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Anchors Away: a Better Alternative to Overdentures Joe Steven, Jr., DDS

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Anchor overview
For the first 22 years of my career I had unknowingly denied many of my patients of a very beneficial service — one that the Zest Locator Anchor Overdenture System provides.

Here's the scenario: A patient has several missing lower teeth and the remaining ones have extensive decay. The patient is asking for a full lower denture. As hard as we try, we just can't convince the patient to have multiple root canals, crowns and bridges done. And as is the case many times, their periodontal condition wouldn't even allow that recommendation. In the past, I would always try to encourage the patient to hold on to at least two strong teeth to support a lower partial for better retention. Some of you might agree with me, while many would disagree, especially if the patient required root canals, build-ups and crowns. Even if a patient chooses to save the two lower cuspids with extensive treatment, most of the time you will not gain the aesthetic and retentive advantages that an overdenture provides.

Now that I am proficient in placing these anchors, I am quick to strongly recommend to a patient that they spend a little more money and save the roots of those two lower cuspids and have the Zest anchors placed in them with the reciprocating attachments self-cured into the denture base. Better yet, save three or four teeth with the anchors if the case allows and the patient is willing. These dentures literally snap into place and stay there.

In some situations, when the patient has already had a root canal done on one or both lower cuspids, the case is obviously much easier to sell. Also, you can always phase into the treatment due to financial concerns by at least saving the lower cuspids with root canals cut flush at the gumline, allowing the patient to wear a regular full lower denture over those root tips. For a long time now, this has been a great treatment for decreasing the gradual resorption of the bone caused by dentures. Later, when the patient can afford it, or simply because they're tired of a loose lower denture, you can insert the anchors into those cuspid roots with the compliment components in the underside of the lower denture.

Case presentation
OK, let's get started and go through a case. Let's assume the only two teeth remaining are the lower cuspids and the root canals have already been done. The photos shown here are actually a case with four remaining roots to be used. First you cut the teeth down to the gumline and level them flat across, even with the gingiva. Use the pilot drill which has a plastic depth reference ring that will make the initial preparation to the desired depth within the canal (Figs. 1 & 2).



Then, with the same slow speed latch attachment handpiece, insert the spot-face diamond bur and complete the preparation. Lightly kiss the top of the root with this bur to prepare a rest seat for the anchors (Figs. 3 & 4). Take the locator parallel post carrier and position the female anchor component into the canal preparation. This carrier allows you to assure parallelism with your anchors (Figs. 5 & 6). If necessary, substitute the 10 degree or 20 degree female anchors to get as parallel as possible.

A useful thing the Zest system has is its locator technology, which allows proper seating without accurate attachment components being perfectly parallel. Meaning that even if your female attachments are not exactly parallel, the locator system allows proper seating. Believe me, it's easier than you think. Then just cement with your favorite C&B cement.

The male processing package contains the metal housing with a black processing nylon male insert and a white blockout spacer. Place the white blockout spacer down around the female anchor. This is used to prevent acrylic from locking under the top portion of the anchor during the chairside pickup procedure. Then, snap the metal male processing cap onto the anchor (Fig. 7). Now we need to relieve the underside of the denture to accommodate the protruding processing male caps. Use a Dr. Thompson's color transfer applicator stick to mark the tops of the male caps. Place the denture in the mouth until it rests on top of the caps which will mark the underside of the denture. Simply take a large round acrylic bur and ream out the marked areas so that the denture will reseat passively (Fig. 8).

Mix a self-cure denture acrylic and place into the recessed areas of the lower denture, seat in the mouth, and have the patient close firmly. After it sets, remove the denture and the male caps will be captured within the denture (Fig. 9). Remove the white spacer and discard. Trim the excess flash acrylic and polish.

Then remove the black nylon processing cap insert and place the appropriate nylon insert. Use the locator core tool (Fig. 10) and remove the black nylon insert with the male removal tool section. Use the male seating part of the core tool to seat the new nylon insert into the processing cap (Figs. 11 & 12).



That's it! Now it's time to impress the patient and snap the denture into place. They love it! Show the patient how to remove and insert the denture a few times, and you're finished (Fig. 13). If you have a patient whose poor dexterity doesn't allow her to remove the denture because it fits too tight, simply remove the clear nylon male insert and replace it with a pink or blue one, which are less retentive.

After you do two or three cases, you will easily do these procedures in less than one hour. I discuss this system in my efficient-prosthetics seminars where the attendees actually practice with a case. Don't make the same mistake that I made for 22 years by depriving patients of this very beneficial service.


Dr. Joe Steven graduated from Creighton Dental School in 1978. He and his two associates, one of whom is his daughter, practice in Wichita, Kansas. He is president of KISCO, a dental products marketing company. He presents a variety of seminars and also authors the KISCO Perspective Newsletter. To arrange a meeting for an upcoming seminar, you can contact Dr. Steven at 800-325-8649 or at jsteven@kiscodental.com.

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