I have a confession: I have done implant restorations and lost money. I'm willing to bet that many of us aren't even aware that we sometimes barely break even with these cases.
Let's calculate what I like to call procedure cost, or the overhead for a specific procedure to be performed in your office. Add up your materials (impression copings, replicas, and abutments), plus your assistant's time, plus your lab bill to get your total cost. Now divide this by your final fee and multiply by 100 to get your procedure cost as a percentage. If your number is between 20-30%, congratulations-you are keeping implant therapy profitable in your practice. If your number is greater than 30%, then you'll want to dig deep into this issue.
Arguably the most frustrating way implant treatment can become less profitable is when we have to repair and remake. In recent years I've seen a rise in the number of lectures and articles focusing on implant complications. Surgical and prosthetic challenges can lead to mild annoyances (e.g., abutment screw loosening) or major headaches (e.g., peri-implantitis).
Remember when a restorative dentist could simply take an impression, send it to the lab, and hope for the best? Those days are fading fast as patients' expectations are rising. The definition of success is no longer merely osseointegration. Patients demand and deserve therapy that can look, function, and be maintained as closely to their original teeth as possible. That means restorative dentists need to be able to better anticipate complications, improve communication with their surgical and laboratory team members, and use advanced techniques such as fabricating implant-supported provisionals.
This issue will help you to reduce complications, improve patient satisfaction, and regain profitability with your implant dentistry. Several authors, including myself, share their best practices toward those ends. Some of the concepts presented may not be for you, but I hope they at least challenge you to rethink your approach to implant therapy. Your patients have raised the bar for implant dentistry in the past 10 years. Have you?
Chris Salierno, DDS
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