Now that we’ve learned how to treatment plan an implant overdenture and also how to insert a Locator attachment, let’s look at how to increase the retention force. When a patient’s implant overdenture is well-supported by tissue and the attachment apparatus is functioning properly, there still may be a need for additional retention. The process for swapping out the old attachment and swapping in a stronger one couldn’t be simpler. Expect a 10 minute appointment.
In order to increase retention we must use the Locator Tool. Here it is:
The head is unscrewed a few twists for coring out the old attachment (bottom left). It can then be screwed down fully to pop off the attachment (bottom right).
For now, just know that the head can be unscrewed or screwed down. When it’s screwed down, a metal pin is firmly exposed. You’ll see why in a moment…
Removing an old attachment from the implant overdenture.
(1) Out with the old… In this case the patient is still wearing the black processing attachments. Remember that these are the ones that come in the metal housing for use while picking up the apparatus. They are the lowest strength attachment but they can actually work pretty well for some patients with low chewing forces. I like to leave them in for a few weeks while the patient gets accustomed to inserting and removing the prosthesis.
Well now we want to pop that out. Loosen the head of the Locator tool a few twists and insert it into the attachment. Scrape the side and the cutting edge of the tool will cleanly pull out the attachment. The metal housing will still be in the overdenture awaiting a brand new attachment. Tighten down the head of the Locator tool and the old attachment will pop off.
This is pretty straight forward, folks. Not much to say here.
(2) … in with the new. Now we can completely unscrew the head of the tool to find a smooth part without any cutting edges. Take the male attachment of the next level of strength, which is blue in this case, and apply it to the tool. Place the overdenture on a hard surface like a counter top and just push it in. There’s no special technique here; just snap it in.
That’s basically everything you need to know to get started on your Locator cases. In Locator Attachments for Implant Overdentures: Part 3 I’ll review a technique for picking up the attachments that’s a lot cleaner than just smearing some hard acrylic all over the place.