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Adis posted an update
This is a 1st time complaint from a pt for me: she says that she can HEAR and FEEL the saliva come through around the #8 MUA of an all on 4. She didn’t have this issue in her pmma which the lab was supposed to copy, and she doesn’t feel it around any other implants. This is a Zirconia fill arch prosthesis and convex on the tissue side.
How much of this is normal? And what’s too much bubbles showing up when she pushes her tongue forward? Any fixes at this point?
Appreciate any input.
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Jedediah, Alvin and Erick3 Comments-
Hey Adis. I know that’s gotta be frustrating. Especially when the trial PMMA was good but to be honest, it just seems like it needs proper tissue pressure and there’s just too much space there which is causing that. You could set expectations and see if the patient gets used to it and then it’s fine or what would be best as to Improve the intaglio surface which says it’s Pfohl zirconia is probably having to refill a new one. You can call the lab and discuss and see if they can do something to improve the intaglio surface by doing a pick up impression of that tissue side so they can improve the proper amount of tissue pressure with a new one unless there’s some way they can do that with the existing, which is typically unlikely with full zirconia. They may be able to lay porcelain on that side best to have that discussion with your specific lab on what they can do. Good luck.
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Thank you for the response. I’ve already had the talk with the patient but she keeps coming back with the other side doesn’t do that. I’ll talk with the lab next.
Is there such a thing as ideal tissue pressure? Do we want it to blanch when seating? And do gum contours change over time? This case is about 1 month in, but what to do if this occurs 2 or 4 years later?
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Typically I do like slight blanching at delivery just knowing that I have sufficient tissue pressure and yes, that will need to be relined over the years because the bone will change in resorb overtime just like you have to do reliance with any type of removable appliance just like a fixed bridge. Can change overtime as well.
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