The Larell One Step Denture can easily be adapted for use with immediate load dental implants. This is a combination process that provides a stable, functional and esthetic implant retained overdenture in a single visit of about two hours. The ease of fabrication of the Larell denture with the stability of the implants is an excellent solution for your edentulous patients. The efficiency of the process along with the cost effectiveness is desirable for the dentist and the patient.
The initial steps of the implant overdenture process are the same as for the standard complete denture. Please see the placement instructions for the complete denture. Initial vertical dimension measurements are made. An alginate impression is taken of the arch and poured in quickset stone. The template is adapted to the ridge and the flanges are adjusted.
Technique 1. Placement of implants at the time the denture is fabricated
The dental implants are placed into the arch in the appropriate position. The surgical technique is based on the specifics of the implant brand and type. Refer to your implant manufacturer for specific placement instructions and armamentarium. A tissue punch or a minimal incision can be done based on the individual case. The implants are placed in their appropriate position per surgical placement instructions. The Housings, with retentive attachments and block out spacers are placed onto the implants.
The Larell denture is then relined in the standard fashion, right on top of the housings. It is then removed from the mouth, spacers removed and finished and polished in the manner of the complete denture.
The routine procedure for a Larell denture is then done. The reline is done in a standard fashion directly in the mouth. Occlusion is checked with articulating paper, the trial inserts are replaced with heavier tension inserts, pressure indicating paste is used to remove any rough spots and the denture is delivered.
This entire procedure will be about two hours including the placement of the implants and fabrication of the Larell denture. Standard aftercare instructions for dentures and dental implants is given.
Technique 2. Alternate technique for placement of implants and allowing them to integrate before fabricating denture
In this technique the implants are placed into the alveolar bone and buried for their full time of osseointegration, typically 4-6 months. A temporary Larell denture can be fabricated and used during this time or the patient can use an existing denture. Following full integration the implants are uncovered and the abutments placed. At this point a new Larell denture is fabricated in a similar fashion to the above technique 1. With the abutments in place the denture template is formed and relined in standard fashion for the Larell technique. Upon removal of the template with reline material the impressions of the abutments are easily identified. These areas are then relieved to pick up the housings. Special pick up material or more of the reline material can be used to pick up the housings. Relief holes can be placed in the areas of housing pick up if desired.
The housings are placed onto the abutments with the initial retentive insert. Pressure indicating paste and articulating paper are used to balance the occlusion and remove any high spots on the intaglio surface. The denture is then finished and polished in the standard fashion. The retentive rings can be changed at this point to a stronger level of retention if desired. The implant retained denture is then complete.