Full Arch PET

113 Rating(s).


Posted on By Howard Gluckman In Anterior/Esthetic

Gone are the days of extracting teeth. In this case we have a honey farmer who tastes too much of his own product and has rampant caries. He wants an aesthetic make over and wanted to have his mouhtrestored. ON balance of further decay we decided that full arch reconstruction on dentine would not be a long term prospect for someone who will continue to taste his product. This is a 2 year follow up




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50 Comments

Preparation for the socket shield and root submergence technique. Perfect teeth for this technique


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1 year post op


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Fantastic Thank you for sharing! Barry


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Howie. Almost PERFECTION! Except you excluded the molar :))). Seriously cool case my friend! LOVE IT! Cheers Chuck.


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I know I could kick myself now. I was skeptical at the time. But you have made me see the light thanks for that.


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Great case, Howard....I look forward to seeing the final results.


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Sweeeeet!!! Howie. A great example and application of SPoT concept. How long do you schedule for something like this. I would be bushed. Was your guide also the provisional? Was it cemented to the two unprepared teeth? Thanks for the nectar.


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This is about a 3 and a half hour job and yes it si time consuming. However I find it easier to extract with PET than I do normally. The provisional was old school impression and a few days later was fitted.


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Ron They are here for you to peruse.


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Spectacular biomimetics.
I guess you won`t need any pink porcelain on this case!
Any issues with raising the vertical all at once with a temporary splinted restoration?


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Howie...

This is pure fleece - this is the case ! This is the namesake
In the last photo you show intial vs 2 year? No loss - what is total implants supporting this case and do you have X-ray with framework ?
In the RST sites- did you contour the roots as to allow emergence of the prosthesis from the so called socket or crestal strip CTG to enhance natural effect ? Just more nectar as Terry said
Exciting times...

Fleecy,

Richard


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I seldom find any issue with opening the bite. There are definitely a few patients who do but in my opinion most will adjust as it is were they were initially. this case had no issues at all


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Great work Howard, honey shade of the crown is too sweet and natural, compliments to your ceramist too.


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Thanks ash


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Howie, outstanding treatment and case. Congratulations as always having a lot of info and knowledge to share. Thanks and good luck my friend.
Best regards,
Manuel


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Thanks you my friend always appreciate it


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Beautiful planning and result. What an amazing service. You're changing the way we think. How were the provisionals planned. Did you take impressions or a scan day of surgery and insert a day or so later?? Regards Naheed


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Thanks Naheed. I agree we are in a total paradigm shift here. The provisional was completed old school. WE did have a wax up to start with and then from there we fabricated the prosvisonals and they were fitted 2 days later


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Howie, perfect in every single detail! I can`t get enough of your pics! Funny, but I am proud of you and share your satisfaction with this great work and service to your patient!
Best regards
Snjezana


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Thank you so much and the feelings are mutual. It is amazing to be able to share such work with people you have so much respect for.

Lots of love
H


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Howie, first: great case. Second: why now a days looks like the natural , and most effective treatment? And I´m sure that this case in 15 years will look as today. I wouldn´t add nothing. Only to wear a nite guard to preserve such BEAUTIFULL treatment you just did. Congratulations, and my compliments! Regards from India, Jorge


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Thank you my friend and I could not agree more.Lots of hugs and travel safely


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Great case! I don't know what I like best the case or the amount of photos . For me, after 1 hour of surgery , i don't care anymore of the pictures and I always get very angry afterwards...
About the inferior prosthesis . Do you always do them in three segments like this one? Are you not afraid of the cantilever at the canine?
Yours
Margarita


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Margarita thanks for the kind words and great questions. I have a second nurse who takes the pics as you can see the is well trained. With regards to the bridges I do prefer to when possible break the bridges up into 3 units each that way i get far more passivity of the superstructure as well as if there is any breakage it is not such a big deal to remove and repair. I do not often go for cantilevers and I don't like that my prostho did in this case but if I was to have a cantilever the ideal one would be a mesial cantilever and not a poster one.


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Thank you for the answer! Although now I´ll have to hire another nurse and train her!!!!


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Howie, Do you have a concern about maxillary ceramics opposing mandibular ceramics in a case where opening the bite is done and where there is the absence of proprioception, given a fully implant supported case. What would be your opinion of ceramics for the maxillary and processed acrylic with denture teeth for the mandibular. I shutter to think of the extractions I've done in implant cases. The panorex of the post-op with the SS and RST is pure excitement. Again, thank you for leadership. You share the tip of the spear. Or Stinger as the case may be!!!


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Terry it is always a concern and hence the patient will always get a bite plate and strict instructions. I do a free with eh different materials opposing the other to reduce risk of wear and fracture. We do tend to go that way in most cases but we needed to do the minimalist in the case as we had ideal VHO because of the PET technique


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Howie,

All I asked for was a X-ray and you gave me the reel and directed a Grammy- Oscar presentation

Cheers,

Richard


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Hey dude like they say in the classics "Go big or go home"


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Howie,

True true


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Howie; Inspirational dentistry my friend...thanks Mo


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Thanks Mo. Im interested to see what Ronald thinks of the finals.


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No doubt it is a great case, Howie and I especially like that the patient wanted a natural result which you certainly gave him. Hard to get our patients here in the US to accept anything less than a "natural" bleach shade...but I have been lucky to find a few.


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So true Ron. I am not a fan of whiter than white. This fits his face far better. Thanks for your kind words


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Howie, a very remarkable work!!! Many innovation inside and applied on largest clinical execution. Bravo. Love it. Armando


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Thanks Armando. Appreciate the kind words


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