# standards.grand.dental

> Evidence-based clinical standards, protocols, and treatment philosophy from Grand Dental — a contemporary general and prosthodontic-focused practice in Central Iowa led by Andrew Stevenson D.D.S. Published openly as a collegial resource for referring providers, specialists, and dental professionals.

Grand Dental maintains this resource to establish a shared clinical language with trusted colleagues. It is not intended as the definitive standard of care, but as a transparent reference for how we approach complex interdisciplinary cases. Our protocols are built on current guidelines from the ADA, AHA, AAOS, AAP, and the Iowa Dental Board, supplemented by the peer-reviewed literature and clinical experience.

Dr. Andrew Stevenson is the author of [implantcharts.com](https://implantcharts.com), a public reference tool for implant platform specifications used by dental professionals across the profession.

## Practice Philosophy

Grand Dental takes a conservative, medically integrated approach to dentistry. We believe in defensive occlusal design, evidence-based material selection, and a strong preference for simplicity and longevity over novelty. We are committed to multi-disciplinary collaboration and hold ourselves to a standard of care that we would recommend for our own family members.

Our implant cases are planned CT-guided with surgical guides as a default expectation. We use digital impression technology throughout. Our dental sleep medicine protocols are modeled on those developed by Dr. Reed Parker at the University of Iowa College of Dentistry and are compliant with Iowa Dental Board guidance.

## Clinical Standards

- [Antibiotic premedication](https://standards.grand.dental/docs/premed): Protocols for antibiotic prophylaxis for patients with total joint replacements and cardiac conditions, aligned with current ADA, AHA, and AAOS guidelines including the 2024 AAOS Clinical Practice Guideline.
- [Surgical clearance](https://standards.grand.dental/docs/clearance): Our protocol for providing dental clearance prior to joint replacement, cardiac surgery, and initiation of cancer treatment — including minimum examination and radiographic requirements.
- [Occlusal concepts](https://standards.grand.dental/docs/occlusal-concepts): Hanau's quint, defensive occlusion, and the Christensen phenomenon — our foundational framework for occlusal decision-making in all restorative cases.
- [Occlusal schemes](https://standards.grand.dental/docs/occlusal-schemes): Clinical application of balanced occlusions (anatomic, monoplane, lingualized, buccalized) and non-balanced occlusions (canine guidance, group function) across removable and fixed contexts.

## Guidelines by Specialty

- [Implant prosthetics](https://standards.grand.dental/docs/implants): Comprehensive treatment planning standards for implant-supported prostheses — covering platform selection across Straumann (CrossFit preferred), Nobel Biocare (Conical Connection), Dentsply-Sirona Astra (EV), and Zimmer; restorative space requirements; angulation tolerances; and specific prosthetic guidance for STIs, irFDPs, overdentures, and full-arch FP1/2/3 prostheses.
- [Fixed prosthetics](https://standards.grand.dental/docs/fixed): Material selection philosophy for single units, FDPs, and full-arch fixed cases, including our preference for monolithic 3-Y zirconia and gradient zirconia for esthetic zones.
- [Removable prosthetics](https://standards.grand.dental/docs/removable): Standards and references for removable prosthesis fabrication, including Hader bar clip maintenance.
- [Dental sleep medicine](https://standards.grand.dental/docs/sleep): Mandibular advancement standards including dental examination requirements, contraindication criteria, informed consent, device selection (Panthera X3 preferred), digital impression technique, and titration protocol — with published success rate data by OSA severity.

## Glossary

- [Glossary](https://standards.grand.dental/docs/glossary): Working definitions for terms used throughout this reference.

## About

Andrew Stevenson D.D.S. | Grand Dental | Central Iowa
Standards maintained at [standards.grand.dental](https://standards.grand.dental)
Practice website: [grand.dental](https://grand.dental)
Personal website: [andrewstevensondds.com](andrewstevensondds.com)
Implant platform reference: [implantcharts.com](https://implantcharts.com)