The BDT Technique bridge

Patrick Coon

Patrick Coon

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This is one of my 1st "BDT" style case. This case we milled out wax crowns after we milled out the Pekkton frame. Going forward we will scan the wax-try in to create the Pekkton frame, then hollow out the denture teeth to fit over the frame. Combine the digital side with the burn-out technique. These cases seem to go a little easier than the full zr bridges, IMHO.

HI Shane,

I would love to see some photos after it all has been milled and after it is completed. It looks really well done.

One question, are you scanning your pre-prosthetic planning mock-ups (denture tooth tryins) and then morphing your wax-ups to match what was in plastic and wax?
 
shane williams

shane williams

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HI Shane,

I would love to see some photos after it all has been milled and after it is completed. It looks really well done.

One question, are you scanning your pre-prosthetic planning mock-ups (denture tooth tryins) and then morphing your wax-ups to match what was in plastic and wax?

So after the Pekkton frame is milled out, and adjusted the frame is scanned in and a new order is created. Individual crowns are selected. I don't re-scan the pre-op I just import it in and reference the two arch's together. For the crowns I found doing the morphing to the waxup created some weird crowns, so I design them to fit inside the pre-op, then cut proximal contacts to zero. Works great.

I've tried doing the crowns by creating an stl files of the pekkton frames and designing crowns over it, but if the frames need any adjustments then the crowns wont fit. So re-scanning the frame is easy enough.
 
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I must have done 30-40 BDT bridges so far and currently have 3 in a queue. My observations:
- Only thing that is repairable is composite additions to the tissue. Once presable crowns are cemented to the frame they are not coming off and you can't whack this thing into the furnace.
- Number of clients do not like going composite route as they claim after a while composite loses its vitality and attracts plaque.
- Peek/Pekk needs volume to get it's strenght from. Thin material is brittle. I had a case where lower incisor broke clean off with pelkkton material still cemented inside the crown. How do you repair this - answers on the postcards please.

I am now thinking of adding following combination to the arsenal - using BDT Technique but mill frame in Zr, cement emax multi teeth to the frame with a glaze paste and then do pink tissue in porcelain. Strong, lighter then Prettau and can be fired in the furnace in the future. Or am I talking kaka?
 
Al.

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Cement with glaze paste ?
You mean paint prep and inside of crown with glaze seat then fire on glaze cycle ?
Will that work ? You done that before ?
 
Al.

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Then to layer tissue you need low fusing lower than glaze/cement ? Or it becomes molten every bake ?
 
kcdt

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I'm still trying to understand the point when acrylic wrap
on titanium frame sells like hotcakes and is completely repairable.
 
Al.

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My understanding is Pekkton is NOT FDA approved in US for fixed ?
If so are these restorations classified as provisional
 
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aqdental

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Cement with glaze paste ?
You mean paint prep and inside of crown with glaze seat then fire on glaze cycle ?
Will that work ? You done that before ?
Search Pablio Caetano , he has a similar protocol. Build a dentin core over a Zr frame, then press e.max veneers/crowns to bond on top and finish in pink porcelain. Not sure how he bonds but I assume glaze). I'm in the process to try similar thing with metal using pressable ingots with a compatible CTE. It should work??
 
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TheLabGuy

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Anyone ever tried to etch that glaze? I have and noticed that the glaze don't etch like the leucite or lithium disilicate materials do at all. I see it under a scope and doesn't looked etched at all, concerns me. Maybe a different type of glaze????
 
TheLabGuy

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palatal rugae...very pretty!!! I actually like all the tissue, very well done. How did delivery go, any post op pics?
 
rkm rdt

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sweet!
2 questions,
are the crowns emax cad or pressed?
is that gc composite gingiva or porcelain?
 
JMN

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Patrick Coon

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Looks awesome. Very well done. the anatomy build and coloration is superb.

I'm missing the cleansability aspect, is it waterpick? Or am I just not seeing it right?

I agree, JMN, but not seeing the tissue side and how the prosthesis is shaped to the tissue, I didn't mention it.

I really like these cases on an esthetic level, but sometimes see some poor designs on the tissue/hygiene side (not saying this is the case here, I just can't tell for sure). But I'm sure Shane and his client have taken that into account.
 
JMN

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I agree, JMN, but not seeing the tissue side and how the prosthesis is shaped to the tissue, I didn't mention it.

I really like these cases on an esthetic level, but sometimes see some poor designs on the tissue/hygiene side (not saying this is the case here, I just can't tell for sure). But I'm sure Shane and his client have taken that into account.
I assumed it was handled, as you, just wondered how. Always looking to learn.
 
shane williams

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palatal rugae...very pretty!!! I actually like all the tissue, very well done. How did delivery go, any post op pics?
Haven't received any information on the delivery. I'll post pictures if I ever get any
 
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