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One of the most challenging undertakings in dentistry for both the clinician and the laboratory is a full mouth reconstruction. For patients who present with excessive wear of their dentition, a full mouth reconstruction is critical in re-establishing functional harmony, pulpal health, esthetics, and protecting the dentition from further damage.
Complex dental cases require proper treatment planning to ensure a successful outcome. These cases must consider the patient’s concerns and desired result as a starting point and then create a
One of the most common options for treating an All-On-4® case is a hybrid prosthesis. But all “hybrids” are not created equal. We are a long way from the days of the only option being a cast metal substructure with traditional acrylic and denture teeth.
Teeth play an important role in daily life. They are not just for chewing, but they also help with speaking clearly, give faces shape, and correct support. Teeth can also
Complex dental cases require proper treatment planning to ensure a successful outcome. These cases must consider the patient’s concerns and desired result as a starting point and then create a treatment plan that will serve the patient in terms of esthetics, longevity, and function. Through this set of criteria, the patient can be educated on each option and limiters before the case begins. This will help build trust and manage the patient’s overall expectations.
Patient Concerns
The first step in treating a complex case is listening to the patient’s concerns. Often patients seek out dental treatment to alleviate pain and discomfort, but another common reason is esthetics. Understanding the patient’s needs is critical to building a treatment plan that will satisfy their biggest concerns. Often there are considerations that the patient is not aware of that will be vital in providing the patient with optimal care.
Dr. Muszynski indicated that the patient’s biggest concern was to eliminate a partial denture that was currently replacing tooth #9 and improve the overall esthetics of his smile.
Diagnosis
Dr. Muszynski provided the existing condition of the patient’s oral condition. As noted above, the patient is missing tooth #9, and the patient wears a partial denture to remedy his tooth loss. While partial dentures have a place in dentistry, they do not function as well as an implant or bridge. They can cause trauma to gums and abutment teeth and contribute to bone loss.
The patient was evaluated for an implant restoration on #9, but it was later determined that he had insufficient bone to support an implant in this area. In addition, the patient indicated that he did not want to go through bone grafting, which eliminated the possibility of an implant at this site.
Other factors in this patient’s current situation included the following.
The patient still has a primary tooth in the C position. This tooth is a complete tooth with an existing short clinical crown.
He is congenitally missing tooth #7.
Tooth #6 is in the lateral position.
Tooth #8 has a very dark underlying stump shade.
Tooth # 11 was missing, and the patient had a fixed bridge on 10-12.
Treatment Plan
After proper evaluation, the patient was determined to have enough bone for an implant placement on tooth #11. The doctor discussed the gingival height/tooth length discrepancy that would be present on the central.
The patient indicated that he felt his lip line was low enough that this discrepancy wouldn’t show. Therefore, he elected not to do any crown lengthening. The implant was placed using a Blue Sky Bio Max NP implant. It was restored with a screw-retainedzirconia crown.
The primary tooth C was a solid, very short tooth. It was restored with a layered e.max restoration. The primary reason to restore with e.max is that it can be bonded to the natural tooth. Since this preparation had no retention, it needed a bondable restoration to improve its retention and strength.
The plan also included making tooth #6 look like a lateral since it was in the lateral position. The bridge on 10-12 was sectioned to allow the original crown on tooth #12 to remain intact (see the image as shown below).
A bridge was then designed to restore teeth numbers 8-10. Because tooth number 8 had a dark underlying shade, it was determined that this part of the case should be restored using a zirconia framework with layered porcelain. Zirconia can mask out severely dark shades and was a great option to mask out this dark stump shade.
In addition to the ability to mask out the underlying color, the zirconia restorations are twice as strong as e.max restorations and are an excellent option for bridges. Then porcelain was layered over the framework to match the color and characterizations of the e.max restorations.
Ordinarily, it is best to restore cases using the same materials to get the best match. However, the best option is to understand the benefits of each material and use them to achieve optimal results. The key is to have ceramists, like those on the Smiles by Design team at Burbank Dental Lab, who understand the art of layering porcelain to match differing materials flawlessly.
The final step in the fabrication process at the lab was to check the case for the following:
Proximal Contacts
Occlusal Contacts
Functional guidance
Overall, harmony between the dental lab and the clinician plays a critical role in achieving successful outcomes (see the image below).
The success of this case must be attributed to the treatment planning and the following:
The expertise of both the clinician and the dental technology team
Excellent treatment planning and communication among all involved
A demonstrated proficiency in both the materials and technologies available
A clear end goal, as directed by the clinician
Treatment Planning & Best Practices
Starting with the patient’s main concerns, a treatment plan can then be developed to address those concerns while ensuring esthetic, function and case longevity are considered in every step.
A patient informed of the options and made part of the planning process will understand the possibilities and limitations of their case. Proper planning will ensure the patient knows what to expect at each process stage (see the image below).
Call us or click the chat button in the bottom right corner for support on your next complex restorative case.
Zir-MAX.M, and Zir-MAX.Me are high strength monolithic zirconias that exceed your expectations for zirconia restorations, ideal for use in full and single crowns and bridges.
Composite restorations provide a viable, option for conservative “biomimetic” metal-free restorations. Burbank Dental Lab technicians are trained to provide ideal marginal fit, full polymerization and lifelike esthetics.
DURATEMP PMMA, a lab fabricated provisional restorations that are milled from PMMA (Polymethylmetacrylate). Our PMMA provisionals are CAD/CAM generated and can be created from either conventional impression or a digital IOS workflow. These provisionals are recommended for long term provisional needs such as implant or surgical cases.
SMART 1® abutments are custom engineered to best meet each patient’s case needs. Burbank Dental Lab uses the most advanced design and milling technologies to deliver the most precise fits available.
Burbank Dental Lab offers three distinct options within the screw retained category of implant restorations: Smart1 porcelain fuse to milled Co/Cr, Smart1 Screw Retained Zirconia, and the traditional Porcelain Fused to Cast UCLA abutments.
Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.
Our New State-Of-The-Art 3d Printers
Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.
Fabrication of the future is here!
Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.
Our New State-Of-The-Art 3d Printers
Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.
What Our Clients Say
“I have been working with Burbank Dental Lab for many years. They always get back to me in a timely manner whenever I have questions regarding a case. Mr. Wyoming...
“I appreciate the quality and efficiency of this lab. I especially like the turn around times for their crowns (about 5 days). Thank you for your work and I highly...
“Burbank Dental Lab’s Smile Design Group helped to transform my patient’s smile with their exceptional attention to detail and overall quality of the emax crowns. The case was a success,...
“Burbank is a terrific dental lab, I always get top-notch work and prompt, courteous customer service.Whether it’s fixed, removable, implants, veneers or anything else, I know I can rely on...
“Burbank is amazing. I am blown away by their craftsmanship. Crowns are absolutely beautiful. Patients love them. Wyoming and Jason have been great with communication. I will continue to send...
“I have been using Burbank Dental Lab for a few years now. I have been very happy with the results. The best part is that the team communicates well regarding...
“Very good service, recommended and attentive I am very grateful to the dental doctor who treated my dental problems very successfully and helped me regain my beautiful smile.”
“I have been using Burbank Dental Lab for several years now and am continually impressed with the quality of their work and their customer service! Everyone that works there is...
“I am very impressed with the attention to detail and easy communication. I use Burbank Dental Lab even though I’m on the east coast because the results are always predictably...
“I have been a client of Burbank Dental for over 20 years. Everyone from the phone operators to the techs to management is wonderful and friendly. I have done a...
“I have been using Burbank Lab for over 30 years and recommend them highly. The owner Tony is a stand-up guy with a ton of integrity and a mensch. The...
“When I want something done right, I send it to Burbank. After experiencing inconsistent quality from my previous lab partners, Burbank was highly recommended by a colleague so I gave...
“After experiencing a decline in quality and communication from our previous lab we decided to give Burbank a try based on the recommendation of several business associates. The service from...
“I am a Heartland dentist in Texas and I have been looking for a comprehensive lab that I could use for implants, removable, and fixed. I discovered Burbank a few...
“Delivery time was excellent! The fit of the screw retained implant crown including emergence profile, contacts, seating, and occlusion were perfect. Didn’t do anything but seat it and torque the...
“Absolutely gorgeous and high-quality maxillary zirconia hybrid on Ti-bases. Their lab followed my prescription exactly. Their technicians have amazing talent. Thank you, Burbank!”
“We were looking for a lab that could accept our digital scans and produce high-quality centric-relation nightguards for patients. Burbank Dental Lab was recommended by a dental school classmate. We...
Burbank Dental Lab has far exceeded all of my expectations, and has fully delivered top tier prosthodontic work. What sets this lab apart from others is the constant communication. When...
“This lab provides restorative dentists with excellent technical support and high-quality lab work at reasonable fees. Their restorations are consistently excellent both from a functional and esthetic standpoint.”
“High quality dental lab with years of experience. Very professional service and results are second to none. Whether its cosmetic work, implant work, or digital, Burbank has their act together....
“In 25 years practicing dentistry I have not delivered a better full mouth rehabilitation crowns and bridge case like the one I did today. Aesthetics, fitting, contact, and occlusion was...
“I have been using Burbank for a while now. They are the only lab I’ve worked with who delivers consistently superior results. Their esthetic and implant work is second to...
“Full Arch fixed prosthetic cases go extremely smoothly with Burbank Dental Lab and their imetric photogrammetry in-office workflow. Highly recommend this workflow for anyone doing full Arch cases. Working with...
“Great Dental Lab for removable and crown and bridge. Amazing customer service. Vince and Dmitri are very accommodating and will ALWAYS work with you. Their product is top notch!” (click...
Hi Tony, hope you’re well. I’ve sent you a before and after case of a #8 old PFM replacement – single tooth next to natural #9. (Click for photo). Also...
“Just wanted to let you all know that I retired a few years ago but I sincerely appreciated both the help and especially the great quality of the work you...
“The implant department at Burbank is amazing! They have delivered casework that has exceeded my expectations and our patients are thrilled! We switched from a local lab to Burbank; our...
“We’ve been using this lab for a few years now and we are very happy. Excellent customer service, very kind billing staff and work is always well done. Every time...
“Burbank Dental Lab has provided us with many years of high-quality work, timely service and friendly staff. Our thanks, from all of us at Westlake Dental Associates.”
“Fantastic case! I just dropped these two implant abutment/crowns in and they were perfect! Thank you!” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent OCCLUSION: Excellent FIT: Excellent SHADE: Excellent ESTHETICS: Excellent...
This case is the case where you sent me the samples of the acrylics for a patient who is very sensitive to different chemicals, etc. She wore each sample disc...
“What an amazing lab to work with. Each person I have encountered has been amazing. From Joel and Kenny to Laura in Accounting to Tony himself. The crowns go in...
“We have used this lab for 18 months. They have proven to be very patient and customer-centric. They produce some really nice work and are easy to work with. Cases...
“Vincent and Karen are the best! I worked with Vincent on a full mouth rehab case. Everything turned out great and the patient is very happy. Working with Vincent made...
“They were great to work with and went out of their way to make sure we received our lab case the very same day. Holly even volunteered to come personally...
“Burbank Dental Lab is our most trusted dental lab for all of our dental work. They are extremely reliable and deliver exceptional products. They are always available for questions and...
“Amazing lab! The work always comes back in a timely manner and is beautiful! Marissa is who we are lucky enough to have help us with our cases and she...
“Very nice case! This patient was very happy. My only adjustment was to reduce the excess in the ovate pontic area that was overdone.” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent...
“I absolutely love this lab, very quick, beautiful work, and very professional. Marissa is so much help, and has answers every single time! Wouldn’t use anyone else!”
“For more than 5 years I have sent my removable lab work to Burbank Dental Laboratory. I delivered a new FUD and new mandibular distal extension RPD with a locator...
“Implant abutment and crown – this case was great! Thank you! The pink porcelain looked great where the gingival margins needed to be leveled.” MARGINS: Excellent CONTACTS: Excellent CONTOUR: Excellent...
“This was the first crown I inserted since we talked about the contacts being tight. This crown was PERFECT!!! Absolutely no adjustments were needed! This was one of those “throw...
“As a new customer to Burbank Dental Lab, I was pleasantly surprised at the interest the staff expressed for the INDIVIDUAL needs of my patients. As an academic, my ideal...
“Burbank is an excellent lab! It is one of the most high-tech operations in the country and I have visited many of them. Tony, Andrew, and the entire team have...
Thank you Joel for an excellent job. What I really love about Joel and Vincent from Burbank Lab is that 1. They listen to the instructions and follow them. 2....
“Thank you Joel for an excellent job. What I really love about Joel and Vincent from Burbank Lab is that: 1. They listen to the instructions and follow them. 2....
“Just completed a maxillary Prettau Zirconium bridge on 5 implants and am very pleased with the service, the attention to detail, and the communication skills of this lab, in particular...
This dental lab is world renowned for high quality of their crown and bridgework. I especially appreciate their expertise in implant castings. I happen to work with a couple of...
