A great deal of Andrew Bock’s dental practice involves converting denture-wearing patients to fixed restorations. In the following article, he explains how this has helped him grow his business while conscientiously serving his patients at the same time.
An untapped market
I didn’t intend to set out to be a “specialist” in implant bars, but I have become one nevertheless. As a prosthodontist who opened a scratch-start practice after nearly three years elsewhere as an associate, I realized that the biggest void in my geographic area was someone who focused on removable prosthodontics.
Many dentists don’t see the potential in this area, because they are frustrated with the experience of dealing with unhappy denture wearers. I chose to look at this as an opportunity where I could educate my denture patients and inform them about the options provided by dental implants.
Frequently, their general dentists simply haven’t had time to sit down and talk about these options, so patients are often hearing this information for the first time from me.
Natural next step
Implant bars represent a natural progression from the conventional denture to an implant-based solution, either fixed or removable.
The All-on-4® treatment concept has provided a huge opportunity for us to provide many of our edentulous or soon-to-be-edentulous patients with an implant-based solution, and every one of these cases requires a bar for final restoration.
I also have been able to help a number of patients with NobelProcera bars in cases where they have multiple, older implants (frequently different kinds in the same arch), or are stuck with an esthetically compromised situation in which a bar is needed for draw, but insufficient space means that a removable overdenture is indicated to allow the flange to optimize appearances.
After more than three years in this market, people have now begun to recognize the technical skill and knowledge I possess on these types of cases. Consequently, we are seeing more and more of them in my practice today.
I see a number of advantages to working with NobelProcera implant bars.
First of all, the extremely capable design software makes it possible for me to work directly with my local laboratory who is well-versed in implant bar design.
Second is the accuracy. If I deliver an accurate cast for scanning, I know—without a doubt—that my bar will fit perfectly.
Third is the removal of the tedious procedures with cast bars and their resulting deficiencies (i.e. no more cutting/soldering/breaking of welded joints, porosity, etc.).
Fourth is the extensive compatibility with different implant systems on the market. I have personally restored implants that are more than 30 years old with NobelProcera bars (including a case that had six such implants, plus three newer implants produced by two different manufacturers), which definitely demonstrates the technique’s versatility. The design possibilities are virtually endless, making innovative treatment options possible.
One final advantage to this technology also ought to be mentioned: A solid warranty is offered with every bar, and the fact that the warranty is backed up by a company of Nobel Biocare’s stature and stability provides me and my patients with an extra measure of confidence.
For the benefit of the patient
Patient benefits, when switching to a bar, are huge! One of my most-used lines is, “You will go back to eating what you want to eat, not what you can eat.” Patients often have forgotten what it’s like to eat whatever they want, without being constantly aware, at best—or self-conscious, at worst—of their denture. Many of my patients say, “This is the closest thing I’ve had to real teeth in a long time!"
Sore spots from denture movement are virtually eliminated. Resorption of jawbone is greatly reduced, meaning fewer relines of dentures and fewer changes in the patient’s appearance (i.e. no more “bitter beer face” when their jaws resorb and they lose vertical dimension).
Self-confidence is greatly increased, and patients are much quicker to smile and laugh without hesitation.
Facial appearance is greatly improved when the patient’s facial muscles are freed from the burden of having to stabilize dentures; I think this is often greatly overlooked when discussing dentures and implant treatment options with patients.
Nutritional status usually improves significantly, as the foods that are easier to eat with a denture are often softer and lacking adequate nutritional value.
Caring for their investment
Partly because of the costs associated with such types of treatment, I usually see patients show an increased effort at oral hygiene in order to protect their investment.
Finally, when compared to implant dentures that use direct or individual attachments (e.g. locator abutments), maintenance and wear of attachment inserts is drastically reduced.