Rescue case

Brett Hansen CDT

Brett Hansen CDT

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One of my doctors had a patient come to him with an implant retained hybrid denture that another dentist/lab did that she is not happy with. She does not like the esthetics of the denture teeth. The problem in redoing this denture is where the implants were placed. There are five and there wasn't enough bone to put implants into the 2nd bi/1st molar area. I have experience in restoring these types of cases using Ti bases and zirconia. We do not do any removables at my lab. I am looking for suggestions on how I could redo this case successfully. I know that ti bases with zirconia is not an option because there isnt enough support for the denture in the distal region.
 

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CoolHandLuke

CoolHandLuke

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couple options: 1. redo the bar to be a Hader style, get Hader clips and make a new denture on the clips.

2. make a ti "skirt" to go over the bar - best idea really to send this to panthera to have them give you a frame over the bar.

3. as you've mentioned, All-on-5 in MUA's and zirc

get a clear commitment about whats salvageable and whats not. get a feel for what the doc is comfortable doing, and before you do anything make a damn good waxup.
 
sidesh0wb0b

sidesh0wb0b

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One of my doctors had a patient come to him with an implant retained hybrid denture that another dentist/lab did that she is not happy with. She does not like the esthetics of the denture teeth. The problem in redoing this denture is where the implants were placed. There are five and there wasn't enough bone to put implants into the 2nd bi/1st molar area. I have experience in restoring these types of cases using Ti bases and zirconia. We do not do any removables at my lab. I am looking for suggestions on how I could redo this case successfully. I know that ti bases with zirconia is not an option because there isnt enough support for the denture in the distal region.
i would agree with Lukes first point. probably the easiest and most predictable result (and probably the lowest cost) is to go with a custom milled hader bar with clips. for an upper, thats pretty poor Tx planning, and this would allow for what looks like could be a thick enough bar in the posterior region to be able to "maybe" reach the molars. setting reasonable standards for final outcome is key. choosing a better tooth mould and setting a proper occlusal plane and midline is also crazy important since shes already unhappy.
we do lots of these sort of cases lately. they are fun when theres lots of communication and everyone is on the same page.
 
lcmlabforum

lcmlabforum

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Before I do any redo with an unhappy patient, I would get pt to record detailed list of exactly what
pt was unhappy about and identify pitfalls and limitations.
I would make sure this was something that we can fix before attempting a redo.
Most providers who do a big case like that would have gone through the traditional
try-in etc, so I would question what was not caught earlier on also.
Hazardous to overpromise a big case.
My 2 cents.
LCM
 

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