screw retained hybrid

[sidesh0wb0b]

a bit baffled. Dr wants a "frame tryin" of a 12 unit bridge (premolar to premolar) over 4 zimmer abuts.
i dont even have a bite yet.

am i missing something? this is a fairly new client, so maybe he was used to doing things differently elsewhere...

 

[JMN]

I'd bet that whoever packed the case missed putting the bite in the bag/box.

 

[Patrick Coon]

a bit baffled. Dr wants a "frame tryin" of a 12 unit bridge (premolar to premolar) over 4 zimmer abuts.
i dont even have a bite yet.

am i missing something? this is a fairly new client, so maybe he was used to doing things differently elsewhere... View attachment 26595

What?!? You can't do it from what he gave you there?

 

[JMN]

Can you link palatal landmarks enough to merge scans?

 

[RCKSTR]

 

[CoolHandLuke]

make wax rims and watch him fume.

 

[RileyS]

Did you read the fine print at the bottom of his note?
"Do your best."

 

[sidesh0wb0b]

lol thanks everyone.
going to make him a bite rim to start. cant do a dang thing until i have a bite to work with. then i will get it mounted and figure out how he wants the frame made

 

[Sevan P]

Once bite is established make a jig try in before cutting anything, once model is verified do what ever you want

Sent from my SM-G920V using Tapatalk

 

[sidesh0wb0b]

Once bite is established make a jig try in before cutting anything, once model is verified do what ever you want

Sent from my SM-G920V using Tapatalk

would a bar and then crowns make the most sense? i have only done the prettau style previously and those can be a nightmare if anything is off at all.

 

[2000markpeters]

Next appointment I would give him a verification jig as well as bite block. You could definitely make him a zirconia frame to receive individual crowns. Good way of doing it because if a tooth does break down the road, you just need to replace that site and not re-fire whole framework.

 

[sidesh0wb0b]

Next appointment I would give him a verification jig as well as bite block. You could definitely make him a zirconia frame to receive individual crowns. Good way of doing it because if a tooth does break down the road, you just need to replace that site and not re-fire whole framework.

i was thinking PMMA frame to see if it fits. is that feasible? and should i just make the jig over the impression posts with some resin cured around the posts?
already sent him a bite block. i feel much more comfy starting with a bite, then proceeding.

 

[Sevan P]

would a bar and then crowns make the most sense? i have only done the prettau style previously and those can be a nightmare if anything is off at all.

I order temp abutment non engaging, then slap some clear acrylic and cure it with the abutment in place, let completely cool and set. Now you have a rigged jig try in. If that fits smoothly you know the model and mouth both match. Then you can do a zir tryin if you like or pmma try in.

Sent from my SM-G920V using Tapatalk

 

[Ken Knapp]

a bit baffled. Dr wants a "frame tryin" of a 12 unit bridge (premolar to premolar) over 4 zimmer abuts.
i dont even have a bite yet.

am i missing something? this is a fairly new client, so maybe he was used to doing things differently elsewhere... View attachment 26595

I haven't done a case like this before.
1. Bite needs to be set.
2. I would recommend a temporary material try in.
3. I would think that a titanium framework with individual zirconia crowns would be best because of the flexibility of the mandibular bone and the posterior to anterior is unsupported and cantilevered.

Ken

 

[sidesh0wb0b]

I haven't done a case like this before.
1. Bite needs to be set.
2. I would recommend a temporary material try in.
3. I would think that a titanium framework with individual zirconia crowns would be best because of the flexibility of the mandibular bone and the posterior to anterior is unsupported and cantilevered.

Ken

good plan, ken
so ti bar/frame sounds good!

 

[Baobabtree]

Have you considered doing a frame in pekkton or biohpp using the BDT technique

 

[sidesh0wb0b]

Have you considered doing a frame in pekkton or biohpp using the BDT technique

hmm, thats not a bad idea at all. will mull it over with the Dr some, thanks
have you done many of these?

 

[Baobabtree]

hmm, thats not a bad idea at all. will mull it over with the Dr some, thanks
have you done many of these?

No I haven't, as I don't have many of those kind of Drs on my books at the moment, although there is one in the works,( the Dr has been doing Ti beams with acrylic, and would like to try a peek Bio HPP next time around). It will be a Bio HPP frame with Visio.lign teeth and composite gum work( all Bredent).

http://www.xpdent.com/catalogs/visio.lign/visio.lign_product_home.aspx?sm=a#

This system being composite veneers and gum work makes sense to me from a repairability perspective.I apologise if you know plenty about this system already.

 

[Contraluz]

lol thanks everyone.
going to make him a bite rim to start. cant do a dang thing until i have a bite to work with. then i will get it mounted and figure out how he wants the frame made

In order to get a bite rim that is close, you can do a palatal matrix off of the initial model and the opposing. Although not precise, it should give you a bite rim that reassembles the situation pretty well.

 

[kcdt]

Looks like the typical leap before looking scenario to me.
They've edentulated the patient and placed fixtures.
Based on what?
If those choices/steps weren't taken before surgery, then it's a ****show.
Hopefully not neck deep.

This is more common than you think.