Future of Specialties

[Stilts]

A couple of dentists I know believe that endo is a fast dying specialty since general dentists are doing so much of the endo these days. I would like to hear what some of you think about the future of the other specialties. Do you think that the business of othodontists will be eaten up by general dentists, like endo?
Any thoughts on the other specialties would be appreciated too.

---

Members don't see this ad.

 

[makushin]

A couple of dentists I know believe that endo is a fast dying specialty since general dentists are doing so much of the endo these days. I would like to hear what some of you think about the future of the other specialties. Do you think that the business of othodontists will be eaten up by general dentists, like endo?
Any thoughts on the other specialties would be appreciated too.

I don't think either of the specialties are going anywhere. Not everyone wants implants or 6-month braces. And there will always be cases beyond the scope of what a GP is capable of or desires to treat.

 

[Regmata]

From all accounts I have heard, endo can be a real pain in the *** and is often farmed out...and invisilign isn't good for much, I think these 2 specialties are pretty safe.

 

[gyzeus]

The GPs that I've shadowed seemed too busy with their own work in general dentistry and they were reluctant to do any work on ortho or even implant.
I've shadowed 3 GPs and all of them said they were not willing to mess up their reputation by getting their hands on the kinds of work that they feel they weren't sufficiently trained in. They also answered that they didn't want to waste extra time and money going through the CE classes for those procedures and spend tons of money on getting new equipments when they are already satisfied with their GP work.

 

[toofshucker]

The GPs that I've shadowed seemed too busy with their own work in general dentistry and they were reluctant to do any work on ortho or even implant.
I've shadowed 3 GPs and all of them said they were not willing to mess up their reputation by getting their hands on the kinds of work that they feel they weren't sufficiently trained in. They also answered that they didn't want to waste extra time and money going through the CE classes for those procedures and spend tons of money on getting new equipments when they are already satisfied with their GP work.

This is why we will always have specialists. Not every General Dentist has the time and/or the desire to do specialty work.

 

[youngmc27]

Specialists are there for a reason they are trained more fully in their specialities and they are better at what they do than the majority of GPs and I for one would not go to a GP for braces, implants, and root canals. I also am only going to take my kids to a pedodontist for the same reasons that I said. Specialists aren't going anywhere.

 

[pietrodds]

Just do fillings are cleanings your whole life and refer everything else out to specialists. If you want to completely hate dentistry then this is them most guaranteed way to do it. The really successful, enthusiatic general dentists do a little of everything and know when to refer. When you look at the financial end of it, it'll blow your mind the advantages of learning how to do good specialty work. Do you want to do two fillings at $90 each or a RCT at $700 with an hour of your time?

 

[armorshell]

Do you want to do two fillings at $90 each or a RCT at $700 with an hour of your time?

Whichever one the patient needs?

 

[toofshucker]

Specialists are there for a reason they are trained more fully in their specialities and they are better at what they do than the majority of GPs and I for one would not go to a GP for braces, implants, and root canals. I also am only going to take my kids to a pedodontist for the same reasons that I said. Specialists aren't going anywhere.

Don't be so quick to write off GP's. There are plenty of GP's that are just as qualified as a specialist to do most ortho, implant and root canals. That is why they are allowed to do them.

 

[servitup]

There are also plenty of GPs who are so motivated by $$ that they bite off more than they can chew at the expense of appropriate tx for their patients.

 

[pietrodds]

if you're going to do specialty work as a GP, make sure you're doing to the level of a specialist. What I see a lot of in private practice is dentists who don't know how to do anything but crowns and fillings are are overtreating for crowns and veneers. If they could provide more comprehensive care both they and the patient would be better off. It's a sin to be cutting veneers on a 30 year old when ortho and whitening will do. This is the mentality though of a GP who doesn't do a little of everything.


As for the one poster's answer to the RCT vs. two fillings... do whatever the patient needs sounds all fine and dandy. Practice a year or two and you'll have a better understanding of what I mean. If you have time in your schedule, do you do the two fillings then refer our the RCT on #28 and go home early since you have nothing else to do.... or do you take the necessary CE to learn how to do RCT properly and then do the treatment for $700 right then and there. The other thing is patients want to not have to go to an outside dentist/specialist if at all possible. Sometimes though, the patient is best served by someone who does that specific area of expertise day in and day out.

 

[dentalstd2008]

Specialists are there for a reason they are trained more fully in their specialities and they are better at what they do than the majority of GPs and I for one would not go to a GP for braces, implants, and root canals. I also am only going to take my kids to a pedodontist for the same reasons that I said. Specialists aren't going anywhere.

It sounds like general dentists have nothing to do since everyone wants to see specialists.

 

[ItsGavinC]

Pediatric dentistry isn't going away. No matter what happens with implants and root canals and all of the fancy stuff, hellacious kids will still be referred out. You can take that to the bank.

 

[DrBadVibes3]

Pediatric dentistry isn't going away. No matter what happens with implants and root canals and all of the fancy stuff, hellacious kids will still be referred out. You can take that to the bank.

Amen to that......

and we cant forget that lovely holiday in October

 

[gryffindor]

Pediatric dentistry isn't going away. No matter what happens with implants and root canals and all of the fancy stuff, hellacious kids will still be referred out. You can take that to the bank.

Hellacious everything gets referred to specialists.

 

[toofshucker]

Pediatric dentistry isn't going away. No matter what happens with implants and root canals and all of the fancy stuff, hellacious kids will still be referred out. You can take that to the bank.

LOL.

 

[toofshucker]

There are also plenty of GPs who are so motivated by $$ that they bite off more than they can chew at the expense of appropriate tx for their patients.

No offense, but that is a pretty extreme thing to say that has no real proof. Show me that there are plenty of GP's that are just in it for the money. Most of the GP's that I know are more than competent in what they do. There is a reason why GP's can do anything they want to, and that is because they have the opportunity to be just as good as a specialist in performing care. Now, whether or not they want to take the time, spend the effort, or would rather focus on a different area of dentistry is another matter.

You really can't argue that for most extractions, most RCT, most perio problems that GP's are under-qualified to perform care to their patients.

 

[SugarNaCl]

Specialists are there for a reason they are trained more fully in their specialities and they are better at what they do than the majority of GPs and I for one would not go to a GP for braces, implants, and root canals. I also am only going to take my kids to a pedodontist for the same reasons that I said. Specialists aren't going anywhere.

That's because dental students and those familiar with the field know the difference. A person from the general public who walks into your office in need of braces likely will not care if you can do it or someone else can... as long as they can get it done and get it done right. Some day I hope to take work away from specialists as a GDP...just kidding Seriously though, even knowing what I know, if my dentist was confident enough to give me braces... I know and trust him well enough to not overstep his range of experience.

For children, I agree... I will send mine to a pedo specialist.

 

[Istr8nthem]

That's because dental students and those familiar with the field know the difference. A person from the general public who walks into your office in need of braces likely will not care if you can do it or someone else can... as long as they can get it done and get it done right. Some day I hope to take work away from specialists as a GDP...just kidding Seriously though, even knowing what I know, if my dentist was confident enough to give me braces... I know and trust him well enough to not overstep his range of experience.

For children, I agree... I will send mine to a pedo specialist.

I felt the very same way for a long time, however, when I decided to go into ortho, I quickly learned that there is WAAAYYY more to know than I ever imagined. This can be said for any specialty, and I am certainly not saying that a well-trained GP can't competently treat ortho cases. What I am saying is that there is often much more than meets the eye in ortho cases and the GP should carefully select which to treat and which to refer. Same can be said about which children are treated and which are sent to Pedo. Both can be great money makers for the GP ("easy" class I cases in ortho and "simple" PRR's, etc in Pedo).

 

[SugarNaCl]

I felt the very same way for a long time, however, when I decided to go into ortho, I quickly learned that there is WAAAYYY more to know than I ever imagined. This can be said for any specialty, and I am certainly not saying that a well-trained GP can't competently treat ortho cases. What I am saying is that there is often much more than meets the eye in ortho cases and the GP should carefully select which to treat and which to refer. Same can be said about which children are treated and which are sent to Pedo. Both can be great money makers for the GP ("easy" class I cases in ortho and "simple" PRR's, etc in Pedo).

Of course I totally agree with you. I'm certain that there are many more complicated issues that GDPs can't, or simply don't wish to deal with. I was totally kidding about wanting to take work away from specialists. I wan't to be well versed in many different procedures, but even this early on im my education I'm not a big enough fool to think that I will be the best one for every job

 

[servitup]

No offense, but that is a pretty extreme thing to say that has no real proof. Show me that there are plenty of GP's that are just in it for the money. Most of the GP's that I know are more than competent in what they do. There is a reason why GP's can do anything they want to, and that is because they have the opportunity to be just as good as a specialist in performing care. Now, whether or not they want to take the time, spend the effort, or would rather focus on a different area of dentistry is another matter.

You really can't argue that for most extractions, most RCT, most perio problems that GP's are under-qualified to perform care to their patients.

I have seen a buttload of crappy endo and tons of patients with mouths full of crowns but no attention to their perio or caries risk from their former GPs. I have seen GPs place an implant and then refer pt to OMFS for biopsy of a site literally right beside their bright and shiny $2k implant. I know GPs who took a weekend ortho course and started treating patients. IMO, if you can't treat the complications of your work, you shouldn't be doing it.

There are a small minority of GP badasses who have spent a ton of money and time becoming good at specialty care but there are also a lot of people who take a weekend course and then decide to "give it a whirl" because of the $$.

 

[SugarNaCl]

I have seen a buttload of crappy endo and tons of patients with mouths full of crowns but no attention to their perio or caries risk from their former GPs. I have seen GPs place an implant and then refer pt to OMFS for biopsy of a site literally right beside their bright and shiny $2k implant. I know GPs who took a weekend ortho course and started treating patients. IMO, if you can't treat the complications of your work, you shouldn't be doing it.

There are a small minority of GP badasses who have spent a ton of money and time becoming good at specialty care but there are also a lot of people who take a weekend course and then decide to "give it a whirl" because of the $$.

Ok, but GPs need to do more than preps and restorations, just as GPs in medicine often do more than take your blood pressure and refer you to a specialist.

 

[armorshell]

Ok, but GPs need to do more than preps and restorations, just as GPs in medicine often do more than take your blood pressure and refer you to a specialist.

Yeah, that's why we have prosthodontists. Also, with the growing specialty of Oral Pathology, we really need to get GPs out of diagnosis as well. It seems clear to me that all perio issues need to go to the periodontist as well. All you "GP" people are crazy and practicing outside of your purview.

please, please know that I'm joking

 

[QCkid]

That's because dental students and those familiar with the field know the difference. A person from the general public who walks into your office in need of braces likely will not care if you can do it or someone else can... as long as they can get it done and get it done right. Some day I hope to take work away from specialists as a GDP...just kidding Seriously though, even knowing what I know, if my dentist was confident enough to give me braces... I know and trust him well enough to not overstep his range of experience.

For children, I agree... I will send mine to a pedo specialist.

Ya know when it comes to Ortho, most schools teach so little that you really don't know enough to make competent decisions about what is treatable. You don't know what you don't know. I've seen ortho that some very competent GP's have done and they thought (thought is the key word) that they had done a wonderful job becuase the teeth were straight. One in particular had almost an edge to edge occlusion with sypmtoms of TMD. His dentist was extraordinarilly happy with his results. Some of these guys just don't understand the standard of care. They think that they are treating to the standard of care of a specialist but they clearly don't understand what the standards are. An ortho patient needs not only straight teeth that occlud properly but should be treated to CR (or as close as possible) with minimal or no root resoprtion. The patient that I described above knows his dentist really well, its his father. His father has a high producing practice in which he does lots of ortho, does 98% of his own RCT's and impacted 3rd's.

 

[Istr8nthem]

Ya know when it comes to Ortho, most schools teach so little that you really don't know enough to make competent decisions about what is treatable. You don't know what you don't know. I've seen ortho that some very competent GP's have done and they thought (thought is the key word) that they had done a wonderful job becuase the teeth were straight. One in particular had almost an edge to edge occlusion with sypmtoms of TMD. His dentist was extraordinarilly happy with his results. Some of these guys just don't understand the standard of care. They think that they are treating to the standard of care of a specialist but they clearly don't understand what the standards are. An ortho patient needs not only straight teeth that occlud properly but should be treated to CR (or as close as possible) with minimal or no root resoprtion. The patient that I described above knows his dentist really well, its his father. His father has a high producing practice in which he does lots of ortho, does 98% of his own RCT's and impacted 3rd's.

And if he is that quick to treat his own child what about all the other kids out there that he doesn't have to see for the rest of his life..... can get a little scary. I would hope that my referring GP's will send their kids to me (they will likely get a professional courtesy) just as I will send my family to them in return instead of treating them myself in my spare time, with a waning GP skill set!

 

[toofshucker]

I have seen a buttload of crappy endo and tons of patients with mouths full of crowns but no attention to their perio or caries risk from their former GPs. I have seen GPs place an implant and then refer pt to OMFS for biopsy of a site literally right beside their bright and shiny $2k implant. I know GPs who took a weekend ortho course and started treating patients. IMO, if you can't treat the complications of your work, you shouldn't be doing it.

There are a small minority of GP badasses who have spent a ton of money and time becoming good at specialty care but there are also a lot of people who take a weekend course and then decide to "give it a whirl" because of the $$.

You completely over exaggerate what you actually know. I have seen plenty of perios and OS place extra implants that have no possibility of being restored just for the extra fee. So according to your scientific study, NOBODY in dentistry should do any dentistry cause they all are in it for the money and not for the good of the patient.

There are bad GP's and specialists, but they are few and far in between. You do what you want with your care, that is your right, but don't spout off untrue exaggerations that are far from true.

 

[aphistis]

You completely over exaggerate what you actually know.

Oh, the irony.

 

[ptrianon]

GPs and specialists alike mess up or otherwise make poor decisions. I'm willing to bet that all this GP bashing that goes on here and on dentaltown (especially in the Endo files - some top notch hate flown around that forum) has more to do with turf issues than standards of care.

Some specialists forget that getting those residency years under their belt doesn't automatically entitle them to a superior status and earning potential than that of GPs. Additionally some GPs get a little trigger happy in doing specialist work without getting the proper training first.

Just my 2 cents

 

[toofshucker]

Oh, the irony.

Grow up. As a moderator, you should try to stay on topic and not direct a thread towards getting shut down due to a personal vendetta. As I said, grow up.

 

[zsy_lzy]

ortho really has a good future.

 

[aphistis]

GPs and specialists alike mess up or otherwise make poor decisions. I'm willing to bet that all this GP bashing that goes on here and on dentaltown (especially in the Endo files - some top notch hate flown around that forum) has more to do with turf issues than standards of care.

Some specialists forget that getting those residency years under their belt doesn't automatically entitle them to a superior status and earning potential than that of GPs. Additionally some GPs get a little trigger happy in doing specialist work without getting the proper training first.

Just my 2 cents

I agree about the DT endo forums. There's a lot of good information getting passed around, but it can be awfully hard to find amid all the haterade.

(For the uninitiated, the Dentaltown forums at www.dentaltown.com are an excellent resource. Anyone interested in, studying, or practicing dentistry can learn a lot just browsing through the numerous forums.)

 

[servitup]

All I am saying is that knowing what I know now, I would be hesitant to have molar endo done by anyone other than an endodontist with a microscope, I would be hesitant to let anyone other than OMFS remove my impacted third molars, I would be hesitant to have gingival grafting, etc. done by anyone other than a periodontist, I would be hesitant to have ortho done by anyone other than an orthodontist.

I think it is great to expand your scope as a GP throughout your career as long as you are clear with your patients about your experience level. I do agree that most patients would prefer not to see a specialist unless they have to.

 

[ItsGavinC]

Hellacious everything gets referred to specialists.

True, but my impression is that general dentists are more likely to attempt to be a hero with a root canal than they are with a 2 year old child.

 

[aphistis]

True, but my impression is that general dentists are more likely to attempt to be a hero with a root canal than they are with a 2 year old child.

Amen to that.

 

[desert rat]

There will always be a need for PEDO and Oral Surgury. The only two growing in demand and worth going into.

The fastest dying specialty is PERIO, don't waste your time with this one.

Implants are hurting the endodontists retreats. It makes for financial sense to get an implant rather than endo retreat.

Public health is a joke and only for military or teaching. Ortho will always be around, but many general dentists have learned this and are hurting the ortho field.

 

[Taxi Driver]

Endo is well with in the scope of a GP as much as an MOD amalgam. The only reason to refer endo is time constraints or funky, curved canals.

Pedo is glorified babysitting. You don't need a specialist for a stainless steal crown. Refer to pedo if the child has developmental anomalies or is just a pain in the neck.

There are plenty of simple ortho cases with in the scope of GPs. extrusion for crown lengthening, minor rotations, invisalign, and even bigger cases if you've had the training. Our instructors brag we get the most ortho training of any school(we actually treat at least one pt), and even suggest that it is within the scope of GP. OF course you have the sense to know what to refer.(everyone likes to attack the strawman GP who practices heart surgery)

Pulling teeth is cake. Impacted thirds have a range of difficulty...some you need to know when to refer.

Perio isn't glamorous but its not going anywhere

 

[SydB]

All I am saying is that knowing what I know now, I would be hesitant to have molar endo done by anyone other than an endodontist with a microscope, I would be hesitant to let anyone other than OMFS remove my impacted third molars, I would be hesitant to have gingival grafting, etc. done by anyone other than a periodontist, I would be hesitant to have ortho done by anyone other than an orthodontist.

I think it is great to expand your scope as a GP throughout your career as long as you are clear with your patients about your experience level. I do agree that most patients would prefer not to see a specialist unless they have to.

Yeah I basically would only trust a GP to do a prophy....

 

[OceanDMD]

There will always be a need for PEDO and Oral Surgury. The only two growing in demand and worth going into.

The fastest dying specialty is PERIO, don't waste your time with this one.

Implants are hurting the endodontists retreats. It makes for financial sense to get an implant rather than endo retreat.
Public health is a joke and only for military or teaching. Ortho will always be around, but many general dentists have learned this and are hurting the ortho field.

Most people want to hold on to their NATURAL teeth at all costs. Especially with how expensive and time consuming implant treatment can be. If you think endo is hurting, you're crazy. Every endodontist I know is too busy. 3 days a week, 7-10k/day, doesn't sound bad to me.

How does it make financial sense? Endo retreats typicallly run around the $1200 range. Implant placement(by a specialist) on average $2000. Abutment fee $600. Crown fee $1000. So, on average a implant treatment per tooth is going to cost you $3600. This doesn't include the potential need for a graft of sinus lift. Often treatment time is 4 months to a year start to finish.

Obviously, you need to pick and choose the retreat cases. But, I dont understand this "financial sense" thing.

 

[Calidental]

Most people want to hold on to their NATURAL teeth at all costs. Especially with how expensive and time consuming implant treatment can be. If you think endo is hurting, you're crazy. Every endodontist I know is too busy. 3 days a week, 7-10k/day, doesn't sound bad to me.

How does it make financial sense? Endo retreats typicallly run around the $1200 range. Implant placement(by a specialist) on average $2000. Abutment fee $600. Crown fee $1000. So, on average a implant treatment per tooth is going to cost you $3600. This doesn't include the potential need for a graft of sinus lift. Often treatment time is 4 months to a year start to finish.

Obviously, you need to pick and choose the retreat cases. But, I dont understand this "financial sense" thing.

If you can get an implant crown for 1600 you should snap it up, everyone ive seen charges more than the fixture, at least 2k.

The argument should be made is it biological sense. Everyone knows that specialists have an upper 90s success rate at RCT, 80s for reRCT. These colleagues do a great job but then look at everything that subsequently has to work for the root canal to have been prudent.
1. definitive restoration placed swiftly. (the pt could be in perio, ortho prostho therapy or disappear which precludes this)
2. pt doesnt get recurrent decay
3. post space did not disturb the apical seal or blow 50% of the dentin (or a wall) out.
4. post and core does not debond due to lack of ferrulle or the higher strength of new resin cements between the crown and post, which is greater than post and dentin.
5. Perio health is good, after all this work which often includes CL a furcation opening up isnt a great thing to see
6. adequate ferrule and biologic width.

With an implant you re worrying about occlusion mainly and this is only in relation to porcelain fracture. no caries, no debond, no pt disappearing, no perio. its all in the planning which the surgeon will normally help the gp in, technique.....not a lot how hard is it to snap an impression and torque down an abutment. again you just have to get the occlusion light.


.

 

[desert rat]

I believe more general dentists do implants than specialists. Most general dentists charge about $800 - $1000 for an implant PFM.

Total price for implant, abutment, crown at my office $2500. Sinus lift $500.

Longevity of implant is 98% at 10 years. Endo does not have that good of odds and retreats have even less longevity odds.

Endodontists have been running to implant courses and that tells you something as well.

When I give a patient the treatment options they will almost always hands down ask for the implant.

 

[desert rat]

I forgot to mention that an endo retreat with new build-up is about $1500, now add the crown cost of $800 - $1000 to that. What is the average longevity of this compramized tooth?

 

[Calidental]

I believe more general dentists do implants than specialists. Most general dentists charge about $800 - $1000 for an implant PFM.

Total price for implant, abutment, crown at my office $2500. Sinus lift $500.

Longevity of implant is 98% at 10 years. Endo does not have that good of odds and retreats have even less longevity odds.

Endodontists have been running to implant courses and that tells you something as well.

When I give a patient the treatment options they will almost always hands down ask for the implant.

In every country except Canada, Australia and the good old USA GPs place more than specialists, that will change towards GPs.

Thats a really good fee desert rat. In my office the full cost (ie non school discounted) implant from a reputable company is $300-350, the cover screw 50, the sterile surgical setup, which is mandated for my malpractice to be covered is 100. So thats 500 which is reasonable on a $2k implant (25%).

Then comes the prosthodontics with the impression coping, analog and stock (not custom abutment) around $200. The crown from a mid range lab is $250. Add on $300 if a custom abutment is needed. Thats 450-750. I cant tell the pt its extra if I or the OS placed the implant badly to fix it with a custom abutment, i have to eat it. So thats ok on a 2k- $2,500 crown. I didnt even provisionalize yet if it was an anterior tooth, making another visit or 2.

Even in my residency program we charged $1700 just for the implant and abutment and that was a few years back. The implant was about $700, so $2400 total.

 

[desert rat]

In every country except Canada, Australia and the good old USA GPs place more than specialists, that will change towards GPs.

Thats a really good fee desert rat. In my office the full cost (ie non school discounted) implant from a reputable company is $300-350, the cover screw 50, the sterile surgical setup, which is mandated for my malpractice to be covered is 100. So thats 500 which is reasonable on a $2k implant (25%).

Bicon implant: about $300 implant and abutment. Biohorizon: $225 implant with abutment, Implant Direct: $165 implant and abutment, Bluesky Bio: $200 implant and abutment. All very reputable companies. Cover scres included, or can be sterilized and reused over and over. Initial surgical setup is free for some, and about $2000 for most. Buy enough implants it is always free.

Then comes the prosthodontics with the impression coping, analog and stock (not custom abutment) around $200. The crown from a mid range lab is $250. Add on $300 if a custom abutment is needed. Thats 450-750. I cant tell the pt its extra if I or the OS placed the implant badly to fix it with a custom abutment, i have to eat it. So thats ok on a 2k- $2,500 crown. I didnt even provisionalize yet if it was an anterior tooth, making another visit or 2.

Very few well placed implants need a custom abutment. When they do, Atlas abutments are about $250 each. I have used one in about 800 implants restored. I do have a patient pay if needed. Mid range lab fee is about $150 - $200 for PFM. 1cc grafting material, $60-80

Implant placement time: 15-30 minutes
Grafting/sinus lift: extra 10 minutes
Uncovering and impression: 10-20 minutes
Deliver crown: 5-15 minutes


Even in my residency program we charged $1700 just for the implant and abutment and that was a few years back. The implant was about $700, so $2400 total.

 

[Calidental]

In every country except Canada, Australia and the good old USA GPs place more than specialists, that will change towards GPs.

Thats a really good fee desert rat. In my office the full cost (ie non school discounted) implant from a reputable company is $300-350, the cover screw 50, the sterile surgical setup, which is mandated for my malpractice to be covered is 100. So thats 500 which is reasonable on a $2k implant (25%).

Bicon implant: about $300 implant and abutment. Biohorizon: $225 implant with abutment, Implant Direct: $165 implant and abutment, Bluesky Bio: $200 implant and abutment. All very reputable companies. Cover scres included, or can be sterilized and reused over and over. Initial surgical setup is free for some, and about $2000 for most. Buy enough implants it is always free.



Then comes the prosthodontics with the impression coping, analog and stock (not custom abutment) around $200. The crown from a mid range lab is $250. Add on $300 if a custom abutment is needed. Thats 450-750. I cant tell the pt its extra if I or the OS placed the implant badly to fix it with a custom abutment, i have to eat it. So thats ok on a 2k- $2,500 crown. I didnt even provisionalize yet if it was an anterior tooth, making another visit or 2.

Very few well placed implants need a custom abutment. When they do, Atlas abutments are about $250 each. I have used one in about 800 implants restored. I do have a patient pay if needed. Mid range lab fee is about $150 - $200 for PFM. 1cc grafting material, $60-80



Implant placement time: 15-30 minutes
Grafting/sinus lift: extra 10 minutes
Uncovering and impression: 10-20 minutes
Deliver crown: 5-15 minutes


Even in my residency program we charged $1700 just for the implant and abutment and that was a few years back. The implant was about $700, so $2400 total.

I just checked out the atlantis website and copied the following

Cost

Let us review the cost of the Atlantis abutment system. The cost of first abutment is $266, a duplicate abutment is $97, lab services are $50, and a provisional is $72, for a total of $485. Plus crown

On a per unit basis, the cost of using this system is approximately $450-$500 in addition to the laboratory cost of prosthetic fabrication, if you take advantage of all the services the system offers. Plus PFM


The cheapest lab I found , Town and Country was 379 plus a fee for the PFM.