C
cmsilvoy
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My very first case with the Ceramill system after doing basic training was to treat "Lee."
Lee is a completely disabled American Veteran.
He came to me from the VA hospital in Fayetteville with a cellulitis infection at 7 and 8.
They dismissed him with an antibiotic and no further instructions as to what to do.
His daughter is a hygienist, so she called me and asked if I would be willing to help him.
I was a little taken back from what I saw.
His dentition was severely worn and had exposed pulps at 7 and 8, with no visible crowns on the maxillary arch.
His collapsed VDO was causing significant problems with aggravating sleep apnea.
We took some impressions, did root canals on 7 and 8 and sent him home.
I mounted and waxed up the case at a proposed vertical and made a stent for temporization.
I brought him back and did post and cores and buildups on all of the teeth and temporized both arches in the same day (by myself, which was no fun).
I left him in temps for 2 weeks and then took my impressions, did all of the model work (my least favorite part is plaster work),and scanned the case.
I wish I had documented this whole thing better, but that's why I am here. I'll get better at it.
Anyhow, here we go! Lower design, all units splinted. Occlusion designed to limit excursive interferences.
Units nested and ready for CAM
Milled unfinished Zirconia
Here's where I suffer. I toil at mechanically polishing and finishing the green zirconia. And staining is no fun. At the time, I used the AGA dip technique which produced a fairly solid A2 shade.
On to the upper, model scan
design
proposal
I milled the upper with the AGA Zolid preshade A2. I hoped that I wouldn't have to mess much with staining and I was very pleased with the resulting match to my lowers.
Now, Lee had his upper right quadrant blown out by shrapnel during one of his tours, and he is not healthy enough for me to finish his case with implants.
My challenges in this case were:
Altering his VDO drastically
Designing an occlusal scheme that would allow him to grind his teeth without stressing the prosthetics or his teeth.
Designing pontics and embrasures that could be cleaned with proxi-brushes and rubber tips.
Here is the case on day of seat. A remarkable transformation. If I can find his pre-treatment photos I will edit the post to include them.
I successfully matched the occlusion with only minor intraoral adjustments. He has reprtedly been sleeping better and his CPAP machine works more efficiently now.
His health has not been good, but I check in on him now again and will as long as he's around.
Constructive criticism welcome.
Chris
Lee is a completely disabled American Veteran.
He came to me from the VA hospital in Fayetteville with a cellulitis infection at 7 and 8.
They dismissed him with an antibiotic and no further instructions as to what to do.
His daughter is a hygienist, so she called me and asked if I would be willing to help him.
I was a little taken back from what I saw.
His dentition was severely worn and had exposed pulps at 7 and 8, with no visible crowns on the maxillary arch.
His collapsed VDO was causing significant problems with aggravating sleep apnea.
We took some impressions, did root canals on 7 and 8 and sent him home.
I mounted and waxed up the case at a proposed vertical and made a stent for temporization.
I brought him back and did post and cores and buildups on all of the teeth and temporized both arches in the same day (by myself, which was no fun).
I left him in temps for 2 weeks and then took my impressions, did all of the model work (my least favorite part is plaster work),and scanned the case.
I wish I had documented this whole thing better, but that's why I am here. I'll get better at it.
Anyhow, here we go! Lower design, all units splinted. Occlusion designed to limit excursive interferences.
Units nested and ready for CAM
Milled unfinished Zirconia
Here's where I suffer. I toil at mechanically polishing and finishing the green zirconia. And staining is no fun. At the time, I used the AGA dip technique which produced a fairly solid A2 shade.
On to the upper, model scan
design
proposal
I milled the upper with the AGA Zolid preshade A2. I hoped that I wouldn't have to mess much with staining and I was very pleased with the resulting match to my lowers.
Now, Lee had his upper right quadrant blown out by shrapnel during one of his tours, and he is not healthy enough for me to finish his case with implants.
My challenges in this case were:
Altering his VDO drastically
Designing an occlusal scheme that would allow him to grind his teeth without stressing the prosthetics or his teeth.
Designing pontics and embrasures that could be cleaned with proxi-brushes and rubber tips.
Here is the case on day of seat. A remarkable transformation. If I can find his pre-treatment photos I will edit the post to include them.
I successfully matched the occlusion with only minor intraoral adjustments. He has reprtedly been sleeping better and his CPAP machine works more efficiently now.
His health has not been good, but I check in on him now again and will as long as he's around.
Constructive criticism welcome.
Chris