At Van Hook Dental Studio, we believe that simplicity and predictability are essential when developing protocols for restorative success. Our recommended protocols for restoring your final Hybrid encompass a five-step approach. These steps usually take 30-45 minutes for each appointment and follow many guidelines used in fabricating complete dentures.
Appointment 1 (Rx-2)
The first appointment for the fabrication of the final prosthesis begins with an evaluation of the provisional restoration. This process would be similar to evaluating a denture wearer for new dentures. Looking at overall esthetics and function of the provisional will aid you in what will need to be corrected if the final. Upper and lower study models with a bite registration are taken along with a series of patient photos. These will aid the laboratory in proper mounting and assist in improvements on overall esthetics.
The second part of this appointment will be the removal of the provisional prosthesis and taking the final impressions. This is accomplished using open tray, abutment level impression copings that are provided by VHDS in our All-Exclusive Package. After the impressions are taken, the provisional is re-secured and torqued to the manufacturers recommendations (usually between 10-15ncm). U/L study models, bite registration and final impressions are returned to the lab along with the patient photos.
Appointment 2 (Rx-3)
The second appointment focuses on recording the desired vertical that the patient will be restored to. You will also be connecting the verification jig at this appointment.
Remove the provisional prosthesis and place the bite-rim on the abutments. Fixate the rim in place with the screws provided. The screw-retained rim provides complete stability during this procedure. Record the patients desired vertical using conventional denture methods. After the bite is verified, remove the rim from the patient and place the jig components in the proper position. Lute the verification jig together with Triad gel or a flowable composite and cure. Remove the jig and place it into the case provided (make sure that all screws are sent along). Re-fixate the provisional and that completes this appointment. Bite-rim with recorded vertical and the connected verification jig are returned to the lab.
Appointment 3 (Rx-4)
The third restorative appointment is all about the esthetics and desired tooth positions.
After removing the provisional restoration, place the esthetic try-in in place and fixate the prosthesis with the screws provided. Evaluate the midline and tooth positions along with overall esthetics of the prosthesis. Check the occlusion and take a new bite if needed. If changes in the set-up are required, please take photos to show the discrepancies. Remove the set-up and re-fixate the provisional prosthesis.
The set-up and check-bite are returned to the lab.
Appointment 4 (Rx-5)
The fourth restorative appointment is another try-in appointment, with the addition of the titanium sub-structure. The titanium substructure adds the strength and long-term durability need to withstand the forces of mastication on the prosthesis. The combination of the substructure along with the special implant teeth that are used provides you with the assurance that the hybrid prosthesis is designed and engineered for long-term use by your patients.
Remove the provisional prosthesis and screw the try-in in place with the screws provided. At this time you should verify the passivity of the substructure by taking periapical radiographs of each site. Once the fit is verified, re-check the occlusion and any final adjustments can be made at this time. Remove the set-up and re-fixate the provisional prosthesis.
The set-up over the substructure is returned to the lab for final fabrication.
Appointment 5 (Rx-6)
The fifth restorative appointment is the final delivery of the definitive prosthesis. Van Hook Dental Studio customizes each prosthesis to your patient’s esthetic demands using special gingival tones and proper anatomy.
Remove the provisional prosthesis and place the final hybrid in position. Fixate the hybrid with the screws provided and torque them in using the manufacturers recommendation. Close the access holes using Teflon tape and add composite for esthetics.