1. IMPLANT RETAINED DENTURES
• Dr. Larry Pitzak, D.D.S. , Western Dental Services Quality Management
• Office 714-571-3168
• Fax 714-571-3698
• Lpitzak@westerndental.com
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2. IMPLANT RETAINED DENTURES
WHY DO IMPLANT RETAINED
DENTURES ????

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4. Does Your Denture Patient Look Like This??
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5. Testimonial

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8. Panorex – Implants and Locators Dr. Parvis Patient WDS Buena Park
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9. Locators in Place Dr. Parvis Patient WDS Buena Park
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10. Denture with Attachments Placed Dr. Parvis Patient WDS Buena Park
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11. CLINICAL CASE
Overdenture – Two Locator Attachments
Clinical case
• Seat two Locator abutments
Clinical case courtesy of J. Bain, DDS
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12. CLINICAL CASE
Overdenture – Two Locator Attachments
Hand tighten with the Abutment Driver and
Take a verification x-ray.
Clinical case courtesy of J. Bain, DDS
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13. CLINICAL CASE
Overdenture – Two Locator Attachments
Torque to 35 Ncm clinically (15 Ncm on the model)
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14. CLINICAL CASE
Overdenture – Two Locator Attachments
Place white block-out spacer ring Seat metal cap
over abutment (may need more with black
than one per abutment) processing male
Clinical case courtesy of J. Bain, DDS
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15. CLINICAL CASE
Overdenture – Two Locator Attachments
Inspect for show-through – Ensure clearance!
Hot Clinical Tip:
Make a vent hole to lingual for acrylic to
escape so you do not trap air and create voids
in the acrylic!
Photos courtesy of J. Bain, DDS
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16. Lingual Acrylic Relief Hole
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17. Over denture – Two Locator Attachments - CASE
Clean receptor sites with alcohol
Photos courtesy of J. Bain, DDS
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18. CLINICAL CASE
Overdenture – Two Locator Attachments
Paint bonding agent on clean
roughened acrylic and add
acrylic into receptor sites and
on metal housing
Photos courtesy of J. Bain, DDS
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19. CLINICAL CASE
Overdenture – Two Locator Attachments
Seat denture and confirm proper occlusion (tap, tap, bite lightly)
Photos courtesy of J. Bain, DDS
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20. CLINICAL CASE
Overdenture – Two Locator Attachments
Check—
• Occlusion
• Patient’s manual dexterity
Photo courtesy of J. Bain, DDS
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21. CLINICAL CASE
Overdenture – Two Locator Attachments
Remove denture, fill any voids in acrylic, adjust any excess acrylic
and polish denture. Remove the black processing male and insert
the selected retentive male into the metal housing.
*** It is often best to start with the lightest force retentive male !
Photo courtesy of J. Bain, DDS
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22. Take Out Parts
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23. STUDENT EXERCISE – PARTS INDENTIFICATION
Impression Copings
Metal Cap
Spacer Locator Implant Abutment
Locator retentive males
Black
Processing
Male
Divergent retentive males Abutment Replicas (Analogs)
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24. PARTS
Overdenture – Two Locator Attachments
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25. PARTS
Overdenture – Two Locator Attachments
• Metal Cap
• Block Out Spacer
Metal Cap
• Black Processing Male
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• Locator Abutment
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26. PARTS
Black Processing male and retentive males
• The black processing male is replaced with the appropriate retentive
male after processing the metal cap into the denture.
• Always start with the least retentive male and progress up for each
attachment.
8515 8524 8527 8529 8547 8548 8915
Processing 5 lbs 3 lbs 1.5 lbs 3–4 lbs .5 lbs 2 lbs
10–20 divergence

27. Divergent Angles of Attachments
Overdenture
Photo courtesy of Per-Olof Karlsson, Sweden Photo courtesy of J. Bain, DDS
Use 10–20 divergent retentive males
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28. PARTS
Overdenture – Two Locator Attachments
• Mandible: 2 or more implants
• Multiple collar heights for variable tissue levels:
0 to 6 mm depending on platform
• Available in NP, RP, WP
Locator Abutments
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29. Different Collar Heights – Measure
The Locator Abutment is selected to be 1.5mm above the tissue height.
Collar Height
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30. Locator Core Tool –Three Parts that come apart
Overdenture – Two Locator Attachments
Male Removal Tool
•Removes retentive & black Abutment Driver
processing male from the metal •The gold-colored end of the
cap. Locator Core Tool is used for
Male Seating Tool screwing and unscrewing the
•Places a new retentive male into Locator Abutments to and
the empty metal cap. from implants and replicas.
•The male is fixed firmly in the cap
when a click is heard.
Male Removal Tool Male Seating Tool Abutment Driver
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31. PARTS
Overdenture – Two Locator Attachments
Male Removal Tool
To remove a retentive male or black processing male from the metal
cap:
• Insert the tip into the cap/male assembly and push straight into the
bottom of the male.
• Then tilt the tool so that the sharp edge of the tip will grab hold of
the male and pull it out of the metal cap.
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32. PARTS
Overdenture – Two Locator Attachments
To remove the male from the male removal tool:
• Screw the tip clockwise completely onto the middle
section. This activates the loosening pin inside the
tip, which releases the male.
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33. PARTS
Male Seating Tool
• Used to insert a retentive male or black processing male into the
metal cap

34. Locator Abutment Driver - PARTS
Machine Screw Driver
Locator Abutment Driver

35. PARTS
Overdenture – Two Locator Attachments
Torque to 35 Ncm clinically (15 Ncm on the model)
Abutment driver
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37. Overdenture – Two Locator Attachments - CASE
Well-fitting denture - DEMONSTRATION CASE
• Chairside abutment selection by tissue height
• Chairside curing of attachments
Denture needing reline
• Chairside abutment selection by tissue height
• Reline impression over Locator metal housing/black processing male
• Laboratory or chairside processing of attachments
Needing new denture
• Chairside abutment selection by tissue height
• Abutment level impression with impression coping
• Laboratory or chairside processing of attachments
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38. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
Correct measurement of tissue depth for collar will ensure that the
abutment is 1.5 mm above the tissue
Tissue Depth = Collar Height
Available in 0-6 mm.
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39. Different Collar Heights – Measure
The Locator Abutment is selected to be 1.5mm above the tissue height.
Collar Height
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40. Demonstration Case
Overdenture – Two Locator Attachments
Clinical case
• Seat two Locator abutments
Clinical case courtesy of J. Bain, DDS
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41. Demonstration Case
Overdenture – Two Locator Attachments
Hand tighten with the Abutment Driver and
Take a verification x-ray.
Clinical case courtesy of J. Bain, DDS
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42. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
• Place a white block-out spacer ring on each
abutment.
• The spacer ring is used to block out the area
surrounding the abutment. More than one
spacer may be necessary.
• Place the metal cap with the black processing
males onto the Locator Abutments.
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43. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
Use an appropriate method to mark
the locations of the Locator
Abutments on the existing denture.
Photos courtesy of J. Bain, DDS
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44. Overdenture – Two Locator Attachments - CASE
• Hollow out the existing denture base in the
marked areas for the locator attachments.
• Most dentists place a hole in the lingual area
to allow excess acrylic to escape and the
denture to seat fully.
• Try the denture back in to make sure you
have clearance and that the denture seats
without rocking on the locator abutment and
is tissue borne only.
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45. Lingual Acrylic Relief Hole
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46. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
• Apply suitable bonding agent onto
the metal caps and on the hollowed
out receptor sites. Light cure.
• Fill the receptor sites with prosthetic
resin.
or
• Use self-curing resin.
• HOT CLINICAL TIP
Best to place and cure one
attachment at a time.
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47. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
Seat the denture and confirm proper occlusion (tap, tap, bite lightly).
Light cure resin or self cure in light occlusion without compression
of the soft tissue.
Photos courtesy of J. Bain, DDS
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48. Demonstration Case
Overdenture – Two Locator Attachments
• Once the resin has cured, remove
the denture from the mouth and
discard the white block-out spacers.
• Fill in any acrylic voids, remove any
excess acrylic and polish the
denture.

49. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
Remove the black processing male and insert the selected retentive
male into the metal housing.
*** It is often best to start with the lightest force retentive male !
Photo courtesy of J. Bain, DDS
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50. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
• Select replacement males by considering preferred
retention and angle of implant divergence.
• Remove the black processing males from the metal
housing using the male removal tool or sickle.
• 6 lbs. of retention per arch total is recommended
(two 3.0 lb males, four 1.5 lb males, etc). But always
best to start at the lowest level of retention.
10–20 divergence
8515 8524 8527 8529 8547 8548 8915
Processing 5 lbs 3 lbs 1.5 lbs 3–4 lbs .5 lbs 2 lbs
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51. DEMONSTRATION CASE
Overdenture – Two Locator Attachments
Locator Male Processing Package
(REF08519-2)
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52. Divergent Angles of Attachments
Overdenture
Photo courtesy of Per-Olof Karlsson, Sweden Photo courtesy of J. Bain, DDS
Use 10–20 divergent retentive males
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53. Divergent Retentive Males
Locator® Extended Range Male Processing Package
(8540-2)
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54. Case
Overdenture – Two Locator Attachments
Well-fitting denture
• Chairside abutment selection by tissue height
• Chairside curing of attachments
Denture needing reline – Locator abutments present or only Implant is in
place
• Key factor is to get the denture to the well-fitting denture stage first
• Only implants in place – reline denture first to a well fitting denture
• Chairside abutment selection by tissue height and proceed as before
• Patient has abutments and denture with attachments and
needs reline
• Order new metal caps, black processing and
retentive/divergent males.
• Remove existing metal caps with retentive males from
patients denture – check for adequate clearance
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55. Case
Overdenture – Two Locator Attachments
• Place the new metal caps with the
black processing males onto the
Locator Abutments.
• Take an impression and pick up the
metal cap with the black processing
males in the impression.
• Remove the metal cap with the black
processing males from the
impression. You will be left with
space to indicate location of
attachments.
• Pour the impression – send to lab.
• Reline comes back from lab - Check
clearance – place white block out
spacer then metal cap with black
processing male chairside and
proceed as shown in the last section
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56. Case
Overdenture – Two Locator Attachments
Well-fitting denture
• Chairside abutment selection by tissue height
• Chairside curing of attachments
Denture needing reline
• Chairside abutment selection by tissue height
• Reline impression over Locator metal housing/black processing male
• Laboratory or chairside processing of attachments
Needing new denture
• Chairside abutment selection by tissue height. Proceed
• as before.
• Impressions and completion of denture.
• Chairside processing of attachments.
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57. Overdenture – Making a Stent - Case
Case
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58. Case
Overdenture – Making a Stent
Before implant placement in the fully edentulous patient,
it is required to have defined the proper tooth position.
This can be accomplished by:
1. An existing denture
2. A new denture
3. A wax try-in that goes unprocessed
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59. Case
Overdenture – Making a Stent
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60. Case
Overdenture – Making a Stent
Lang Pressure Pot
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61. Case
Overdenture – Making a Stent
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62. ADVANTAGES OF DOING IMPLANTS AT WDS
• PATIENT SATISFACTION
• DOCTOR SATISFACTION
• LEARN – EXPERIENCE
• MENTOR HELP
• INCREASE PRODUCTION
• WIN-WIN

63. DOCTORS
If you Never start a case
you will Never gain the Experience to Learn.
If you do not Learn you will Never gain Experience.
He who has the Most Experience WINS!

64. Winners take great Vacations!
Roatan – Bay Islands - Honduras
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65. Winners eat well each night
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66. Winners have time for relaxation
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67. Don’t just be an Average doctor
―ONE OF THE CROWD‖
Be an Experienced doctor – Be a WINNER!
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70. Winners have time for relaxation
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71. Eat well each night
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72. Travel - Roatan – Bay Islands - Honduras
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73. Sea Turtle
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74. 300 lb Grouper
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75. Clownfish in Anemone
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76. Jacks
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77. Tarpon
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78. Turtle
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