We firmly believe that success with All-on-4® starts with a team approach to manage the many variables for all involved including the patient, lab, surgeon and dentist. This process should always begin with collaborative case planning upfront to ensure smooth execution from all parties throughout the case which typically spans over the course of several months. Case planning together puts us all on the same page and helps us to address adequate bone reduction, ideal implant placement, restorative options, patient expectations and treatment sequence. Communication is critical in these complex cases to get the result your patient wants for the investment they are making in their mouth and overall health. Our technical team is here to assist you with case planning and execution throughout the case.
Our provisionals are made with the same attention to detail as our regular denture work. When your patient wakes from surgery, they will be ecstatic even with their temporary set of teeth. Our provisionals can be either conventionally hand-crafted or digitally milled depending on the workflow you prefer. We always begin with an immediate denture as a safety net should implants not torque. It is important to always discuss that possibility with your patient. We then convert it chairside to a fixed implant bridge. Our provisional is made entirely of acrylic incorporating the abutments that will attach the bridge to the implants for a custom fit. The temporary prosthesis will extend back to the most distal implant which is necessary for proper implant healing. We highly recommend waiting 6 months for the tissue to thoroughly heal and remodel before moving on to the final restorative phase. Consider the provision a “test drive” phase to determine exactly what your patient wants for their final restoration.
Chairside conversions by a seasoned technician are critical in getting your patients a precise custom fit for their investment. At Wiand, we use extreme care to only place the best chairside. They are thoroughly and properly trained in “The Wiand Way” before converting on their own. Our conversion specialist is there to consult as much or as little as you need with things like bone reduction and implant placement to ensure the prosthesis will have enough room to function properly and that there will be adequate interocclusal space for the upcoming final restoration. We do this based on the experience of completing thousands of All-on-4® cases with dentists and surgeons who all work differently. Our goal is to ensure all parties get with they need during surgery to ensure each can successfully complete their part in the case. Our conversion specialist is efficient, professional and always on time, an extension of your team to maintain the professional standards inside your practice.
After 6 months, your patient should be healed and ready to proceed with their final restoration. Using our protocol, we can achieve this final phase in as little as 3 appointments. Over the past 10 years, we have mastered the fabrication of the conventional hybrid bridge. This acrylic restoration incorporates a Montreal Style titanium implant bar designed by us. It is fixed implant supported full arch bridge that is non-removable by the patient. The benefit of this design is the exposed titanium on the intaglio surface giving the patient the ability to properly clean and maintain it. In addition, we offer several restorative upgrades such as our Zirconia Thimble Hybrid for the heavy bruxer and Swiss Loc Bar Overdenture for those who need lip support or for their prosthesis to be removable by the patient or caregiver, all of which are currently designed and fabricated in house.