SlideshareTo IRSC Members: some slides have been removed from the slideshare. If you need more information about any of the topics mentioned in the headings, feel free to contact Dr. Bishop or Dr. Abey by email.

Bishop(at)teethin.com

Abey(at)teethin.com

IRSC2013 IRSC2013

Final Meeting for 2013

November 14: Dental Laboratory Showcase

Implant Restorative Study Club

Problem Solving in the Restorative Phase of

Treatment

sponsored by Prosthodontics of Central Indiana

Implant Restorative Study Club

Problem Solving in the Restorative Phase of

Treatment

sponsored by Prosthodontics of Central Indiana

August 29, 2013The Monon Center, Carmel

Goals for this eveningGoals for this eveningAssuming everything has been done to prepare for success to this point!

Managing problems at try in/placeWhen to return to the lab, or not

Managing “emergencies” and later problems

ProblemsProblemsFixed

Removable

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour5. Excess cement

At follow up and emergencies:1. Porcelain fracture

2. Loosening:crown

abutmentimplant

implant

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour5. Excess cement

At follow up and emergencies:1. Porcelain fracture

2. Loosening:crown

abutmentimplant

implant

proximal contacts:

not usually perfect from the lab...why?

proximal contacts:

not usually perfect from the lab...why?

Sequence:Check both proximal contacts (floss

test)which contact is tightest?(floss test)

DiscloseAdjust

Check seating (explorer)Check BOTH contacts again(floss

test)Which contact is tightest?

DiscloseAdjust

Check seating(explorer/bite cotton roll hard 5min/10min)

Check BOTH contacts again(floss test)

Which contact is tightest?DiscloseAdjust

Check seating (seems down) Check contacts again. If 1or 2 open

contacts, If perfect, Make BWX (quite often has to be

vertical)

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour5. Excess cement

At follow up and emergencies:1. Porcelain fracture

2. Loosening:crown

abutmentimplant

implant

Where should it be?

Where should it be?

Discuss:A.out of occlusion

B. occlusion in clench. (What about non-clenchers)?

C. normal, tooth-to-tooth type contact

Suggested Sequence for

centric:Assumptions:

2 proximal contacts are present.Full seating confirmed with VBWX

1. (Implant crown out): confirm contact of adjacent teeth with shim

2. Place crown onto abutment3. Check adjacent teeth with shim

4. If out of contact, mark with Accufilm5. Adjust

Repeat steps 3.-5. until shim contact present adjacent teeth.

6. Check implant crown with shim. If out of contact,

7. If in contact, adjust a tiny bit more. (always get pt feedback on

occlusion; and metal occlusal more forgiving)

How about excursive movements?

How about excursive movements?

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/contour5. Excess cement

At follow up and emergencies:1. Porcelain fracture

2. Loosening:crown

abutmentimplant

implant

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour

5. Excess cementAt follow up and emergencies:

1. Porcelain fracture2. Loosening:

crownabutmentimplant

implant

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour5. Excess cement

At follow up and emergencies:1. Materials fracture: porcelain/acrylic resin

2. Loosening:crown

abutmentimplant

implant

Problems: FixedProblems: FixedAt try in/placement:

1. Proximal contacts2.Seating

3. Occlusion: missing.....where should it be anyway?

4. Buccal emergence profile/proximal contour5. Excess cement

At follow up and emergencies:1. Materials fracture: porcelain/acrylic resin

2. Loosening:crown

abutmentimplant

implant

Problems:RemovableProblems:RemovableAt try in/placement:which inserts to use?

locator heightAt follow up and emergencies:

soft tissue problemsunstable/non-retentive

fractured base

At try in/placement:locator height- tissue height

- restorative space- position of implants

- ability of patient to seat

Problems:RemovableProblems:RemovableAt try in/placement:which inserts to use?

locator heightAt follow up and emergencies:

soft tissue problemsunstable/non-retentive

fractured base

Problems:RemovableProblems:RemovableAt try in/placement:which inserts to use?

locator heightAt follow up and emergencies:

soft tissue problemsunstable/non-retentive

fractured base

Problems:RemovableProblems:RemovableAt try in/placement:which inserts to use?

locator heightAt follow up and emergencies:

soft tissue problemsunstable/non-retentive

fractured base

IRSC IRSC

Finally:

Please complete your survey online:

http://www.surveymonkey.com/s/68TMNG9

November 14: Dental Laboratory Showcase

This is the information that I mentioned about a course for the Prettau Bridge: the full arch zirconia bridge. Dr. Weir feels that Dr. Tischler is a highly appropriate authority on the subject. Check out the website below, or contact Dr. Weir.

This is the information that I mentioned about a course for the Prettau Bridge: the full arch zirconia bridge. Dr. Weir feels that Dr. Tischler is a highly appropriate authority on the subject. Check out the website below, or contact Dr. Weir.

From: "C. Douglas Weir" <dweir1(at)netsurfusa.net>Subject: Date: August 27, 2013 4:44:01 PM EDT

To: Bishop Doctor Christine <chrisbishop88(at)gmail.com>

http://www.tischlerdental.com/

There is a great amount of info if you click on the "for dentists" tab.

The next course is Nov 8-9.