Initial Restorative Procedure (Rx-1)

The first restorative appointment for the All-on-4, Immediate Load Procedure, starts with the records needed for the fabrication of the conversion prosthesis. This prosthesis is similar to an immediate denture and will act as the basis for the provisional fixed hybrid.


The impressions needed for the fabrication of the provisional need to capture all of the landmarks of the dentition including vestibules, full palate, retromolar pads, and the hamular notches. These are important to capture, as we will need these areas to stabilize the prosthesis during the conversion process. The impression material can be PVS or alginate as long as they are treated as the manufacturer recommends. Distorted impressions or bad models can complicate the day of surgery and compromise the ability to immediate load the prosthesis.

Bite Registration

A bite registration of exactly where the patient will be restored to is necessary to ensure proper function of the provisional prosthesis. If the patient does not have enough dentition to capture a proper bite, then we will make a bite rim to assist with the bite registration.

Note: Opening a bite on an articulator has shown to give inaccurate results which can compromise the conversion process. Van Hook Dental Studio recommends that all open vertical cases be done with a proper bite registration or through splint therapy.

Fully edentulous patients will go through conventional steps to fabricate a new denture to be used as the provisional.

Note: Van Hook Dental Studio does not recommend the use of the patient’s existing complete denture as the conversion prosthesis. We cannot guarantee that the teeth and materials used to make the existing denture can withstand the forces that in implant supported fixed dentition will apply to the prosthesis. The prosthesis that Van Hook Dental Studio fabricates will have the proper occlusal schemes and we only use high impact teeth and acrylics for maximum strength.

Van Hook Dental Studio provides you with a nine-month warranty for the provisional and will make any repairs to the provisional during the interim phase.


Proper patient photos are an important tool for our technical specialist to use to accurately set-up your case on a semi-adjustable articulator. The technicians will also use the photos to guide them for the right tooth positions. Good photos can aid the technicians with midline positions and proper length of the teeth. The esthetics of the provisional is an important factor for patient satisfaction and we go through great lengths to ensure that the provisionals exceed the patient’s expectations.