ANSWERS

How do oral surgeons coordinate with restorative dentists?

Oral surgeons and restorative dentists coordinate through a shared digital workflow: the restorative dentist plans the final prosthetic, the surgeon places implants to that plan using a CBCT-derived surgical guide, and a single lab fabricates the guide, custom abutments, and final restoration.

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Why it works this way

The handoff problem

The classic failure mode in implant cases is sequential, not collaborative. Surgeon plans placement off a CBCT, places the implant, hands a healed site to the restorative dentist months later, and the restorative dentist discovers the angulation does not support a screw-retained crown. Now you are cementing, or remaking, or telling the patient about an additional procedure. The 2023 AAID clinical guidelines on team-based implant dentistry call this the prosthetic-driven planning gap and recommend the restorative endpoint be defined before the surgical guide is designed.

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Who should design the surgical guide, the surgeon or the lab?

The lab designs the guide from the restorative dentist's prosthetic plan and the surgeon's CBCT, then the surgeon reviews and approves before milling. This keeps the guide prosthetic-driven rather than placement-driven. The surgeon's clinical judgment on bone, sinus, and nerve proximity stays in the surgeon's hands; the lab handles the CAD execution and the merge between restorative design and surgical anatomy. Approval sign-off is documented on the case ticket before any milling begins.

What information does the lab need from both clinicians upfront?

From the surgeon: a recent CBCT in DICOM format, planned implant system and platform, and any anatomical constraints noted. From the restorative dentist: an intraoral scan of the arch and opposing dentition, a bite registration, shade selection if anterior, and the planned final restoration design (screw-retained or cement-retained, single or bridge). Photos of the patient's smile line help with anterior cases. All three inputs arrive before guide design begins.

How long does a coordinated implant case take from extraction to final crown?

Standard single-implant timelines run four to six months: extraction and graft if needed, three to four months of healing, implant placement with the guide, eight to twelve weeks of osseointegration, then impression and final crown delivery. Immediate-load and All-on-X workflows compress this; the provisional goes in the day of surgery and the final prosthetic delivers three to six months later. Coordinated planning at the front end is what makes these timelines predictable rather than aspirational.

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This answer is one piece of a larger workflow. The pillar page covers materials, turnaround, and how we build the case to your specification.

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