A Full Mouth Dental Implant Case. The patient is always right!

This week we completed a full mouth upper implant case using a cast bar and denture teeth. This was the case in the laboratory.

On the articulator

One particular issue we has was the size of the teeth; the patient had a fixation on the size of teeth and was concerned that oversized teeth would make the denture stand out and not look natural. However we went ahead and made the fixed implant bridge as requested following the try in of the teeth she asked for.

Dental Implant Bridge Palatal View

Dental Implant Bridge Labial View

Here's the finished result notice the size of the denture teeth!

It's interesting to note the difference between how the bridge looked on the articulator and then in the mouth. On the arictulator the small size of the teeth were not as apparent, but in the mouth, with the reference points of the nose and smile it is immediately clear to us as dental professionals that they are slightly too small.

But the patient is always right? And she loved them, but this could so easily have been a mistake rather than a success.

So, what lessons can we draw from this?

I think the biggest lesson is to use photographs both in the laboratory and in the surgery to communicate and share. On articulators we can easily make a mistake as we don't have the reference points of the nose and smile... but in the mouth, those small mistakes quickly come to light.

So get those photos shared.... how else can we avoid simple mistakes like getting the size of the teeth right?

Dental Implant bars - How to get them right first time...

Choosing the right type of restoration for a large full arch implant reconstruction can be difficult. Many times a denture may be the best option (perhaps to replace lost support for the face) but the patient won't accept as removable appliance! It's a difficult one to manage.

So here are our top tips for ensuring a predictable result:

1. Start, pre implant placement, with a try-in full denture WITH gum work
2. If the patient ideally wants a fixed bridge have another try-in WITHOUT gum work so you can see the emergence of the teeth
3. Use the try-in to decide if there is enough room for a bar or studs, if not enough room discuss options with us.
4. Do not proceed until the patient is happy with the try-in
5. Get us to turn the try-in in to a stent
6. Place the implants using the stent
7. Once integrated get us to make the bar with a 'snap' on bite block and final test set up
8. Once happy go through to completion

The key is the set up at the beginning, don't be tempted to guess or move too fast without getting this right. This is THE absolute KEY to predictability.

To help further with this we are running a study evening, here at the lab (a quick 15 minutes from Kings Cross Station or Jnct 22 on M25) on Tuesday 30th November 6:30pm for 2 hours.

Study Evening - The Edentulous Patient, an evening looking at CADCAM Bars and Frameworks

To book, please call the lab on 01707 663293 or book online here http://www.sbodentallaboratory.co.uk/events.html

We look forward to seeing you.

How to accurately raise the patients bite

We do lots of cosmetic smile design reconstructions in the lab, and one frequent request for occlusal rehab cases from our dentists is this "Please open the bite by 1.5mm", sounds simple huh?

Well, the problem is - where do we raise the bite from? Many replies we get to this question say "Raise the bite on the posterior teeth by 1.5 mm", but if we do this, then anterioirly the bite is raised much more.

Some times we are asked to simply raise the bite vertically by 1.5mm, but this again has big problems due to the arc of closure.

Opening the bite on an articulator is never the best solution, here is a diagram which seeks to demonstrate this further.

Notice that if the bite is opened vertically then the upper/lower relationship looks very different to if it is raised on the articulator itself due to the arc of closure... obvious really! However this is simply an exageration of what happens when we open the bite on the articulator... we have NO WAY of knowing if the arc of closure is the same as in the mouth, this means we have no way of knowing if the new opened bite will be the same new opened bite when the restorations are fitted... a recipe for disaster.

To overcome this, we recommend opening the bite in the mouth to the amount that you wish, then recording this increased vertical dimension with a squash bite. This then ensures that the opening we mount to is the same as your patient.

How have you overcome this same problem?

Technology makes implant dentures more predictable using Biomet

Over the years we have produced many, many implant cases using dentures on beams to restore the patient's teeth. Implant borne dentures on a beam solve a number of problems that fixed bridges don't:

1. They are removable which makes the case far more cleanable
2. They are far better at supporting the lip in cases of extreme bone loss
3. They can more easily be repaired

However, implant borne dentures aren't without their problems:

1. They often involve clips, attachments and/or milling which makes the cost unpredictable and often high
2. This wide use of components often means they need laser welding or soldering, this can introduce weaknesses in the design making them more prone to fracture
3. The bars are usually made of gold, while this is bio-compatible, the gold interfaces with titanium so there is a chance of some electrolytic corrosion at that interface

Modern advances in CADCAM technology have now brought together the advantages of implant beam dentures and made huge progress in removing the problems.

Using Biomet3i CAM StructSURE (r) Precision Milled Bars it is now possible to have all the benefits of a beam design with a denture AND have none of the conventional negatives. These bars are precision milled from a solid mass of industrial grade titanium which makes them incredibly strong and bio compatible.

Due to the savings made on components and manufacturing costs we are, amazingly, able to offer these bars at up to a 20% saving on our standard prices... so you get a better product at reduced price...a dental 'no brainer' really.

Biomet3i CAM StructSURE (r) Precision Milled Bars are also available in a design that is suitable for direct application of acrylic teeth, so if screw access position is good then this is a great alternative to the classic 'beam design' gold and acrylic denture.

For fixed conventional bridge work that requires composite layering (such as GC Gradia) , this is also possible using this same system using a CADCAM copy milling technique.

For further information and to discuss case management, please call Keith at the lab on 01707 663293

Save money on implant abutments & get a better product, find out how...

I’d like to personally invite you to an

Astra Atlantis Cost Effective Implant Abutment Experience

This is a perfect opportunity to find out how you can easily have:

1.     Cheaper Implant Abutments to increase profit margins

2.     More Bio Compatible Implant Abutments to provide a better product

Astra Atlantis is a revolutionary leap in technology that allows us to design implant abutments with extreme precision, to match soft tissue contours, in 3 materials - Zirconia, Titanium, Titanium/Gold Hue.

Astra Atlantis also have a unique 'Gemini' abutment system which is 2 abutments - 1 for highly accurate soft tissue contouring during temporisation, and another exact replica that is used for final restoration production. This technique saves time and creates a far better aesthetic result.

The evening will include 2 brief presentations, 1 from Keith Shrubb (Implant Director at SBO) and Christian Flynn from Astra. Plus an extended time to truly experience the full advantages of the system and answer your questions.

Date of the Astra Atlantis Experience: 13^th May 2010

Start time: 1830

Venue: SBO Dental Laboratory

Cost: £0

If you restore implants, want to save money AND want a better product then you need to book to come on this Astra Atlantis Experience to find out how to make the most of this amazing system in your practice.

Places are limited as we have a small friendly lab, so please book early to avoid missing out. Simply reply to this emai/blog with your practice details and I will add you to our list:

Name: 

Address: 

Phone number:

Number of place to book:

Alternatively call Mark on 01707 663293 or print and fax this to 01707 662092

I really look forward to seeing you,

What cases do you want to be doing more of?

This is a blog post about getting more patients to your practice so you can treat them with the high quality dentistry you know you can provide. Would you like more of the right patients to your practice? Indeed would you like some one else to find those patients for you so you can continue to be the very best dentist?

At the end of this post I will make a commitment to spend money helping you find those patients.

In a moment I will tell you about the money I will spend on your practice, but before I do that you need to know that I've just had one of those profound light bulb moments. This light bulb moment started yesterday when I jointly facilitated (with Azimuth Dental dental business coach) a business/marketing development day for 12 dentists.

The dentists brought to the meeting their biggest dental business problems facing them today. As a facilitator I spent the day entirely in the mind of the delegates whilst we worked through these problems. I had NO agenda, NO presentation and NOTHING prepared other than a very carefully thought through structure for the day. You know that all successful businesses have a structure, indeed all successful humans have a structure - when you prep a tooth for a PFM you work to a structure because structure gets results... the result of our structured day?... 12 VERY happy dentists with REAL results that THEY generated.

Whilst online this afternoon I came across this blog post on Twitter (very much worth a read) about creating a remarkable business that truly reflects what the customer wants, and the light bulb glowed brightly.

I've been stupid.

I've been dumb.

I've spent thousands marketing to get new dentists to send their cases to the lab and I haven't once stoppped to REALLY get inside their heads and ask "what do you want?"

I've told you that we do implants, I've told you that we do cosmetic cases, I've even told you we do anti-snoring devices and that I will send patients to your practice.

So here's what's new, I'm not going to tell you what we do, I'm going to ask what you want...

so here's that question...

what type of restorative cases would you ideally like to be doing more of?

some suggestions might be...

• regular dentures
• flexible dentures
• implant supported dentures
• veneers
• crowns
• single implants
• large implant cases
• inlays
• gum shields
• occlusal splints
• anti-snoring appliances
• full mouth reconstructions
• other

And here's my financial commitment to you now...

If you reply to me with what you want to be doing more of, I will allocate a major share of my marketing budget for 2010 to attracting those patients and putting them in touch with YOU

I will take a consensus of opinion from all responses I get to decide on which treatments I will promote. I'll attract these patients by using a structured approach, which gets results, using a variety of techniques including Twitter, Facebook, websites and more. I'll then put these patients in touch with the dentist closest to them.

So to start getting these patients sent to you, you need to tell me what you want to be doing more of (the only caveat is that it is lab related... for obvious reasons!), to do this you can:

1. Twitter DM me: @markoborn
2. Facebook message me: Facebook.com/dentistmarketing
3. email me: mark@sbodentallaboratory.co.uk
4. call me: 01707 663293
5. comment on this blog post

At the end of April 2010 I will collate all responses and put together a structured marketing package that will start to put relevent patients in contact with you, thereby building your practice with cases that you want to do, building our lab with happy dentists and ultimately providing patients with the service they desire and quality dentistry they can be proud of... truly a win, win, win situation.

So reply now while its fresh, what cases do YOU want to be doing more of?

Get updates of patients looking for a dentist...

You may be aware that we are currently running a series of adverts on Facebook, Google and Bing telling patients about the SBO Silensor Anti Snoring device. We are collating the patient details in to a geographical database of locations around the UK.

Currently we have 100 fans on our 'Stop Snoring Tonight' Facebook page and have 24 new patients looking for a dentist on our database... all this in only 3 weeks!

We would love to be able to provide your details to these patients, who have visited the patient anti-snoring page on our website and then to encourage these patients to come to you for their device, they are pre-educated and ready to go for the anti snoring device.

To be kept up to date with this rapidly growing database of new patients the easiest way is to

Subscribe to SBO Silensor Anti-Snoring Appliance Database by Email

Your details are totally secure and will not be used for any other purpose. Updates of patients will also be limited to once per week.

This is an innovative scheme from the UK's most proactive dental laboratory... watch out for more coming soon...

any questions please don't hesitate to call 01707 663293,

regards,

Mark

P.S. For a list of towns where patients are looking for a dentist to provide an SBO Silensor Anti Snoring Appliance please

Subscribe to SBO Silensor Anti-Snoring Appliance Database by Email