Top Questions About the Locator® Attachment

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A: The three pieces of information needed to select the proper-fitting Locator® Abutment (Zest Anchors; Escondido, Calif.) are: type of implant, diameter of implant and tissue cuff measurement. Locator Abutments are available for all major implant systems and have tissue cuff heights ranging from 0 to 6 mm in 1 mm increments. The tissue cuff height measurement must be taken at each implant site using the deepest side of the tissue for measuring from the apical shoulder of the implant to the crest of the tissue. If the measurement is 3 mm, choose a 3 mm tissue cuff height for the Locator Abutment. If the measurement is 3.5 mm, choose the next highest tissue cuff available, 4 mm. This will place the working portion of the Locator Abutment at or slightly above the gingival level.

Editor's note: Another option is to take an implant-level impression and allow the lab to select the appropriate attachment using the master cast.

A: The placement of a Locator Abutment into the implant should always start with the tactile feel of the hand driver to avoid cross-threading. However, the torque value of a hand driver is only about half of the final torque value of 30 to 35 Ncm that is necessary to avoid loosening of the abutment during function and possible fracture when the abutment is no longer properly supported by the implant. Special torque wrench insert tools are available to fit all dental torque wrenches and connect directly to the triangle drive portion of the Locator Abutment.

Editor's note: The Locator instrumentation can be purchased through Zest Anchors (800-262-2310, zestanchors.com).

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A: The Locator Denture Cap is never sold with the final nylon insert because the Locator Processing Male eliminates any pivoting off center while the titanium denture cap is being processed into the denture and is designed to position the metal cap into the proper position of vertical resilience. The black Processing Male places the Locator Denture Cap in the upper position of vertical resilience so that the gingival tissue surrounding the abutment can help support the overdenture during mastication function. The yellow Processing Male is used with Locator Bar Attachments and places the Locator Denture Cap in the lower position of vertical resilience because the overdenture is solidly supported by the bar.

Editor's note: For lab-processed cases, Glidewell provides the attachment with the processing cap (black for freestanding attachments, yellow for bar overdenture attachments). A vial containing the spacer, as well as clear, pink and blue caps comes with each attachment. The desired caps can then be selected and inserted based on the desired retention and the patient's ability to remove the prosthesis.

Q: How many Locator Male Attachments should be processed at one time?

A: When placing Locator Denture Cap Males into the overdenture using a direct chairside process, the most conservative approach is to pick up one at a time and no more than two at a time. After curing the first Locator Cap Male into place, leave the Processing Male in the metal cap and make sure the denture snaps in and out properly. Repeat this process for each additional Locator Cap Male so that any fit problem can be identified at a single site. After all the Locator Cap Males have been

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Q: What is the proper level of retention for a Locator Overdenture?

A: A good rule of thumb is to start the patient with just 6 pounds of retention for his or her overdenture. That means using two 3-pound pink Locator Males if the patient has two Locator Abutments, and dropping down to 1.5-pound blue Locator Males if the overdenture is supported by four Locator Abutments. Use of the new nonretentive gray male can reduce overall retention of multiple Locator Attachments while still providing rest support for the overdenture.