STEP-BY-STEP INSTRUCTIONS TO PLACE LOCATOR ATTACHMENTS (This is a chairside procedure!) Order of Treatment 1. Make denture. 2. Measure tissue cuff height; order the parts. 3. Pick up the attachments INTRAORALLY.
Step 1 Make the best denture ever. If possible, take the impressions with the healing caps in place. I start the denture fabrication 3-4 weeks after the implants have been placed. You do not need to make a new denture if the existing denture fits!
Step 2 Remove healing caps. Measure the tissue cuff from the top of the gingiva to the top of the implant with a perio probe; record this in your patient chart. Replace healing caps immediately.
The TALLEST measurement is the length to purchase you must have the top 1.5mm exposed. 4mm measured on lingual 1mm measured on buccal
Step 3 Place the Locator abutment into the implant. Torque into place. (20-35NCm).
Place the Locator Implant Attachment Select the Locator abutment with the proper tissue cuff height. Hand tighten in the mouth using the Locator torque driver. Torque in the Locator abutment to 20-35 Ncm. Courtesy of Dr. Robert Vogel
New Product Locator Delivery Sleeve #8394
STEP - BY - STEP TECHNIQUE Step 4. Start to hollow out denture over healing caps. The denture is taken to completion during the healing of the implants
Step 5 Insert a Locator denture cap (with black processing male) onto each Locator abutment. Courtesy of Dr. Robert Vogel
Step 6: Use GC Fit Checker to be sure absolutely NO pink acrylic shows through. NOW DO IT AGAIN!!! Check for clearance on ALL of the attachments before the next step
THIS IS THE MOST CRITICAL STEP FOR SUCCESS. Do not go any further until you are sure that there is no acrylic showing through the FIT CHECKER. To shortcut here will cause the need to redo, or start over, probably at the next appointment when the unhappy patient returns. Time is money.
Step 7. Place vent holes on lingual/palatal of denture. ONLY AFTER YOU ARE POSITIVE THAT THERE WAS 100% CLEARANCE WITH THE FIT CHECKER
Step 8 Place a white block-out spacer over the head of each Locator abutment. Insert a Locator Denture cap (with black processing male) into each Locator abutment, leaving the white blockout spacer beneath it. Courtesy of Dr. Robert Vogel
WARNING: Only pick up one attachment at a time. Period. No exceptions. 9 Step 9. Wet one indentation with a little monomer. Mix a self-curing acrylic (like Jet or Trim) and place a small amount in the recess of the denture and around the metal cap of the processing cap male. Insert the denture into position in the oral cavity. Once the denture in proper position, maintain it in a passive condition (very light centric) while the acrylic sets. Set a timer for 5 MINUTES
Mrs. Jones, please bite together just hard enough that you feel the denture touch all the gums, BUT DON T SQUEEZE ANY HARDER. You ll have to keep your teeth together until the timer goes off.
QYK-SET by HOLMES DENTAL 1-800-322-5577 This sets in 2 minutes! HOLMES # 77300
10 Step 10 Once the timer goes off, remove the denture and discard the white block-out spacer. It may still be stuck to the implant. Step 11 Repeat steps 9 and 10 on the second attachment.
Step 12. Fill in any air bubbles/voids around attachments. Put in pressure pot for 10 minutes. Step 13. Remove excess acrylic from around the locator in the denture and the vent hole; polish the denture base. 12 7 13 UNIFAST LC by GC America
Step 14 Remove the black processing male from the metal denture cap with the Locator male removal tool. (Crochet hook end on old tool.) Courtesy of Dr. Robert Vogel
Courtesy of Dr. Robert Vogel 15 Step 15 The Locator male seating tool is used to firmly push the Locator replacement male into the metal denture cap. WARNING: Use the least retentive possible. Beware of arthritis.
RETENTION VALUES OF NYLON MALE INSERTS GRAY = ZERO RETENTION RED =.5-1.0 lbs (extended range) BLACK PROCESSING MALE =1-1.5 lbs (short life) BLUE = 1.5 lbs ORANGE = 2.0 lbs (extended range) PINK = 3.0 lbs GREEN = 3.5-4.0 lbs (extended range) CLEAR = 5.0 lbs
IF THERE IS NO RETENTION IMMEDIATELY, OR WITHIN 1 st WEEK 1. You did not REALLY take the fit checker step to completion ABSOLUTELY NO PINK CAN SHOW THROUGH! 2. The patient bit down too hard while the acrylic was setting the mucosa was compressed and now wants to decompress. 3. The attachment was below the gingival margin.
How many of these things do I use? Mandible Minimum 1 Maximum 2 Maxilla 4. Period.