Zirconia copings for removable case????

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taylor tori

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Im an implant guy here so I wasn't sure what to tell this Dr about this. He sent me this case, the coping fit well. I guess, my question is, can I use these 4 copings to process a denture to them? He doesn't not like metal at all her is a ceramic only guy, including his implants.. If acrylic wont process to ZR then is their some kind of male attachment I could design into these copings that would fit into a female(3shape)? Because I could totally redesign the coping this other lab had made... Thanks for helping with this...


Taylor
 

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bigj1972

bigj1972

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Zirconia alone will not bond to acrylic. However a primer from GC may be available, From looking at your case, biggest question is where are the denture teeth going to go? I see bad impression and copings to tall. I see denture fractures around copings in the future along with veneer tooth pop-offs. Bad case. Like most cases like this, ass backwards. A denture template should have been made before implants were placed. Now all that can be made is an expensive bad denture. First a lower denture tryin needs to be made so you can see what room you have to work with. Then you can see what room if any is available.
 
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Affinity

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This needs moved to the facepalm thread. If the copings are undercut, and quite substantially, it might lock in well enough. But then how do you fit teeth over these copings? Hopefully you have some room.

Are there holes in the top of the copings? Where the hell did the Dr learn this?Hmmmm2
 
Affinity

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On 2nd look, Im assuming these are only telescopic copings and not meant to be processed in the denture, I think these should be treated as Galvano copings but you still need a frame.. If it were me, I think, I would leave the copings, scan them, make a PEEK or acetal frame with posts for teeth and see if there is any room, if not, send it back to the other lab to figure out.. This is like eating someone elses leftovers off their plate..
 
bigj1972

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On 2nd look, Im assuming these are only telescopic copings and not meant to be processed in the denture, I think these should be treated as Galvano copings but you still need a frame.. If it were me, I think, I would leave the copings, scan them, make a PEEK or acetal frame with posts for teeth and see if there is any room, if not, send it back to the other lab to figure out.. This is like eating someone elses leftovers off their plate..

Exactly....for this case its gonna have to have a framework. The Dr may have to sacrifice his wants and go with metal or pony up and go for PEEK. I'd abandon the idea of copings if this thing is going to be embedded into a denture. Poorly thought out. This technique is not in any manual I ever read.

Don't be a hero, dummy up, send it back, and save yourself a lot of headache and lost billable hours trying to make something work.
 
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taylor tori

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Exactly....for this case its gonna have to have a framework. The Dr may have to sacrifice his wants and go with metal or pony up and go for PEEK. I'd abandon the idea of copings if this thing is going to be embedded into a denture. Poorly thought out. This technique is not in any manual I ever read.

Don't be a hero, dummy up, send it back, and save yourself a lot of headache and lost billable hours trying to make something work.

Might Just do that!
We will see.
On 2nd look, Im assuming these are only telescopic copings and not meant to be processed in the denture, I think these should be treated as Galvano copings but you still need a frame.. If it were me, I think, I would leave the copings, scan them, make a PEEK or acetal frame with posts for teeth and see if there is any room, if not, send it back to the other lab to figure out.. This is like eating someone elses leftovers off their plate..
Very interesting, thanks. I think Ill pitch this to him . Scan, make a bar from pmma bond the pmma bar to the zirconia copings and process the denture to the pmma bar. What do you think?
 
bigj1972

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Might Just do that!
We will see.

Very interesting, thanks. I think Ill pitch this to him . Scan, make a bar from pmma bond the pmma bar to the zirconia copings and process the denture to the pmma bar. What do you think?

Just remember PMMA is standard denture acrylic. It will not offer any strength increase above the denture base itself. Go with metal or PEEK, forget acetal, will not bond to PMMA and will contribute to base fracture. If DR insist on copings, grind them down to be screw housings. that's all there purpose is. Look for a bonding liquid.
 
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Affinity

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This is a protocol ive read about and Ive posted an article.. but the zr copings should be cemented in the mouth and remain there, not in the denture. This is a euro technique, they use a lot of galvano copings. So theoretically, you should have galvano copings made over the zr abutments, then cement those into a frame. Theres a reason this is done in europe mostly $$$. Just hope you have tons of vertical to cram all of this in there.. those copings look very long.. You can always do a zr bridge over it like in this article:

http://www.joionline.org/doi/pdf/10.1563/AAID-JOI-D-09-00065
 
Affinity

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Also the zr copings should be very highly polished.
 
kcdt

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I've never understood that cray cray over metal. The implants and screws are titanium FFS!
As for the case.
Start over.
Someone tried to fabricate telescopes without any knowledge or proper sequencing.
What you have now is garbage.

Last one I did was titanium primaries, secondaries, and a chrome tertiary. Atlantis mills these all day long.
If you get your ducks in a row it's no harder to execute than a bread and butter Locators case.

FWIW, this harkens back to the days of combo cases where the CB lab just slaps **** anywhere.
The failure is always in lack of team effort because pieces are fabricated out of sequence and thus w/o referrence to the prosthesis.

Had to look it up. Conus images.jpeg.jpg
 
kcdt

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[QUOTE="bigj1972, post: 296018, Bad case. Like most cases like this, ass backwards. A denture template should have been made before implants were placed. Now all that can be made is an expensive bad denture. First a lower denture tryin needs to be made so you can see what room you have to work with. Then you can see what room if any is available.[/QUOTE]
Bingo. W/o proper sequence even something simple like Locators can fubar. See it all the time
 
Jason D

Jason D

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This whole case is just wrongheaded

Start over and do it properly. You should not be trying to make it up as you go along.

You are screwing with a human being on the other end not some high school science fair thing “just to see if it would work”

People who do stuff like this should not be involved in treating real patients to satisfy their own curiosity or creativity.
 
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JMN

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Theee is an option coming that would make zirconia to pmma possible.

GC will be releasing to the US the successor to Metal Primer II, called Metal primer Z, sometime this quarter. It's already in the EU.

This one is supposed to bond resin cements and pmma to zirconia as well as creating a chemical bond to all metals.

Those zirconia jelly beans on this case are still way way way outta reality. No room for anything but a bare shell of tooth and that's if you're lucky.

If sanity won't prevail at the office and allow you to use a Conus tyoe solution as KCDT pointed to, you're in for nothing but trouble and looking at something that will need to be 'rebased' (more like redone) every year from stress fractures as the pmma will be so thin over those copings it will not be able to absorb anything close to enough force.

I'd tell them we can go there way, but it has no coverage when it breaks. Don't say if. Say when.
 

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