Master models are shown for a full mouth oral rehabilitation – Smile Makeover – that is about to be given to the patient. This video on Full Mouth Implants, Crowns and Veneers was created in our NYC dental implants office.
You will see master models that show seven porcelain veneers that were cemented in the upper right quadrant last week and three dental implant jigs for the upper left, lower left and lower right quadrants of dental implants. There are a total of nine dental implants.
The custom dental implant abutments and porcelain fused to Zirconium core bridges will be shown along with synthetic gum tissue used by the dental lab to create the emergence profile of the final aesthetic porcelain. The jigs help maintain the relationship of the second stage custom abutments during insertion while also helping to create a very accurately fitting ceramic bridge. A Zirconium core allows very little adjustment in case it doesn’t fit so that accuracy in the beginning is very important.
VIDEO TRANSCRIPT: Hi this is Dr. Jeff Dorfman at the Center for Special Dentistry discussing a full mouth dental implant case that will go in this morning. What you will see here are master models of the upper jaw from this tooth all the way to this tooth this is porcelain that we put on about a week or two ago, and then what we have here are jigs covering dental implants. There are dental implants here, there are dental implants here, and there are also dental implants here. What we plan to do today is unscrew the second stage dental implant abutments, put them into the patient’s mouth for the last time—this is porcelain with zirconium frame—then I’ll be trying this in to make sure this upper looks nice, and at the same time I’ll take this all ceramic all porcelain no metal here. I’ll be trying this one in here and I’ll be taking this one and trying it in over the dental implants that are here. And then when this goes in hopefully everything will fit fine, and the patient will walk out with a full mouth of porcelain and a full mouth of dental implants excluding this side. A few of the interesting variables here are if you notice here it appears like the dental implants are showing through the gum, and what I have here is actually synthetic gum tissue which is used by the lab to build up the gum tissue in this area—this is off the model in this moment—so the dental lab knows exactly where the porcelain should end relative to the gum. If you look down here you will see some remnants of that synthetic gum tissue where the bottom is being made. Another interesting thing is that these are jigs to actually confirm how all of these implants need to be screwed in to bone. The reason why these jigs are important—and you can see a jig for up here and there’s another jig for down here—the reason why these jigs are important, is if I unscrew each of these second stage implants, you will see that on the underside of them, this is actually for an impression, but it’s the same idea, you will see the underside of this second stage dental implant piece, you will see a hexagonal shape, and this is a hexagonal male, and in the implant which is inside the jaw bone, the very top of it actually has a hexagonal female. So this hexagonal male, and you can see the screw popping through, fits into the hexagonal female at the top of the dental implant, and since it’s a hexagonal shape, this can actually be rotated in any one of six different positions on the implant. The difficulty on insertion is that you can see that these implant abutments have a very significant configuration, so even though each of these can be rotated in one of six different degrees around the dental implant, in terms of making this fit, this is a very precise fit here on top of here, so one needs to maintain whichever of the six insertion paths where this works. And that’s a difficulty, and that’s the intention of why we actually have these jigs in place to maintain that conformation as we screw in these second stage abutments before we put in the porcelain. This is Dr. Jeff Dorfman at the Center for Special Dentistry in New York, and we have two visiting students with us watching this procedure today.