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Implants
Planning a Big Case
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<blockquote data-quote="corona" data-source="post: 226225" data-attributes="member: 3230"><p>yeah Brett , in the end we will give the clinician what they ask for .... that is not the issue . Informed consent is what the doc and the patient will need . Will the ceramic chip in the future ... who knows ....may not ... but studies show that if the patient is a "hard biter" or bruxism or not a class 1 patient , then chances increase significantly and YOU will be left holding that expensive bag to repair. I would tell him I would be glad to do it , BUT given how patient presents , it is not within the scope of the materials long term stability . IF the material chips , then a charged WILL be assessed , as you will have to most likely strip the entire bridge and essentially start over again . Remember , There is no more periodontical ligament to take the minute stresses of chewing and function , therefore a stronger material should be indicated . I wonder if the clicking is his insurance policy out of a bad situation and a way to get you to remake the case for free ? In any case ... We should probably know more about what kind of occlusion classifaction patient is presenting with before we go any further . Are we looking at pretty good CO ? What kind of cusp height are you dealing with ? Whats the AP spread allowing you to go back ? What kind of occlusion are you going to design ? Cuspid rise ? group function ? . Is the patient going to wear a NG for protection ? What are the patients chewing habits ? How old is the patient ? All these things matter and things i would like to know because material choices = all these things .... and we havent even talked about esthetics and your backdoor key /plan . something i always like to have ready for these kind of cases.</p></blockquote><p></p>
[QUOTE="corona, post: 226225, member: 3230"] yeah Brett , in the end we will give the clinician what they ask for .... that is not the issue . Informed consent is what the doc and the patient will need . Will the ceramic chip in the future ... who knows ....may not ... but studies show that if the patient is a "hard biter" or bruxism or not a class 1 patient , then chances increase significantly and YOU will be left holding that expensive bag to repair. I would tell him I would be glad to do it , BUT given how patient presents , it is not within the scope of the materials long term stability . IF the material chips , then a charged WILL be assessed , as you will have to most likely strip the entire bridge and essentially start over again . Remember , There is no more periodontical ligament to take the minute stresses of chewing and function , therefore a stronger material should be indicated . I wonder if the clicking is his insurance policy out of a bad situation and a way to get you to remake the case for free ? In any case ... We should probably know more about what kind of occlusion classifaction patient is presenting with before we go any further . Are we looking at pretty good CO ? What kind of cusp height are you dealing with ? Whats the AP spread allowing you to go back ? What kind of occlusion are you going to design ? Cuspid rise ? group function ? . Is the patient going to wear a NG for protection ? What are the patients chewing habits ? How old is the patient ? All these things matter and things i would like to know because material choices = all these things .... and we havent even talked about esthetics and your backdoor key /plan . something i always like to have ready for these kind of cases. [/QUOTE]
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