Overview: This guide outlines the clinical workflow for implant-supported locator overdentures that involve tooth extractions and the use of a surgical guide.
Patient Selection Criteria
The doctor should use this workflow if the patient meets the following requirements:
The patient requires full extraction of dentition on one or both arches.
A surgical guide is necessary for the placement of the dental implants.
The treatment plan includes an immediate load of an implant-supported overdenture after surgery.
Note: If the treatment plan does not require extractions or surgery, use the Implant Supported Overdenture Without Extractions & Surgery Workflow article instead.
Pre-Surgery Procedures
The initial phase focuses on capturing necessary scans and submitting case information via the Dandy Portal.
Appointment 1 Procedures
The doctor must determine if the patient can establish a bite before proceeding with specific scan workflows.
When the patient cannot establish a bite:
Follow the Overdenture Without Exactions Workflow to use a wax rim for new denture fabrication.
Follow the Fully Edentulous CBCT Workflow.
When the patient can establish a bite with existing dentition:
Follow the Immediate Denture Workflow.
Scan the upper arch, lower arch, and the bite.
Perform a CBCT Scan.
Submit all scans, CBCT data, and implant case information in the Dandy Portal.
When the patient can establish a bite through a current denture:
Follow the Complete Denture from Existing Workflow.
Scan the upper arch, lower arch, and the bite.
Follow the Fully Edentulous CBCT Workflow.
Submit all scans, CBCT data, and implant case information in the Dandy Portal.
Implant Treatment Planning
Dandy provides a surgical plan for the doctor to review and approve via a live review or video session.
Dandy fabricates the immediate denture after the plan is approved.
Surgical Procedures
The second appointment involves the physical placement of implants and the initial seating of the prosthesis.
Appointment 2 Steps
Place the dental implants according to the surgical plan.
Cut reliefs for the healing abutments.
Seat the immediate denture.
Post Osseointegration Procedures
The final phase involves the chairside pickup of the denture housings after the implants have successfully integrated with the bone.
Appointment 3 Steps
Actions Before Chairside Pickup:
Remove the implant healing caps and place the locator abutments.
Verify that the locator abutments sit above the soft tissue.
Apply blockout spacers to the locator abutments.
Seat the denture housings with black nylons onto each abutment to confirm a passive fit of the overdenture.
Test-fit the overdenture using PIP paste and a bur to verify the relief; reduce material if necessary.
Check the occlusion against the opposing arch.
Dry and clean the overdenture thoroughly to ensure the pickup material bonds correctly.
Chairside Pickup Steps:
Place the auto-polymerizing pickup material inside the overdenture reliefs.
Guide the overdenture into the patient's mouth and ensure it is seated completely.
Instruct the patient to close into their natural bite.
Remove the overdenture once auto-polymerization is finished according to the manufacturer’s instructions.
Fill any voids around the abutments with additional material, ensuring no material enters the inside of the abutments.
Use a carbide bur to remove excess material on the intaglio or lingual surfaces.
Polish the overdenture for a smooth finish.
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