1. Restorative Overview
Replace Select™
1

2. Nobel Replace Select™
Restorative Overview

3. Life changing experience !
3

4. The NobelReplace Implant System - Goals
4

5. The NobelReplace Implant System - Goals
HOW DO WE GET THERE?
5

6. Key to successful Implant restoration depends
1)Accurate Diagnosis and treatment planning.

7. Key to successful Implant restoration depends
• 2)Execution of required Technical procedures.
7

8. Key to successful Implant restoration depends
• 3)Meeting or exceeding the patient’s realistic expectations
4)Establishing good patient doctor communication
resulting in patient confidence
8

9. Nobel Replace
Implant System
9

10. Nobel Replace Implant System - Color Coding
Safety
Color Coding ensures safety by guaranteeing accurate device/material selection throughout the surgical and
restorative processes. Platform 3.5, 4.3, 5.0, 6.0mm
Predictability
Any NobelReplace™ implant in any patient can be very quickly identified by visual inspection eliminating need
for a radiographic analysis or platform measurement etc.
Organizational Benefits
Universal color coding ensures inventory organization and stocking efficiency. It is virtually impossible to open
the wrong package and inventory analysis is simple.
10

11. The Implant System –
Tri-channel Internal Connection
Tactile and Easy to Use
Accurate prosthetic positioning
Internal connection with three channels that provide accurate and
repeatable indexing of abutment to implant. Positive lock is
noticeable when seating an abutment and the abutment is situated
correctly in the connection. Once locked, the internal connection
resists rotation.
Secure abutment placement
Three interlocking channels guide correct abutment placement also
in sites with poor visibility and limited inter-occlusal space may
compromise the clinician’s ability to manipulate the abutment.
Prosthetic versatility
Tri-channel connections supports all forms of restorative solutions
11

12. The Implant System - Parts
12

13. The Implant System - Parts
Abutment: Anything that Is attached to the implant and remains
in the mouth between appointments.
Healing Abutments:
1) Come in various heights.
2) Placed by the periodontist.
13

14. The Implant System - Parts
Abutments:
Standard a) “Off the rack” and is never modified
b) Abutment placed before the impression – abutment
level impression
c) Impression coping picks up Standard Abutment shape
and position in the arch
d) Abutment Replica duplicates the abutment exactly
Custom a) Abutment prepped at the lab (sometimes in the
mouth)
b) Abutment placed and torqued at the time crown is
delivered
c) Can be one-piece abutment/crown (UCLA abutment)
d) Impression at implant level
e) Needed to mimic the contours of the soft tissue
f) Must have soft tissue duplicated in model
14

15. UCLA Abutments:
Angled Abutment Zirconium Abutment
15

16. The Implant System - Parts
Screws:
Abutment a) One size for yellow, blue and green implants
b) Different size for Narrow Platform (pink) implant
c) Torque to 35 Ncm
Prosthetic a) One size only
b) Torque to 15 Ncm only
16

17. The Implant System - Parts
1) Machine Screwdrivers
The Machine Screwdriver is
inserted into the handle. There
are two screwdrivers of different
shaft lengths in the Restorative
Tool Kit.
Unigrip Screwdrivers Multi-unit Hex Driver Locator Abutment
Driver
17

18. The Implant System - Parts
Tools:
1) Manual Screwdriver
2) Manual Torque Wrench
Push with finger or
thumb here until the
bar bends to desired
torque
Put index finger
here to stabilize
18
wrench

19. The Implant System - Parts
Manual Torque Wrench
The Torque Wrench directional pin can be removed by
unscrewing the pin cap. Your staff will take the pin out
when sterilizing the Torque Wrench between patients.
It is critical to ensure that the pin cap is tightened
completely before use. If not, the ratchet will click, but
will not tighten the screw.
19

20. The Implant System - Parts
Tissue Punch
Put index finger here
to stabilize wrench
The Tissue Punch is used to remove any tags of
tissue that have grown over the Implant and prevents
complete seating of any abutment.
20

21. The Implant System - Parts
Impression Copings:
Closed Tray a) Plastic snap-on, abutment level
b) Plastic snap-on, implant level (do not use)
c) Metal screw-retained, abutment level
d) Metal screw-retained, implant level
Open Tray a) Metal only
b) Screw retained
21

22. The Implant System - Parts
Closed Tray Impressions:
Closed-Tray Impression Copings are indicated for:
•single implant cases
•multiple implant cases when the implants are parallel so that the impression
can be removed from the mouth without tearing the impression
Some Closed-Tray Impression Copings stay in the mouth when the impression is
removed. They must be loosened from the implants after the impression is taken and
they must be reinserted into the impression before pouring the stone.
22

23. The Implant System - Parts
Open Tray Impressions:
Open-Tray Impression Copings should be used when the
implant(s) are not parallel to each other or the natural teeth and it
is unlikely that the impression can be removed from the mouth
without tearing the impression material.
Open-Tray Impression Copings are
attached to the implants by means
of a long abutment screw.
Open-Tray Impression Copings will stay in the impression when it
is removed. So they must be loosened from the implants after the
impression material has set.
23

24. The Implant System - Parts
Open Tray Impressions:
To loosen the screw and free the impression coping from the implant, the screw
of the impression coping must extend through the impression tray so that it can
be loosened. The impression tray must be modified to allow access to the
screw.
24

25. The Implant System - Parts
Open Tray Impressions:
Be sure to locate the screw before the impression material sets. Once set,
loosen the screw, then remove the impression. Turn the screw
counterclockwise to loosen it.
25

26. The Implant System - Parts
Implant Replica: A replica of the Implant used to reproduce 1) the exact location
of the Implant in the prosthetic model, and 2) the surface connection between the
Implant and the restoration.
Abutment Replicas
Implant Replicas
26

27. The Implant System - Parts
Temporaries:
Healing Cap a) Not tooth shaped
b) Abutment level
Custom a) Cement or screw retained
b) Abutment or implant level
Engaging: Prevents rotation of the restoration. For single units only.
Non-engaging: For multiple units that are splinted.
27

28. The Implant System - Parts
Overdentures:
Locator
Clip/ERA
28

29. The Implant System - Parts
Maintenance:
Implants can only be cleaned with implant-specific cleaning instruments that can clean
plaque and tartar, but will not scratch the surface. Tartar does not penetrate the implant
surface like it does on natural teeth, so it does not require the same planing action to
clean the tartar.
Do not use metal instruments around implants to avoid scratching the surface. Scratched
surfaces attract more bacteria that could lead to tissue inflammation around the implant.
Although a metal perio probe can be used to measure the tissue height, it should NEVER
be used to probe the “sulcus.” The tissue does not attach to an implant as it does to a
tooth, and probing will disrupt the tissue junction.
29

30. The Implant System - Fit
FIT OF ANY PART TO THE IMPLANT IS CRITICAL !
To verify FIT, a verification x-ray is taken every time any
abutment, impression coping, or temporary abutment is
attached directly to the implant.
30

31. The Implant System - Fit
FIT OF ANY PART TO THE IMPLANT IS CRITICAL !
How to identify inadequate fit:
31

32. Exercise # 1
Posterior Single Units – Snappy Abutment™
Hot Clinical Tip !
DO NOT ANESTHETIZE WHEN SEATING ABUTMENTS
OR COPINGS ONTO THE IMPLANT. Patients should feel
no discomfort when placing and removing implant parts. If
there is discomfort, check for the cause – something is
wrong. Most often, discomfort from placing parts directly
onto the Implant is due to small areas where the soft tissue
has grown or collapsed over the Implant margins and that
tissue is being pinched between the parts. When this is the
case, anesthetize and then use a tissue punch to clear
away the offending soft tissue.
32

33. The Implant System - Fit
What a difference X-ray angulation can make !
33

34. The Implant System - Fit
FOR MULTIPLE UNITS CONNECTED BY A BAR OR
SPLINTED, PASSIVE FIT IS CRITICAL !!
34

35. The Implant System - Fit
FOR MULTIPLE UNITS CONNECTED BY A BAR OR
SPLINTED, PASSIVE FIT IS CRITICAL !!
Implants will never accommodate to even a slight framework misfit !!
For that reason ALMOST ALL multiple unit cases
will require indexing and soldering of the
connectors, including bar connectors. It is best to
request all abutments/crowns be sent as individual
pieces, rather than try to see if a one piece prosthetic
will fit.
Index in the mouth using a product like Zap-It. Send
back to the lab for soldering. Try-in after soldering
and verify with an X-ray. It is sometimes necessary
to index and solder each connector one at a time.
But there is no substitute for passive fit.
35

36. Soldering Technique

37. Hands on exercises
37

38. Prosthetic Kit
38

39. Exercise # 1 Posterior Single
Units – Snappy Abutment™
39

40. Exercise # 1
Posterior Single Units – Snappy Abutment™
Snappy Abutment:
•Standard abutment
• Snap-fit connection
• Ideal for posterior single implant
restorations
• Short profile - used without modification
•Cemented crowns only.
40

41. Exercise # 1
Posterior Single Units – Snappy Abutment™
The Snappy Abutment comes in two different collar heights
and two prepared abutment heights.
• 4.0mm (regular) 5.5mm (tall)
Collar Collar
0.5mm 0.5mm
0.75mm, NP Only 0.75mm, NP Only
1.5mm 1.5mm
41

42. Exercise # 1
Posterior Single Units – Snappy Abutment™
Clinical measurements
42

43. 43

44. Exercise # 1
Posterior Single Units – Snappy Abutment™
Hot Clinical Tip !!
DISINFECT THE IMPLANT AND THE IMPLANT PARTS.
In many cases, when you remove implant parts from the
mouth, there will be a bad odor from bacteria that get into
and around the connections. Always keep chlorhexadine
gluconate 4.0% (Peridex) on hand and use a syringe to
flush the implant, screw openings and soft tissues. It is a
good idea to place all parts in a small cup of chlorhexadine
as they are taken from the mouth.
44

45. Exercise # 1
Posterior Single Units – Snappy Abutment™
1) Seat the Snappy Abutment
onto tooth # 13 of the model.
2) Ensure that it is seated all
the way down.
3) Clinically, an X-ray would be
taken AND SAVED to verify fit.
45

46. Exercise # 1
Posterior Single Units – Snappy Abutment™
4) Clinically, the abutment would be torqued to 35 Ncm.
Torque to 15 Ncm on the model.
46

47. Snappy™ Abutment: Quick Placement Review
Remove Healing Abutment Place Snappy Abutment VERIFY FIT WITH AN X-RAY
Torque 35 Ncm Looking Good !
47

48. Exercise # 1
Posterior Single Units – Snappy Abutment™
Orientation
When the implant is placed one of the Internal Trichannel
Connector receptors should be oriented to the buccal.
As a result, one of the grooves should also be oriented to
the buccal. The Snappy Impression Coping has an arrow
to show the location of the corresponding buccal groove.
48

49. Exercise # 1
Posterior Single Units – Snappy Abutment™
Place the Snappy Impression Coping.
Listen/feel for the SNAP.
49

50. Exercise # 1
Posterior Single Units – Snappy Abutment™
Take the impression with a stock tray (no modification) and PVS or a
similar impression material. The Snappy Impression Coping will come out
in the impression.
50

51. Exercise # 1
Posterior Single Units – Snappy Abutment™
Place Snappy Implant Replica into the Snappy Impression Coping.
Clinically, after disinfection of the impression, the case would next be sent to the lab
for pouring of the soft-tissue model and fabrication of the crown.
51

52. Exercise # 1
Posterior Single Units – Snappy Abutment™
Temporizing the Snappy Abutment can
be done simply by using Snappy Healing
Cap to prevent soft tissue collapse.
Or a temporary crown can be made
using the Snappy Plastic/Temp Coping
(engaging or non-engaging). Acrylic is
added to the Plastic/Temp Coping and it
is shaped and polished like any other
custom acrylic temporary.
52

53. Exercise # 1
Posterior Single Units – Snappy Abutment™
Hot Clinical Tip !!!
COVER AND PROTECT THE ABUTMENT or
PROSTHETIC SCREW. Before cementing a temporary or
a final crown, place a small piece of cotton and an easy-to-
remove sealing material over the screw that connects the
abutment to the implant. Good materials to use internally: a
small dab of light-body impression material or gutta percha.
For the openings in screw-retained crowns, place cotton
and cover with composite.
53

54. Exercise # 2
Anterior Single Units – Closed-Tray Impression
54

55. Exercise # 2
Anterior Single Units – Closed-Tray Impression
55

56. 56

57. Exercise # 2
Anterior Single Units – Closed-Tray Impression
1) Place Closed-Tray Impression Coping
on tooth # 8 in the model.
2) Clinically, an X-ray would be taken
AND SAVED to verify fit.
3) Hand tighten with Unigrip
Screwdriver.
4) Fill the Unigrip Screwdriver hole in the
top of the Impression Coping screw with
some wax. If you don‘t, it may be
difficult to seat the impression coping
back into the impression with the
necessary precision.
57

58. Exercise # 2
Anterior Single Units – Closed-Tray Impression
5) Take impression using PVS or similar material in a stock tray.
6) Remove impression when set. Closed-Tray Impression Coping will stay ON THE
IMPLANT. The impression will have a negative mold of the impression coping.
58

59. Exercise # 2
Anterior Single Units – Closed-Tray Impression
7) Remove Closed-Tray Impression Coping with hand screwdriver (turn
counterclockwise).
8) Attach Implant Replica to Closed-Tray Impression Coping using hand
screwdriver.
59

60. Exercise # 2
Anterior Single Units – Closed-Tray Impression
9) Seat Closed-Tray Impression Coping back into impression making sure that the
coping is fully seated with all indexing lined up correctly.
10) Clinically, after disinfection of the impression, the case would next be sent to the
lab for pouring of the soft-tissue model and fabrication of the abutment and crown.
60

61. Exercise # 2
Anterior Single Units – Provisionals
11a) Place an Implant-level Temporary Abutment
(cementable). Hand tighten only.
As with all parts that connect to the Implant, a
verification of fit X-ray is necessary.
Clinically, you may simply replace the Healing
Abutment. Remember to take an X-ray to verify that
the Healing Abutment if fully seated.
The Cementable Temporary Abutment
is seated on the implant and hand
tightened. Acrylic is added to the
“sleeve” to create a custom temporary.
The temporary is cemented to the
Temporary Abutment with just a tiny
amount of temporary cement (it might
be a good idea to add some vaseline to
the temporary cement).
61

62. Exercise # 2
Anterior Single Units – Provisionals
11c) Essix Appliance temporary.
An Essix Appliance temporary can be used over the healing abutment for
short term temporization. The trays are easily made using the same
equipment used for suck-down bleaching trays, only the tray material is a
firm plastic, not rubbery like the bleaching trays. A denture tooth is placed
on the model to replace the missing tooth and acrylic or the denture tooth
can be used to build a replacement inside the appliance.
62

63. Exercise # 2
Anterior Single Units – Deliver Custom Abutment
12) Seat the Custom Abutment and finger tighten.
13) Clinically, an X-ray would be taken AND
SAVED to verify fit.
14) Clinically, the abutment would be torqued to
35 Ncm. Torque to 15 Ncm on the model.
15) Clinically, the crown would be tried-in,
adjusted and delivered (with temporary cement
only – so the crown can be retrieved at a later
time, if necessary). Remember to seal the
opening for the abutment screw with cotton and
gutta percha or impression material.
63

64. Exercise # 2
Anterior Single Units – Deliver Crown
64

65. Exercise # 2
Anterior Single Units – Deliver Crown
CONCLUSIONS: Some types of cement commonly used for the
cementation of implant-supported prostheses have poor radiodensity
and may not be detectable following radiographic examination.
Most radiopacity
TempBond Original Kerr Mfg
TempBond NE Kerr Mfg
Fleck’s Mizzy, Inc
Dycal Dentsply Intl
RelyX Luting 3M ESPE
RelyX Unicem 3M ESPE
Improv Alvelogro
Premier Implant Cement Premier Products Co
Least radiopacity
from Wadhwani C, Hess T, Faber T, Piñeyro A, Chen CS.
65

66. Exercise # 2
Anterior Single Units – Deliver Crown
One piece screw-retained crown advantages
• no concern with cement removal
• cost-effective without use of gold
• if tissue recession over time, no visible margin
• easily retrievable to modify without destroying crown
Cement-retained crowns:
MPI & SBI scores: worse over time
Screw-retained restorations:
MPI & SBI scores improved over time
(Modified Plaque Index, Sulcus Bleeding Index)
66

67. Exercise # 3
Posterior Multiple Units – Open-Tray Impression
67

68. Posterior Multiple Units
Hot Clinical Tip !!!
KEEP THE IMPLANT COVERED. In many cases,
when you remove the healing abutments from the
mouth, the tissue can collapse into the space that
was vacated. To prevent this, it is best to remove
one healing abutment at a time and place the Multi-
unit Abutment as quickly as possible. Remember to
always rinse with chlorhexadine gluconate 4.0%, and,
after placing the abutment, take a verification-of-fit X-
ray.
68

69. Posterior Multiple Units – Open-Tray Impression
1) Using the yellow plastic carrier, place
the Multi-unit Abutment with the Multi-
unit Abutment Screw on tooth # 4. Hand
tighten with the Multi-unit hex driver.
2) Clinically, an X-ray would be taken
AND SAVED to verify fit.
3) Clinically, the abutment would be
torqued to 35 Ncm. Torque to 15 Ncm
on the model.
69

70. Posterior Multiple Units – Open-Tray Impression
4) Place the Multi-unit Open-tray
Impression Coping on the Multi-unit
Abutment. Place the Multi-unit
Impression Coping Guide Pin.
5) Hand tighten only.
6) No X-ray is necessary - the
impression coping is not attached to the
implant.
70

71. Posterior Multiple Units – Open-Tray Impression
7) Prepare impression tray by cutting
away an area to allow the Impression
Coping Guide Pin to exit the impression
tray when it is fully seated in the mouth.
8) Take impression with PVS or similar
impression material.
9) Unscrew the Guide Pin completely to
allow the Impression Coping to come
apart from the Implant. Remove the
impression (the Impression Coping will
remain in the impression).
71

73. Exercise # 4
Overdenture – Two Locator Attachments
73

74. Exercise # 4
Overdenture – Two Locator Attachments
Resilient tissue-supported overdenture
•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 Attachment
74

75. Exercise # 4
Overdenture – Two Locator Attachments
Torque to 35 Ncm clinically (15 Ncm on the model)
75

76. Exercise # 4
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
• Abutment level impression with impression coping
• Laboratory or chairside processing of attachments
76

77. Exercise # 4
Overdenture – Two Locator Attachments
The Locator Abutment is selected to be 1.5mm above the tissue height.
Once the abutment is seated, an x-ray must be taken to verify fit.
Tissue Depth
77

78. Exercise # 4
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.
• Place the metal housings with the black
processing males onto the Locator
Abutments.
78

79. Exercise # 4
Overdenture – Two Locator Attachments
• Use an appropriate method to mark the
locations of the Locator Abutments on the
existing denture.
• Hollow out the existing denture base in the
areas of the Locator Denture Caps.
• Most dentists place a hole in the lingual area
to allow excess acrylic to escape and the
denture to seat fully.
79

80. Exercise # 4
Overdenture – Two Locator Attachments
• Fill the receptor sites with
prosthetic resin (light cure or self-
curing resin).
• Apply suitable bonding agent onto
Locator metal housings. Lingual
connecting holes may be used to
anchor the metal housings in the
denture.
• Seat denture and confirm proper
occlusion (tap, tap, bite lightly).
• Cure resin in light occlusion without
compression of the soft tissue.
• 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.
80

81. Exercise # 4
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 Locator Core Tool.
• 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
81

82. Exercise # 4
Overdenture – Two Locator Attachments
Male Seating Tool Abutment Driver
•Separate the Male Removal Tool •The gold-colored end of the
section from the Locator Core Tool Locator Core Tool is used for
and use the Male Seating Tool end screwing and unscrewing the
to place a new male into the empty Locator Abutments to and
titanium metal housing. 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
82

83. Exercise # 4
Overdenture – Two Locator Attachments
To remove the male from the instrument:
• Screw the tip clockwise completely onto the middle
section. This activates the loosening pin inside the
tip, which releases the male.
83

84. Exercise # 4
Overdenture – Two Locator Attachments
Male Removal Tool
To remove a Locator male from the titanium metal housing:
• 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 housing.
84

85. Exercise # 4
Overdenture – Two Locator Attachments
Locator Male Processing Package
(REF08519-2)
85

86. Exercise # 4
Overdenture – Two Locator Attachments
Locator® Extended Range Male Processing Package
(8540-2)
86

87. Exercise # 4
Overdenture – Two Locator Attachments
Clinical case
• Seat two Locator abutments
Clinical case courtesy of J. Bain, DDS
87

88. Exercise # 4
Overdenture – Two Locator Attachments
Hand tighten with the Abutment Driver and
Take a verification x-ray.
Clinical case courtesy of J. Bain, DDS
88

89. Exercise # 4
Overdenture – Two Locator Attachments
Torque to 35 Ncm clinically (15 Ncm on the model)
89

90. Exercise # 4
Overdenture – Two Locator Attachments
Photo courtesy of Per-Olof Karlsson, Sweden Photo courtesy of J. Bain, DDS
Create space in the denture base for the metal housing
90

91. Exercise # 4
Overdenture – Two Locator Attachments
Place white block-out spacer ring over abutment (may
need more than one per abutment)
Clinical case courtesy of J. Bain, DDS
91

92. Exercise # 4
Overdenture – Two Locator Attachments
Inspect for show-through – Ensure clearance!
Photos courtesy of J. Bain, DDS
92

93. Exercise # 4
Overdenture – Two Locator Attachments
Clean receptor sites with alcohol Seat metal housing
Photos courtesy of J. Bain, DDS
93

94. Exercise # 4
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
94

95. Exercise # 4
Overdenture – Two Locator Attachments
Seat denture and confirm proper occlusion (tap, tap, bite lightly)
Photos courtesy of J. Bain, DDS
95

96. Exercise # 4
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
96

97. Exercise # 4
Overdenture – Two Locator Attachments
Check—
• Occlusion
• Patient’s manual dexterity
Photo courtesy of J. Bain, DDS
97

98. Exercise # 4
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
• Abutment level impression with impression coping
• Laboratory or chairside processing of attachments
98

99. Exercise # 4
Overdenture – Two Locator Attachments
• Place a white block-out spacer ring
on each abutment to block out the
area surrounding the abutment.
• Place the metal housings with the
black processing males onto the
Locator Abutments.
• Take an impression to pick up the
black processing males and the
metal housing for laboratory
placement of the housing.
• Better yet, complete the reline and
add the housings as shown in the
last section.
99

100. Exercise # 4
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
• Abutment level impression with impression coping
• Laboratory or chairside processing of attachments
100

101. Exercise # 4
Overdenture – Two Locator Attachments
Locator Impression Coping
101

102. Exercise # 4
Overdenture – Two Locator Attachments
Place white block-out spacer rings, and then place Locator impression
copings.
Clinical case courtesy of Allen L. Schneider, DDS
102

103. Exercise # 4
Overdenture – Two Locator Attachments
Final impression with full Abutment replicas in place –
extensions and border ready to pour model. Follow
molding! standard denture steps.
Photos courtesy of Allen L. Schneider, DDS
103

104. Exercise # 4
Overdenture – Two Locator Attachments
Clinical case courtesy of Allen L. Schneider, DDS
104

105. Exercise # 5
Overdenture – Making a Stent
105

106. Exercise # 5
Overdenture – Making a Stent
fore implant placement in the fully edentulous patient,
s required to have defined the proper tooth position.
is can be accomplished by:
An existing denture
A new denture
A wax try-in that goes unprocessed
106

107. Exercise # 5
Overdenture – Making a Stent
107

108. Exercise # 5
Overdenture – Making a Stent
108

109. Exercise # 5
Overdenture – Making a Stent
109

110. ck
ba
hing
eryt
ev
ut
ep
leas
P
110

111. 111