Seamless Transition From a Removable to a LOCATOR FIXED® Zirconia Solution for the Maxilla

Fig 1. The maxillary arch had five existing implants with LOCATOR abutments that were used to support and retain a removable implant prosthesis. The number and position of the implants, esthetics, occlusal vertical dimension, and occlusion established with the existing prosthesis were acceptable.

Fig 2. LOCATOR FIXED housings with processing inserts were snapped over the existing LOCATOR abutments and an intraoral scan of the maxillary arch was taken. Scans of the opposing dentition, the bite with the existing prosthesis, and all surfaces of the existing maxillary prosthesis were then recorded.

Fig 3. The data from the scans was digitally transferred to the laboratory (Absolute Dental Services) along with detailed instructions for creating a digital wax-up and designing the definitive zirconia prosthesis. Retentive recesses were planned in the prosthesis to accomplish the chairside pick-up of the LOCATOR FIXED housings.

Fig 4. A prototype PMMA prosthesis was printed for the try-in procedure.

Fig 5. The CAD/CAM-fabricated, milled zirconia prosthesis had retentive recesses incorporated to enable the chairside pick-up of the LOCATOR FIXED housings. The contour, surface texture, and anatomy were to be finalized post-milling.

Fig 6. Liquid ceramic (Miyo®) was used to replicate the form, contour, and color of the gingival tissues and natural teeth, creating an esthetically pleasing definitive restoration (Signature A.R.T., Absolute Dental Services).

Fig 7. Blockout spacers were used to block the undercuts associated with the existing LOCATOR abutments. The LOCATOR FIXED housings with processing inserts were placed on the LOCATOR abutments.

Fig 8. The definitive prosthesis was placed over the abutments and housings, and its fit and occlusion were verified. An intraoral direct pick-up of the LOCATOR FIXED housing within the recesses was accomplished using Chairside® Attachment Processing Material (Zest Dental Solutions).

Fig 9. The LOCATOR FIXED housings were picked up in the prosthesis. The black processing inserts were removed, excess resin was eliminated, and the prosthesis was adjusted, finished, and polished as needed.

Fig 10 and Fig 11. Appropriate LOCATOR FIXED inserts were placed into the housings with the Enhanced Core Tool (Zest Dental Solutions) (Fig 10), which was also used to press the inserts down firmly until they snapped into place (Fig 11).

Fig 10 and Fig 11. Appropriate LOCATOR FIXED inserts were placed into the housings with the Enhanced Core Tool (Zest Dental Solutions) (Fig 10), which was also used to press the inserts down firmly until they snapped into place (Fig 11).

Fig 12. The prosthesis with the appropriate fixed inserts was placed over the abutments and firmly seated around the arch. The LOCATOR FIXED insertion and removal tool was used as per the manufacturer’s recommendations.

Fig 13. Definitive LOCATOR FIXED zirconia prosthesis placed in the mouth.