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Frank Duncan
Frank Duncan,
Category: Dental
Satisfied Customers: 1
Experience:  Dentist at Frank L.Duncan, DDS
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Customer Question

Please do not answer this question unless you are a practicing dentistAbout four weeks ago I had the four front teeth in my lower jaw extracted. The eye teeth at either end of the gap are in good condition and are currently under a six-tooth temporary bridge that covers the gap. I would like to get the eye teeth capped and get a partial denture in the same visit. Is this something that is commonly done? When I leave the dentist's office after the temporary bridge has been removed, which teeth will the partial denture be attached to?
Submitted: 11 days ago.
Category: Dental
Expert:  Dr. G replied 11 days ago.

Hi you will leave that day with an interim partial denture which is resin based. Resin based interim partial dentures sometimes have distal clasps around your last tooth for retention but not always. The final partial denture will be delivered after or at the same time your final canine crowns are cemented -- this depends on how your dentist wishes to proceed. The canine crowns will have special guide planes to ensure proper seating of your partial denture.

Expert:  Dr. G replied 11 days ago.

Here is an example of a final cast metal partial denture.

Expert:  Dr. G replied 11 days ago.

Here is an example of an interim partial denture. Just imagine in your case 4 teeth instead of 1 are replaced.

Customer: replied 11 days ago.
I have read about the CEREC technology that would allow the canine teeth to have a crown placed on the tooth in one visit. Can this be done in the same visit as the partial denture is created? Do I know which teeth the partial denture will be attached to?
Expert:  Dr. G replied 11 days ago.

In your case it may be more predictable to have them made by a lab in the traditional manner This is because the teeth have to be properly designed with guide planes to accommodate the partial denture. Also most partial dentures require a framework tryin before resin is added. This will be overall at least 3-4 visits most likely for a cast metal partial which is superior to a resin one. You will have to ask the dentist which teeth rest seats and clasps will be placed on (this is dependent on your individual bite and tooth shape). Models are taken and then the partial denture frame work is designed with these factors in mind.

Customer: replied 11 days ago.
I thought the CEDEC allows the dentist to create the crown the same day, which is particularly important in my case. I have had a temporary bridge in my mouth for about a month already. If I were to leave the dentist's office without the temporary bridge which he would have removed, what will be in my mouth?
Expert:  Dr. G replied 11 days ago.

The issue is not just placing a crown on the tooth. In order to properly support a partial denture the crown has to be designed in a very specific way. CEREC is not really setup to do this like a traditional lab can. With CEREC your dentist would have to manually create guide planes by grinding on the surfaces of your new crown - not as good as having it perfectly cast from the lab. If you dentist already has an impression of the area which they should if it is prepared with a temporary bridge as you state then you would leave the office with an interim partial denture for the front 4 teeth and temporary crowns on both of your canine teeth.

Expert:  Dr. G replied 11 days ago.

This attachment shows an interim partial denture for 1 tooth just imagine your would be for 4

Expert:  Dr. G replied 11 days ago.

I advise you to further discuss treatment sequencing with your dentist as there are many treatment variations possible.

Customer: replied 11 days ago.
The temporary bridge was created by a dentist who cannot continue as he has just left town, so I do not know what happened to the impressions he made. Therefore, i am essentially going to a new dentist at this time.
I also don't understand why a lab could produce a more custom design than the CEDEC
Expert:  Dr. G replied 11 days ago.

The lab that makes the crowns will also concurrently make your cast metal framework partial. They will be fully compatible and custom designed together. The partial has to slide up and down the sides of the crowns in a very specific and parallel way If you have cerec crowns placed on first then they will have to be retrofitted and ground to accommodate the partial denture.

Expert:  Dr. G replied 11 days ago.

If you got a resin partial it wouldn't matter but they aren't nearly as nice as cast metal.

Expert:  Dr. G replied 11 days ago.

The crowns you will get on your canine teeth are technically called survey crowns - specifically designed for support of partial dentures.

Customer: replied 11 days ago.
What would the final crowns be made out of? I am looking for the best quality.What would the temporary crowns be made of?In total, about how many visits would this procedure take?I forgot to ask, what is your specialty and how long have you been practicing?
Expert:  Dr. G replied 11 days ago.

Temporary crowns are made of tooth colored acrylic resin.

Final crowns are porcelain fused to metal or zirconia

Usually to get a cast metal partial its 4-5 visits total

Expert:  Dr. G replied 11 days ago.

The most important thing for you to do is have a thorough discussion with your treating dentist about number of visits and steps. They may be comfortable using CEREC and if they are the more power to them. Best of luck with your new smile :).

Customer: replied 11 days ago.
I plan to be traveling in about two weeks. Would I be able to travel with the temporary crowns and partial?As I mentioned before, I forgot to ask how long you have been practicing and what is your specialty.
Expert:  Dr. G replied 11 days ago.

Yes you should be able to travel. I received my dental license in 2009.

Expert:  Dr. G replied 11 days ago.

I'm going to open the question back up so you can get some other opinions also since you seem to have many questions :).

Expert:  Drew Moore DDS MS replied 10 days ago.

Hi. I am Dr. Drew Moore. By the way, Just Answer only allows professionals in the field access to questions. In other words, an attorney couldn't get on here and give dental advice. They filter pretty well. I want to make sure I understand. You are missing the lower front 4 and the lower canines, the eye teeth on each end, have been prepared for crowns, because there is a bridge going across and covering the spaces of the 4 missing teeth. Is that correct? Do you have a picture or can you provide a picture of what you have now?

Expert:  Drew Moore DDS MS replied 10 days ago.

I'm looking at the history and will weigh in on some of those issues. A lab makes better crowns than Cerec, because a person will wax up a crown on the tooth model, like a jeweler does. So, it is custom made. The metal substructure might be scanned and milled. But, once the metal substructure is made, a real person is taking and "stacking" wet porcelain onto the metal and adding shades and such, so it is custom. Cerec is getting better, but it is designed on a computer and if the dentist or tech isn't really, really well-trained and skilled, the margins will not be as good as a lab fabricated crown. Also, the cerec crowns are made from a block and the colors, while much better than they used to be, are limited. So, what will probably happen is that the dentist will ask the lab to make crowns on the eye teeth, #s 22 and 27 and have them add special ledges, or "rests". The final partial will sit on your other teeth and those rests, like Dr. G showed in his picture. My question is if 22 and 27 are crowned, already, why are you not considering either a permanent fixed bridge, or implants in the bone where #s 23, 24, 25 and 25 used to be?

Expert:  Frank Duncan replied 4 days ago.

Hello, Frank Duncan, 37 years in general Dental Practice . It's very common to have 2 crowns and a partial placed at the same time. However it would involve impressions sent to a lab for fabrication. There are no instant cerec type partials. The crowns can be fabricated by cerec but then an impression would have to be made for partial fabrication to fit to the crowns. I suggest a flexible partial for comfort and less possibility of damaging the bone on the crown abutments. Also I suggest that you don't go into a new Dentist saying you want the best unless you find a dentist thru a good referral source. You don't want to be examined based on how much money you are willing to spend. I suggest that impressions are taken and 2 Zirconia crowns and a flexible partial be fabricated simultaneously and this should make you happy.

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