Subframe with 10 implants

[Nicolai]

used Omega porcelain for the whole thing including the pink tissue. There is not composite or acrylic. Everything was hand made under 60X

 

[TheLabGuy]

Pretty substructure
What type of metal? 60X? The only thing I would worry about is would be the food trap around the peripheral and underneath. Any concern?

 

[rhicks3302]

Nice work! Any concern about mandibular flexure?

 

[TheLabGuy]

Nice work! Any concern about mandibular flexure?

Is that even talked about anymore? I thought the research showed it wasn't clinically significant, is there new research?

 

[rhicks3302]

Nothing new that I've read. Depends on the doc your working for and his/her training as to what they believe. Both my local surgeons think flexure should be accounted for in design.

We've made mand. hybrids on 8 or 9 implants and the patient has no issues. I've also seen it the other way too, where a patient experiences sometimes great discomfort until we split the hybrid into segments. I've never personally seen implant loss attributed to it.

To be honest, I haven't seen the research that showed it wasn't significant.

 

[droberts]

I have a case right now, 6 implants. Most distal implants are in 2nd molar. This particular doctor is not concerned with flexure. Although, the opposing is a denture Right now these will be Ti temp abutments connected with a Ti sub-structure with denture teeth to be used for temps. Final will be a fixed case. Back to flexure, done one. Implants placed 1st molar. Fabricated two bars, left a space between 24&25 that patient could snap floss for hygiene. Nice case above.

 

[TheLabGuy]

We've made mand. hybrids on 8 or 9 implants and the patient has no issues. I've also seen it the other way too, where a patient experiences sometimes great discomfort until we split the hybrid into segments. I've never personally seen implant loss attributed to it.

To be honest, I haven't seen the research that showed it wasn't significant.

Yeah, I shouldn't of said 'significant', bad choice of words on my part. Rather, that clinicians don't really take into account flexure while planning cases is what I was getting at. It does sound like you have had some experience with this though. How many cases did you have to go back into and split the hybrid with?

 

[rhicks3302]

Yeah, I shouldn't of said 'significant', bad choice of words on my part. Rather, that clinicians don't really take into account flexure while planning cases is what I was getting at. It does sound like you have had some experience with this though. How many cases did you have to go back into and split the hybrid with?

Agreed. Most don't even think about it. I've only had 1 that I had to go back and separate. A few of my docs prescribe hybrids in segments, partly because of mandibular flexure and partly because they feel that they are easier to service in segments.

I'm not sure flexure is a big deal. I guess I'm just programmed to think that way.

 

[TheLabGuy]

That's good stuff. I hear that all the time, that flexure isn't anything to worry about, but to go back and take the time to segment it after you're all done would be a pain. Thanks

 

[Nicolai]

Sorry I should have elaborated more. The alloy use is IPS d. Sign 91. Secondly I build it all under 60x microscope (LW scientific). There is no worries for food trap because the lingual is slightly open and patient cleans with shower flosser or water pick. All the implants and crowns are made individually, this makes for easy retrieval. Does anyone need help with one these gladly give some advice

 

[Alistar]

Sorry I should have elaborated more. The alloy use is IPS d. Sign 91. Secondly I build it all under 60x microscope (LW scientific). There is no worries for food trap because the lingual is slightly open and patient cleans with shower flosser or water pick. All the implants and crowns are made individually, this makes for easy retrieval. Does anyone need help with one these gladly give some advice

What type of restorations were placed on the stumps?

Very shiny work and good pics.

Any pics with the prosthetic fully completed and in the mouth?

Thanks for posting.

 

[a88nn]

Very precise, shiny work and nice pictures. Which implant system was used here?
I like implants and have this type of work frequently, but sometimes i have a problem with gingival part, especially when surface is degraded. I've never done gingiva first. I begin with long, long teeth, divide it into crown part and invisible part. I don't know if it's a good way to do it. Does anybody have some step by step pictures of this kind of work?

 

[dental-group]

Totally agree! Greet! But sometimes the new product is ture

Nothing new that I've read. Depends on the doc your working for and his/her training as to what they believe. Both my local surgeons think flexure should be accounted for in design.

We've made mand. hybrids on 8 or 9 implants and the patient has no issues. I've also seen it the other way too, where a patient experiences sometimes great discomfort until we split the hybrid into segments. I've never personally seen implant loss attributed to it.

To be honest, I haven't seen the research that showed it wasn't significant.

Totally agree! Greet! But sometimes the new product is ture!

 

[Nicolai]

These are Certain abutments cast together with framework. The PFM crowns will be cemented individually in order to cover all screw holes. This is in case one crown breaks it can be easily replaced. The step by step is to difficult to explain, one must watch several be constructed to begin to understand. Each subframe is unique to the patient so the steps vary. I Did this when I was 25 yes old boo-yah

 

[patmo141]

Pretty sweet.

Nicolai, is there a "Distal Box" on the distal of that right molar (#30)? It looks like a crown prep done on a tooth with a previous amalgam or something or is that just the light?