Restorative Workflow: Overdenture to Fixed Prosthesis

Overview

Patients may change from overdentures to fixed prostheses seeking improved esthetics, function, and self-confidence. The primary considerations are:

Highly accurate implant level impressions.
Choosing MUA angles and collar heights.
Prosthetic space and flange considerations: Many overdenture patients need a flange for lip support, and may be a disqualifier for a fixed prosthesis. A minimum of 13mm of space is required (15mm is ideal) from implant platform to screw exit around the arch.
Trying in a prototype in as few appointments as possible.
Lab Tech Chairside support for a conversion: A lab tech can help process the All-On-X day of conversion (restorative conversion).
The goal of the Overdenture to Fixed Prosthesis workflow is to seat MUAs at the ideal orientation and capture records for a Printed Try-In.

Prerequisites

Technology & Materials

Photographs

Workflow Steps for using the Overdenture to Fixed Prosthesis Workflow for a Printed Try-in


Step	Instructions	Image
1.	Remove the overdenture and the bar and capture an implant-level impression. This impression must capture the tissue detail around each implant in order to determine MUA angle and collar height. Tip: The height is measured from the top of the implant to the top of the healing collar.
2.	Produce a denture via one of two methods: a. Duplicate the existing overdenture using a using a flasking technique, or 360° scan the existing denture with an IOS. Denture must be in an acceptable condition. b. Produce a new denture using conventional techniques.
3.	Capture a wash impression inside the new denture. Capture a bite and opposing model.
Important: The following steps are for the second appointment. Do not proceed until the appropriate MUAs and a conversion denture are at hand.
4.	Remove overdenture and bar, seat the MUA’s, and perform the denture conversion. This is a traditional All-On-4 type conversion, turning the denture into a ‘hybrid’. See the Freehand Denture Conversion protocol (page 45) for more details.
5.	Once complete, send patient home for a time period that allows approval, equilibration, modification to doctor and patient satisfaction.
6.	Perform the Flasking Technique. See page 30.
7.	Send all records to ROE Dental Laboratory. Next, ROE will fabricate or provide in-office printing files for the Printed Try-In. The Printed Try-In is a 3D-printed prototype of the final prosthesis. See page 58 for more details.

Additional Resources

For more information concerning Restorative Protocol's:

Contact Information

For help with Restorative Protocol's for your next case, contact ROE Dental Laboratory:

The following workflow details the steps necessary for clinicians to interact with ROE using the Overdenture to Fixed Prosthesis Workflow for a Printed Try-in.