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Full Arch Implant Prostheses: Part II - Fabrication Procedures

Course Number: 618

Sixth Clinical Appointment

Placement of the Maxillary Implant Supported Overdenture

Healing abutments are removed and the locator abutments (retrieved from the laboratory) are attached to the implants, verified radiographically, and torqued as per the manufacturer’s recommendations. The maxillary implant-supported overdenture is adjusted as needed, finished, polished, and placed in the patient’s mouth. The black processing elements are changed to pink, grey, or blue retentive elements depending on the amount of retention desired.

Placement of the Mandibular “All-on-5” Prosthesis

The healing caps are removed and the mandibular restoration is tried, adjusted, finished, and polished. The occlusion (bilateral balanced) is verified. The screws of the mandibular restoration are tightened and torqued as per the manufacturer's recommended torque values. A second torque may be applied to the screws to counteract the effect of screw relaxation. The screw axis holes are packed with Teflon tape and composite resin. The patient is educated and instructed regarding the hygiene procedures and scheduled for routine maintenance recalls. Patient is advised to brush at least twice daily. The use of floss, interdental cleaners, and water irrigator is also recommended for cleaning the hard to reach areas.46,48

Note: A retrievable fixed implant supported prosthesis can also be fabricated using the LOCATOR FIXED attachment system. The attachment system is less complex due to the elimination of the need for cement, screw-access channels, and prosthetic screws. The LOCATOR FIXED attachment housings may be picked up in the prosthesis via a chairside procedure.

Both the clinical steps and laboratory procedures are greatly simplified with this fixed attachment system, thus, the prostheses supported by the system can be fabricated quickly and in a cost-effective manner.