THanks for posting. I perform this procudure similarly. The most important part is making certain that the denture base seats without contact to the locator housings. One think I do differently is that I do not hold the denture in place when the attaching resin has veen placed. I find it best to have the patient close and stay closed during the "pick up" .
+Edward Dergosits Thank you for the great comment. I find that this varies by clinician comfort level, but I have found that most denture patients don't close properly when asked to and they can typically have a cusp kick the denture slightly forward or to the side. Additionally, I find that when I control the pressure on the ridge, I can apply just enough pressure to slightly compress the tissue but not overly compress the tissues. Most of the time clinicians don't want to risk "missing the bite" or "having to adjust the bite after pick-up"... 9/10 I never need to adjust the bite and that 1/10 times it's a tiny adjustment. Experiment yourself, try it next time :)
hi dr thanks for great presentation- big fan?? quick question...can i use more than one white o ring to prevent undercuts? what does one do if worst case scenario the denture locks?
Best simple advice I can give: 1) until you do enough cases to “eyeball” it, after you’ve seated your locators try on a housing with the black insert to confirm the proper height selection 2) be 100% certain that the denture passively seats without interfering with the housings 3) USE YOUR WHITE BLOCK-OUT O-RING 4) Follow the pickup resin directions on when to remove to make sure the denture doesn’t lock on
French Frys I think the “undercuts” can be from 2 things: 1) the flange on the Locator or 2) angulation between the Locator’s own axis & a plumb line. Neither would be likely except if you have some extra height to the Locator. Usually the distance between the Locator’s retentive flange & the soft tissue level is about equal to the height of the seated jacket housing, & if you have the o-ring on when you pick up the housing then little-to-no acrylic/resin could flow up on to the Locator shaft since the entire exposed height is covered by the housing & the o-ring. But if you have extra height then the resin can flow around the Locator body & give you an unseating diameter smaller than the Locator’s flange diameter. Even then, unseating would probably bust through this as the locking on resin would usually be thin. It might scare you & the patient, but no big deal. Except, if you have an extra few millimeters & the locked on portion is too thick to bust past. Then you can feel the attachment disengage & the denture will try to unseat, but it will only move a millimeter or 2 & can’t move forward. This just happened to me for the first time ever: I successfully picked up 3 of 4 upper attachments (4, 6/7, & 13 sites), but my final site (9) Locator was too short to really engage well because the ridge sloped sharply from mesial to distal. I switched from a 3 to 4mm height & the mesial was perfect but the distal had 1.5mm exposed between the housing & tissue. It locked on for sure in that area. The patient wouldn’t give up trying to get it out, & tried for 10 minutes, but I had to go through the occlusal & cut the housing out, then insert my driver through the “access” & unseat the Locator to retrieve the denture. The Locator wouldn’t pull through still; I had to take it out through the new access. It SUCKED. This was a newer R-Tx Locator which has more height & a wider flange as compared to the heritage unit, so it might happen more easily with these, though they are so worth using. If you can see more than a millimeter of gold (or purple for R-Tx) with your housing seated then block this out with rope wax (hard to do) or “liquid dam”. If the Locator is longer & coming out at an angle then the divergence might create a practical undercut as well, so just pick up 1 at a time. Hope that helps!
I noticed that you didn't have the patient occlude while you were setting the material. Seems rather dangerous not to ascertain that the occlusion is proper before you set the attachments to the intaglio surface..... Is the rest of the intaglio surface of the denture tissue borne? or are the only surfaces touching the intaglio surface at the two locators?
sir,I worked at the dental gourp,in Maryland for years when idid thoes dentures always had lingual bar in lower dentures and I did dup models so doc,s did not have to see it in yours?is that how you likes yours thanks
While you're curing the material, shouldn't you have the patient come lightly into occlusion just to make sure everything is oriented properly? Otherwise, you could be adjusting occlusion a little.
david moheban Zest makes a great resin called Zest Chairside pickup material. It doesn’t require any priming, sets up much more predictably as an automix material, & seems to be stable over time. I’ve had housings not pick up properly or have voids with other materials, but never once with Zest Chairside.
david moheban Also, once you order the proper locators, the jacket housings & inserts are pretty universal. You can order a Processing Kit from Zest which contains 2 x jacket housings with 2 x black, blue, peach, clear inserts. You can also order 10 packs, or individual packs of each of the components. If you’ll do an occasional case, it’s just easier to order the 2 pack Processing Kit. If you’ll do more then order the 10 Pack. If you find that you have a strong preference for 1 color, just order the jacket housings with the black inserts, & then packs of the color you prefer. I feel like so many people have so many different expectations that it’s easiest to order the 10 packs of Processing Kits rather than the bulk of a few pieces
david moheban Not with the right tool. The Locator core tool will pop the black insert right out, & then make sure you have it set up so you can twist the end to extend it. Twist it again to retract it, place the blue insert on the tool & seat it into the housing & hear it click into place. Twist the tool to extend the end & it should automatically free the tool from the insert while leaving the insert in the housing
Thanks for the video! Great refresher on a technique that I don't use every day!
THanks for posting. I perform this procudure similarly. The most important part is making certain that the denture base seats without contact to the locator housings. One think I do differently is that I do not hold the denture in place when the attaching resin has veen placed. I find it best to have the patient close and stay closed during the "pick up" .
+Edward Dergosits Thank you for the great comment. I find that this varies by clinician comfort level, but I have found that most denture patients don't close properly when asked to and they can typically have a cusp kick the denture slightly forward or to the side. Additionally, I find that when I control the pressure on the ridge, I can apply just enough pressure to slightly compress the tissue but not overly compress the tissues. Most of the time clinicians don't want to risk "missing the bite" or "having to adjust the bite after pick-up"... 9/10 I never need to adjust the bite and that 1/10 times it's a tiny adjustment. Experiment yourself, try it next time :)
Edward Dergosits na
hi dr thanks for great presentation- big fan?? quick question...can i use more than one white o ring to prevent undercuts? what does one do if worst case scenario the denture locks?
I need this so bad. I’m from Maryland.
Best simple advice I can give:
1) until you do enough cases to “eyeball” it, after you’ve seated your locators try on a housing with the black insert to confirm the proper height selection
2) be 100% certain that the denture passively seats without interfering with the housings
3) USE YOUR WHITE BLOCK-OUT O-RING
4) Follow the pickup resin directions on when to remove to make sure the denture doesn’t lock on
French Frys
I think the “undercuts” can be from 2 things: 1) the flange on the Locator or 2) angulation between the Locator’s own axis & a plumb line.
Neither would be likely except if you have some extra height to the Locator. Usually the distance between the Locator’s retentive flange & the soft tissue level is about equal to the height of the seated jacket housing, & if you have the o-ring on when you pick up the housing then little-to-no acrylic/resin could flow up on to the Locator shaft since the entire exposed height is covered by the housing & the o-ring. But if you have extra height then the resin can flow around the Locator body & give you an unseating diameter smaller than the Locator’s flange diameter. Even then, unseating would probably bust through this as the locking on resin would usually be thin. It might scare you & the patient, but no big deal. Except, if you have an extra few millimeters & the locked on portion is too thick to bust past. Then you can feel the attachment disengage & the denture will try to unseat, but it will only move a millimeter or 2 & can’t move forward.
This just happened to me for the first time ever: I successfully picked up 3 of 4 upper attachments (4, 6/7, & 13 sites), but my final site (9) Locator was too short to really engage well because the ridge sloped sharply from mesial to distal. I switched from a 3 to 4mm height & the mesial was perfect but the distal had 1.5mm exposed between the housing & tissue. It locked on for sure in that area. The patient wouldn’t give up trying to get it out, & tried for 10 minutes, but I had to go through the occlusal & cut the housing out, then insert my driver through the “access” & unseat the Locator to retrieve the denture. The Locator wouldn’t pull through still; I had to take it out through the new access. It SUCKED. This was a newer R-Tx Locator which has more height & a wider flange as compared to the heritage unit, so it might happen more easily with these, though they are so worth using. If you can see more than a millimeter of gold (or purple for R-Tx) with your housing seated then block this out with rope wax (hard to do) or “liquid dam”.
If the Locator is longer & coming out at an angle then the divergence might create a practical undercut as well, so just pick up 1 at a time. Hope that helps!
French Frys
We’ll see in 1 week🤞! But that’s the plan!
Very nice job. thank you.
thank you for sharing this informative video
seria muy bueno que tradujeran estos videos al español, gracias.
I noticed that you didn't have the patient occlude while you were setting the material. Seems rather dangerous not to ascertain that the occlusion is proper before you set the attachments to the intaglio surface..... Is the rest of the intaglio surface of the denture tissue borne? or are the only surfaces touching the intaglio surface at the two locators?
sir,I worked at the dental gourp,in Maryland for years when idid thoes dentures always had lingual bar in lower dentures and I did dup models so doc,s did not have to see it in yours?is that how you likes yours thanks
What do you use to disinfect or sterilize the Locator RTX before inserting into implant?
Hello Dr. Just a question, those locator abutments can be used with any internal hex connection implant?
hello, how do i know which size of locator attachent to use? thanks!
While you're curing the material, shouldn't you have the patient come lightly into occlusion just to make sure everything is oriented properly? Otherwise, you could be adjusting occlusion a little.
Fantastic!
Also can you please post brand names of everything from the injectable resin to inserts you used?
david moheban
Zest makes a great resin called Zest Chairside pickup material. It doesn’t require any priming, sets up much more predictably as an automix material, & seems to be stable over time. I’ve had housings not pick up properly or have voids with other materials, but never once with Zest Chairside.
david moheban
Also, once you order the proper locators, the jacket housings & inserts are pretty universal. You can order a Processing Kit from Zest which contains 2 x jacket housings with 2 x black, blue, peach, clear inserts. You can also order 10 packs, or individual packs of each of the components. If you’ll do an occasional case, it’s just easier to order the 2 pack Processing Kit. If you’ll do more then order the 10 Pack. If you find that you have a strong preference for 1 color, just order the jacket housings with the black inserts, & then packs of the color you prefer. I feel like so many people have so many different expectations that it’s easiest to order the 10 packs of Processing Kits rather than the bulk of a few pieces
Is it hard to remove the processing inserts and swapping them out for the blue nylon ones?
david moheban
Not with the right tool. The Locator core tool will pop the black insert right out, & then make sure you have it set up so you can twist the end to extend it. Twist it again to retract it, place the blue insert on the tool & seat it into the housing & hear it click into place. Twist the tool to extend the end & it should automatically free the tool from the insert while leaving the insert in the housing
Problem
Oh no! All his muscle attachments have no relief 🤭🤭 that denture is going to cut him. especially on the right