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Special Issues
July/August 2023
Volume 44, Issue 1
Peer-Reviewed

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

David A. Little, DDS

This case illustrates the seamless transition from a removable implant prosthesis to a fixed implant prosthesis. The same legacy LOCATOR® (Zest Dental Solutions, zestdent.com) abutments that were used to retain the removable implant prosthesis were utilized to support and retain the fixed implant prosthesis by simply switching the conventional LOCATOR housings and inserts with LOCATOR FIXED® housings and inserts. A 68-year-old man who was unhappy with his maxillary removable implant prosthesis was referred to the author's practice for the fabrication of a fixed implant-supported prosthesis. Digital scans of the maxillary arch (with scan bodies placed on the LOCATOR abutments), the opposing natural dentition, the occlusion with the existing maxillary implant-supported prosthesis, and all surfaces of the existing maxillary prosthesis were recorded. The data obtained from the scans was electronically sent to the dental laboratory along with detailed instructions for the fabrication of the definitive prosthesis with recesses for the chairside pick-up of the attachment housings. A polymethyl methacrylate (PMMA) prototype was printed for the try-in to verify esthetics, phonetics, tissue contour, design, and occlusion. Following try-in, the definitive zirconia restoration was milled using CAD/CAM technology. The LOCATOR FIXED housings were picked-up chairside. The patient was pleased with his fixed implant-supported prosthesis.

Key Takeaways

A patient's existing LOCATOR abutments can be used to transition from removable to fixed implant prostheses. Because both the clinical steps and laboratory procedures are greatly simplified with the LOCATOR FIXED attachment system, prostheses supported by the system can be fabricated quickly and cost-effectively.

Staged treatment may be provided for patients with financial limitations. The patient can start with a removable prosthesis and then transition to a fixed implant prosthesis in the future.

These fixed restorations are retrievable; they can be easily removed and reseated for hygiene maintenance.


About the Author
David A. Little, DDS
Private Practice, San Antonio, Texas; Fellow, American College of Dentists, International College of Dentists, and American Society of Dental Esthetics

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.

Figure 1

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.

Figure 2

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.

Figure 3

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

Figure 4

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.

Figure 5

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).

Figure 6

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.

Figure 7

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).

Figure 8

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.

Figure 9

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).

Figure 10

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).

Figure 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.

Figure 12

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

Figure 13

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