Temporary fixed teeth on the day of All-on-4 surgery are usually created through a coordinated surgical and prosthetic workflow that begins before the patient enters the operatory. The treatment team first establishes the intended tooth position, vertical dimension, occlusion, smile line, lip support, restorative space, and prosthetic contours. Those records may be transferred into a prefabricated denture, digitally designed provisional, printed conversion prosthesis, or another immediate-load restoration that can be connected to the implants after surgery.
Once the failing teeth are removed, the ridge is prepared as planned and the implants are placed, the surgeon evaluates whether the implants have sufficient primary stability for immediate loading. Multi-unit abutments are selected to correct implant angulation and create a restorative platform. Temporary cylinders are then attached, and the provisional restoration is indexed to the intraoral implant positions. The exact method differs according to whether the team is using a conventional denture-conversion technique, a digitally prefabricated prosthesis, photogrammetry, guided surgery, or a laboratory-supported workflow.
In a conventional conversion, the prosthesis is relieved so it seats without contacting the abutments or tissue in unintended areas. The temporary cylinders are picked up with an appropriate resin while the prosthesis is stabilized in the verified bite position. After the material sets, the restoration is removed, reinforced and finished outside the mouth, and converted into a screw-retained provisional. Cantilevers and unsupported areas may be shortened, cylinder connections are refined, and the intaglio surface is shaped to permit tissue healing and hygiene.
Before delivery, the team verifies passive seating, screw access, tissue clearance, prosthetic thickness, esthetics, phonetics, vertical dimension, and occlusion. The provisional should rigidly splint the implants while avoiding excessive loading during early healing. Occlusal contacts are commonly adjusted to reduce destructive forces, particularly in distal cantilever areas and in patients with parafunctional risk. The patient must receive clear instructions regarding diet, hygiene, medications, and follow-up.
In SOTA Dental’s Clinical Excellence Program, Dr. Nestor Marquez, the lead training doctor, teaches participants how surgical decisions affect the immediate provisional. Doctors review the restorative plan before surgery, observe the relationship between implant placement and prosthetic conversion, and receive direct mentorship throughout the live-patient workflow. Dr. Nestor Marquez emphasizes that same-day teeth are not simply attached after implant placement; they are the result of careful coordination among surgery, prosthetics, the laboratory, and the patient’s anatomy.
Qualified dentists who want hands-on exposure to immediate full-arch workflows under Dr. Nestor Marquez’s supervision can apply at https://sotadental.com/doctors-clinical-excellence-program/.
