The following implant supported locator overdenture workflow is applicable for patients with an existing denture to be used to establish their VDO and/or bite and requires a chairside pickup.
- Scan and order - Extraorally scan existing appliance and intraorally scan the bite.
- Seat - Seat the new denture.
To be used for the following clinical scenarios:
√ Converting an Immediate Denture into an Implant Supported Overdenture (using the Immediate Denture as a reference) post-osseointegration of implants.
√ Relining and/or making an exact copy of a current Implant Supported Overdenture.
√ Ensure the patient’s healing caps are covering implant locations or where applicable that the abutments are clean and dry.
√ Make any necessary adjustments to the existing denture to ensure fit and correct VDO.
√ Remove denture and apply light body wash (avoid excess material).
√ Place denture in the patient’s mouth and have the patient move lips and move tongue side to side, and gently push down on the denture. Let the denture sit while impression material sets.
√ Remove and trim off any excess impression material, especially on the occlusal surface.
√ In the case of an overdenture, remove and trim off any excess material from the nylon caps, reseat and verify centric relation.
√ If teeth are significantly worn down, use blue mousse to fill the bite on the occlusal surface to verify that the VDO is correct.
√ Take photos of the patient [highly recommended]:
- A head on photo with the patient smiling naturally (wearing dentures).
- 2 profile pictures (1 from each side) with the patient smiling naturally (wearing dentures). • [If possible] A head on photo of the patient with cheek retractors in place (wearing dentures).
Fabricating a single arch denture Fabricating dual arch dentures
√ 360 scan of Reference Denture
√ Intraoral scan of opposing
√ Register bite via intraoral bite scan
(from molar to midline) with blue mousse
Fabricating Lower Arch Denture - 360 Scan Lower (Extraoral)
√ On the scan page, select “Denture” for the lower jaw.
√ 360 scan of both Reference Dentures
√ Register bite via scan of both arches in occlusion outside of mouth (full arch from molar to molar) with blue mousse
√ Start scanning from the retromolar area and proceed along the buccal to the other side, be sure to roll slightly over the incisal edges of the anterior teeth.
√ Move over to the lingual, and scan across to the other side. Pause and let the software process.
√ Begin on the buccal and scan full across to the other side of the arch.
√ Scan the buccal border with the scanner looking straight down at it and rock the scanner back and forth to capture a portion of both the exterior and interior of the appliance.
√ At the end, scan slightly over to the intaglio surface of the denture. This will be your “reference point.”
√ Pause the scanner and let it process scanning data.
√ Commence on that same “reference” point, and begin scanning the lingual, capturing the entire interior.
√ If while scanning, the scanner loses its spot, pause and begin on the closest reference point.
√ Inspect the scan & trim any unwanted parts (i.e. gloves, excess layers, etc.). Simply scan again if any area is missing.
Fabricating Upper Arch Denture - 360 Scan Lower (Extraoral)
√ Select “Denture.”
√ Start from the occlusal on one side, and move along to the other side. Again, slightly roll over the incisal edges of the anterior teeth.
√ Move over to the lingual, and scan all the way across. Pause and let the scanner process scanning data.
√ Starting at the midline, capture the entire palate in a side to side motion, then in one motion at the last molar, move over the occlusal to the buccal and scan across to the other side.
√ Very intentionally scan the buccal border with the scanner looking straight down at it, rock the scanner back and forth to capture a portion of both the exterior and interior of the appliance.
√ Before pausing one more time, move the scanner over to the intaglio surface to capture a “reference point.” Pause and let the scanner process scanning data.
√ Resume at the reference point and scan the intaglio, side by side and then along the ridges.
√ Similar to before, trim any excess material and re-scan any missing areas.
Register Bite - Scan Bite (Intraoral)
√ Place denture(s) back into the patient’s mouth, and scan the bite in the patient’s mouth from molar to midline (ignore the confirmation sound). If blue mousse is needed for worn down denture teeth, scan the bite with the blue mousse in place.
Before Chairside Pickup
√ Remove implant healing caps and place locator abutments (where applicable); Verify abutments are above the tissue
√ Apply blockout spacers to abutments
√ Seat denture housings with black nylons onto each abutment to confirm passive fit of the prosthesis over the housing
√ Verify reliefs by test fitting denture (using pip paste and a bur, reduce material if needed)
√ Check the occlusion against the opposing arch
√ Dry and clean denture thoroughly before adding material for chairside pickup to ensure material bonds properly
√ Place chairside auto-polymerizing material inside denture reliefs
√ Guide denture in mouth, being sure to seat the denture all the way down. Have patient close into bite
√ Remove once auto-polymerization is complete (follow manufacturer’s instructions)
√ If there are voids around the abutments, place additional material carefully so as not to get any inside the abutments
√ Using a carbide bur, clean up any excess material on the intaglio and/or lingual areas
√ Polish as needed for a smooth finish
√ Drill lingual exhaust vents for excess material connecting into relief holes
√ When placing auto-polymerizing material inside denture reliefs, set a timer or put some on your glove to test for polymerization