GAP Australasian Dentist Sept Oct 2020

Category 66 Australasian Dentist FIgure 10 FIgure 7 FIgure 11 FIgure 8 FIgure 12 FIgure 9 professional answers, we should refer to precise data which never includes policies such as $10.00 lower price. Let us assign an hourly cost to our work and to our employees’ labour. We add in a reasonable company profit and the result of it might surprise you. Don’t mistake value for cost. Something can have a (personal) value and not be expensive! Value can also derive from shortage of goods, their utility, their need to pay production factors, etc… Reasoning about the determination of price coming from costs might seem easier than the value seen from the demand point of view. Once you have realized your target, all you have to do is choose the segment of customers for your marketing strategy. Let us now talk about the technical aspect of our device. Our “All on 4”, requested by the clinician, provides the use of 4 osseous-integrated implants; moreover, the request is for high comfort and there are no restrictions about the material to be used (Fig. 5). Our project involves technical knowledge of total prosthesis, fundamental to all types of rehabilitation; as regards materials (thus costs), Toronto can be zircon or traditional composite. This choice will be made by the clinician (perhaps…the customer). But the company has to perform its best. In our case the client has chosen the “least expensive” so our advice is to use a carbon inner structure for its comfort and mechanical qualities. As mentioned, before we proceed as if it were a total mobile prosthesis, starting with individual trays (Fig. 8) to include implant transfer. The following step is to create an aesthetic mock-up to try it in the patient to evaluate the tooth length and position and to assess the labial result during the aesthetical try-in (Fig. 9-10). In some cases (according to the clinician) old prostheses can be referred to. These, when treated with radiopaque substance, allow latero-lateral x-rays (Fig. 11) and so a deeper study of the jaw (Slavicec’s method); moreover, it can be useful in guided surgery (Fig. 12) and in Cad/Cam prosthesis (fig. 13). If a centric registration is available, I always prefer an aesthetic try-in of the front set with a distal extension in Patten Resin, so to confirm or evaluate correct centric relation between jaws. Once the teeth are set up (Fig. 14) and prosthetic spaces are defined we can start planning and shaping internal structure; this will come following the clinician’s verification of implant correct position by means of a template of Patten Resin made in the lab on the master model. The shaping of the structure is achieved considering the position of prosthetic teeth, as well as a relieved area to accommodate the acrylic to bond the teeth to the final frame. One must also allow for adequate strength and support of the bar structure. A verticulator may be very useful in this process (Fig. 16-17). When using carbon fibres our sections should never be less than 9 mm2. Having finished shaping (Fig. 18), we will proceed with muffling (Fig. 19-20): mould and print will be made in silicon; after washing the muffle, the Ti-bases on implant will be sandblasted and screwed onto the analogs, canals and their inner screws will be protected by silicon and topped with pivots to facilitate hoeing of carbon fibre. The preparation of carbon fibre includes resinous filling material, which FIgure 13 FIgure 14 FIgure 15 clinical