DENTAL LAB NEWS AND TECHNOLOGY TRENDS
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Published by Gnathodontics, Ltd.
Winter 2009-10
© 2010 Gnathodontics, Ltd.
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Restorative dentists are well aware that proper implant
placement is crucial to the success of implant supported
restorations. It frustrates me as to how often we receive
implant cases with compromised implant positioning in
respect to the restorative requirements and expectations
of the patient. Granted, there are occasions in which
the implant surgeon cannot place implants in positions
that are in harmony with restorative needs even if a
carefully designed surgical guide stent was available at
the time of surgery. However, way too often I hear that
the surgeon was not supplied with a surgical guide stent
in instances that I’m confronted with what amounts
to a restorative and laboratory nightmare due to poor
implant placement. Perhaps these instances would be
more excusable in the early days of implant dentistry
when experience levels were still low, but such an excuse
does not hold up today, nearly 45 years since Professor
Branemark placed the first root form implant.
Thankfully, at the present time, the majority of the
implant cases we’re involved with have undergone proper
presurgical planning including a well designed surgical
guide having been fabricated and sent to and used by
the implant surgeon. Evidence of this is the frequency
in which we are involved in the presurgical planning
process plus the large volume of surgical guides made at
Gnathodontics and the growing demand for this service.
In order to fully utilize our presurgical implant
services we require the following:
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For single implant cases or small semi-edentulous designs: preliminary cast with bite registration |
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For large semi-edentulous or fully edentulous designs:
preliminary casts mounted to a semi adjustable articulator,
preferably utilizing a facebow transfer for mounting the
maxillary cast
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Written description of the anticipated treatment plan and any alternative treatment plans under consideration |
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Most likely implant positions and implant system to be used |
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Request for a cost estimate (especially important for larger reconstructions and/or unfamiliarity
with our implant pricing structure) |
From the materials and information on the previous page we will provide you with:
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Diagnostic wax-up in white presentation wax |
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Radiographic imaging guide (if needed) with markers or barium coating |
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Surgical guide duplicating the diagnostic wax-up in clear orthodontic resin |
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Guide holes or guide sleeves at the diameter you specify placed at ideal restorative positions |
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Cost estimate(s) based on proposed treatment plan(s) |
In the near future (hopefully by the first quarter of 2010)
we will be installing the newest generation NobelProcera
Scanner here at Gnathodontics. Included in the software
package will be the Nobel Guide Software which will
enable us to assist you in digitally planning implant
placement based on cone beam CT imaging. We will
keep you informed of these exciting new developments.
In the meantime, if you are not currently utilizing our
presurgical implant services I urge you to do so. You
will end up with far fewer “nightmares” and far more
successful implant cases and most important of all,
satisfied patients
Our normal turnaround for relines and repairs is one
production day in the lab. In other words, if we pick it up
Tuesday morning, you would get it back on Wednesday
morning by noon. (In the Metro area.) Your patients’
don’t want to be without their teeth overnight? To serve
these patients who want a rushed service, we offer same
day relines and minor repairs for an extra fee.
Because of the coordination involved in rushing
a same day case, these repairs must be scheduled in
advance and we can only accept a limited number of
these cases per day. When you schedule these cases, your
pickup must be ready by 9:00am. That gives us enough
time to get it back to our office and do the repair in
time for our regular afternoon drivers to deliver the case.
Our regular afternoon driver can return the case to you
by 3:00pm.
In order to do same day repairs, we must get the case
to our office early in the morning and have a few hours
to work on the case. In order to get the time we need, we
send a special driver who only picks up same day repairs.
Our same day driver is responsible for picking up same
day repairs and relines and getting them straight back
to the lab. It is important
that you give the case
only to this driver and
not to any courier service
or normal delivery driver
who may come by. We
will call your office that
morning to confirm that
your case is ready to pickup.
Because of the rushed
nature of these repairs, we
can only promise same day service for simple acrylic
repairs. In the amount of time allowed, we cannot repair
clasps (2 days in lab), replace attachments, or do soft
relines (also 2 days in lab).
Another option is for your patient to deliver the
case with prescription and wait for the repair here at
our lab. This also should be arranged in advance to
ensure that the appropriate personnel are here. Thanks
for your understanding of these time sensitive cases. It
is our goal to provide you with the best possible service
AND repair/reline.
Valplast is a very popular metal-free flexible resin material that is indicated for both bi-lateral and uni-lateral tissue
supported tooth replacement. Cases for Valplast are surveyed and designed here in the lab similar to our Wironium
cast metal partials to ensure an accurate path of insertion.
Insertion Instructions:
When inserting a Valplast partial you should first
submerge the appliance in hot, (almost boiling) water
for 60 seconds, (this allows for a smooth insertion and
excellent adaptation to natural tissues in the mouth).
Then, once the appliance has cooled to a tolerable level,
insert into the patient’s mouth. If a clasp isn’t fitting
perfectly, you may adjust it slightly by immersing that
area of the partial in hot water and bending the clasp
outward or inward as needed.
Adjusting:
If any reduction or adjustments are needed, the material
needs to be handled differently than conventional
acrylics. A #13 green mounted stone, (similar to those
used for porcelain adjustment) may be used to quickly
reduce the surface yet leave it very smooth. If melting
occurs, use lower rpm’s and lighter pressure. You can
also use a green rubber point using the same motions
to achieve a fine smooth finish. A sharp scalpel can be
used to remove any build-up or roughness. The surface
should look almost polished at this point. Use a course
pumice and brown Tripoli with a soft rag wheel until
completely smooth. A high luster can be achieved using
Val Shine polishing compound with a soft rag wheel.
Adding Teeth and Repairing:
Teeth and clasps may be added to the Valplast appliance
by taking an alginate impression with the partial in
place. To rebase a Valplast partial, begin by taking
the rubber base impression under the case. To assure
full and correct occlusion as the rubber material sets
inside the partial, your patient’s mouth should be
closed. When the rubber base impression has set, take
an overall alginate impression. As you remove the case
from the mouth inside the impression, make certain the
case is positioned correctly in the impression. Pour the
model promptly and send it to Gnathodontics without
separating the denture from the model.
Cleaning Valplast Appliances:
Using the recommended
Pro Tech cleaner or TCS
cleaners will help to
prolong the life of the
appliance and keep it
looking new. The use
of abrasive cleaners
such as tooth paste is
discouraged as they will
roughen the surface and cause discoloration. For more
information on Valplast, contact myself at ext. 200 or
Ralf Weisenbeck at ext. 210.
With the price of gold near all time highs, it makes
sense to prescribe Gnathodontics’ flat rate Porcelain to
Noble restorations. Using the latest Noritake and Vita
porcelains, our highly skilled ceramists create vital, life
like restorations over our super strong, precise fitting
Noble substructures, (Argen Argelite 70+). Suitable for
single units and long span bridges alike, our porcelain to
noble restorations are built to your exacting instructions
with special emphasis being placed upon form and
function. You won’t find a more esthetic and precise
fitting pfm restoration anywhere for your dollar.
Priced at $159 per unit, which includes alloy, our
Noble Crown restoration will satisfy your patients’
expectations while providing you with a quick seating,
sensibly priced restoration that you can be proud
to prescribe! And, as always, each Noble Crown
restoration is hand made by skilled technicians here at
Gnathodontics, Ltd.!
© 2009 Gnathodontics, Ltd.
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