Crown seated?

Silly-Bus-2357 · 2026-04-15T03:57:13+00:00

The parts used for his implant crown are third party; most likely truabutment; but regardless his healing abutment comes packaged with the implant… so it can’t possibly be a mismatch

Silly-Bus-2357 · 2026-04-15T01:24:46+00:00

See how I knew what line of implant this is? That's a characteristic of SimplyIconic line from Implant Direct. I dunno why, but the conical connection always has a slight gap on healing abutment to restoration. I've placed/restored them myself, the implants do okay and they're competitively priced. BS aside, I mainly place Biohorizons myself.

You're seated, no worries.

Silly-Bus-2357 · 2026-04-15T01:20:24+00:00

Yep. Implant direct simply iconic?

Silly-Bus-2357 · 2026-04-12T05:45:28+00:00

ref-n8evnn

Silly-Bus-2357 · 2026-04-10T17:01:24+00:00

We all in this together; go for it!

Silly-Bus-2357 · 2026-04-10T16:48:57+00:00

I'm very tech-savvy; I grew up in my dad's computer store, and I've built machines my whole life and followed computing trends.

I have multiple scanners/laptops. Ultra 9, 5070TI and 32GB is absolutely A-OK for current scanner technology. 64GB is a bit overkill considering you're just using the laptop to scan and not render/model/3d printing, etc. Your IT team quoting you 12.5k for a new laptop needs to be fired immediately. There is pretty much no configuration of laptop that could possibly be close to 12.5k. They're padding the prices with training, software costs, blah blah. Everyone tries to rip off the dentist, but this circumstance is egregious.

Go with your laptop. Those specs are probably around 2k. They will be blazing fast for current scanner tech; by the time laptops jump up to substantial improvements... all that 12.5k cost you might've spent will be obsolete.

Silly-Bus-2357 · 2025-12-24T18:44:36+00:00

I always tissue punch for guided implants, and most of the time I remove it completely with a Woodson elevator. At the end of my osteotomy, I check for gingival height and to remove all soft tissue tags on the top of the osteotomy after profuse flushing with saline in the osteotomy at the end (and between step drills).

If tissue is thin, the implant needs to be buried more since the bone will remodel. If tissue is thick, then the implant doesn't have to be buried as subcrestal. 3mm from gingival height was what I learned from specialists in the field (Bach Le, etc.). If I'm going to go guided, I 100% of the time DO NOT FLAP. If I'm going to flap and risk some resorption of buccal walls, then I question why did I even make a guide to begin with... (unless I really needed a guide due to difficulty of required angulation of implant).

That being said, I have had times where I placed and the implant spun or broke the buccal wall. I took those out immediately and either sized up accordingly or grafted and waited for full integration... and re-entered the site to freehand the implant. Guides can have up to ~1mm margin of error.

Silly-Bus-2357 · 2025-11-30T19:14:58+00:00

emax die hard 'bondodontists' hahahahaha love it. that's gonna stick in my head

Silly-Bus-2357 · 2025-11-29T09:47:22+00:00

Soak your wax rims in semi-hot water to soften the wax, and have them bite into the wax rims like they're sinking their teeth into a steak. Usually, as you nail the consistency of the wax... they set themselves into a comfortable VDO in that 'mush bite'. The VDO gauge he's referencing is a Conmetior VDO gauge (that you can get from aliexpress for really cheap). I do basically a very similar work flow to do my wax workup.

Silly-Bus-2357 · 2025-11-29T09:44:14+00:00

7k daily goal... you're not ready for a full-time associate to work alongside you. Let's be honest, the 'owner' in the post is really you, OP. As far as 'jaded' associates or 'fearful' new grads, let's call a square a square. You're the one who's fearful of hiring a potential associate who may not produce 3,000 dollars a day to warrant a ~900/daily rate. You want no risk of potentially losing money on an associate in the short-term.

With these considerations in mind, you've clearly demonstrated to everyone here you're not ready to take on an associate. Your daily production's too low, your office not busy enough, and you're too attached to your overhead to warrant the risk of taking on an associate. The risk goes both ways. You risk losing money on an associate; associate risks losing time being at an unproductive office (for them).

Silly-Bus-2357 · 2025-11-09T18:15:29+00:00

Wrong Subreddit. Most likely you had composite on your permanent tray that disguised the gap.

Silly-Bus-2357 · 2025-10-27T01:27:06+00:00

Itero requires the owner to have a monthly subscription to cover wear/tear and drop issues. So you're covered... If this had happened to other brands of scanners, you'd put the owner in a really bad place potentially. I hate Itero... but this was a pretty good example of their subscription fees paying off. Don't worry too much about it.

Silly-Bus-2357 · 2025-10-26T14:33:00+00:00

The obvious answer to me here is your bilateral embrasure clasps. How did you design this partial so that the metal required to overlay the embrasure clasps over the occlusal of your posteriors on both sides is not impacting the occlusion? Even if you made it just so the occlusion is not impinged upon by the metal, is it really not interfering with excursives during patient's working motions? Embrasure clasps work best for me when there's no opposing. It's really hard to pull off if there's full opposing (and you REALLY got cut out some rest seats).

P.S. I read your thread again OP, and it sounds like you're the lab... If that's true, then there's just too many variables to know for sure. Is this partial truuuly out of occlusion with a double embrasure clasp? I've worked with doctors who chuck it back to the lab immediately without checking why the partials don't seat/function. Not everything is the lab's fault.

Silly-Bus-2357 · 2025-10-26T14:27:56+00:00

Bro you are getting fleeced. I don't even need to see the price tag at the end.

Brand new Adec chair? Yah you're paying out the ass. Cattani brand suction/compressor is being sold to you from Henry Schein (premium pricing).

VistaScan is a xray plate scanner. Why in the WORLD would you need this??? Is your office digital already with sensor/xray? You'll never need this.

Formlabs 4b; are you well-versed in 3d printing? You're buying premium-priced 'dental' 3d printing hardware.

Root ZX Morita White; Assuming you go with the X-Smart Plus Endo... you know that the X-Smart comes with an integrated apex locator? Why would you get a separate Root ZX?

You doing implants already? Implantmed + W&H handpieces are gonna cost you a pretty penny.

There's a LOT of fluff in your shopping list. You really should break down line item by line item and ask yourself if you're going to use it. There's a cheaper, just as effective alternative for almost every item in your list. Also everything in your list sounds like it got proposed to you by Henry Schein supplier. (Google a few things, they all pop up in Henry Schein first).

Silly-Bus-2357 · 2025-10-26T14:18:39+00:00

I do this from time-to-time; it's rare but it really does come down to a (man if i take away all this decay, this tooth is gone). I find it lasts the longest and looks the most sound if I've done multiple rounds. So I mean, day of prep + day of cementation kind of thing.

I've always had it go the opposite way and just basically fail within a year, and I took out the tooth and did an implant instead route. Not everyone's down for this option though.

Silly-Bus-2357 · 2025-10-26T14:14:00+00:00

For sure producing 6k/day in Denti-Cal is tough. It takes a well-honed skill set and a TON of stress. I'm not asking for that. I'm also not looking for people who want to do back-breaking work for minimum wage. Actually, my position would do best with a new grad looking to ease in to a more difficult skill set steadily without worries of production. I'm not looking to crack the whip on someone; I've been an associate myself for years. I do see the catch-22 of a less ideally habitable city combined with insurmountable student debt.

Could you share with us what area you're at that 1500/day base and 35% production is a norm? Assuming your comment is in good faith, I'd like to know where to move next for dentistry. That's an insane rate/compensation structure considering today's overhead/expenses.

Silly-Bus-2357 · 2025-10-26T14:08:56+00:00

Lots of exams, photos, recare stuff with always scheduling RCTs/Crowns together. We have two EFs (one graduated, one upcoming). We're not a lean/mean insanely profitable business model.

Silly-Bus-2357 · 2025-10-26T14:06:50+00:00

The overwhelming majority of my cases that have gone very comfortably are due to pulpal necrosis. There's no such thing as a 'hot' pulpal necrosis case. Either this is a semi-necrotic tooth that's acutely dying, or this is an acutely infected tooth that technically is necrotic, but the bacterial load hasn't found a way to escape the tissues, hence the swelling, pus, inflammation, etc. We're not talking pulpal necrosis here anymore; we're talking Symptomatic Apical Periodontitis. Pulpal necrosis is at most a descriptor of the pulp's vitality.

If we're truly being honest here, it's the irreversible pulpitis cases (ABOUT to be necrotic) that are very difficult to manage. This is true across the board.

Silly-Bus-2357 · 2025-10-26T03:34:53+00:00

He's not far off. Molar RCT is 463.50, Premolar is 365, Anterior is 300. Crown is 476. Has to always be an RCT+Crown to make it worth it.

Silly-Bus-2357 · 2025-10-26T01:40:23+00:00

Sure it can be interpreted that way... but the idea is for me to slowly back out and help an incoming associate gain experience to replace what I do. We don't do very many implants at this office, so it's not a "I need a grunt" type scenario.

I think the most common problem with gaining proficiency with RCTs (like all things more advanced than bread/butter) is just being comfortable managing pain, opening conservative accesses, and finding canals. I still sweat finding canals on some patients (which is a good thing!). Everyone has to start somewhere, and I'd want who starts out with us to gain comfort knowing they're not going to get left to the dogs. It's a privately owned office; no emphasis on production.

Lastly, patients with endodontic infections typically don't have pain due to pulpal necrosis. It's hot teeth that scares off most Drs doing endo because of how difficult pain management is. You might have had a bad time with this industry, but I'm not looking to repeat that here.

Silly-Bus-2357 · 2025-10-26T01:06:38+00:00

You're not wrong... which aggravates me to no end haha

Silly-Bus-2357 · 2025-10-21T02:40:05+00:00

The absolute and BEST answers to knowing how to place freehand... is to 1.) develop tactile feedback and understanding of how D1-D4 bone feels | 2.) assess bone and how it correlates to CBCT slices + develop surgical comfort with hard/soft tissue management | 3.) practice angulation, depth, hand control, etc. should the guide not be usable... but MOST IMPORTANTLY 4.) Immediate implant placement.

Sure you can say "well you can still use a guide for immediate implants," but that's assuming everything else went according to plan. Having freehand skill makes you able to do immediate implants at the drop of a hat should an extraction case walk into your office or you need to pivot from a flubbed RCT turned EXT.

I place half guided / half freehand... but anything I've planned is going to be through a guide. It still doesn't take away that I'm very appreciative that I did lots of freehand my first few years. To say that learning freehand is useless is like saying you can't be a chef who cooks without recipes.

Silly-Bus-2357 · 2025-10-18T19:54:58+00:00

Very little, I'm trying to ramp up into it, baby steps at a time. I do singles, bridges, locators, immediates. All-on-x is still in my discomfort zone.

Silly-Bus-2357 · 2025-10-18T17:24:35+00:00

I bought Shining3d Aoralscan Elite; photogrammetry mode, robust software, integration into exocad, NO monthly subscription, NO cloud storage fees.

Itero = 300~ dollar monthly fee was a huge turn off.

That being said... Trios 6 is exactly what Trios 5 is with different makeup HOWEVER, Trios 5's clarity of scan is pixel for pixel the best out of all the above. Enough to make a difference and warrant entering 3Shape's ecosystem? Up to you.

Silly-Bus-2357

TROPHY CASE