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hello this is dr. Michael Shearer and this is learned locator what we're going to be doing in this webinar today is is a clinical demonstration of the zest chairside attachment processing material we have our patient here with two dental implants these happen to be 3i 3.2 5 millimeter diameter implants and we're removing his healing abutments on those implants we're gonna go ahead and measure our tissue depth for our locator attachment this happened to be 3 millimeters for each implant we're measuring from the platform of the implant to the top of the tissue I like to go ahead and irrigate each implant with paradox prior to insertion of my locator attachment I use the included attachment delivery mechanism with this particular implant brand I hand tighten the attachment until it's just barely snug we remove the little delivery cap and then I go in with the core tool and just firm it up just with a snug finger pressure we go ahead and repeat that same technique for the other implant this happens to be a single piece healing abutment the other side was a two-piece healing abutment we irrigate the implant site with paradox also do a measurement and then deliver the locator attachment again finger snug and then a little bit firmer figure snug with the locator core tool what we like to do is go ahead and check our parallelism at this point as well as do a follow-up panoramic or periapical radiograph to verify that the implants and the attachments are connected properly we're ensuring that we don't have any gaps present also verifying the torque value for each implant I like to torque down the locator attachment just with the locator insert on a spring-loaded torque delivery device depending upon your implant brand it's somewhere between 20 and 30 Newton centimeters for each locator attachment at this point what we're doing is we're putting on the black or the processing oring spacer this is just going to be snapped lightly on top of the locator attachment we place the denture cap on the top of that we place the denture with an initial relief chamber or relief hole on top of the denture cap verifying if we have any contact I like to do one at a time I just find it easier to manage rather than trying to do both of them at the same time once we verify that we have adequate clearance in the intaglio surface of my complete denture I'm going to add the second blockout spacer and the locator that's your cap I like to insert at an angle rather than straight up and down I find it easier to insert the d'etre cap when you come at it at an angle now again just verifying that the denture is passive I'm not binding anywhere when the denture is in place you might have a little bit of binding when it goes up and down however that is normal as long as you don't have the binding effect when the dentures in place I like to use a fit indicating paste a PDS type material inserting it into the intaglio recessed area of the complete denture and finger pressure we're moving it carefully and marking any areas of show through where I'm seeing the denture showing through on the fit checking material at this point we're creating mechanical undercuts using a round bur the chairside material works best when you use a mechanical undercut as well as a vent hole on the lingual slopes of the complete denture and that's very easily placed with a number six or number eight round bur additionally you can take an inverted cone bur and create additional mechanical undercuts on the intaglio surface of that relief chamber as you can see I want to see holes punching through completely on the lingual slope allowing the material to easily vent out the lingual slope surface we do not need a primer or any sort of conditioning agent for the chair side material what we're gonna do is inject directly into the recesses filling about two-thirds of the way full drawing off the locator denture cap as well as putting just a hair of the chair side processing material on top of the locator attachments carefully seeking the denture in a passive fashion on the attentions Ridge I'm going to be holding the complete denture with a light finger pressure creating a c-shaped around the patient's mandible what I like to do is give the chair side attachment processing material about 30 seconds and the mouth prior to initiating it with a light curing unit this material is a dual cured material with a true light cured component meaning that was some of the other materials that exist on the market the like here merely adds heat to accelerate the curing step this material is actually activated by the light dramatically reducing the amount of time in the mouth and increasing efficiency I like to go ahead and cure from the buccal and lingual slopes 20 seconds from the lingual 20 seconds from the facial of each particular attachment you might be able to get away with a little bit less time than that however I find this is a very effective technique in all of the patients I've treated with this material again holding a gentle finger pressure around the complete denture my assistant would be light curing the denture and the slopes while I'm holding the nut sure so as we approach the end of the light curing cycle I'm just going to take my fingers and verify that the attachment seemingly is going okay up to this point just verifying I have retention and stability I like to disengage from the posterior aspect of the complete denture I find it easier to remove when you grab it from the back part of the denture and this is what I also teach my patients initially it might be stuck in there pretty well as we remove it from the patient's mouth you'll kind of get a sense that everything is starting to feel pretty good as we look at the attachments and how the denture caps have been picked up we have a pretty good flow a little bit of excess has come out the lingual and minimal resin flash on the intaglio surface we do have a couple of voids that we can fill in it's pretty simple with the chair side materials since it can bond to itself what I like to do is just air dry off the intaglio surface adding additional chair side using the angled tip in addition to the mixing tip I like to fill up the initial portion of the recess without the angle tip I find it's it's a lot easier to insert with without now you don't need to use an explorer here if you don't want to the handling characteristic allows you to very easily add the material just using the tip also setting it with a light cure takes about 20 seconds now we're going to be removing the processing mails and inserting the blue nylon inserts that the patient will be wearing now the blue processing are part of me the blue male inserts are present within the denture I'm going to be snapping that back on to the implants verifying that I have adequate retention and stability with the blue attachments the patient generally feels it right away that things start to feel really really pretty nice I'm going to be testing anterior posterior as well as lateral motions to verify that I have adequate retention and stability tongue is going to be moving around verifying that I have good stability and that concludes my patient demonstration of utilizing the zest chairside attachment processing material this is Michael Shearer and thank you for tuning in to learn locater