Revised_SOW_Dental_Lab_Contract.pdf

VA CT Dental Service

B.3 PERFORMANCE WORK STATEMENT

1. Definitions

1. VACT Healthcare System: Newington and West Haven Campuses

2. Special Handling: “Special handling may require accelerated in-person pickup and delivery timelines, subject to COR or CO approval.”

3. Routine Handling: A dental laboratory work authorization that is usually performed and returned within a specified time frame.

4. Turn Around Time (TAT): The length of elapsed time between pickup of the dental lab order by the contractor until the receipt of the complete order by VA Dental Service.

5. COR: Contracting Officer’s Representative.

6. SAD: Standards of Acceptable Deliverables.

7. Dental Laboratory Services: Those laboratory procedures that are required for the treatment of dental patients. These would include, but not be limited to, all laboratory fabrication aspects of complete dentures, removable partial dentures, fixed partial dentures and crowns, and dental implant prosthesis.

8. Working Day: Any twenty-four-hour period of the typical administrative work week, i.e. Monday through Friday (M-F). For example, if the contractor is allowed 5 working days for a prosthesis and he picks it up on a Monday, it would be due back to VA the following Monday. Federal holidays occurring M-F are not considered a working day.

2. Term of Contract

1. The proposed contract period is for one year with four (4) 12-month option periods, one FAR

52.217-8 six-month extension if exercised.

Anticipated Period of Performance:

Base Year – 10/01/2026-09/30/2027

Option Year 1 – 10/01/2027-09/30/2028

Option Year 2 – 10/01/2028-09/30/2029

Option Year 3 – 10/01/2029-09/30/2030

Option Year 4 – 10/01/2030-09/30/2031

3. Scope of Work

1. The Contractor shall provide all resources necessary to accomplish the requirements described in the Performance Work Statement (PWS). The Contractor shall provide dental laboratory services outlined in this PWS. The contractor shall furnish local facility (in-person) pickup with a designated driver (and not a shipping service) will be available to pick-up and drop-off daily at both locations, Monday through Friday between the hours of 8:00 a.m. and 4:00 p.m. local time, all labor, transportation, materials, general dental laboratory tools, equipment and supervision required to provide comprehensive Dental Laboratory Services to the VACT Healthcare System, Newington Campus: 555 Willard Avenue, Newington, CT 06111 AND West Haven Campus: 950 Campbell Avenue, West Haven CT 06516.

2. The main purpose of this contract is for all dental laboratory items that require a fast turnaround and/or urgent requirements for processing and repairs/relines to facilitate clinical care in a timely manner for patients. The contractor shall provide all dental laboratory fabrication steps for removable prosthetics, including but not limited to complete dentures, removable partial dentures, implant retained complete and partial dentures, flexible partial dentures, cast articulations, impressions/model work, occlusal guard fabrication, rebases, relines and repairs.

These are dental laboratory items that require a fast turnaround and/or urgent requirements to facilitate clinical care of patients.

3. The dental laboratory services that may be authorized under this contract include, but are not limited to:

• Acrylic services for complete dentures, removable partial dentures and flexible partial dentures (including immediate dentures)

• Acrylic services for implant retained partial and complete dentures

• Occlusal guards

• Radiographic/Surgical Guides

• Digital dentures

• Custom trays, Occlusal bite rims

• Acrylic repairs

• Relines and rebases

• Fabrication of full crowns and fixed partial dentures when they are abutments for removable prostheses

• Removable cast partial denture frameworks

• Diagnostic wax-ups

• Custom provisional C&B prostheses

• Cast post and cores

• Denture duplication

4. The Contractor shall provide sufficient management to ensure that the work specified in this contract is performed efficiently, accurately, on time, and in compliance with the terms and conditions of the contract. The Government reserves the right to add additional dental products and/or services, within the scope of the original contract, via a dually signed modification. Contractors should be able to receive and process digital CAD/CAM files and should make that capability known in their response to the solicitation. The contractor shall provide a direct pick-up and drop-off to and from the Dental Clinics of each campus West Haven and Newington and will be located within a 25-mile radius of at least one campus but will be able to drive for local pick-up from both campuses.

3. Performance Requirements The Contractor shall provide services and support to VAMC Connecticut as defined herein.

1. The Contractor shall fabricate dental prosthetic items in strict accordance with the dental laboratory order for the fabrication of dental prostheses, which shall include but not be limited to the following; all laboratory fabrication aspects of complete dentures, removable partial dentures, fixed partial dentures and crowns (if it relates to overall treatment that includes removable prostheses), removable implant prostheses, and ability to receive digital files/impressions through various impression scanners.

2. Special handling may be required on specific orders and will be authorized on a case-by-case basis by the VAMC.

3. Special/customized fabrication standards may be required on specific orders and will be authorized on a case-by-case basis by the VAMC.

4. The contractor will be a full-service dental laboratory that could integrate the combined treatment needs of the prosthetic patient requiring simultaneous fixed, removable and implant prosthetics.

5. The normal turnaround time (in working days as defined) for dental prosthetic items shall be as outlined in the following table. In case of longer turn-around times, the Contractor must notify the COR of the delay, in writing, as soon as the delay becomes known and before the maximum number of days has expired. This notification must include the reason for delay and the requested amount of additional time.

24 – 48 Hours 3 Days 3-5 Days 5-7 Days

Complete and removable partial denture acrylic resin repairs

Custom impression trays

Diagnostic wax-up, (4 teeth or less)

Occlusal Guards

Complete and removable partial denture, tooth additions/repairs

Transitional removable Partial Denture, processed (3 teeth or less)

Heat cured provisional restorations (4 teeth or less)

Complete and Removable partial Denture, tooth set-up

Complete and removable partial denture, relines

Articulation of casts with/without facebow

Tooth rearrangements, complete and removable partial dentures

Complete and removable partial denture, process and Finish

Complete and removable partial denture, rebase

Articulations with model and die work and impression scanning

Flexible partial denture, process and finish

Solder/Laser Weld Record base and occlusal rims

Flexible partial denture, tooth set-up

Acrylic Flippers Processed surgical guides

Transitional partial set-up and process

Cast post and core restorations

6. The contractor certifies that all alloys, metals, and components of dental prostheses are in compliance with and meet FDA, ANSI and American Dental Association department standards. The Contractor must assure that dental prostheses or appliances assembled or created under the contract will not be manufactured outside of the United States.

a. American National Standards Institute (ANSI) Requirements Standards by the ANSI in cooperation with the American Dental Association Department of

Standards require that all materials used for fabrication of dental prostheses meet the Standard Practices for Biological Evaluation of Dental Materials.

b. Food and Drug Administration (FDA) Requirements Contractor must comply with the regulations governing FDA Quality System/Good Manufacturing Practices for products distributed in the United States dental laboratories.

FDA regulations prohibit the use of lead in the surface material used to fabricate dental prostheses.

7. Contractor shall provide the following services at VA CT Healthcare System, Newington and West Haven Campuses:

a. Forms for the authorization of work at their facility.

b. Once daily in-person pick-up and delivery Monday through Friday in the

Dental Clinic, to include but not limited to:

i. All impression pouring/handling.

ii. All necessary procedures relating to Dental Laboratory Services.

8. Contractor shall consult with the appropriate using Service at the VAMC regarding any specific dental laboratory order.

9. Dental Laboratory will allow dental staff and residents to arrange visits to the laboratory to demonstrate all processes and techniques. This is to be arranged on a mutually agreeable schedule.

10. Consideration will be given to include dental staff and residents in any available continuing education courses (CE course) held at the laboratory, space permitting.

11. BUSINESS ASSOCIATE AGREEMENT (BAA): For your information, please find the attached Business Associate Agreement (BAA) template included as part of the solicitation. The attached BAA will be requested and shall be filled out in its entirety, signed and submitted upon award. If your company already has an active National BAA, you may include a copy of your current National BAA in place of completing the attached BAA document.

12. This BAA applies exclusively to the dental laboratory fabrication activities performed by the Contractor and does not apply to transport operations. No Veteran PHI or PII is disclosed during transport due to the requirement that all identifying information be secured inside the transport container. As such, transportation activities under this contract do not trigger BAA obligations.

4. Transport and Chain of Custody

1. Government Packaging – Orders provided to the contractor during in-person pickup will include the following information:

a. Date of order

b. VAMC Case Number

c. Contract number and order number

d. For supplies and services, description and quantity as per prescription

e. Place of delivery or performance (including consignee)

i. A copy of the Manifest listing all the cases being transported will also be included

f. Accounting and Appropriation data

2. Delivery/Transport Method - Contractor shall pick-up and hand deliver all cases with at least once daily in-person pick-up/delivery. The Contractor shall provide in-person pickup and delivery of all dental laboratory cases to and from the VA CT Healthcare System campuses once daily, Monday through Friday, between 8:00 a.m. and 4:00 p.m. All transport shall occur exclusively by designated Contractor personnel. The use of commercial couriers or mail services—including FedEx, UPS, USPS, DHL, or any third-party carrier—is strictly prohibited unless expressly authorized in writing by the CO. No separate transport or delivery charges may be invoiced under this contract. All costs associated with in‑person pickup and delivery shall be fully included in the Contractor’s line‑item pricing.

3. Delivery Locations:

West Haven VA Medical Center

Department of Veterans Affairs

West Haven Campus, Dental Clinic 160

950 Campbell Avenue

West Haven, CT 06516

Newington VA Medical Center

Department of Veterans Affairs

Newington Campus, Dental Clinic 160

555 Willard Avenue

Newington, CT 06111

4. Contractor Packaging - Contractor shall adhere to the following guidelines when packaging products for return to VA:

• Remove dies from models, wrap in cotton and place in plastic containers.

• Wrap all components individually in bubble wrap and secure.

• All items shall be packed in durable transport containers with sufficient protective material to prevent movement during transport.

• All completed cases shall be disinfected and returned to the authorizing VA clinic exclusively via the required in‑person pickup and delivery method.

• Contractor must identify the specific type of metal used in each prosthesis with transport.

5. Contents - Contractor shall include the following items in each product returned to

VA:

• All original materials supplied by VA

• Chain of custody from receipt of items to packaging for transport

• Itemized non-payable invoice or packing list as detailed in Section IX.

• A copy or original of the manufacturer label, to provide a description of the metal alloy components and percentages used in the fabrication of each of the requested dental products. Contractor shall identify in writing (per case), the type of porcelain used in the fabrication of the porcelain fused to metal dental restorations

• A copy of the original lab prescription from the authorizing VAMC

6. Veteran Information Protection - The Contractor shall ensure that no Veteran personally identifiable information (PII) or protected health information (PHI) appears on the exterior of any package, transport container, or material used during transport. All identifying information—including names, dates of birth, medical record numbers, and case documentation—shall be secured inside the container and accessible only to VA clinical staff. This requirement ensures that no PHI is disclosed during transport and supports VA’s intent to avoid the need for a Business Associate Agreement (BAA) for transport activities.

7. Prohibition on Commercial Courier Services - The use of commercial courier, mail, or third‑party delivery services—including but not limited to FedEx, UPS, USPS, DHL, or any contracted parcel carrier—is strictly prohibited under this contract. All transport of dental laboratory items shall occur exclusively via in‑person pickup and delivery performed by designated Contractor personnel. No exceptions shall be permitted unless explicitly authorized in writing by the Contracting Officer (CO).

8. Delinquency - Delinquent delivery shall not exceed 5% of the number of orders placed per batch, per quarter, and/or the total number of orders placed for this contract period (year).

5. Privacy, PHI, and BAA Requirements This BAA applies exclusively to the dental laboratory fabrication activities performed by the Contractor and does not apply to transport operations. No Veteran PHI or PII is disclosed during transport due to the requirement that all identifying information be secured inside the transport container. As such, transportation activities under this contract do not trigger BAA obligations.

6. Materials and Manufacturing Standards Noble Alloys (Noble Metal Content must be > 25% Gold + Platinum Group) shall be used in the fabrication of complete gold crowns and fixed partial dentures (bridges) and in porcelain fused to metal crowns and fixed partial dentures. As per the American Dental Association "Revised Classification System for Alloys for Fixed Prosthodontics," www.ada.org/2190.aspx for Noble Alloys. The combined total of the metals (gold plus the platinum group) must be greater or equal to 25%). Metals of the platinum group are platinum, palladium, rhodium, iridium, osmium and ruthenium.

The contractor shall provide porcelain fused to metal crowns and fixed partial dentures with options of metal occlusal surfaces, crown (survey) under partial denture, porcelain labial butt margin and implant crown and abutments. The contract laboratory shall identify by affixing the most recent manufacturer label to provide a description of the metal alloy components and percentages used in the fabrication of each of the requested dental prostheses. The contract laboratory shall identify in writing (per case) the type of porcelain used in the fabrication of the porcelain fused to metal dental restorations and in instances where porcelain application only is requested. The alloy used for PFM restorations shall contain less than 30% silver.

Non-precious alloys (nickel and beryllium free) shall be used for resin-bonded fixed partial dentures.

Cast metal partial denture frameworks shall be fabricated of a cobalt chromium metal alloy; free of nickel and beryllium.

The VA system uses multiple implant systems. They are not universal. The VAMC will provide the stock abutments or "cast-to" custom abutments for fabrication. For "cast-to" abutments, the offeror will design and fabricate a suitable abutment.

7. Ordering and Delivery Documentation Ordering Procedures - Task orders against this contract will be placed in accordance with this section. All task orders placed incorporate all terms and conditions of the contract.

Ordering Officials - Task orders will be placed by ordering officials designated by the Contracting Officer (CO). Ordering officials must be licensed dental providers. Ordering officials will be from the West Haven and Newington VA Medical Center. The ordering facility will issue a prescription to a contractor. Prescriptions constitute binding orders under this contract.

8. Quality Assurance All dental prostheses returned from the contracted laboratory will be evaluated by the authorizing VAMC. Returned prostheses that fail to meet patient requirements will be returned to the contractor for correction, adjustment, or remake. All dental prostheses returned to the contractor for correction, adjustment, or remake shall be delivered to the authorizing VAMC within three (3) business days of date received. Communication back and forth between the VA and the Vendor is important to maintain and coordinate the quality assurance aspects of this contract.

The contractor will follow the Standards of Acceptable Deliverables (SAD), which is attached. Dental Laboratory procedures and products will be assessed by the COR by using the SAD of Dental Laboratory procedures. Prostheses delivered to VA also must adhere to the following standards:

Marginal integrity – crown and bridge prosthetic margins are complete and closed to the marked die margins

Occlusal relationship – the prosthesis contacts the opposing teeth positively and lightly when biting

Esthetics/anatomic contours – the prosthesis matches the shape and contour of the surrounding teeth, as well as the prescribed shade/color

Acrylic resin - Acrylic dentures will utilize Lucitone 199 acrylic resin or equivalent and be able to provide injection molded acrylic resins

Denture Teeth - Dentures will utilize Trubyte IPN (Dentsply) teeth or equivalent

Products not conforming to the stated requirements will require rework. Financial responsibility for rework is defined in paragraph IX. (2). Acceptable quantities of rework are defined in paragraph IX. (3).

Financial Responsibility - Prostheses returned to Contractor for rework due to Contractor error shall have necessary corrections, adjustments, or remakes performed no cost to VA.

Prostheses returned to Contractor for rework due to VA error will have necessary corrections, adjustments, or remakes performed at contract rates – payable by VA. The Contractor must provide proof that the error was due to VA error for consideration of payment under the contract.

Frequency of Rework - Rework due to contractor error shall not exceed 5% of the number of orders placed per batch, per quarter, and/or the total number of orders placed for this contract period (year).

Quality Assurance Surveillance Plan (QASP) - Describe your quality management system that is currently in place that will ensure the needs of the Government are met daily. Please also provide any quality certifications or licenses obtained. Please submit a Quality Assurance Surveillance Plan (QASP) as part of this technical submission. The QASP template can be found under section D (attachments), if needed. In addition to the SAD, the Government will also use the contractor’s QASP to assess the quality of the delivered products.

The COTR will notify the vendor in writing monthly any issues concerning quality complaints of dental laboratory items providing detailed information for the vendor to correct identified discrepancies.

Cleanliness - Contractor shall adhere to OSHA standards and disinfect all dental impressions and prostheses.

The contractor service requirements are summarized in Performance Standards that relate directly to mission-essential items. The Performance Standard briefly describes the minimum acceptable levels of service required for each requirement.

QASP

Task # Required Service Performance Standard Monitoring Method

Incentive/ Disincentive

Provide Dental Laboratory Services as outlined in the SOW and SAD

100%

Perform services in accordance with Joint

Commission on the Accreditation on Healthcare

Organizations (JCACO) standards, federal regulations or accreditation regulatory entities, including, but not limited to, the American

Dental Association (ADA) and the Contractor's respective state, requirements for operation as a dental laboratory.

Periodic Inspection

Positive/Negative Past Performance

Practice quality control and safety measures, including Universal

Precautions for Infectious Disease

Control.

100% Perform services in accordance with Joint

Commission on the Accreditation on Healthcare

Organizations (JCACO) standards and Safe Workplace Regulations.

Random Inspectio n

Positive/Negative Past Performance

Provide quality and appropriate documentation regarding the services provided.

95% Perform services in accordance with the Performance Work

Statement.

Customer Complaints

Poor performance may result in re-performance at Contractor's expense or termination of the contract.

Provide quality dental prostheses with marginal integrity

98% of the time (less than 5% errors in terms of accuracy)

Dental prosthesis will demonstrate acceptable level of marginal integrity when evaluated on dental stone model or implant abutment.

Customer Complaints

, direct observation and evaluation

Exercise of option period

Provide quality dental prostheses with occlusal relationship

98% of the time (less than 5% errors in terms of accuracy)

Dental prosthesis will demonstrate acceptable level of occlusion when evaluated on dental stone model or implant abutment.

Customer Complaints

, direct observation and evaluation

Exercise of option period

Provide quality dental prostheses with esthetics and anatomical contours

98% of the time (less than 5% errors in terms of accuracy)

Dental prosthesis will demonstrate acceptable level of esthetics and contours when evaluated on dental stone model or implant abutment.

Customer Complaints

, direct observation and evaluation

Exercise of option period

Provide quality dental prostheses with dental materials (alloys) used in fabrication

100% of the time, dental alloy used in fabrication of porcelain fused to metal and all gold restorations will be classified as Noble metal or High Noble metal (if requested) and made in USA.

Direct observation, review of manufacture’s alloy label.

Fabricate all dental prostheses without exception in the USA

100% of the time all dental prostheses will be fabricated in the United States of America

Direct Observation and contractor quality assurance

Exercise of option period

9 Delivery of Casework (Dental

Prostheses)

98% of the time all dental prostheses will be received by the VA by the required turn-around time

Direct Observation

9. Special Requirements

1. The contractor shall notify the contracting officer of any proposed changes in subcontracted dental laboratories and have prior written approval (by the contracting officer) before any changes are implemented. The contractor agrees to absorb any increase in charges as a result of any changes in subcontracted laboratories.

2. Quality Control: Dental Laboratory procedures and products will be assessed by the COR by using the SAD of Dental Laboratory procedures (copy attached). Contractor shall provide with upon request a detailed description of quality control procedures.

Contractor shall provide with upon request a detailed description of quality control policies and procedures followed by the contractor in the fabrication of dental prostheses.

3. The contractor will provide the following, upon request, as well as provide copies during the term of the contract to the CO and COR upon request.

a. A mutually agreeable time for pickup and delivery.

b. Telephone numbers and contact people are to be used by the using service at the VAMC to inquire about specific dental laboratory orders.

c. A narrative description of the laboratory’s quality control program.

4. The contractor shall maintain acceptable services, reporting systems and quality controls as specified herein. Failure to comply with the specified terms and conditions and/or failure to perform satisfactorily may be grounds for pursuing termination of the contract.

Appendix A – Standards for Acceptable Deliverables

(SAD)

1. Complete Dentures

a. Master Casts

i. Base is 10mm thick at the thinnest portion of the cast

ii. 3mm wide land area throughout the circumference of the cast

iii. Sulcular depth 3mm on buccal, to follow the contour of the buccal vestibule

iv. Sulcular depth 3mm on lingual to follow the contour of the vestibule

v. Free of bubbles and defects

vi. All anatomic areas of impression included on cast

vii. Tongue area, flat across the arch

viii. Base is parallel to the plane of occlusion or residual ridge

b. Impression Trays

i. Rigid and fabricated from the appropriate material

ii. Covers all indicated anatomy

iii. Handles do not interfere with border molding movements, formed as prescribed, so as not to displace facial musculature

iv. Impression material retentive features included in the tray as prescribed

c. Record Base

i. Is well adapted to the residual ridge

ii. Covers all indicated anatomy

iii. Is extended to the land area

iv. Is adequately thick for rigidity

v. Is smooth and free of sharp area

d. Occlusion Rim, Maxillary

i. Is fabricated from the prescribed baseplate wax

ii. Is 10mm wide in the posterior section

iii. The posterior sections are placed over the crest of the residual ridges

iv. Is straight from the buccal aspect of the record base border to the buccal aspect of the occlusion rim

v. Taper in width to 3mm in the anterior section

vi. Anterior section angles 5 degrees anteriorly from the horizontal

vii. Anterior is 22mm long from the extent of the labial flange

viii. Posterior is 18mm long from the extent of the buccal flange

ix. All wax is smooth, without voids

x. Adheres well to the record base

xi. The occlusal plane is flat, generally parallel to the residual ridge

e. Occlusion Rim, Mandibular

i. Is fabricated from the prescribed baseplate wax

ii. Is 10mm wide in the posterior section

iii. The posterior sections are placed over the crest of the residual ridges

iv. The posterior sections stop at the beginning of the upward incline of the residual ridges

v. Is straight from the buccal aspect of the record base border to the buccal aspect of the occlusion rim

vi. Tapers in width to 3mm in the anterior section

vii. Anterior section angles 5 degrees anteriorly from the horizontal

viii. Anterior is 18mm long from the extent of the labial flange

ix. Posterior extends to the top of the retro-molar pad

x. All wax is smooth, without voids

xi. Adheres well to the record base

xii. The occlusal plane is flat, ideally parallel to residual ridge

f. Wax Trial Dentures, Maxillary

i. The midline of the arranged teeth matches the marked midline of the occlusion rims

ii. The incisal edges of the anterior teeth are placed in the same plane as the incisal surface of the occlusion rim

iii. The occlusal scheme by default is to a Class I occlusion with a balanced set-up, unless otherwise specified.

iv. The inter-dental wax fills the embrasures up to the contact points.

v. Adequate inter-dental wax fills the embrasures to allow for finishing of the acrylic resin

vi. A 4mm band of simulated attached gingiva is present, elevated to simulate buccal bone

vii. The palatal area is 2mm thick

viii. A 1mm band of wax is palatal to the posterior teeth to allow for finishing of the acrylic resin

ix. Wax does not overlap onto the beginning/palatal of the ridge-lap area of the anterior teeth

x. The opposing occlusion contacts into proper interdigitation at the established vertical dimension of occlusion

g. Wax Trial Dentures, Mandibular

i. The midline of the arranged teeth matches the marked midline of the occlusion rims

ii. The facial surfaces of the anterior teeth are placed in the same plane as the contoured facial surface of the occlusion rims

iii. The incisal edges of the anterior teeth are placed to develop the horizontal and vertical overlap necessary for the individual clinical requirements

iv. The occlusal plane of the mandibular posterior teeth is at the appropriately indicated superior aspect of the pear-shaped pad.

v. The central groove line of the mandibular posterior teeth is placed over the crest of the residual ridge

vi. The number and size of posterior teeth are in harmony with space available from the distal of canine to the beginning of the ascending ramus

vii. The inter-dental wax fills the embrasures up to the contact points

viii. Adequate inter-dental wax fills the embrasures to allow for finishing of the acrylic resin

ix. A 4mm band of simulated attached gingiva is present, elevated to simulate buccal bone

x. A 1mm band of wax is lingual to the posterior teeth to allow for finishing of the acrylic resin

xi. Wax does not overlap onto the beginning/lingual of the ridge-lap of the anterior teeth

xii. The buccal shelf area is concave, of adequate thickness

h. Processed and Polished Prosthesis

i. The acrylic resin free of pits, fissures, and porosity

ii. The acrylic resin is polished on all non-tissue bearing areas

iii. The denture borders are anatomically complete

iv. No evidence of flash remains on the denture borders

v. The denture bases remain adequately thick for rigidity

i. Remount Casts (if required)

i. The denture borders are well supported around the buccal periphery

ii. Base is 10mm thick at the thinnest portion of the cast

iii. 4rnm wide land area throughout the circumference of the cast

2. Removable Partial Dentures

a. Custom Impression Trays

i. Rigid and fabricated from the appropriate material

ii. Covers all indicated anatomy

iii. Handles do not interfere with border molding movements, formed as prescribed

iv. Impression material retentive features included in the tray as prescribed

b. Rests

i. Follow the dimensions and location of the design

ii. Fill the prepared rest seats completely

iii. Are minimally 1.5mm thick

iv. Are no greater in contour than the original marginal ridge/buccal cusp ridge/fossae area

c. Minor Connector

d. Follow the dimensions and location of the design

e. Are broad and fan shaped at the junction with the major connecter

f. Are minimally 1.5mm thick

g. Crosses the gingival margin at 90 degrees

3. Proximal Plates

a. Follow the dimensions and location of the design

b. Are thinned and tapered only at the marginal ridge areas, when no rest is present

4. Major Connectors

a. Follow the dimensions and location of the design

b. Have definitive external finish lines

c. Have definitive internal finish lines

5. Denture Base Retention

a. Follow the dimensions and location of the design

b. Show a broad connection to the major connector

c. Are not extended more than 2mm buccal to the crest of the residual ridge

d. Contains a tissue-stop that contacts the residual ridge of the master cast

6. Retainers, Indirect

a. Follow the dimensions and location of the design

b. Are broad and fan shaped at the junction with the major connector

c. Are minimally 1.5mm thick

d. Crosses the gingival margin at 90 degrees

7. Retainers, Direct

a. Follow the dimensions and location of the design

b. Are uniformly tapered to the retentive tip

c. Are minimally 1.5mm wide

8. Wax Trial Removable Partial Dentures, Maxillary

a. The midline of the arranged teeth matches the marked midline of the occlusion rim

b. The facial surfaces of the anterior teeth are placed in the same plane as the contoured facial surface of the occlusion rims

c. The incisal edges of the anterior teeth are placed in the same plane as the incisal surface of the occlusion rim

d. The inter-dental wax fills the embrasures up to the contact points

e. Adequate inter-dental wax fills the embrasures to allow for finishing of the acrylic

f. A 4mm band of simulated attached gingiva is present to simulate buccal bone

g. A 1mm band of wax is palatal to the posterior teeth to allow for finishing of the acrylic resin

h. Wax does not overlap onto the beginning/palatal of the ridge-lap area of the anterior teeth

i. The opposing occlusion contacts into proper interdigitation at the established vertical dimension of occlusion

9. Wax Trial Removable Partial Dentures,

a. The midline of the a teeth matches the marked midline of the occlusion rims.

b. The facial surfaces of the a teeth are placed in the same plane as the contoured facial surfaces of the occlusion rims.

c. The incisal edges of the anterior teeth are placed in the same plane as the incisal surface of the occlusion rim.

d. The occlusal plane of the mandibular posterior teeth is at the appropriately indicated superior aspect of the pear-shaped pad.

e. The central groove line of the mandibular posterior teeth is placed over the crest of the residual ridge

f. The number and size of posterior teeth is in harmony with space available from the distal of the canine to the beginning of the ascending ramus

g. The inter-dental wax fills the embrasures up to the contact points

h. Adequate inter-dental wax fills the embrasures to allow for finishing of the acrylic resin

i. A 4mm band of simulated attached gingiva is present, elevated to simulate buccal bone

j. A 1mm band of wax is lingual to the posterior teeth to allow for finishing of the acrylic resin

k. Wax does not overlap onto the beginning of the ridge-lap area of the anterior teeth

l. The buccal shelf area is concave, of adequate thickness

10. Processed and Polished Prosthesis

a. The acrylic resin is free of pits, fissures, and porosity

b. A smooth junction exists between the acrylic resin and external finish lines

c. The acrylic resin is polished an all non tissue bearing areas

d. The denture borders are anatomically complete

e. No evidence of flash remains on the denture borders

f. The denture bases remain adequately thick for rigidity

11. Fixed Partial Dentures (FPD)/Crown

a. Custom Trays

i. Indicated relief has been well adapted

ii. Is well adapted to the teeth and residual ridge

iii. Covers all indicated anatomy

iv. Completely fills the vestibule

v. Is extended to the beginning of the land area when indicated

vi. Is adequate for rigidity

vii. Is smooth and free of sharp areas

b. Working Casts/Dies

i. All necessary anatomic landmarks are included

ii. Dies are stable, retentive, and do not rotate

iii. No bubbles or defects present in the cast

iv. Dies are properly trimmed, retaining as much root structure as possible

v. Die spacer is applied to prepared surfaces leaving 1 mm free at margin

vi. All dies are numbered.

c. Cut-Back Design for Veneer Application

i. Coping/wax crown cut-back design allows for a uniform 2mm thickness of veneer

ii. Proximal cut-back design allows for marginal ridge veneer support

iii. Rigid connector size is maximized, within the constraints, for periodontal health and esthetics

iv. A uniform transition exists between metal and veneer material

d. Veneer Application

i. Axial contours are within normal limits for the particular tooth and/or arch form

ii. Applied veneer shade matches the requested shade per shade guide submitted or universal (Vita, Trubyte, Ivoclar, etc.) system

e. Finish/Polish of FPD/Crown

i. Axial contours are within normal limits for the particular tooth and/or arch form

ii. A uniform transition exists between metal and veneer material

iii. No unsupported veneer material remains on the allow substructure

iv. All margins are closed on the die

v. The established vertical dimension of occlusion is maintained when the FPD/crown is articulated

vi. The veneer material is appropriately finished (glazed, polished, etc.)

vii. The substructure metal is highly polished

f. Surveyed Crowns for Removable Partial Denture Abutments

i. All aspects of FPD/crown fabrication are employed

ii. Posterior occlusal rests:

1. are ½ the width of the buccal-lingual cusp tip width

2. are spoon-shaped, deepest toward the center of the tooth

3. form an acute angle with the guide at the most axial point

4. re-establish original marginal ridge contours

5. maintain occlusal contours

iii. Cingulum rests:

1. are placed in the gingival 1/3 of the crown to avoid occlusal interferences

2. provide a positive stop for the removable partial denture

iv. Guide planes:

1. include a 1mm wide band of surface parallel to the established path of withdrawal from the facial line-angle to the

2. lingual/palatal line-angle

3. relief provided at the gingival 1/3 of the axial surface

v. Survey lines, circumferential direct retainers:

1. begin in the gingival one-third of the abutment adjacent to the rest

2. end in the occlusal 1/3 of the abutment to establish the desired undercut

3. allow for the terminal one-third of the retainer to be placed into the undercut

vi. Survey lines, bar direct retainers:

1. a “U” shaped survey line established the desired undercut

12. Implant supported Crowns and fixed partial dentures.

a. Laboratory able to provide at cost any necessary components, including:

i. Lab analogs

ii. Lab screws

iii. Temporary or permanent abutments

iv. UCLA style abutments

b. Laboratory to follow Rx indicating cemented or screw retained prosthesis fabrication.

i. Screw retained prosthesis will have a metal chimney screw hole

ii. Cemented prosthesis to follow Rx for either milled custom abutment fabrication or utilization of standard abutment, as indicated.

c. Occlusal contacts for implant supported prosthesis will be “just right” by default, unless Rx indicates otherwise.