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Adis posted an update
I have a full arch fixed case mid-restorative phase and would like feedback from the community and Drs. Ivan and Jed.
I did wax rims and VDO/bite last visit, now the lab sent back a U/L wax trying. The bite is off on the L which is fine and needs a reset, my question is on proper lip support vs. a very large anterior cantilever of the teeth in relation the the upper implants.
I’ve restored about 10 full arches and this is the first time I’m getting teeth this far away from the implants. I’m worried about the shelf on the facial and also the cantilever effect in occlusion. The other concern is if I have them move the teeth further palatal, the lip support is going to decrease.
A little background the patient has been edentulous for a few years, couldn’t tolerate dentures and wasn’t in a hurry so he’s without any temps until we get this right.
Can, Jedediah and Cayleen2 Comments-
I wouldn’t be too concerned out the anterior cantilever effect and it has great support with all splinted implants. However, looks like he has plenty of lip suppor so you could splint the difference and it’s a little bit easier for the lab to make a very cleanable prosthesis and it convex with not concavities. That is most important is not the intaglio surface is convex and not concave. Also, I would definitely have the lab do a trail/esthetic PMMA for the patient once you establish your design and have them wear it for 2 full weeks to make sure that pt. Likes it, bite is good, speech is good, etc prior to going to your final material then that PMMA can become the pt.’s back up in the future if needed.
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Thanks for the reply, I will have them reset the max. teeth to about 1/2 the way out, then place the lowers to match and do another try-in before doing the PMMA.
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