Trios-implant studio-imes-icore w/ temp

[prestige.dental]

Guide for Nobel active 3.5 implant. Milled by imes.

And temp cemented to NT trading tibase.

 

[rkm rdt]

Awesome!!! I want to do that.

 

[JohnWilson]

Well done! No way to get the fixture more upright to allow for ling access hole?

 

[cadfan]

angled channel done just one click in E......

 

[prestige.dental]

Well done! No way to get the fixture more upright to allow for ling access hole?

Plan to place eMax crown and CAP says we can't make a hole in the eMax block with imes icore. So making hole by hand is messy business. U don't get a nicely milled clean hole.
So we will make custom tit abutment anodize it and eMax crown




Has anybody found a way to use the eMax block with pre- milled hole without using the CLOSED Cerec system.

Is it that big of a deal to make a hole through the eMax.

The hole can made through pressing eMax though.

 

[prestige.dental]

angled channel done just one click in E......

Where do u get the fda approved screws and screw driver from for ASC.

 

[zero_zero]

I'm pretty sure that the strategy could be tweaked to allow for grinding a hole...not sure how the tool would handle the job tho...

 

[JohnWilson]

angled channel done just one click in E......

Of course but the question was about the planning.

Guys/gals I do not want to come off as a know it all. Hell I have to pull out the magic wand as much or more than the rest of you. What I am trying to do at the end of my career is to really push better planning.

Over the years our industry full of MacGyver stye techs have ALLOWED poor planning to become the norm. Today with CAD/CAM we have WAY more tools and techniques to solve the failures that our clients provide to us. WHY, with advancement in technology EVERY fixture today should be planned and not allow the bone hunters of yesteryear place another implant by winging it.

Now don't get me wrong I am by no means calling this case a failure, I think it looks GREAT! I am just asking a question why can we not upright this fixture a few more degrees?

Lets all agree that the more vertical the restoration is to the bone it will often result in a healthier longer lasting less bone loosing restoration? IF we are going to do a guide for a single then lets make it the best possible outcome . Perhaps this is, I can not tell from the CT image but that was the gist of my question.

As for emax for screw retained crowns the exact file you used for your nt-temp can be milled wax and pressed to provide a perfect channel. Is it something I recommend? NO but we still do them routinely. I do feel Zirconia with the proper reduction and cutback can look as good or better if designed right with much greater fracture toughness.

 

[cadfan]

fda is maybe a problem thats why i am happy where i am without fda but i remember there was a solution before they came out with that high intelligent hole inside the e-max block.Screws are the same up to 15 degrees than there are flex drivers out and other srews but fda is still a problem .On a front teeth its a normal angel the bone has 20-30 degrees at this place so if you place the implant sub optimal its ok for the screw channel and fda if you place it perfect you have trouble because of a angled channel for me always a bit like a bad comic.

 

[JohnWilson]

Where do u get the fda approved screws and screw driver from for ASC.

For 10* correction or less you do not need an ASC style screw the stock or 3rd party fda cleared base and screw combo allows enough movement of the driver to allow such a modification to the channel.

OR since this is a noble conical fixture you COULD do a REAL ASC abutment if the correction was 15<25 however from the planning that is not the case.

 

[JohnWilson]

I just saw that you are a foreign trained dentist here in the states, here I thought I was helping a lab tech out with all of these posts.

Good luck dr

 

[prestige.dental]

I just saw that you are a foreign trained dentist here in the states, here I thought I was helping a lab tech out with all of these posts.

Good luck dr

Hello John:

I am a dentist and a lab tech located in Fremont , CA. We are a low production facility as we are learning the trade. We have bought complete CAP package and they are our support.

We are a implant center with a attached CAD CAM milling center/ lab. We do milling for other local lab techs with simple cases as they do not have imes I core.

With your help and everybody else we try to enhance the profession and I feel that I should have put forward my degrees/CV earlier.

I have a masters degree in mechanical engineering from Univ of Connecticut 2005 and DMD from Univ of Connecticut 2000.

My interests are CAD /CAM manufacture of implant prosthetics. I have been devoting most of my working day in the R n D of implant prosthetics. I enjoy giving the local lab techs a tour of my lab and inspiring them to use my machines as we are more like a r n d facity than a production lab. The machines are sitting idle most of the time. But we are slowly picking up.

 

[JohnWilson]

Are you a practicing dentist? You have to realize "FOR ME" I share on this and other sites for the betterment of the "trade". When I see a dentist come to a site that is specifically for techs to get our hard earned knowledge to exploit it for themselves in house it makes me unhappy.

I am the most straight forward sharing tech because dentistry has been good to me because I have worked my ass off and studied my ass off. After 30 years in the trade it has driven me to share to new techs coming up to pass on this knowledge because god knows there were very few doing that when I was coming up.

I am all for the betterment of dentistry but my allegiance is to my tradesmen in the trenches STRUGGLING to keep a piece of the ever shrinking pie, always looking for a way to put out better products utilizing what ever means possible.

When I see a Dr looking to do things their-self I have ZERO issue for that and applaud their tenacity. Generally I wonder why they are not more business savy but at the end of the day thats not my concern.

As for anonymity and hiding your credentials I can not fault you for that, it is a tech site and I am sure I am not the only one that feels the way I do, your responses on this site is because people thought you were a tech, this I can absolute be certain of

Again good luck to you but don't expect my participation in your threads.

 

[Labwa]

Please take this as constructive criticism. I would have to agree with John here...You spent time doing two stage and block grafting and then not utilize the increased buccal bone graft a bit more?
ASC are great to get out of trouble but remember they have wider screw holes, they must allow for more width down around the screw head (just above the fixture), less titanium around the zirconia interface and narrower screws. I dont think the strength will be as good as a regular Procera CC abutment..

I'm not sure about e.max on a base either. Bearing in mind I say that after doing 0 of them...i don't like it...i would never do it. My thoughts are e.max is not strong enough. Zirconia will provide better strength with great aesthetics. But each to their own.

would love to see this case go through to temp if you care to share. once again not trying to insult the plan. I respect the result you are chasing.

 

[zero_zero]

.......... We have bought complete CAP package and they are our support..............

Then, they should be able to address all your questions...no ?

Are you a practicing dentist? You have to realize "FOR ME" I share on this and other sites for the betterment of the "trade". When I see a dentist come to a site that is specifically for techs to get our hard earned knowledge to exploit it for themselves in house it makes me unhappy..............

As long as he's asking all this trivial questions, I wouldn't be worried 'bout any exploit...lol...

 

[prestige.dental]

Are you a practicing dentist? You have to realize "FOR ME" I share on this and other sites for the betterment of the "trade". When I see a dentist come to a site that is specifically for techs to get our hard earned knowledge to exploit it for themselves in house it makes me unhappy.

I am the most straight forward sharing tech because dentistry has been good to me because I have worked my ass off and studied my ass off. After 30 years in the trade it has driven me to share to new techs coming up to pass on this knowledge because god knows there were very few doing that when I was coming up.

I am all for the betterment of dentistry but my allegiance is to my tradesmen in the trenches STRUGGLING to keep a piece of the ever shrinking pie, always looking for a way to put out better products utilizing what ever means possible.

When I see a Dr looking to do things their-self I have ZERO issue for that and applaud their tenacity. Generally I wonder why they are not more business savy but at the end of the day thats not my concern.

As for anonymity and hiding your credentials I can not fault you for that, it is a tech site and I am sure I am not the only one that feels the way I do, your responses on this site is because people thought you were a tech, this I can absolute be certain of

Again good luck to you but don't expect my participation in your threads.

John:

You are a very fair person. And I respect your integrity and empathy for the fellow techs.

Yes I am a practicing dentist but my concentration is on not letting this lab fail and and be able to pay the salaries of the techs who are by the way some arpiring young kids who can't afford going to school and are learning on this half million dollar investment. They waste a lot of material and redos. Looks like I have a tech school going, hoping that these kids would remain loyal and stay after they have learnt the art and have become good.

Everybody looks at me like I am crazy buying these machines and studying day and night and losing money at the same time in the lab business, but I am ok.

The lab tech should be able to see how his restoration came out to be in the patients mouth and see the happiness on the face of the patient or that the doctor spent 3 hours fitting the crown and patient being all mad.

I am going to Spain to spend a week at Dr cuadrados lab/clinic to learn the art of using trios so that you can do model less manufacture of implant prosthetics with high accuracy. I do nt know what magic he has and what protocol he has developed that he can make passive screw retained bridges with trios only.

I will share my info my visit to Spain is any good.

 

[prestige.dental]

Please take this as constructive criticism. I would have to agree with John here...You spent time doing two stage and block grafting and then not utilize the increased buccal bone graft a bit more?
ASC are great to get out of trouble but remember they have wider screw holes, they must allow for more width down around the screw head (just above the fixture), less titanium around the zirconia interface and narrower screws. I dont think the strength will be as good as a regular Procera CC abutment..

I'm not sure about e.max on a base either. Bearing in mind I say that after doing 0 of them...i don't like it...i would never do it. My thoughts are e.max is not strong enough. Zirconia will provide better strength with great aesthetics. But each to their own.

would love to see this case go through to temp if you care to share. once again not trying to insult the plan. I respect the result you are chasing.

I thought a lot about it and decided to make it cement retained on anodized custom ti abutment

We always try to make screw retained but when I placed the implant on the cat scan, it looked well encased/ centered in bone if the axis came out from facial.

 

[prestige.dental]

Please take this as constructive criticism. I would have to agree with John here...You spent time doing two stage and block grafting and then not utilize the increased buccal bone graft a bit more?
ASC are great to get out of trouble but remember they have wider screw holes, they must allow for more width down around the screw head (just above the fixture), less titanium around the zirconia interface and narrower screws. I dont think the strength will be as good as a regular Procera CC abutment..

I'm not sure about e.max on a base either. Bearing in mind I say that after doing 0 of them...i don't like it...i would never do it. My thoughts are e.max is not strong enough. Zirconia will provide better strength with great aesthetics. But each to their own.

would love to see this case go through to temp if you care to share. once again not trying to insult the plan. I respect the result you are chasing.

Hello labwa:

Here it is

The pmma does not show on X-ray. The temp was made on tit engaging cyclinderical on legacy 3.5x13 implant and not on tibase as planned as the overnight shipment got delayed that was gonna bring the active implant.