This is a continuation of this case – A single central incisor implant.
The patient returned for the final impression after two months of healing.
Since the provisional maintained the soft tissue profile, there was a lot of space around the impression coping when attached to the implant for the fixture-level impression.
In the past, when I’ve tried to register this “sulcus” with the wash material in my impression, it results in a somewhat fragile extension of the impression. Continue reading
While screw-retained implant crowns are favored today, certain clinical situations dictate cemented crowns on custom abutments. I won’t be going into the different scenarios that favor screw-retained over cemented. Nor will this article cover the advantages and disadvantages of each approach. I’ll assume you already know that… Or, you simply have your own preferences.
I prefer screw-retained whenever possible. But, sometimes it’s not possible or practical.
This article describes a way to document where the screw access in the abutment is relative to the cemented crown restoration for future reference if needed.
Implant screws sometimes come loose. Fortunately, I have seen none of mine… yet. But, it could happen to any of us, eh? I’ve had plenty of cemented implant crowns show up in my practice with a loose screw. It’s a vexing issue. There are typically two options:
I got an emergency call from a long-standing patient a week ago on Saturday. We did a smile makeover with porcelain restorations for him 17 years ago, and he’s been a regular patient ever since. He told me that he bit into a candy that he expected to have a soft center. It didn’t. And, he heard a “crack,” then his front tooth was loose.
I met him at the office and determined he fractured the root. The crown of the tooth was still hanging on by some soft tissue. No pain, though. Since it was a Saturday, and I was working alone, I simply splinted it with some flowable composite to try to stabilize it until Monday.
We discussed his options:
He decided he wanted a more predictable long-term result and chose the implant.
On Monday, we got a pre-op impression and sent him over to the periodontist for extraction and immediate implant placement. I used the pre-op model to make a Siltec putty matrix for a provisional.
On Tuesday, he had the extraction and implant placed.
He drove over to my office immediately after that. The periodontist also placed a provisional abutment (PEEK material).
I shortened the provisional abutment a bit and Continue reading
Over the years (since 1999), I’ve gradually added to my website. After 22 years, I’ve got over 50 pages on my site.
Something I’ve constantly advocated (to other dentists) is to avoid “catch-all” web pages on your website. For example: Putting a list of all your services on a single “Services” page dilutes the SEO (search engine optimization) potential for your website. Instead, put each service on its own web page.
If you offer veneers, for example, it deserves its own web page. If you put it on the same page as the laundry list of all your services, it simply won’t show up when someone searches “Veneers dentist my town.” A page dedicated to veneers is far more likely to get noticed (and more highly ranked) by Google. I’ve written about this before.
This time, it’s a bit different. This time it’s about the “About Us” page on your website. Most dentists have a “Meet the Dentist” page. Or (worse), they have a “Meet the Team” page that includes the dentist. The dentist should have his or her own page, of course. The team gets its own page, too.
Typically on the “Meet the Dentist” page, we have the usual rundown of our qualifications and professional background, experience, and associations. BORING!!! Many will add something personal, as well… Like our family, pets, or our oil painting or fishing hobbies. BORING!
But, what if there was something about you that distinguishes you as different? Or as similar to a particular group of people? Continue reading
Over the years, I’ve encountered colleagues that claim veneers are doomed to fail…. Or, that they are less predictable than crowns. “Veneers pop off.” “Veneers break,” they say.
I’ve been fortunate to have practiced for almost 33 years (so far), 27 years in one place. I’ve also been fortunate enough to have a number of patients who have been in my practice for a long time. As such, I’ve had the opportunity to observe the longevity of my own work… for better or worse!
When patients move away, we can at least claim “geographic success!” If your cases move away, they haven’t failed… as far as you know. Some of mine have stuck around.
I was discussing the current situation with COVID hysteria, (unconstitutional) rules, and social implications with my wife at lunch. And a nuclear analogy sprung to mind for me….
We have reached a critical mass of willful ignorance and suspension of critical thought. The disinformation campaign aimed at controlling EVERY SINGLE aspect of society has reached a critical mass that it has become a self-perpetuating chain reaction. What we have is “fissionable fear and willful ignorance” resulting in mass compliance with even the most ridiculous new rules over essential and routine evolutions and the minutiae, as well.
Cover your face. Not once, but twice! Don’t go to church. Don’t sing out loud. Don’t see your family, even if they’re dying. Don’t see your children or grandchildren. Don’t even cheer for your favorite football team inside your own home – Use a noisemaker or stomp your feet, instead. No shit. That came from the CDC. This is real. And, it’s being accepted by people because we’ve reached that critical mass I referred to earlier.
Rather than a health issue, following the “rules” is a matter of SOCIAL COMPLIANCE. Continue reading
There are some serious potential problems with the COVID vaccines that are not being brought to light by those with the power to do so. The media and politicians are not discussing this at all. I’ve been reading the peer reviewed medical literature instead of listening to the talking heads. I have posted links and excerpts to three peer reviewed articles below. Decide for yourself.
I’m posting some references regarding the potential problems with the new SARS-COVID vaccines. To be clear, the concern is NOT a “side effect” or “reaction” to the vaccine itself. The concern is what happens when a vaccinated subject is exposed (“challenged”) to the live virus.
These are peer reviewed journals, which means the submitted articles / studies undergo strict scientific scrutiny before being published. These studies / articles bring up some VERY serious potential problems. Continue reading
Composite build-up placed and final prep. Laser troughing for impression.
This will be a short blog post.
Today, a long-time patient was in the chair for a crown delivery. None of these photos are of this particular case.
As is usually the case, the crown dropped in with perfect contacts… and a tiny bit of occlusal adjustment. The patient was satisfied with the esthetics and gave the nod to cement it.
After cementation and clean-up, I sat the patient up and asked her to make sure it still feels good. (Some patients’ occlusion changes when I sit them up after adjusting in while supine in the chair.)
She confirmed it felt good and then said:
“Your crowns are not cheap. (They aren’t!) But, they are always very good. At previous dentists, my crowns were always difficult and needed a lot of adjustments. Your temporary crowns always stay in – this one was in for 6 weeks. And, your crowns always fit without adjustments.” Continue reading
Invariably, when I post a photo of a diastema case on a dental group, the usual suspects come out of the woodwork to explain why the spaces are there. Usually, it’s the “myofunctional therapy” and “dental sleep apnea” fanbois and girls.
Oftentimes, from a single photo, they’ll make the call. “The patient obviously has tongue thrust and needs myofunctional therapy!” I posted the following case on some dental social media groups and got exactly that.
This patient drove 180 miles and likely passed 2,000 dentists on the way… to come see me. Her chief complaint was the gaps between her teeth. She’s a model. She’s had orthodontics TWICE.
Sure enough, the tongue is pressed FIRMLY up against the teeth in this pre-operative photo. It’s GOTTA be the dreaded tongue thrust that caused the spaces, riiiiiiiiiiiiiight? Continue reading
Copyright protected by Digiprove © 2020 The Dental Warrior® It only took me 32 years to come to this conclusion. I hope this article will shorten that time for you.
You know how they say, “your reputation precedes you?” Certainly, we’re all aware that we have a “reputation” as dentists… at the very least with our own existing patients. Presumably, since they’re still your patients, your reputation is likely “good” with them. Perhaps your reputation may extend beyond your patients to their family or friends, with whom they had conversations about their experience in your practice.
Depending on your professional relationships extending from your practice, you may also have a reputation among colleagues and other connected professionals.
Many of us work hard to maintain a good reputation. We hope for good online reviews from our patients. We hope our specialist referrals speak highly of us to our patients. Those specialists may occasionally return the favor of referral due to our reputation with them.
I recently learned that reputation isn’t the same as your brand. And, by brand, we’re not talking about naming your practice, “Del Boca Vista Smiles” or even “Smiles by Dr. Schmuckatelli.” Branding is not a cool logo, either. Your name and logo may REPRESENT your brand, but they are not your brand.
Copyright protected by Digiprove © 2020 The Dental Warrior®