Pittman Dental Surgical Implant Procedure

The beauty and simplicity of the process is the limited chair time and visits that are required to achieve not only highly esthetic restorations but also fully functional restorations at the time of surgery with no adjustments required. We can have the patient in for an initial consult where scans or impressions are taken along with CBCT scans and other vital information is gathered. From there, we can produce a virtual mockup of the desired final restoration and utilize that throughout the process as our final “blue print” to map out every other aspect of the surgical process always keeping our final goal at the forefront of everything we do. We utilize multiple software applications to accurately plan each case utilizing all records taken including photos and facebow records. All parties involved can view a 3d manipulatable image to have input on the final restoration. Once approved, we then begin the process of planning the implant placement utilizing 360Imaging software. The restorative Doctor and Surgeon will be asked to attend a GoToMeeting to finalize and approve the implant placement. This is usually only a 15min meeting to verify and approve what has already been planned and make adjustments as needed before printing the surgical guide(s) and milling the surgical PMMA. At the time of surgery, we provide chairside assistance to help walk through the surgical process and finalize the immediate load PMMA. Our process has been proven to cut the surgical procedure time in half in most cases!

Surgical Guide Steps:

1. What is needed to begin the process of planning the final prosthesis and implant placement.
   1. CBCT scans. If a denture is currently in place then the scan will need to include the denture intraorally. You can upload these files directly to us by using our Doctor Portal at pittmandental.com.  Once in the “Doctor Portal” you can then upload your files. For more information on how to upload your files click here. We can also install the 360 courier portal so that you can drag and drop files there. You can also put the files on a disc or usb device and physically send the files. We can assist you in getting these files uploaded to us if needed.
   2. Scans or impressions of the patients existing situation. If the patient has a denture, we need an accurate impression of the denture in place.
   3. Bite records including a facebow or at a minimum a stick bite.
   4. As many pictures of the patient at rest, smiling, in repose, from the side view, etc.
   5. Any information detailing the bite classification or modifications desired. Is the patient happy with all of these things? Definitive restoration desired? Bar + Denture Teeth, Bar + PMMA, Zirconia Hybrid, Shade.
   6. Implant brand and surgical kit to be utilized.

2. We will then produce a virtual diagnostic that can be sent to all parties involved to view. No special software is required. It can be viewed and manipulated 3deminsionally from any platform including cell phones, laptops, tablets, computers, etc. We will need to make the changes virtually in lab to the restoration if desired or required. Once the final design is approved we can then begin the process of virtually planning the implants.                                                                      

3. Utilizing Treatment Planning software, we virtually plan the placement of the implants based on the final desired outcome of the restoration. We import the CBCT scan and .STL files of the current situation and the approved diagnostic models. Once the implants have been planned we will then invite the restorative Doctor and Surgeon to a GoToMeeting where we will walk through the surgical plan virtually and make any changes as needed. Once approved, we are able to produce both the surgical guides and PMMA restoration that will be placed at the time of surgery within 15 days. This PMMA has multiple advantages to the antiquated way of denture conversion. It is stronger, more esthetic, more accurate bite, much easier to clean, simple placement at the time of surgery……just to name a few. This restoration is an exact replica of what was planned at the beginning of the process and ultimately a precursor of the final restoration.

4. The day of surgery, we offer our chairside assistance as a part of our surgical package. Our chairside conversion specialist is there to assist in the process. If you need chairside assistance for guided or non-guided cases, please click here. We will provide our Diamond Latch guide with attachment screws , drill protocol, and an immediate load PMMA. We also offer a back up denture just in case we are not able to gain primary stability at the time of surgery. WE NOW ARE ABLE TO CAPTURE DATA AT THE TIME OF SURGERY TO STREAMLINE THE PROCESS OF TAKING THE PATIENT TO THE FINAL RESTORATION! This data will give us the information that we need to provide you with an appliance that serves 4 purposes in one. Verification index, aesthetic try in, bite/VDO, and captures the tissue. This will ultimately cut chairside and post op appointments in half!
   Our goal is to stream line the entire process by planning ahead and mapping out each and every step. Our average surgery takes half the time of the conventional denture conversion process. We do still offer this service of denture conversion if deemed necessary or preferred.
   
   
5.  Once all implants are osseo integrated and ready for the final restoration to be placed, our chairside conversion specialist is available to come and assist in taking impressions utilizing our verification index. They will also record any changes needed or desired from the immediate load PMMA and capture images of the patient. All of this is included with the final restoration.
   
   
6. We will then design a try in PMMA that the patient can wear over a period of time to verify that they approve the changes that may have been made. Once all adjustments and modifications have been made intra orally, we will then capture the changes in a new impression or scan and import that data back into our design software to fabricate the final restoration.
   
   
7. Our final restoration can be delivered once again utilizing our chairside conversion specialist. They are there to modify, if needed, the restoration and assure a smooth delivery of the final prosthesis.
   
   

   For more information about surgical guides and our chairside services, click here.