1. Shade photos of adjacent teeth if matching or lower teeth if full arch
2. Anesthesia
3. If intra-oral scanning, scan both arches and erase teeth to be prepped
4. Prep right or left side of arch only
5. Fabricate provisionals for the prepped ½ of arch – evaluate midline and provisional length relative to unprepared other half of arch (I take photographs with patient sitting upright in assistant’s stool with retractors in). This allows me to be certain that I am not canted in my preps/provisionals and if I’m not looking to add length, I can document that the provisionals are the same length as the unprepped side. If I am planning on adding length, then I can measure the length added on the provisionals. Adjust occlusion if maintaining the VDO (critical)
6. Anesthetize and prep other half of arch
7. Try-in impression tray (if needed)
8. Isolate, place retraction cords or laser tissue trough…prepare for impressions
9. Photo of preps with shade tabs for lab
10. Scan or impression materials reviewed with team members
11. Remove retraction cords, rinse, or cleanse preps with Concepsis or other appropriate solution
12. Impression…evaluate impression, retake if necessary
13. Bite registration. Because we adjusted the provisionals for the first side prepped, we can place those provisionals when taking the bite registration for the other side, then use the bite registration of the second side to go back and take the bite registration of the side that we placed the provisionals
14. Trim bite registrations, verify fit and accuracy
15. Fabricate and adjust provisionals for 2nd half of arch
16. Full face photo with retractors in place for evaluating horizon/prep plane
17. Cement provisionals, final adjustments