THE INCI-DENTAL BLOG

I’m enjoying writing the series on managing wear but it is pretty tricky to write and is taking some time. I’m about halfway through the next blog/essay (lol) but I won’t finish it tonight.

I have however been cropping photos for the feature and wanted to put some up as a taster. I’ve just taken some post ops today and I’m pretty pleased with them. Yes, there are things I would change and maybe I will over time but as a 2 week review of a big case like this I’m just happy that 1) They have all stayed on proving that the occlusion is good and 2) That the patient is made up with them.

I’ll go through the case in more detail as and when but basically these are free-hand composite build ups of upper 3-3, with an immediate acrylic denture providing provisional posterior support. It’s not the end of treatment; that will require a cobalt chrome denture, possibly changing the composites for aesthetic reasons and maybe, if the patient wants them, some crowns but I hope you think there is an improvement.

Overall the case is going pretty well so far, I’m pretty happy with the composites and very happy with the new occlusion. You will never get quite as aesthetic a result with composite as you can with porcelain (in my hands anyway) but I think these are pretty good and I’m getting better all the time. There has been almost no prep apart from caries removal for any of these build ups though and that counts for something and in the mouth when they are not dried out they look even better.

I’m most pleased with the contact point I’ve made between the upper right lateral and the right central incisor.It took some doing, first shaping a matrix to get the emergence nice then another martix to build the tight, narrow, contact. With such a large cavity present I think the end result is a pretty good achievement.

On the down side, the left central incisor is just a bit flat near the incisal edge so it reflects the light in an unpleasant way, also the denture shade could be better and the denture doesn’t quite contact on the left premolar but hey it’s still not bad for under 4 hours work and a very cheap lab bill.

NB: I used  Burkard Hugo’s matrix technique, under rubber dam for all the build ups as described in this blog.

On a side note can I just say thanks to all the people who have told me they are enjoying the managing wear series, it means a lot; I will try to get more up asap. Unfortunately I’m just really busy at the moment with key skills, a new play I got cast for, The BDA event, MFDS part 2 in May and starting a scary rotation on oral surgery (for which I really need to do some reading).

I absolutely love it all today though, so happy with my job, my life and my dreams

Have fun and enjoy your dentistry

Chris

p.s. Pride can come before a fall, I really want to learn and I’m more than happy to take critique on the case but please read my clinical disclaimer and tred softly on my dreams.