Watson Dental Lab Fixed Hybrid Protocol

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Watson Dental Lab Fixed Hybrid Protocol Watson Dental Lab has put Protocols in place to: Ensure maximum quality and fit of the final restoration. Maximize Dr. /Patient/ Lab communication and participation Streamline an otherwise lengthy process. Minimize chair and bench time Maximize the use of CAD technology we have In Lab Consult the Lab for parts and Abutment Selection. Using a Custom Tray (optional) or perforated plastic full arch tray, place the open tray impression copings onto the abutments, verify they are seated into place Properly with bite wings Inject a medium body material around the entire impression Coping. After loading the entire tray with impression material, seat the tray ensuring that the guide screws of the copings extend fully through the previously made openings in the tray. Send both arch impressions, implant components, and bite verifications if requested to the Lab for processing. Watson Dental Lab will fabricate casts, Verification Jigs and/or Bite Blocks if necessary to obtain VDO and implant Jig placement. The Components will be sent to the Dr. for verification Stage 1 If verification fails, see addendum A Once the casts are verified as accurate, and all the necessary components are together, the CAD design phase can begin. Screen shots can be sent to the Doctor (if requested) or should the Lab have questions during the design phase. The design phase should also include any areas where tissue shaded porcelain is expected on the final restoration. We recommend adding tissue to improve esthetics and add strength to the final restoration. Stage 2 Once the design phase is completed, PMMA temps are milled and the implant copings are bonded in place. Tissue shade acrylic can be added at this time to give the Doctor and Patient a clear idea of the final restorations esthetics, phonetics, and occlusion. The restorations fit should be checked for passivity. (acrylic flexes, zirconia does not). Any and all adjustments need to be made to the Lab provisional before it is returned to the Lab, as this will typically serve as the template to be scanned for the final restoration. If the patient requires a long term temporary, 2 Provisionals must be fabricated. (One for the patient to wear, one for the lab to proceed with the final restoration). *The Patient Provisional requires titanium copings for strength, the Lab Provisional requires plastic or composite type copings. The final restoration will have zirconia or Titanium implant interfaces milled into the Solid restoration.

*PMMA temps are not intended for long term use. We may also bulk up areas to extend the life of the provisional. Stage 3 Final adjusted PMMA is sent for zirconia fabrication Please note that implant type can greatly alter final cost, and final fit of the restoration More Options Not only do some implant systems have more options available, CAD systems simply are NOT created equal. Our system Library contains the 2-CONnect system, an innovative interface that greatly changes the Hybrid process. This system allows us to scan, design, and mill from file with exact implant positioning. The 2-CONnect copings allow for minor adjusting before bonding to the final Zirconia restoration. This also gives us a Titanium screw seat instead of Zirconia. The 2-CONnect system is a proven system with 510k approval, and offers the most accurate and stable overall connection. * 12mm Vertical space required Components Available for: Nobel Replace 4.3 & 5.0 Nobel Active 3.5 & 4.4/5.0 Biomet 3i Certain 3.4 & 4.1 Straumann Bone Level 3.3 & 4.1/4.8 Straumann SynOcta 4.8 RN & 6.6 WN Zimmer Tapered Screw-Vent 3.5 & 4.5 Astra Tech OsseoSpeed 3.5/4.0 & 4.5/5.0 Dentsply- Friadent Frialit/Xive 3.4, 3.8 & 4.5 Talk to us about 2-CONNect when planning your next case. Additional Requirements As with any implant or precision component, we require them to be new or unused, or usable with our discretion.* We also reserve the right to order the components needed for PMMA Lab Verification Provisional and/or Patient Provisionals and incur reasonable costs without Doctor Notification.* We do not accept casts or components from other Labs without the understanding that all parts (casts, implant position, tissue, etc.) must be either verified or fully re-made. Please enclose the Hybrid script, filled out to completion *this greatly reduces manufacture turnaround times, and ensures a proper fit/ stability Photos courtesy of Nobel Biocare 2-CONnect Argen Digital

WATSON DENTAL LABORATORY A Full Service Dental Lab 819 Wagon Trail Austin, TX 78758 (512) 440-7181 Fax: (512) 440-7178 www.watsondentallab.com frontoffice@watsondentallab.com Texas Reg. #2207 Doctor Name: Patient (last, first) Office Name/ Location PMMA try in date: Sex: M F Age: Implant Position Implant Type Platform Size Mark the Restoration Area/ tooth numbers Additional Area Notes: PMMA Lab Verification Patient Provisional Vita Shade Check for 2-CONnect compatibility and call me Patient Photos emailed jrobinson@watsondentallab.com Email me CAD for approval (increases return time) Implement tissue in the design Facial Buccal Lingual Mapped Below Additional Tissue Notes: Final Restoration Special instructions: Shade Gingival shade if applicable Do not layer Cut back and layer incisal Anterior 6 Dr. Signature: Date: License# Lab Use Case received: / Notes: Upper Impression or model Lower impression or model Bite registration Components included Inventory:

Fixed Hybrid Schedule Case received, all components present. Stage 1 5-10 working days 2 Days to pour models and evaluate, order parts for Verification jig if needed. 2 Days to fabricate Verification Jig once all parts are received. Add 3-5 business days if all components are NOT present upon case delivery. At this time we will order components for PMMA fabrication 1 Day case delivered (2 if shipped) Stage 2 8-10 working days Full case returned to lab w/ Verified Jig. All components should be present in Lab. 2 Days. The CAD design phase should be done within 2 full days of the case being delivered back to the Lab. Emailing screenshots may add to working time. 2 Days allowed for milling and QC of PMMA. 3 Days (up to) allowed for attaching interfaces, articulating, and polishing the PMMA framework. 1 Day case delivered. (2 if shipped) *Add an additional 1-2 Days production time for an additional Patient Provisional. (Provided the components were also ordered in stage 1) Stage 3 10-15 working days In stage 3, the adjusted PMMA is returned to the Lab and sent for Zirconia fabrication 7-10 Days allowed for Zirconia design, milling and sintering 2-4 Days allowed for seating and final restoration finish (gingival porcelain, stain, glaze, adjust etc..) 1 Day case delivered (2 if shipped) Help us make your case go smoothly Please read our Protocol Please fill out the prescription to completion Please include the necessary components

Addendums: A Section the verification jig as needed, re-position in the mouth, and lute back together with cold cure acrylic. (Light cure will not bond to acrylic and will typically de-bond in the lab) Do NOT screw the jig back down on the model after removal, this will distort or fracture the jig.