Skip to content
Submit a Ticket
  • There are no suggestions because the search field is empty.

How do I evaluate whether a patient can transition from a removable prosthesis to fixed under GuidedSMILE Revisions?

This is the single most important conversation to have before records are submitted. Not every patient should go fixed, and the decision has to be made with measurements rather than assumptions.

The five evaluations

Evaluation How to assess it Decision point
Prosthetic space (fixed over fixed) Measure implant platform to implant platform between arches using the CBCT or dual scan At least 26 mm is required, because tissue is subtracted and prosthetic thickness is added back
Prosthesis thickness Cross-section of the denture, gum to gum 10 mm is the practical floor. Anything at 10 mm or above is workable, though 10 mm is not preferred
Inter-arch space, tissue to tissue Cross-section measurement Short measurements (examples of 17.3 mm and 13 mm have been shown) require bone reduction, opening the bite, or a combination
Lip support and flange Profile cross-section A fixed prosthesis cannot carry a flange. If labial bone is absent, elevating bone leaves a ledge and lip support is lost
Speech Chairside verification during the transition workup Confirm before committing the patient to fixed

Why the 10 mm floor matters esthetically

A 10 mm prosthesis will produce a visible transition line and gummy display for many patients. The rule of thumb: everything above the necks of the teeth will be displayed once the case goes fixed, because the tissue sits underneath the prosthesis. That is what drives the bone reduction decision, and it should be quantified during planning rather than discovered in surgery.

Capturing a true smile line

Patients under-smile for the camera, which hides display problems until it is too late. Use all three of the following:

  • Photograph the full smile.
  • Photograph the exaggerated smile, prompting the patient to smile as hard as they can.
  • Then have the patient close their eyes and smile as hard as they can. Closing the eyes changes the muscle recruitment and the lip commonly rises further, sometimes by another 1 to 4 mm. This behavior is documented in the literature.

You do not want surprises at delivery. Capture the highest lip position the patient is capable of.

The lip support conversation

This is the most common reason a patient should stay removable. If the patient has ridge bone but little or no labial bone, bone reduction will elevate the ridge, and a fixed prosthesis has no way to restore the missing labial contour. The result is a ledge and a loss of lip support. Because a fixed restoration cannot be built with a flange, this must be discussed with the patient before the case is planned.

For removable alternatives, review ROE's full arch solutions, which include bar and LOCATOR overdenture options.

 

Resources

    Contact Information

    For immediate chairside support or troubleshooting assistance, contact ROE Dental Laboratory: