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Medical Forum / General / Dentistry / September 2005Three cases, SVP
Howdy all. Sorry to bother youse with these things all the time, but I really don't have any others to bounce ideas off of here locally. This first is a class III severe with crowns on Upper centrals. I think they are acrylic crowns, as they are lucid to the xray. They may be early Procera or something, but I doubt it. http://tinypic.com/dlksyb.jpg [IMG]http://tinypic.com/dlksyb.jpg[/IMG] What say I just sand blast the sh*t outta the labials and silane 'em and put composite over 'em? Or try to bond pocelain over 'em after reducing 'em 0.8mm? ----- This next is a Czech MD who has many implant and crowns in her mouth, and the perio between the UR 2nd PM and 1M is not resolving. I've gotten good results elsewhere in her mouth. I suggested crowning the 2nd PM to have a better tissue response to subgingival restorations (composites right now) and to resist the continual forces of bruxism. (She doesn't want to but a guard in, either NTI or any other. She would rather crown all the teeth as they become damaged(!). http://tinypic.com/dlkw28.jpg [IMG]http://tinypic.com/dlkw28.jpg[/IMG] http://tinypic.com/dlkvwm.jpg [IMG]http://tinypic.com/dlkvwm.jpg[/IMG] The hick is a very short clinical crown on the palatal http://tinypic.com/dlkv81.jpg [IMG]http://tinypic.com/dlkv81.jpg[/IMG] and she is recently post pacemaker so we have to premed her with antibiotics before each appt. Rather than do a cown lengthening on the palatal, what say we try to do a Richmond style crown+post together? Does anybody have any thoughts on that? It's either that, or we open up the palatal flap, remove bone, reduce the tooth right then and perhaps take a Hoos style impression of the abutment at the same time. Let heal up six to ten weeks and then put in the crown... ----- This one is a _Sanitary_ partial denture metal frame work. A local lab came to see me and showed me this model amoungst others. http://tinypic.com/dlkxl5.jpg [IMG]http://tinypic.com/dlkxl5.jpg[/IMG] http://tinypic.com/dlkxuc.jpg [IMG]http://tinypic.com/dlkxuc.jpg[/IMG] I would think that the potential damage to the palatal aspect of the covered teeth by constant plaque contact would obviate any advantage to having the palate mostly uncovered...? ----- Finally, this last is a tooth I took out recently. I'll see him back again in 6 weeks to decide if we need to do any perio or bone procedures. http://tinypic.com/dlky1z.jpg [IMG]http://tinypic.com/dlky1z.jpg[/IMG] ----- Thanks for any thoughts SP  SignatureTake out the TRASH to reply Flap's Reply: Got some radiographs you can show? Flap http://flapsblog.com > Flap's Reply: > [quoted text clipped - 3 lines] > > http://flapsblog.com Unfortunately no. I can go back and get them, but that won't be till Monday. Thanks SP SignatureTake out the TRASH to reply >Howdy all. Sorry to bother youse with these things all the time, but I >really don't have any others to bounce ideas off of here locally. [quoted text clipped - 6 lines] > >[IMG]http://tinypic.com/dlksyb.jpg[/IMG] REPLY This looks like some kind of quick-cure acrylic, that is not dense enough for permanent materials. It wears away ...... >What say I just sand blast the sh*t outta the labials and silane 'em and >put composite over 'em? Be sure to use a bonding agent that will bond to chemically-cured (self-cure) acrylic. For example, Pulp-Dent has a five-bottle mix-up up bonding stuff that workd just great. Oh wait ....... it you are placing composite over them, then I would mechanically groove into the old teeth ....... Joel >Or try to bond pocelain over 'em after reducing 'em 0.8mm? > [quoted text clipped - 57 lines] >Thanks for any thoughts >SP > REPLY > [quoted text clipped - 7 lines] > (self-cure) acrylic. For example, Pulp-Dent has a five-bottle mix-up > up bonding stuff that workd just great. OK... Bisco has a one bottle that is supposed to do the same thing, or so they say. > Oh wait ....... it you are placing composite over them, then I would > mechanically groove into the old teeth ....... OK.... except I was thinking that the micro etcher would provide enough retention. I can try that though. The reason I thought against it was that I wouldn't want to attack those surfaces with the high speed and have them explode off the metal framework under the force generated. I'll use (and ruin) a few diamond burs. Thanks SP SignatureTake out the TRASH to reply >> REPLY >> [quoted text clipped - 10 lines] >OK... Bisco has a one bottle that is supposed to do the same thing, or >so they say. Will Bisco bond photobonding "adhesive" to chemically cured acrylic? That's the question ....... >> Oh wait ....... it you are placing composite over them, then I would >> mechanically groove into the old teeth ....... [quoted text clipped - 7 lines] >Thanks >SP > >OK... Bisco has a one bottle that is supposed to do the same thing, or > >so they say. > > Will Bisco bond photobonding "adhesive" to chemically cured acrylic? > That's the question ....... I'll check with them before opening the bag... Once you do that, you can't send it back. Thanks SP SignatureTake out the TRASH to reply >> REPLY >> [quoted text clipped - 19 lines] > have them explode off the metal framework under the force generated. > I'll use (and ruin) a few diamond burs. Parkell Add & Bond is great for bonding new resin to old resin or acrylic. "Stovepipe" <stove99p...@yahoo.ca> wrote in message > OK.... except I was thinking that the micro etcher would provide enough > retention. I can try that though. The reason I thought against it was > that I wouldn't want to attack those surfaces with the high speed and > have them explode off the metal framework under the force generated. > I'll use (and ruin) a few diamond burs. Parkell Add & Bond is great for bonding new resin to old resin or acrylic. _________________________ dentaldoc writes: Although I haven't tried the Parkell Add & Bond myself, I've heard good things about it. Parkell makes some great products. When you mention "explode off the metal framework," are these crowns the acrylic-bonded-to-metal type? I thought they were plain acrylic. - dentaldoc Here ya go Bill ....... QUOTED, This first is a class III severe with crowns on Upper centrals. I think, they are acrylic crowns, as they are lucid to the xray. They may be early Procera or something, but I doubt it. http://tinypic.com/dlksyb.jpg END QUOTE, Joel >"Stovepipe" <stove99p...@yahoo.ca> wrote in message > [quoted text clipped - 17 lines] > >- dentaldoc > "Stovepipe" <stove99p...@yahoo.ca> wrote in message > [quoted text clipped - 13 lines] > > - dentaldoc Sorry for being so lazy as to not have taken pics of the xrays. You see an opaque metal crown framework but the surrounding white stuff is lucid on the film. I'll post it next week when I go in and take another pic. I meant that if you take a highspeed to that white stuff, it probably isn't going to file away like porcelain would. If the underlying bond or adhesion to the metal is weak, it's gonna flake off, and then he's gonna need a new crown, which he can't afford. Thanks SP SignatureTake out the TRASH to reply >If the underlying bond or > adhesion to the metal is weak, it's gonna flake off, and then he's gonna > need a new crown, which he can't afford. Why do you need to be the hero to these people? If he cannot afford it, then leave it alone. Patch any leaking margins with amalgam and tell him to come back when he has saved enough money. I bet you a filet dinner that the guy spends more than the cost of new crowns on vacations, nicer than "basic" automobiles, beer, etc. Signature. Amatus . > >> "Stovepipe" <stove99p...@yahoo.ca> wrote in message [quoted text clipped - 26 lines] > Thanks > SP > >If the underlying bond or > > adhesion to the metal is weak, it's gonna flake off, and then he's gonna [quoted text clipped - 5 lines] > guy spends more than the cost of new crowns on vacations, nicer than "basic" > automobiles, beer, etc. OK,,, thanks. I think I'm gonna sell the little shop of destitutes and move on. If they won't support me, I won't support them. Thanks SP SignatureTake out the TRASH to reply > > OK.... except I was thinking that the micro etcher would provide enough > > retention. I can try that though. The reason I thought against it was [quoted text clipped - 4 lines] > Parkell Add & Bond is great for bonding new resin to old resin or > acrylic. Parkell! I should have thought of them... Ray Berlotti and gang... Thanks, NOYB SP SignatureTake out the TRASH to reply StovePipe wrote: Parkell! I should have thought of them... Ray Berlotti and gang... Thanks, NOYB SP --------------------------------- I thought that Bertolotti was Danville Engineering . . . . - dentaldoc > StovePipe wrote: > [quoted text clipped - 4 lines] > SP > --------------------------------- > I thought that Bertolotti was Danville Engineering . . . . > > - dentaldoc You're right: that is his _own_ company, I believe. He _does_ mention Parkell in his lectures, so I figured he does some development with them as well. Thanks SP SignatureTake out the TRASH to reply >>> REPLY >>> [quoted text clipped - 21 lines] > >Parkell Add & Bond is great for bonding new resin to old resin or acrylic. REPLY Thanks! Valuable tip. Do we sandblast or rough up the old material or what? Joel NYOB and Bill suggested: > >Parkell Add & Bond is great for bonding new resin to old resin or acrylic. > [quoted text clipped - 5 lines] > > Joel I really feel I should give the Danville MicroEtcher IIA fully autoclavable a chance to create enough surface retention so that I _don't_ have to mechanically hack into the stuff. My little finger tells me it will be enough with the right bonding. Thanks SP SignatureTake out the TRASH to reply >>>> REPLY >>>> [quoted text clipped - 28 lines] > > Valuable tip. Do we sandblast or rough up the old material or what? Yes. I use 99% alcohol on a Q-tip to clean the surface too. > >>Parkell Add & Bond is great for bonding new resin to old resin or acrylic. > > [quoted text clipped - 5 lines] > > Yes. I use 99% alcohol on a Q-tip to clean the surface too. Where do you get that EtOH? I can only get 94% EtOH here in the liquor store. They really look at me funny when I go back there every month or so, but you can at least be sure that the stuff is not adulterated with benzene, as it is for human consumption ('pure' vodka). <hic> :-/ Thanks SP SignatureTake out the TRASH to reply >> >>Parkell Add & Bond is great for bonding new resin to old resin or >> >>acrylic. [quoted text clipped - 12 lines] > benzene, as it is for human consumption ('pure' vodka). <hic> :-/ > Thanks I'm pretty sure I buy it from Patterson Dental. A google search for 99% isopropyl alcohol returned this site: http://www.cpr-savers.com/Industrials/antisep%20oint/isopropyl.html > >> Yes. I use 99% alcohol on a Q-tip to clean the surface too. > > [quoted text clipped - 5 lines] > > http://www.cpr-savers.com/Industrials/antisep%20oint/isopropyl.html Ah!!! That explains it. I just assumed that EtOH would be more appropriate than isopropyl, as alcolol based bonding systems like SingleBond (which is what I use) are ethanol based. Since any alcohol would be an adulterant, I thought the ethanol would be less of a contaminant. Thanks SP SignatureTake out the TRASH to reply >> >> Yes. I use 99% alcohol on a Q-tip to clean the surface too. >> > [quoted text clipped - 11 lines] > would be an adulterant, I thought the ethanol would be less of a > contaminant. When you clean something with 99% isopropyl alcohol, it isn't around very long before it evaporates completely. I have no idea what the other 1% is though, nor if it contaminates the surface. I'd say from personal experience that it doesn't affect the bond strength one bit. > When you clean something with 99% isopropyl alcohol, it isn't around very > long before it evaporates completely. I have no idea what the other 1% is > though, nor if it contaminates the surface. I'd say from personal > experience that it doesn't affect the bond strength one bit. I'm betting the other 1 percent is distilled H2O. Thanks for the advice. SP SignatureTake out the TRASH to reply >>> >> Yes. I use 99% alcohol on a Q-tip to clean the surface too. >>> > [quoted text clipped - 16 lines] >though, nor if it contaminates the surface. I'd say from personal >experience that it doesn't affect the bond strength one bit. The other 1% is Schwepps ....... >>>> >> Yes. I use 99% alcohol on a Q-tip to clean the surface too. >>>> > [quoted text clipped - 18 lines] > > The other 1% is Schwepps ....... Blech. Canada Dry is much better. > Since any alcohol >> would be an adulterant, I thought the ethanol would be less of a [quoted text clipped - 4 lines] >though, nor if it contaminates the surface. I'd say from personal >experience that it doesn't affect the bond strength one bit. The 1% is very likely water. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >I thought the ethanol would be less of a >contaminant. > >Thanks Many peoples favorite contaminant of good scotch whiskey -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >I'm pretty sure I buy it from Patterson Dental. At an exorbitant markup no doubt. Am no fan of PDCO. >A google search for 99% isopropyl alcohol returned this site: -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>I'm pretty sure I buy it from Patterson Dental. > > At an exorbitant markup no doubt. > > Am no fan of PDCO. I am. My rep is great. I owned a 1 year old Matrox compressor (bought against his recommedation) that needed repair twice (under warranty) in the first year. Patterson took it back for a full refund and swapped it out for an Air Techniques. I've had other pieces of equipment go down, and Patterson is in my office with a "loaner" in less than an hour or two. I get free shipping on all goods...even overnight stuff. And virtually anything I order up until 6pm shows up at my office the next day. I pay more...but the service is worth it. >>>I'm pretty sure I buy it from Patterson Dental. >> [quoted text clipped - 14 lines] > >I pay more...but the service is worth it. Different strokes and all that... -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > This one is a _Sanitary_ partial denture metal frame work. A local lab > came to see me and showed me this model amoungst others. [quoted text clipped - 8 lines] > covered teeth by constant plaque contact would obviate any advantage to > having the palate mostly uncovered...? Funny thing, that was my first thought! I think you're right. I have never been comfortable with excess metal coverage over the gingival margin, especially on the palate. Most successful partial denture designs minimize such coverage and produce either a palatal strap or a "toilet seat" type of design on the palate. Nice pictures of the chrome frame. ;-) > ----- > [quoted text clipped - 3 lines] > > http://tinypic.com/dlky1z.jpg http://tinypic.com/dlsxfc.jpg This type of case is always interesting to watch the healing. In my experience, depending on the root position, sometimes the bone fills in if you give it long enough, and six weeks is pretty short. But each case is individual. - dentaldoc > > I would think that the potential damage to the palatal aspect of the > > covered teeth by constant plaque contact would obviate any advantage to > > having the palate mostly uncovered...? > Funny thing, that was my first thought! I think you're right. I have > never been comfortable with excess metal coverage over the gingival > margin, especially on the palate. Most successful partial denture > designs minimize such coverage and produce either a palatal strap or a > "toilet seat" type of design on the palate. Yes, like a full bar on a lower RPD will damage the surface and the gingiva if the PRD is not scrupulously cleaned and if it doesn't fit well. > Nice pictures of the chrome frame. ;-) Thanks. They were surprised when I asked if I could take a couple of pics for my study club. I didn't tell them that alla youse are elsewhere in the world. > > Finally, this last is a tooth I took out recently. I'll see him back > > again in 6 weeks to decide if we need to do any perio or bone [quoted text clipped - 10 lines] > > - dentaldoc I know it... I'm not gonna go probing down there at six weeks. I'm just gonna check that he hasn't lost bone and palatal gum tissue more than he has to. If he _has_, I think I'm best to refer him to the local perio guy. Thanks SP SignatureTake out the TRASH to reply |
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