Case Study

Collaboration For Complex Cases: The Benefits for Dental Technicians & Dentists For Innovative Solutions

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Introduction


This case study illustrates the metal-free, biocompatible alternative completed in May 2024 in collaboration from the dental practice perspective with Dr. Paul Moore to meet the needs of the patient for a removable solution. Using Tecno Med Mineral, a thermoplastic high quality resin material solution from Zirkonzahn® we manufactured this ‘Removable Tecno Med Thimble Bridge with Individual Prettau® Crowns on Titanium Friction Bars.

As a Guaranteed Irish dental laboratory specialising in creating premium dental restorations, it is extremely important for our customers to see what a great collaboration can bring to life through planning and strong communication. The value of seeing the final case fitted in the patients mouth is critical for us as a team and also allows us to celebrate and invite other customers to showcase our collective success together. Additionally, it opens up conversations about the restorative possibilities that our current or potential customers did not know we offer.

Procedure 


Diagnostic Phase: Digital photographs, wax bite rims and verification jigs were used to establish the current patient situation. The collaboration to meet the patients personalised treatment plan from their dentist took the patient’s aesthetic choices, oral anatomy, and facial features into account. However, the hygiene aspect drove the treatment planning in a direction of a removable prosthesis further. 


Multi-Units placed on Implants


Alignment

Treatment Planning: The dentist and the technician started the collaboration for this case by creating an upper and lower prototype to establish a new stable occlusion with enough VDO to support a removable prosthesis. 


Developmental Stages:  

  1. Prototypes: Upper and lower PMMA protypes were fabricated to establish an approximate version of the final outcome for the patient with occlusion and lip support taken into account. 


Trial Fitting: During this stage the dentist has time to make any necessary adjustments for the patient before we go to final production.  Using the LaminateButler™, a sterile autoclavable silicone palette gives the dentist a place to layout all of the restorative components for the patients appointment. Confidence with the alignment of the two solutions is critical at this stage to prevent the need to make any adjustments on the final fitted restorations. Being a removable solution for the patient, the high impact resistance of this product allows for confidence and effectiveness and easier hygiene maintenance at home.  


Try-In Step – Assess Speech, Occlusion, Function & Aesthetics

  1. Titanium Bars: Upper and lower titanium Grade 5 bars were milled and subsequently, placed into a parallelometer and brought to a high surface polished finish at 2 degrees. Easily captured images using the VisionButler™ the Autoclavable Lip & Cheek retractor illustrate this case nicely for us in the laboratory also in terms of fitting at this stage of the process.


  1. PEEK Friction Sleeves: Two Tecno Med friction sleeves were produced for the corresponding bars. 
  1. Mineralised Tecno Med Mineral: This is a ceramic reinforced PEEK material with a high flexural strength and impact resistance. 
  1. Prettau® Dispersiv Crowns: Individual zirconia crowns were fabricated on the Tecno Med Mineral and bonded. 
  1. Gingival Composites: The Tecno Med Mineral structures were subsequently layered to create a high aesthetic finish.  

The benefits of this means the individual crowns can be replaced if necessary, this dental restoration supports impact resistance unlike conventional, monolithic zirconia. It still however maintains the durability and aesthetics of a conventional zirconia restoration. 



Placement: The patient attended for final fitting of the titanium bars which were secured to the implants and the removable friction restorations were glided into place. Final case images pending, but a very successful for the patient, the restoring dentist and us a dental laboratory team.




Conclusion


Fostering a culture of innovation for cases like these can only be realised when we can showcase both the manufacturing process from the dental laboratory and the outcome for the patient on the practice side. Building trust and shared knowledge comes from working closely together over time and this supports the implementation of higher standards in our manufacturing processes and collaborations become easier.

Being able to illustrate the communication required in terms of the clinical and technical skills needed for complex case collaboration via case studies. This also ensures that at each step of a cases development, we can clearly see how the dental technician and dentist are supporting each other for the best restorative outcome for the patient.

Final Upper & Lower Implant Bridges


Senior Dental Technician: Sean Wilkinson

Images: Dr. Paul Moore & PD Ceramics Ltd