Introduction:

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.

To submit your guided surgical plan, click here.

From there, we can produce a virtual mock-up 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 manipulable 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 15 minute meeting to verify and approve what has already been planned and adjust 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! Visit our Chairside Conversion team page to learn more about their experience and process.

Steps 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 going to the Doctor Portal button at the top of this page and then find “Send a STL file”. You can then upload your files. 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 about overjet, incisal edge, opening the bite, etc. Is the patient happy with all these things and ultimately the desired outcome of the final restoration? What type of restoration is desired? Bar + Denture Teeth, Bar + PMMA, Zirconia Hybrid? Shade?
6. Type of implants and surgical kit to be utilized
7. 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.

Virtual Planning

Utilizing 360Imaging 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 can produce both the surgical guides and PMMA restoration that will be placed at the time of surgery. 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.

The Day of the Surgery

The day of surgery, we offer our chairside assistance as a part of our surgical package. Our chair-side conversion specialist is there to assist in the process. 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, esthetic try in, bite/VDO, and captures the tissue. This will ultimately cut chairside and post op appointments in half!

Our goal is to streamline the entire process by planning 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.

For more information about our Chairside Conversion team, go to www.pittmandental.com/chairside

Once all implants are Osseo integrated and ready for the final restoration to be placed, our chair-side 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. 

Education

We also offer our assistance in helping patients and practitioners navigate the hurdles and obstacles associated with the process of intraoral surgery and implant placement.  From our experience, there are three major hurdles that patients must cross over to get to the point of commitment to a surgical procedure. Fear, time, and finances.

Our chairside conversion specialist is available to help explain the process and help navigate the hurdle of fear. Knowledge and understanding are key to eliminating fear.

Our process has lowered the number of visits needed to capture the data and deliver accurate restorations that have been accurately mapped out. Not only the number of appointments has been minimized with our process, but the amount of chair time has been cut in half on the day of surgery. Time is valuable and we strive to deliver a quality product as quickly as possible.

Finances

We also strive to assist you in navigating the hurdle of finances by staying on top of the ever changing dental and medical codes for billing. Many of the surgical procedures preformed can be billed not only through dental insurance but also medical insurance utilizing the ICD-10 and CPT codes. We suggest referring to the “2018 HCPCS Level II” coding book to cross reference dental and medical codes. This will allow you to best file for your patient and utilize as much assistance financially from all resources that are available to your patient.

Every dollar matters in today's economy and patients want to know that you are exhausting every possible resource to assist them in crossing over the hurdle of finances. Once they know that you understand and are there to help they are more likely to commit because they understand that you are fighting for them. These are a few resources we have found helpful in this process.

 

• ADA Dental Insurance Codes
• American Medical Association   1-800-621-8335
• American Dental Coders Association    1-833-469-2322

We also suggest offering your patience financing options through:

• Care Credit
• Lending Club

 

Other Helpful Documents

• Chairside Conversion Checklist
• Active Chairside Conversion Checklist
• Chairside Conversion Team Bios
• Dual Scan Protocol Process