I am this close to losing my sh$t: 2 Attempts at Midlines and Mushbites in Digital Hybrids

So one of the things that Dr Joe and I wanted to do at Brighterway, besides perfecting an all digital full arch workflow, is try different techniques that researchers or lecturers are talking about and trying to prove if they work or not.  I was at the Tru Abutment Symposium and one of the lecturers said that he gets the patient’s bite by simply mesuring from the Glabella ( above bridge of the nose) to just below the nose and opening the patient to that dimension.  We do this all the time with occlusal rims, but he just squirted blue mousse in there.  I was a bit skeptical, but hey, what do I know?  Let’s try it! We got a measurement of 76mm.

So we had that patient bite down and took a scan with the blue mousse and used fiducial markers on his attached tissue.  We had a cad designer design it and we 3D printed this on Carbon, using Anaxgum composite for the gingiva.

 

Hmmm, I wonder what is off here?  Is it the Golden Proportion?  Is it the gingival heights?  LOL NO THE MIDLINE IS OFF BY A WHOLE TOOTH!!!!!  I should have picked it up looking at the scans.  You can see that the lower denture shifted quite a bit when we took the bite.  Well, back to the drawing board.  At this point we still did not have a bite. I guess in retrospect I could have used the hybrid as the new bite and shaved it down, but I saw another FB poster just have the patient bite down on the scan bodies!!  The thought is that these are 15mm tall, so we have built in the minimum height for the hybrid.  Well, lets give it a try!  Patient was sort of teetering on #3 implant, turns out that may give us some grief. Round 2.

We sent the next scan to the awesome folks at Burbank  and they designed based on my scans.  TBH Burbank really is the best lab around for digital hybrids.  They really understand the whole process.  For the time being we gave up on 3D Printed hybrids and have gone back to milled PMMA.

We cemented these ti bases into the PMMA sub structure and let it harden in the mouth.  As you can see my midline is still off, although not as bad as before.  This midline is easily corrected in the lab and when I seat the Zirconia final I’ll post it.  So to summarize, mush bites don’t work with digital hybrids as well as just having the patient bite down on the scan posts!

 

Want to learn more about 3D Printing and Digital Hybrids?  Come to a printing party!!  Come to Vegas!!  2 days all 3D printing, aligners, surgical guides, wax ups and digital dentures!!

 

https://www.eventbrite.com/e/dental-3d-printing-party-las-vegas-tickets-54627261610