Zest Locators: Anyone Else Experiencing Loss of Retention?

Dr. R: I have seen this same loss of retention with locators, although I have not done as many as you in last 6 years, I have probably had 4 or 5 cases where the coating was worn off the abutment and could not get retention. These are not tied to specific implant brand. I too have gone through increasing the retentive rings with marginal, short term results. In one case Zest did replace the abutment at no cost. It is worth a try, they are expensive! I tend to think it is the result of some patients just chewing with more force. One other thing, all the ones I have had occurred with only two implants present.....a good argument for placing 4!

I posted this same problem on Dentaltown.com last year with interesting comments. When a worker from Zest got on and told me how attachments of any type will wear over time, it became a new discussion piece when talking to patient and planning restorative options of fixed vs removable implant prosthetics. Whenever a Locator patient comes in stating they have lost retention, don't jump to a different insert. Take you intraoral camera and evaluate the outer gold coating of the Locator male attachment looking for metal showthrough. If no camera, then untorque and remove to evaluate. When you see it, purchase a new one and replace. It's happened on me about 4 times in the past few years. Do a search on Dentaltown and you'll find my thread...

I have found with denture precision attachments like the zest locators that some patients clean their denture with tooth paste and leave behind some residue, leaving an abrasive grit that eventually wears the metal component.

Thank you Malcolm for that bit of excellent insight

Hey Back Action, Avason! J/K. How you been doing in NC? Glad to see you here. Good answer, like the idea.

I have done only about 5 implant overdenture cases, two lower anterior implants, with virtually no problems. However, my most recent case, in about 8 months, came back with loss of retention. Patient told me that he sleeps with his dentures in. He also seems to be an especially hard chewer. I think he may be bruxing during sleep and distorting the locator plastic inserts. He had the clear inserts originally and could hardly get the denture out of his mouth.

Jon, Great to hear from you. Been a long time. Where are you at now? NC's been a good fit for us. Close to Charlotte but still far enough away to not have the crazy city/traffic life....

hi guys, I experienced the same thing with locators, and now say that the nylons may need replacing every year at the patients cost. I also say abutments WILL need replacing at 5 years. If the patient knows this and say 2 of 4 are worn, then hopefully they will be happy. I do tend to try to upgrade the patients to syncone at the time of treatment planning because of this. (i think its a much better system and not much more difficult-no elastomers to go wrong!) I have not had a patient back that I have said this to yet so we will see how they react!! Till then its replace them for free which is a ball ache! All the best, Mike

With all attachments they get worn with time. Have been using ball attachments with some patients changing the teflon yearly and the ball abutment after 5 years. The locators have lasted longer and they are more forgiving if the implants aren't perfectly parallel.