Implant Laboratory Procedures

Study Notes

Mandibular two-implant overdentures improve denture retention, stability, and patient satisfaction, especially in cases of significant mandibular bone resorption.
Patients often present with unsatisfactory existing dentures with worsened fit, retention, and comfort due to bone resorption.
Key diagnoses include edentulous maxilla or mandible, severe bone resorption in the mandible, and ill-fitting dentures.
Clinical exam reveals significant mandibular ridge resorption.
Radiographic imaging (e.g., panoramic radiographs or CT scans) assesses available bone for implant placement.
A treatment plan considers two implants for overdenture retention, or multiple implants for a fixed prosthesis.

Diagnostic Casts: Well-extended alginate impressions create diagnostic casts accurately representing the patient's anatomy for surgical and prosthetic planning.
Custom Impression Trays: Custom trays precisely capture implant sites and adjacent tissue impressions, ensuring accurate prosthesis fit.
Implant Placement: Two implants are placed in the anterior mandible between the mental foramina, guided by patient anatomy and bone structure.
Healing and Osseointegration: A healing period (e.g., 12 weeks) allows for implant osseointegration (bone bonding). Healing abutments are positioned to shape the soft tissue surrounding the implants.
Definitive Intraoral Impression: After osseointegration, a definitive impression is taken utilizing Locator abutments (specifically for overdenture retention). These abutments provide resilience and ease of use.
Master Cast and Occlusion Records: A master cast is produced from the definitive impression; record bases and occlusion rims are constructed to determine the future prosthesis's vertical dimension and alignment.
Wax Denture Try-In: A wax denture is created and tested in the patient's mouth to check fit, aesthetics, and function.
Final Denture Processing and Insertion: The final overdenture is processed, adjusted, and securely attached to the Locator abutments.

Locator attachments are commonly used because of their durability and ease of maintenance. They provide a stable connection between the denture and implants, enabling comfortable speaking, eating, and smiling.
Regular follow-up appointments monitor implant/prosthesis health. Attachments might require replacement over time due to wear; however, implant-supported overdentures are generally predictable and long-lasting.

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