unit bridge can not be in the best interest of the patient, axial loading and all that, plus the guy must of at least done an x-ray to determine the bone depth so he knows where the schneiderian membrane is, just do a sinus lift .......

 

[paulg100]

"just do a sinus lift ......."

well you would think so wouldnt you... a dentists mind works in mysterious ways... or maybe patient no wanna pay the dollar.

are any companies doing multi unit inserts yet? so you could mill a pmma temp and lute em in place for a fixture level temp?

 

[Labwa]

Core3d have them. im sure nt trading would??

 

[Rex Kramer]

Looks like the sturgeon took the all on 4 seminar but left a bit early...

 

[ceram1]

There should be a hotline for bullsh1t like this, that is a law suit unless they were placed at one of those central american destination clinics. I wonder if that patient was able to sit after that procedure?

 

[doug]

So did the doc crawl up the patients a$s to place the #14 implant?

 

[Jo Chen]

Keep it as simple as possible. Two custom abutments. Make the temp and subframe at the same time. Duplicate the model with the custom abutments in place for backup. Have Dr. deliver abutments and temp. Once the Dr. is ready to go to final have him take a pickup impression with the definitive subframe.

 

[lcmlabforum]

Looks like the sturgeon took the all on 4 seminar but left a bit early...

I think you mgiht be right that a sturgeon swiming up stream placed that implant also . . . or
they were planning for eventual conversion to an All on 4 later on.
LCM

 

[shane williams]

Maybe this guy is in the same office as the Dr who offers veneers on Ebay!!
"Buy one implant placed correctly, get two more WHERE EVER THE HELL I WANT for half price!!"

 

[2thm8kr]

Maybe this guy is in the same office as the Dr who offers veneers on Ebay!!
"Buy one implant placed correctly, get two more WHERE EVER THE HELL I WANT for half price!!"

Or maybe the doc who did the cuspid and 2 premolars on one implant that was posted awhile ago.

 

[shane williams]

Or maybe the doc who did the cuspid and 2 premolars on one implant that was posted awhile ago.

you forgot the molar too!! I remember that case before the thread was taken down, I saved those pics of that case. 4 unit bridge on a very small implant. Great dentistry. Maybe it's a family thing, you know the ones where the brother is the dad, is the uncle...you know one of those kinds families.

 

[DocAires]

Use a 30 degree mua on the most distal implant and a 17 on the mesial which will omprove the draw.Then use temp titanium cylinders cut down to appropriate length and use a screw retained provisional with the small titanium screws that are torqued to 15 degrees.
The Docs final case them will be screw retained onto the angled MUA which are left in place in the mouth.

 

[Hary]

I think the Dr. had to open a hole in back of the neck of the patient to put that second implant:der:

 

[CRWNMKR]

How did the impression post get by the lingual of the molar?

 

[Daniel Watters]

Agreed on the multiunit abut for the 2-6 (15)....(is that right? I'm from Canada eh..) Don't know about the multi 17 degree on the 1-4 errrrr..13? Hopefully just the bridge and abutment. If I haaaaad to, we could go fixed Zir frame and bridge. How much room do we have there?