Multidisciplinary approach

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Multiple crowns

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Removable partial denture

Appointment 1: Initial examination including OPG and iTero scan. Oral hygiene appointments also
Appointment 3; Preparation appointment - all teeth prepped for new crowns
Prep appointment workflow -Restoration replaced tooth 2.6 mesial prior to preps - Pre-treatment scan upper and lower arch and bite > existing crowns 11/21 removed > 13 11 21 23 prepared for new full coverage crowns > restorative scan taken for crowns + new denture
Appointment 4: Try-in appointment - Temps removed and crowns tried in along with denture framework with teeth in wax. photos taken adjustments to denture and crown teeth heights and widths requested. denture and crowns back to the lab for denture finish. temporary restorations replaced.
Appointment 5: Insert - all crowns inserted with Fuji Plus luting cement. chrome denture insert. Occlusion adjusted on opposing existing full acrylic denture. PA radiograph to confirm no retained cement.

Treatment plan: New crowns on #13, #11, #21 and #23 with new P/- CoCr denture
The complexity in this case is associated with the immediate manufacture of the cobalt chrome denture simultaneously with the crowns. This allowed for the design of the framework in unison with new crowns, creating ideal retention without the need for clasps visible on the 13/23. This also minimized/eliminated the time between the crown insert and the denture insert.
Ideally, we could insert the crowns and then re-scan for the denture, however, the patient's desire to maintain a full complement of teeth necessitated the requirement to replace the temporaries and continue to use the existing denture whilst awaiting the final denture finish.
The Lab desired a try-in of the denture framework prior to finish to confirm the ideal fit.
This is a wonderful test on the accuracy of the scanner as any discrepancy would cause an ill fit of the precision denture