- All Photos
Step 6 I divested the prosthesis, adjusted the occlusion and customized the final denture base. Using Candulor’s Aesthetic Color Kit with cold-cure acrylic modifiers, I applied natural colors to the soft tissue. Next, I polished the prosthesis to a high luster to seal the pores of the acrylic base. To achieve healthy, natural-looking gingiva, I studied the texture and color patterns of gingiva from my collection of before-and-after ceramic veneer photos.
Step 2 I used the Gerber technique to establish proper occlusion with the PhysioStar teeth. I decided to make a fixed ceramic-acrylic hybrid bridge with no ridge lap on the multi-unit mandibular implants. I used a high noble, white gold ceramic alloy for optimal biocompatibility and to give the underbody of the bridge a hygienic, non-porous ceramic surface for long-term results.
I opted for a ceramic hybrid bridge because it’s easier to maintain long term. The new light-cured gingival composites blend and bond beautifully to both the hard-packed, heat-cured denture acrylic and ceramic underbody, giving the dentist a cost-effective, easy way to repair or replace chipped denture teeth chairside. Plus, the patient won’t have to go without his teeth if a repair is needed.
Andrea Hegedus, CDT, is the owner of Great Lakes Smile Design Studio, in Muskegon, MI. With 25 years of experience, she completed a B.S. with Honors in Prosthodontics from Ferris State University in 1990; is a memberå of the AACD, Francis B. Vedder Study Club, NADL and MACDL; and actively participates in the AACåD’s Give Back A Smile program for domestic abuse victims. She can be reached at Andrea@glsmiledesign.com, www.glsmiledesignstudio.com and via the Great Lakes Smile Design Studio page on Facebook.
Step 1 Models with the plaster wall were provided and I mounted them to a semi-adjustable Candulor Articulator and made Splash Putty Guides (from Discus Dental) that helped maintain the patient’s smile line and muscular facial parameters throughout the fabrication.
Step 8 I mounted the final prosthetic on my Candulor Semi-Adjustable Articulator for final photos and presentation.
Step 5 This is the customized full waxup with ceramic gingival body on the mandibular hybrid bridge. Next, I flasked the wax setup, boiled it out and hard packed it with heat-cured acrylic.
Step 4 I reset the mandibular teeth over the ceramic cast framework with proper buccal support following the Splash Putty Guide.
Step 7 I adjusted the final prosthesis for the prescribed working and balancing occlusal function.
Step 3 Using the Splash Putty Guides made from the wax setup, I created the internal cast framework using pattern resin and Camlog UCLA implant abutments.
Step 9 For my digital documentation of the case, I selected the photos demonstrating each fabrication step and used Apple’s Keynote application to create the presentation.
The competition was extremely challenging, knowing each fabrication step was going to be graded for quality and that I had to provide excellent, high-resolution, untouched photos for credibility. It was by far the most detailed learning experience I’ve ever had. The playing field quickly evened out because of the multiple steps you need to successfully complete; even the most experienced technician can make a catastrophic mistake. The ultimate heart and soul of the experience was to keep going even when I thought I had failed, because the final step was understanding my own potential to cross the finish line. The competition was a great way to push new ideas in a safe environment and to see all the fantastic results from other technicians around the world.