Restorations Du Jour

[Al.]

I haven't posted in quite a while. Been so busy.

I thought Id start a thread like Rick did on DT where if anybody had a case they wanted to post they could do it without having to make a new thread for it.
That can be a pain and intimidating to some people to start a thread in the case presentation section.

Anyting dental related, in the lab or clinical, removable or fixed, wax ups, abutments, castings, model work, provisionals, whatever. Any old cases you have that disappeared into the archives, Move or repost them here.

Here's a tough implant case in the esthetic zone on a female.





I made a little wax up for the Dr to slip on to see if I was in the ball park.



Final seated. Didnt take pics of the case in the lab. Not enough time.
Sure I see some changes Id like to make, but they were happy and it went in the first try. Patient cried, thats always a good sign.
FYI I charged the equivalent of 1 extra unit for the tissue porc.




Anyway feel free to post up anything here, dosent have to be a museum peice, just your everyday production stuff.

 

[EJADA]

very nice. I can see why patient was so happy.

Happy Patient - Happy Dentist YAAAA

 

[rkm rdt]

I've been getting alot of these types of cases recently .

Nice job Al

 

[AshleyMarkDMD]

I would have to agree that the esthetic outcome was impressive. Honestly - surprising. A tribute to a lab technician success - I suppose we could discuss implant placement in another forum?

Did you folks decide to restore in group function or canine guidance?

Thanks

Ashley

 

[charles007]

Al, your pink tissue cases are always nice to see.. I guess I need to do a practice case so I can get my waxing technique up to snuff before a real case walks in the door... I bet once your accounts sees the pink they run from partials........I'm guessing this is one of the rare times that NP comes in handy with less weight and cost ? OR Tit ?
Wonder if this is a problem using Titanium with the height needed ? disk !
I bet Rob, Scott, Mark, Paul or John can answer that question !

 

[TheLabGuy]

You're right Charles, I'm dealing with a case right now because of that. Disk height can be a bummer

 

[JohnWilson]

Very cool case Al,

I particularly liked the way you were able to lap the distal of the central at the gingival and still were able to get the case to draw. Was this a screw retained case or abutments and a bridge?

Your pink porc. work is quite impressive.

 

[Xydorf]

First of all, fantastic work If you were in Sweden Al, I would send all my high-end work to you (if you had the time to handle it, that is )

Secondly, am I the only one to think there are FAR to few options on how to reconstruct the gingiva?

I don't know of any gingiva shade guides.

I don't think there are that many colors to choose from (please correct me if I am wrong). In full-arch cases this is not an issue, but in cases like these it might be (although here it fit quite well). Any thoughts on this? Should I post this question in another forum?

 

[JOE_Z]

.


Vita makes a shade gingiva shade guide

 

[DMC]

Pure Oral Sex.

Damn nice work.

Love that Stinky Pink.

 

[patmo141]

The lab work looks beautiful. Look's like you will be doing number 9 soon

 

[Al.]

Thanks.

Here is a case, one of the most difficult types for me.
6 unit anterior bridges.
Usually there is ridge loss so the pontics are often longer than the cuspids and its hard to make the pontics look like they are growing out of the gums.



Requested shade is A2. I used A4 in the connection areas.




Lingualize the connections so they can be opened up on the facial.



Also after the pontics are exactly where I think they should be I trace it on the stone, then ditch it slightly, on the edge with a 330 bur.
Then I added a bead of porc on the edges of the pontics so they will press into the gums a bit and help them look like they are growing out rather than sitting on top like fake fingernails.



It came out pretty decent not the Mona Lisa but the patient was happy and the Dr paid and by eye it is hard to tell its fake.

 

[smile4me]

Al your work is amazing! thanks for sharing !

 

[artemis25]

@AI
In this case what glaze you use it ? Is it powder glaze or paste ?
I use powder glaze mix with liquid. The final result is surface with many small tiny bubbles like pimples . These problem saw with loupe x3.5. Then i remove it with silicone rubber and diamande paste.

What company (brand) of glaze you use it??

 

[Al.]

Artemis, I use paste glaze. Put it on thin then rubber wheel the surface lightly with a pink rubber wheel.

This slpint has 2 pontics and there isnt enough room for both so I rotated one.
Wrapped the dentin on the incisal edge with a bit of clear then wraped that with reg incisal and some white incisal.

A3/A35 was the shade requested. But I used C4 on the cervical and interproximal.
Margins are all at or above the gum.








This is all I got from the Dr.

 

[JohnWilson]

Sure would have been nice if Doc prepped the mescal of 22 sub G. Would have allowed that rotated pontic to flow a bit better.

I think you did a nice job trying to solve the space issue. I am sure this dude has not had teeth looking this good in a very long time.

 

[Al.]

John thanks for the detailed info you gave me about doing the acrylic tryins for full arch screw retained splints.

I have 2 in the works now and I did it close to the way you recommended and I think its going to be a big time saver because the first tryin the bite and midline were so far off if it was a metal frame tryin it would have been a remake.

I remounted with the acrylic splint screwed down added on the occ and had to bring the facials back 3mm now its going back for a 2nd acrylic tryin.
I sent it first in sections and let him lute it together with pattern resin.

Anyway thanks, and Ill probably take some pics later.

 

[JohnWilson]

Glad you were able to see value in this technique, it really can save your ass when things are not as we think they should be.

Acrylic is infinitely easier to modify, so try and get it dead on balls accurate before you invest and chuck the metal.

I am super proud of you Al, you really are taking yourself to the next level. Your work continues to inspire me.

Would you have ever thought prior to learning the importance and the power that photography has had on your growth, that you would be able to attract the caliber of practitioners that you are servicing today?

No matter where we are at in our careers, there is always a small amount of doubt in our heart/head that we will be successful with FMR cases. The more cases I complete in my lab, the more I realize there is so much more than just restoring 28 teeth. The compensation must also be substantially higher than just multiplying your singles rate.

 

[desertfox384]

Well said John.
Al, could you detail the incisal layering in the upper 6 unit case? I cant seem to get mine to "pop" quite like that.

 

[marvel]

ALL About Bites and Guidances: 2-Day Hands-On Morphology Workshop

[T]he esthetic outcome was impressive....[might we discuss] implant placement [somewhere?] ... Did you folks decide to restore in group function or canine guidance?

Al, those gals must be feeling like Brook Shields and Lisa Rinna, or whoever is their favorite celebs, and my guess is their bfs will be stealing lots more kisses.

AshleyMarkDMD et al, the class below is advertised as "a practical approach to posterior tooth morphology," but of course, this includes prosthetic teeth of all types, too, plus the influence of canine guidance vs relative lack thereof and group guidance on the masticatory system, and how anteriors come into play and are affected by it all, and how occlusion affects phonetics, too.

Mr Russ DeVreugd may not have the final word on functional bites, dental morphologies and tooth anatomies, but he certainly has a detailed, well thought out, cutting-edge system with impressive clinical successes, his own and those of his students.

Plus from another pov there is all those happy talkative p/ts...:blah::bump2::blah::blah::blah::blah::bump2: :bump2: :bump2: :blah::blah::blah::blah::blah::blah::blah::blah:

I certainly want that system at least considered for my final teeth.

The geometric artwork is intriguing and inspiring on its own, even in diagram. Here is a taste from one of Russ's own papers: http://www.idseminars.com/articles/QDT_Article_1997.pdf

Had I the money for 3 seats in this workshop I'd have ASAP reserved them long before now for me, my Doctor, and the Master Tech who will make my teeth, I would just kidnap them and go. And afterward I would eavesdrop as my Dr (a pros) and Mr DeV toss around ideas...and mebbe understand enough to volley a Q or few back and forth myself.

Well! :focus: Mr DeV posted yest AM there still is room in the class, and yours truly is dreaming of going till the laaaast second....

I still have room in my Nov. 11-12, 2001 Course.
A Practical Approach to Posterior Tooth Morphology on Vimeo

You can be sure Mr DeVreugd's name will come up in discussion with my Dr and Master Tech before anybody puts their hand to making my final teeth.