Need a Good Prosthodontist. Help!

I am looking for a really good Prosthodontist who considers restoring teeth an art. Who uses IPS Empress II for all-ceramic restorations or CAPTEK for pfms. I want to consult.

Comments

  • Misa HayaseMisa Hayase Member PExer
    I know lots of good prosthodontists... however I'm just not sure if they use the brands you mentioned. May I ask why the preferrence for those specific brands of ceramic? Anyhow, i'll ask around and get back to you on that!
  • M_LoverM_Lover Mister PExer
    I need to get a bridge done in the anterior region. It's an ethetic zone so I'm thinking all-ceramic. I surfed the net and found out that Empress II will give good esthetics and is also durable. However, I'm also thinking of longevity. The manufacturers of CAPTEK claim that their product can rival all-ceramics in esthetics but can give the strength of a traditional porcelain fused to metal restoration, doesn't cause graying at the gumline and also minimizes bacteria accumulation. Although of course, to see is to believe. I would like to have a choice on which will be most beneficial for me in the long run. Although of course the expertise of the lab technician is a factor and of paramount importance in the appearance of the restoration. I also realize that the dentist should be a good prosthodontist to give the technician a good working basis in terms of preparation of the tooth, to give a more natural look. Sana lang mabait din yung doktor at hindi ako pagsasamantalahan. Thank You. I'll be expecting refferals from you. I really have to have this done as soon as possible. Thank You

    :)
  • the_poll_masterthe_poll_master ~sanXie~ PExer
    M_Lover
    hi! sounds like you know some technicalities about prostho. are you in any way in the dental field?

    anyway, those are great choices. empress (the full pocelain shell) really looks 100% natural. some time ago i (together with an associate) did it to my cousin on both her upper central incisors, and they looked great! *okay*

    its been over six years now and they're still intact. no signs of darkening gums, no foul smell, no discolorations :nope:

    the price, though is pretty steep. of course when things get pricey it must be for some reason. and with empress it IS the quality indeed. you just have to take extra good care of it though, most especially if you'll be considering the full porcelain shell. porcelain fused to metal needs no that much caution since it's backed by a metal core.

    questions: how many units (of the bridge) are you planning to have? are the teeth vital? have they undergone any rct (root canal treatment)?

    hello misa :wave: it's been a long time, huh?! don't you think this should be merged in your thread?

    :redsmile:
  • Misa HayaseMisa Hayase Member PExer
    Doc Pollmaster! Looks like this thread falls on your lap! Hahahaha. I have an FPD final tomorrow... and I don't particularly relish the subject, heheheh.

    M Lover: You sound like you really know what you want! Well good for you! :) Will ask some of my profs tomorrow. :)
  • M_LoverM_Lover Mister PExer
    Nope I'm not into dentistry. Sad to say, experiences with my past dental procedures have not been pleasant. I won't go into details. I just charge it to experience. This time around, I thought I'd try to equip myself with as much information as I can so I will make wise choices and be able to discern if the practitioner indeed knows what he/she is doing. You're right, I know dental jargon more than I need to..... blame the internet.

    I need a 3-unit anterior bridge from tooth #7, 8 as pontic and 9. Tooth 9 had been prepared previously. Tooth seven is still virgin. No RCT. Prepared teeth are healthy. I hope I won't need an RCT. However, I have the impression that most dentists here in the philippines are not yet comfortable with using all-ceramic for bridges. I know that for the moment, it is indeed contraindicated for bridges spanning more than 3 units, and that certain factors should be considered for success (ie. demands more tooth reduction or a different preparation and the pontic space should not be too wide, the bite and whether the patient is also a bruxer) In these respects, my condition is ideal for all-ceramic. Although if I see that the empress and captek crowns don't really have too much of a difference, I'd go for captek. I wouldn't want to have nice teeth but always worry about what I eat or whether I can bite into something or not. Thnx. ;)
  • the_poll_masterthe_poll_master ~sanXie~ PExer
    M_Lover so the situation is like this: 7-x-9? tooth #8 is missing, right?

    since a 3-unit full porcelain shell is out, and your option is still to have empress/captek crowns, i suggest the following:

    tooth #9 has been prepared, it is the canine, right? therefore highly stable due to its anchorage (has the longest roots in the oral cavity making it the most stable). it then can, hypothetically speaking, take on another tooth - #8. the 2-unit bridge can use #7 as some kind of "abutment" only by using some kind of "ear" or "rest" on it (to prevent torquing).

    tooth #7 can be left alone as it is - a virgin.

    although some dental practitioners may argue with the idea of a two-unit bridge, it being not that stable and the possibility of torque for the bridge, i personally think it is best for the patient's (your) interest.

    first, conservative dental procedure will be done to you. less dental tissues scuffed off during tooth prep. only the abutment tooth will be sacrificed.

    second, of course cheaper. while a 3-unit full porcelain will cost you (at a rough eastimate) 18,000 (if each unit costs 6,000) then that'll be less 1/3 of the total cost.

    misa :howdy: goodluck with your fpd exam!

    :redsmile:
  • M_LoverM_Lover Mister PExer
    Thnx. Mali pala ako kung gayon. left central incisor yung missing. Right central incisor yung prepared. Sorry.

    I wanted sana to make it more rigid kaya I decided to go for the 3-unit bridge. I'm going to a dentist tomorrow for a consultation. I'm quite nervous. Phobic na yata ako. Pero I promised myself not to commit yet to a treatment. I would at least get another opinion. Thought I'd compare what each would want to do to improve my upper anterior arch and see samples of their work, check for proper preparation, color matching choices and labwork quality and for marginal integrity.

    The quotations I got ranged mostly from 7,000/all-ceram crown to 10,000 each. Would you believe I also got a quotation for 16,000 a crown?:rolleyes: Even those with gold copings do not cost that much. How else would they expect their practice to grow if they overcharge like that. Asa pa sa referrals. Anyway, I've set a ceiling for this procedure. I promised myself not to spend more than 30,000 for it. Siyempre naman kung talagang magaling yung dentist at lab technician niya, he can really charge 10,000 per unit if he wants. I really hope I'd be satisfied this time.

    Pero ang saya sana kung magaling na mura pa.
  • the_poll_masterthe_poll_master ~sanXie~ PExer
    so how was your visit to the dentist?
  • M_LoverM_Lover Mister PExer
    Well, it went quite well. I told my story. He took an impression and told me that he will first evaluate the bite and study how much of my teeth he has to shave off, make a temporary and to see if he can do all-ceramic. He quoted 10,000/tooth. He suggested 3-units for long-term stability. I told him of my esthetic concerns. He seemed indifferent and did not say or did anything at all to appease me. He said he'll try. I didn't ask to see samples of his work. I thought he'd get upset if I expressed doubt in his capabilities. He had post graduate studies in the states for prosthodontics so who am I to scrutinize his techniques. He was also referred by other dentists. He teaches and gives seminars on prosthodontics, so I guess he might be really good. I kinda trust him but also feel some anxiety over the final restoration. Heto na naman ako.

    He x-rayed the molar I want evaluated to see if it he can still salvage it. I'm going back there tomorrow to have it done na. Pero he always closed with "If you decide to go through with it...." He also told me I need 4 routine "pasta"s. He didn't charge me anything for the consultation and the x-ray.

    Parang sige na nga. I really want this to get done as soon as possible. I have to start trusting somebody or else I will have to live with this provisional for the rest of my life. Just praying this won't end as a nightmare... ala rico yans baga. :D
  • the_poll_masterthe_poll_master ~sanXie~ PExer
    hey M_Lover that's great! sounds like your doc is damn good... what's his name?

    great huh, he didn't charge you for the x-ray *okay*

    :redsmile:
  • M_LoverM_Lover Mister PExer
    His name is Dr. Austin Ang. He teaches at UE. Any feedbacks about him? I just came from his clinic this morning. I have fears but will wait until next week before I tell stories of my procedure.
  • the_poll_masterthe_poll_master ~sanXie~ PExer
    M_Lover oh, yes, dr ang! he used to be my clinical instructor at ue :D ... u are indeed in good hands *okay*

    :redsmile:
  • Georgia10Georgia10 Member PExer
    Hi M_Lover, how's your experience with Dr. Austin Ang? Ok ba yung gawa nya?
  • Georgia10Georgia10 Member PExer
    Hello po. Need help. I have a complicated case. I've been wearing denture (acrylic yata) for like 14 years na. Can't afford kasi namin yung RCT before kaya bunot lang ang naging option. All 4 top incisors yung nawala, then after siguro 8 years, yung 3 (2 premolars and 1st molar) teeth naman sa upper left arch yung naalis. Wala na din yung 1st premolar sa upper right arch. Sa ibaba naman po, yung 2nd premolar and 1st molar yung wala na. Can't remember kung kelan naextract kasi dati basta masakit pinapabunot na namin agad, hindi pa ko aware sa consequences noon :(. The 1st premolar lower right arch naka-crown. Also the 2nd premolar and 1st molar sa left arch naka-crown din, all PFM. Dahil sobrang nahihiya ako sa dental status ko, and I had bad experience with my previous dentist, natakot na ko magpunta ulit ng dentist. Yung na-jacket na ipin ko nagnana dati and ang ginawa lang ng dentist ko, inextract yung nana using injection. Ilang beses pabalik-balik ako hanggang sa naisip ko na hindi nalang bumalik sakanya. Then naging busy sa work at iba pa and napabayaan ko yung ipin ko. Kapag may kasama ako hindi ko na nalilinis maigi yung denture kasi nahihiya akong tanggalin. So after like 6 years, this September lang, nagpatingin ako sa dentist na malapit, sa SM Novaliches, kasi yung lower right 1st premolar na naka crown namamaga yung gums ko. Since nakapalagayan ko ng loob yung dentist and i decided to trust her, naisip ko na din pagawa ng new denture yung sa taas and baba kasama ng pag root canal sa namamaga kong ipin. Flexible denture ang nirecommend sa akin and yun ang inunang gawin, yung RCT after na lang daw ng antibiotic ko. Kaso hindi ko nagustuhan yung gawa sakin, marami po kasing tingin ko dapat i-adjust sa denture. Imbes na mag improve yung smile ko parang mas pumanget pa po. Tabingi *** lip ko sa taas kapag nagsmile. Tapos hirap na hirap ako kumain. Parang hindi binigyan ng much effort gawin yung denture. Nagalit pa sakin yung owner (senior dentist na) ng cljnic nung sinabi ko yung mga gusto ko ipa-adjust. Tinataasan ako ng boses at sinabi na irefund nalang daw. Naiyak nga po ako sa pakitungo nya sakin, matanda na po kaya hindi ko na lang sinagot at naiyak nalang ako sa sama ng loob. Usapan namin ng dentist ko na igagaya sa old denture ko yung shape ng new denture kasi complement sa mga pangil ko. Pero yung gawa po nila ibang iba. So pumayag din naman sila na iadjust, pero hindi pa rin po ako talaga satisfied pero hinayaan ko na lang. Then after that nalaman ko na hindi na daw pala gagawin yung root canal ko and denture sa baba. Sabi ng dentist ko iRCT pa rin nya ako but sa ibang clinic na, i agreed naman sabi nya she'll text me na lang. Kaso she never texted me back or even answer my calls, she left the clinic na. So naghanap nalang ako new dentist after few days kasi namamaga nanaman yung ipin ko after i stopped the antibiotics. Ayun dun na ko nagpaRCT. Ok na but under observation pa kasi yung abcess umabot na din sa canine but hindi pa naman daw need na i-RCT but candidate na. My new dentist is an endodontist. She's okay naman but i'd like to consult with prosthodontist para sa new dentures ko up and down. Ang problema po kasi yung ibang teeth ko sa upper right medyo bumaba na kasi matagal ng walang ipin sa baba. Yung sa left side naman medyo tumaas ata yung mga ipin sa baba. I badly need someone who can help me make my new dentures na maganda and pinagisipan talaga ang paggawa considering aesthetic and function. I'm getting married na po kasi soon and I'm hoping I can have a nice smile naman on my wedding day. Can you please please please refer me to a very good prosthodontist? Thank you in advance! :)
  • smilewarriorsmilewarrior Moderator PEx Influencer ⭐⭐⭐
    ^ Mahirap nga ang kaso mo. :( With your previous denture, bago ba ito niluto ay nagtrial ba sila sa iyo? Trial fitting means the denture is not yet "cooked" and is made primarily of wax, fake teeth and a base. Kumbaga sa wedding dress may "fittings" and "adjustments" din ang denture bago ang final product. Lahat ng gusto mong pabaguhin, lahat ng hindi ka masaya these issues all need to be addressed BEFORE the denture is processed ("cooked"). Habang hindi pa ito luto, mas madali ibahin ang porma nito. This means it will take several appointments before a proper denture is made, and that is why they cost the way they do. Wala naman kasing instant, yung tipong sinukatan ka today, biglang ginawa at niluto ang denture tapos magugulat ka na lang luto na pala siya at ikakabit na sa iyo. Hindi na masyadong maiiba ang porma ng pustiso kapag luto na ito.

    With regards to the placement of the teeth of your denture, they will be affected by the positions of your real remaining teeth. Sabi mo nga nagsihabaan na ang mga iba mong ipin, sadly this means maaring hindi magawa sa iyo yung tipong kapag ngumiti ka ay mukha kang artista o mukha kang sasali sa Binibining Pilipinas. May limitations kumbaga. :(

    Siguro sa susunod kang magpagawa ng denture, tanungin mo muna kung magta-trial muna ng denture bago ito iluto. Para makita mo muna kung ano itsura nito bago ito maging matigas at hindi na mababago masyado. Also note there is a scientific basis to tooth placement in dentures. Ibig sabihin minsan gusto ng pasyente na ilagay sa certain position ang mga ipin pero hindi naman pwede kasi kapag sinunod ang pasyente ay may mangyayaring masama ( biglang luluwag ang pustiso, o ang pustiso palaging natatanggal, etc. etc. ).

    I will try to send you a private message later when I have time.
  • Georgia10Georgia10 Member PExer
    Wow thanks sa prompt reply smilewarrior! :) haha hindi naman po mala artista or beauty queen ang nais ko. Basta decent smile lang ok na ako lalo na sa front kasi un talaga ang kita agad. :) I understand naman po yung limitations lalo na sa case ko.

    Yung sa old upper denture ko naman po tingin ko ok pagkagawa kasi madami po nagsasabi na maganda yung smile ko kahit hindi nila alam (or yung iba baka nahalata na) na fake teeth hehe. Actually matagal bago napapansin na fake yun, kapag malapitan siguro at ininspect yung gilagid ko. May friends ako na matagal bago nila nalaman, nung sinabi ko lang. Hehe.

    About naman sa bagong denture, walang trial na naganap :( . Akala ko nga po meron muna trial kasi nung nagresearch ako nabasa ko na meron dapat trial ang valplast kasi mahirap nga daw po ireline. Nagulat ako ng nalaman ko na yun na pala yun walang trial. Kaya nga po nirerequest ko na lang na kahit yung shape nalang ng teeth sa harap medyo ayusin, and yung bite po mahirap. So ayun medyo niremediohan yung pontics mas umayos naman po after and yung sa bite nagkagat ako with articulator paper ba yun? Aside from that rough din po yung denture, hindi po napolish maigi. Andaming rough surfaces. Sinabi ko na po yun pero pinapabalik na lang ako after a month. Now almost a month na, ganun padin po rough talaga. Hindi pa naman ako nakakabalik kasi naisip ko magpagawa na lang ng bago sa prosthodontist na.

    Yung flexi partial ko po super duper sikip feeling ko kawawa na gums ko :(.

    Thanks po i'll check my inbox :)

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