Dr. Gold asks us:
I have been making overdentures with ERA attachments.
I have heard a lot of positive comments about Locator and ERA-VKS SG attachments. Have any of you used these for your dental implant supported overdenture cases? What are the other alternatives? Is there anything specific to watch out for? Also I am looking for a dental implant system that be used for removable partial
dentures. Any suggestions or comments?
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Locator is a better version of the ERA. Lower vertical height and more durable. Just be careful to use the white spacer rings to block the undercuts if you are picking up the attachments chairside. Also work well with partials. I use 3i, you can order the Locator abutments from them directly.
I called SternGold today and they made some good arguements why an ERA attachment is superior to locators. They claimed the ERA wears much better.
The zest locator is an excellent attachment. Its ease of use ,chairside insertion etc. makes it far superior to the era.As noted above the white blockout gaskets are key. You will never go back to era. Changing the nylon retainers are a breeze as well.On a similar note i would like to mention that in the question you stated that the overdentures are implant supported. Overdentures should be implant retained. The surrounding structures should be what’s supporting the od. this is not semantics its physics, follow the basics and extend your case accordingly.They’ll require much less maintainence and be more sucessful.
As an OMFS I see patients returning from restorative dentists with various attachments. The Locator is a great attachment for the patient but expensive. O-rings work well and are cheaper and easy but require some maintainence or teach patients to change O rings.
I’ve seen and used a lot of implant systems. I assume you are a GP and plan to place and restore? Look at Biohorizons internal or external connection and free abutment. The abutment doubles as the fixture mount and preppable/cementable C&B abutment either temporarily or 90% of the time it is the final abutment. Cost $259
I am an implant rep. I have seen many cases with different attachments. I must say the Locator abutment is far superior to any overdenture attachment on the market today. It is 1.68mm shorter than the ERA and the color-coded snap rings are simple and predictable. The Locator 56,000 cycles, Sterngold ERA 2,000. I will give you the study to back it up. O-ring, ERA, Locator. You decide, good, better, best.
Yes, please do post the study here, thanks.
As a dental technician, I have seen many cases, both with the ERA and the Locator. First, with the micro size, the ERA is the same height as the Locator and almost 2mm narrower. As far as function and durability, they both perform well as long as the implants are parallel. With divergent implants the ERA performs much better due to it’s angle correction capability. I have found that the ERA is the only overdenture abutment on the market that is capable of properly correcting divergent implants while maintaining vertical resiliency. I have personally switched over several cases from Locators to ERA’s because of this and have seen improved performance and patient satisfaction.
An important difference is that the ERA is resilient and the Locator is not if the implants are at all off angled. As soon as the Locator has to pivot to try to deal with even a small angle, all of the tiny amount of vertical movement is gone and now you are dealing with a non-resilient attachment. As mentioned before, the overdenture should implant retained. Without resiliency, most of the forces are placed directly on the implant, which is not the ideal situation. Resiliency allows the forces to be directed more toward the tissue and away from the implant.
You can use O-rings but you need adequate height between upper and lower ridge and you may have to perform alveoloctomy to gain that. The height of the ball atttachment is about 7mm. Then you need space for the acrylic, metal substructure and teeth. They are simple but not forgiving if you have more than 1 non parallel implant or not enough interocclusal space .Changing the o-ring is easy and inexpensive. I would examine the patient, space, retention required, number of implants,location of implants in the arch,arch form, A-P spread etch
This topic has spread across the internet over the past 5 years. With almost all views positive for the Locator from users who have used the o-rings ERA’s and Locators.
B,Seavey (Sterngold) points out the difference between the Locator and the ERA as being the resiliency of the male in the cap. His views on this are WRONG. The Locator male is always picked up in line with the abutment. If the abutment is off 10 degree’s the male is in line with that 10 degree’s.
That means that the male will pivot 8 degrees off of that ten. In reality we found that with two Locators the actual movement needed is more like 4 degrees. Zest Anchors did a survey of Locator users who have also used the ERA, in about 200 replys only one chose the ERA over the Locator.
Scott Zest Anchors.
Been placing implants since 1981, & using ERA since they came out with them as abutments. Have had great success with them. Easy to use, easy to change when needed. Over the years I have changed many overdenture cases to ERAs for various reasons making many satisfied and comfortable patients. After all isn’t that why we do this? Different things work well in different hands. That does not mean one is better than the other. It is a matter of being comfortable with what you use.
I have implants on my lower jaw that require O-rings, 2 small ones and 2 large. All was well until the Dentist retired. He provided a lab name to my new DMD but that lab has quit handling the o-rings. I found another DMD that can provide you with rings at $10.00 each plus the over inflated cost of an appointment with him. I have always required frequent changes to keep my denture firm. Cannot afford that man. Any suggestions. I paid 60cents each at the last lab.
Can I find less expensive o rings to hold fast my dentures? Also the last o rings do not feel as tight as the previous ones. I have 4 on the bottom, 3 on the upper (one implant not usable). My dentist charges $115 for each and I need them changed every 6 months for great fit but feel that $1150 plus office charge is rather excessive. Can I buy them myself and insert them ? Should I consider other alternatives?
Did you ever find the “O” rings you needed? I also can’t afford my dentist who charges too much. If you can buy them on the net, please give me the web address. Thank you from the bottom of my wallet.
damagedknee@att.net
I have two lower implants and the dentist I have to see is 3 hours from where I live. In order to get o rings replaced I have to travel that distance then pay a great amount. Can anyone tell me where I can buy these o rings so I dont have to make that trip as often? jasands50@gmail.com