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I have a patient with two mandibular implants placed at approximately 20 degrees divergence. The original plan was for a 2-implant LOCATOR overdenture, but I'm concerned about the angulation. Should I use the LOCATOR R-Tx with its improved pivot technology, or should I consider angled abutments? What has been your experience with divergent implants and LOCATOR attachments? The patient is 72 years old, good bone density, and currently wearing a complete mandibular denture with poor retention. Both implants are well-integrated at 3 months post-placement.
I'm considering switching from traditional heat-cured PMMA to Ivotion for my implant overdenture cases. Has anyone had long-term experience (3+ years) with Ivotion overdentures on LOCATOR attachments? Specifically interested in: - Fracture resistance compared to traditional acrylic - Color stability over time - Patient satisfaction differences - Any issues with the LOCATOR housing integration My lab is pushing me toward Ivotion but I want real clinical feedback before making the switch.
I've been using the alternating 600mg ibuprofen / 1,000mg acetaminophen protocol for my implant patients and most do well. However, I had a patient last week who placed 4 implants for an overdenture and reported significant pain at 48 hours despite following the protocol. Questions: 1. Should I be pre-medicating differently for multi-implant cases? 2. When do you consider adding Exparel (bupivacaine liposome)? 3. Any experience with StellaLife products as adjunctive therapy? 4. At what point do you prescribe narcotics?
I'm trying to establish clear criteria for when to recommend LOCATOR F-Tx fixed versus a traditional screw-retained full-arch prosthesis (like All-on-4). What clinical and financial factors should drive this decision? I understand F-Tx is newer and potentially more cost-effective, but I want to make sure I'm not compromising outcomes for my patients.
I have a 58-year-old patient with Type 2 diabetes (HbA1c of 9.2%) who is desperate for implants. She's been wearing a complete mandibular denture for 8 years and has significant ridge resorption. She's been referred to her PCP multiple times but her diabetes management hasn't improved. What is the current evidence on implant success in poorly controlled diabetics? At what HbA1c level do you draw the line? Any special protocols?
I'm struggling with case acceptance for full-arch cases. My treatment coordinator presents the plan but patients often get sticker shock when they hear $28K-$52K. We lose about 60% of full-arch consultations. What scripts, strategies, or presentation techniques have worked for you to improve acceptance rates on high-value implant cases?
How often are you replacing LOCATOR inserts (processing males) in your overdenture patients? The manufacturer suggests based on retention loss, but I'm looking for real-world timelines. Also, what color insert sequence do you typically follow? Do you start with the lightest retention and work up?
Expert Panel
Questions are answered by experienced clinicians and specialists. Expert answers are marked with a gold badge for easy identification.
Dr. Tom Bilski
Co-director, Midwest Implant Institute
Implant Prosthetics & Practice Growth
7 answers contributed
Dr. James Park
Prosthodontist
Full-Arch Rehabilitation
1 answers contributed
Dr. Lisa Nguyen
Oral Surgeon
Surgical Protocols & Pain Management
1 answers contributed
The Q&A Forum is a peer-to-peer knowledge exchange for clinical education purposes.
Always verify clinical recommendations with current evidence and your professional judgment.
Moderated by Dr. Tom Bilski — Co-director, Midwest Implant Institute, Columbus, Ohio