All-on-4 advice

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drock

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Hi all,

I thought I seek a li
I've attended an All-on 4 course (Joe Coursey )a few months ago and it was great! Our lab is in the process of negotiating with a client to perform all the conversions for all his cases. We are charting into new territory here with this so I would appreciate some feedback and advice here. I sat thru two surgeries and conversions (done by a denturist) to get a good understanding of the process . The Dr wants to phase out the Denturist one floor down form his office and instead partner up with our Lab and he has his specifics reasons.
1. patient perception- After placement of implants the Denturist takes over with the conversion (2.5-3hrs in her own office 1 flr below) and some post treatment such as maintenance and cleaning during the healing process again, in her own denturist office. Dr has had some minor complaints from patients that they are no longer under his care which is not true. I think bottom lines he wants to keep his patient.
2. Streamlining the process/ more control and consistency. Dentist wants to simplify the procedure, what I see, keeping the patient in his office during the conversion so no transporting the patient etc. To me, it's already a very convenient setup to have a denturist in the same building one set of stairs down. Again, that brings up pt perception. Also, he is starting to get a few referrals from other dentists and denturists. He would like us to do the conversions for those cases, as well as the final prosthesis. He does not want the referring dentist or denturist to use there own lab to do any conversions in his office. He will tell the referring Dr that he will be using someone he trusts for the conversion and final prothesis...which makes complete sense.
2. Cost factor- The denturist charges roughly $7000-7500 for the conversion and final prosthesis. The dentist is looking into cheaper options....no surprises there! fyi the same denturist gets $10000 from a specialist here. so that the going rate here.
The dental office has a small lab which we may use to do trimming and polishing. we will have the surgical room to ourselves during the conversion. we will have access to some of his girls if needed and some materials such as masks, gowns, gloves, rubber dams if needed. The dentist might factor those things into the cost. we will probably bring our own light cure machine and handpiece and materials. In our lab we have 2 clinical chairs where we offer patient care services for our clients. so the possibility of us doing post surgery maintenance is there.
During the surgical procedure the denturist was present. The dentist wanted to make sure the denturist was happy with the positioning and required bone augmentations. So with the surgery and time for conversion it was approx. 6 hrs of the denturist time.
With some of your deep knowledge and expertise in offering this kind of service what is your experience in negotiating with clients. What are some things we should be discussing with the Dr. What are things we have to consider so we aren't losing out on this. And what do you charge for this kind of service. Or what would you charge in this scenario? what do you guys do and you don't you do? how long are you in the office doing conversions? what are the pros and cons you see with this. Currently, if you can believe this, No other labs are offering this conversion service so we want to get on board fast first. most conversions are done by dr themselves or denturists.
I really appreciate your help!
Sincerely
Derek
 
BobCDT

BobCDT

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Personal opinion, teeth in a day is really not practical unless guided surgery is used. If used the insertion time is dramatically reduces and the procedure is simplified.
If there is no guided surgery we are going with an impression of the implants after placement (same day) and fabricating the temp using CAD CAM in a couple of days. This protocol is comparatively simple. Just screw in the temp and check occlusion. Temp cylinders are set into the provisional in the lab prior to delivery.
 
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lcmlabforum

lcmlabforum

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Bob, you make it sound so simple because you have done a lot or your surgeon is good.
Derek - look how long the denturist took and how much she expects to be paid. What makes
you think you, as a new start up, have the inventory, time and effort resources to do it for less
and deliver the same result? Are you able to provide that 'eye' to check placement, an issue
which by itself, opens up a can of worm since it is really the one with the license that should
make that call. Does you state/place allow a denturist to practice with a license? If so,
what position would you be putting yourself under and what risks are you going to be exposed
to? Being first has the benefits and hazards - are you fully armed/loaded to handle all emergencies?
Have you had something locked in before and the patient is gagging, etc?
LCM
 

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