Locator Fixed Patient Case Study: From Diagnosis to Delivery

Introduction

Full-arch implant rehabilitation presents practitioners with a spectrum of treatment options, each with distinct clinical indications, financial considerations, and patient outcomes.

This case study documents the complete clinical journey of a partially dentate patient whose treatment evolved from an initial goal of a screw-retained prosthesis to consideration of a snap-on overdenture, ultimately culminating in a mandibular Locator Fixed prosthesis.

The case illustrates how anatomical findings, patient financial constraints, and emerging product availability can reshape treatment planning while maintaining optimal clinical outcomes.

The patient, Rosa, presented with severe dental compromise requiring full arch rehabilitation. Her treating clinician collaborated with oral surgeon Dr. Michael Shapiro, utilizing both digital and analog workflows to achieve a final result of a monolithic zirconia Locator Fixed prosthesis for the mandibular arch and a conventional implant-supported overdenture for the maxilla.

Patient Presentation and Clinical Findings

Rosa presented as a partially dentate patient with multiple clinical challenges that demanded comprehensive evaluation before treatment planning could proceed.

Extraoral Assessment

Clinical photography served as the foundation for treatment planning. Once a patient leaves the office, photographs become the primary reference for determining tooth position within the facial framework. Rosa demonstrated several telltale signs of vertical dimension loss. The corners of her mouth turned downward, a condition known as commissural droop. Jowl formation was evident. When assessed against the principle of facial thirds, her lower facial third appeared shortened, indicating a collapsed vertical dimension.

Capturing a genuine full smile proved essential for planning the prosthetic transition line. Patients who have experienced significant dental deterioration often suppress their natural smile due to self-consciousness. Having the patient say an exaggerated "E" activates the perioral musculature and produces a more representative smile. Alternatively, recording video while engaging the patient in conversation and capturing a spontaneous laugh provides authentic smile dynamics. Still frames extracted from video offer valuable information for laboratory communication regarding where the prosthesis should transition to tissue without visible demarcation.

Lateral photographs typically inform anteroposterior tooth positioning decisions. However, in Rosa's case, the absence of anterior teeth and their severe wear limited the diagnostic value of this view.

Intraoral Findings

The intraoral examination revealed extensive pathology. Rosa presented with severe occlusal wear and a reverse overjet where her lower teeth crossed anterior to her upper teeth. She lacked any posterior occlusal stop, and her vertical dimension had collapsed significantly. An anterior slide was present, meaning her habitual closure position represented centric occlusion rather than centric relation, with the mandible positioned approximately five to six millimeters anterior to its actual seated condylar position.

When guided into centric relation, Rosa's initial contact occurred on a canine. As she closed further, she slid down an incline plane, contacted the anterior teeth, and drove the mandible even further forward. This long-standing pattern had led to compensatory labial flaring of the mandibular anterior teeth, creating a canted presentation that required consideration during implant placement planning.

Radiographic examination confirmed decay in multiple areas, tooth shifting and drifting, and periapical pathology. The maxillary arch demonstrated inadequate bone volume for immediate implant placement. The mandibular arch, while suitable for implant placement, presented flat posterior ridges with a floor of the mouth that elevated above ridge height when the patient opened, creating significant challenges for the stability of a removable prosthesis.

Super-eruption of unopposed teeth had consumed available restorative space in several areas. Additionally, Rosa lacked adequate attached tissue in multiple sites.

The Importance of Centric Relation Records in Full Arch Cases

Full-arch rehabilitation demands records captured in centric relation rather than habitual occlusal records. The clinical consequences of recording in centric occlusion are predictable and problematic.

When a patient like Rosa has developed an anterior slide over years of compensatory function, their habitual bite position may be millimeters anterior to true centric relation. If the laboratory creates a prosthesis based on this forward position, significant problems emerge on surgery day. Once teeth are extracted, the patient loses proprioceptive feedback from periodontal ligaments. The mandible drops back, the condyles seat in the fossae, and the patient suddenly presents as a skeletal Class II relationship. The posterior teeth contact heavily while the anterior teeth remain open.

Addressing this discrepancy during a lengthy surgical procedure, when the patient has already been in the chair for hours, creates a poor experience for everyone involved. Many surgical offices lack high-speed handpieces, forcing practitioners to adjust occlusal settings with surgical drills. Proper centric relation records allow the prosthesis to fall into place predictably, shortening surgical time and improving patient outcomes.

An additional clinical observation warrants mention. While not formally studied, experienced practitioners often find that the first point of contact in centric relation provides a reliable indication of appropriate vertical dimension. This initial contact point serves as a valuable reference point for establishing the occlusal vertical dimension.

Treatment Planning and Medicolegal Documentation

The Obligation to Present Tooth-Saving Options

Even when extraction appears clinically apparent, practitioners must maintain documentation demonstrating that conservative alternatives were discussed. This medicolegal consideration protects both patient and practitioner.

If Rosa's teeth were to be saved, treatment would require endodontic therapy with post space preparation to rebuild the central incisors. Post, core, and crown restorations would follow. Crown lengthening surgery would be necessary to establish an adequate ferrule for crown retention. Gingival grafting would address areas lacking attached tissue. Orthodontic treatment would be needed to correct the labially flared teeth, though anchorage for such movement was questionable. Finally, a removable partial denture would be required because the posterior bone was inadequate for implant placement.

When patients consider the cost, duration, number of specialists involved, and uncertain outcomes of such comprehensive conservative treatment, most reach the same conclusion Rosa did: extraction-based treatment makes more sense for their situation. The critical point is that this decision belongs to the patient, documented with their signature, rather than being imposed by the clinician.

The Evolution of Rosa's Treatment Plan

Initial Patient Decision

After reviewing all options, including associated costs, advantages, disadvantages, and risks, Rosa expressed a desire for a fixed treatment but determined it exceeded her financial capacity. She elected to proceed with four-implant snap-on overdentures for both arches.

Anatomical Findings That Changed the Mandibular Plan

As impression procedures commenced, the mandibular anatomy revealed why a removable solution would prove problematic. The posterior ridges were remarkably flat, and the floor of the mouth was elevated above the ridge height when Rosa opened. Practitioners experienced with removable prosthetics recognize this anatomy as a source of persistent frustration. Partial dentures on such ridges lack stability. Complete dentures pop up during function despite refinements in technique.

The treating clinician recognized that an immediate denture on this lower arch would function like a rototiller, disrupting sutures, traumatizing tissues, and generating sore spots that would bring the patient back repeatedly with complaints. This anatomy was incompatible with a positive initial experience.

The Clinical Decision

The clinician and surgeon decided to proceed with immediate loading of a fixed screw-retained restoration in the mandibular arch, absorbing the additional cost to provide the patient with a stable foundation during healing. The hope was that experiencing fixed teeth would convince Rosa to invest in permanent fixed treatment when finances allowed.

Three months post-surgery, Rosa loved her fixed mandibular prosthesis but continued to decline the hybrid prosthesis fee. At this point, the clinician introduced Locator Fixed as an emerging option that could provide fixed treatment at a more accessible price point, and Rosa accepted.

Workflow Considerations for Full Arch Treatment

Digital and Analog Integration

Locator Fixed accommodates digital, analog, or hybrid workflows. Each method offers distinct advantages that practitioners should weigh based on case requirements and personal preference.

Digital workflows accelerate case completion by eliminating physical shipping and enabling electronic file transfer. Patients often perceive digital technology as an indicator of practice modernity. Cross-contamination concerns diminish, and specific procedures can be delegated to trained staff.

Analog workflows retain essential advantages, particularly in complex full-arch cases. Current intraoral scanners frequently fail to capture all critical anatomical landmarks, including retromolar pads, mylohyoid regions, and hamular notches. These landmarks inform tooth positioning decisions. Physical mounted models allow hands-on evaluation with shim stock and articulating paper before the prosthesis ever reaches the patient's mouth.

Rosa's case required analog techniques for specific procedures. No scanner could capture an accurate centric relation bite registration on her compromised dentition, lacking posterior stops. Traditional prosthodontic protocol demanded baseplates and wax rims, vertical dimension establishment using rest position phonetics, minus 2 to 3 millimeters for occlusal vertical dimension, and centric relation bite registration at that established vertical.

A cautionary note regarding digital workflows: delegating scanning to assistants who capture habitual occlusion rather than guided centric relation introduces errors that propagate through the entire planning and fabrication sequence. The laboratory may recognize that something appears wrong, but if the clinician approves the records, the case proceeds with those errors built in.

The Role of Facebow Transfer

Facebow transfer becomes essential when vertical dimension changes are planned. The facebow establishes proper condyle-to-incisal edge spatial relationships, accurate hinge axis orientation, and correct horizontal positioning of the anterior occlusal plane. When laboratories open vertical dimension on mounted casts without facebow data, they introduce cant and positional errors that manifest clinically as occlusal discrepancies.

Diagnostic Workup and Prosthetically Driven Planning

Mounted Model Analysis

Diagnostic mounting places the case in the practitioner's hands for direct measurement and evaluation. Interocclusal space, occlusal plane orientation, and three-dimensional arch relationships become tangible and assessable.

The fundamental principle guiding full-arch treatment planning is that tooth position must be facially driven, while implant position must be prosthetically driven. Facial photographs establish where the patient's teeth should be within the patient's face. The prosthetic setup then dictates where implants must be placed to support those teeth. In Rosa's case, implants could not be planned for her existing splayed and compensated dentition. They had to be planned according to the corrected tooth positions established in the diagnostic setup.

Clinician-Controlled Tooth Setup

Maintaining control over tooth positioning ensures that the vertical dimension and occlusal plane remain consistent throughout treatment. When delegating setup to the laboratory, detailed instructions and photographs must guide the work. Laboratories setting teeth "to air" without proper opposing arch reference inevitably introduce positioning errors that only become apparent when restoring the opposing arch and discovering the original setup was suboptimal.

For the mandibular posterior teeth, positioning followed the guideline of setting two-thirds up the retromolar pad to establish proper occlusal plane orientation.

Preserving Model Integrity for Surgical Guide Fabrication

When the diagnostic setup is scanned for surgical guide production, the teeth must remain completely unaltered. Any modifications, whether chipping, leveling incisal edges, or adjusting contacts, will compromise guide fit. The laboratory scans the lower arch with teeth in place for upper setup reference and without teeth for surgical guide design.

The Putty Matrix Technique

Before finalizing prosthetic design, a putty matrix is created around the set teeth, allowing direct visualization of the available restorative space. The matrix is removed, teeth are removed from the setup, and the matrix is repositioned on the edentulous cast. Direct measurement of buccolingual width, vertical height, and overall prosthetic space prevents the discovery of inadequacies on delivery day.

This technique revealed a critical finding on Rosa's case: insufficient clearance existed between the maxillary tuberosity and mandibular retromolar pad. Processing the denture as designed would have created acrylic interference with thin sections prone to fracture. Because the timing coincided with planned maxillary implant surgery, a communication to the surgeon requesting tuberosity reduction during that procedure resolved the issue without requiring separate intervention.

Surgical Planning and Interdisciplinary Communication

The Challenge of Team Coordination

Complex cases historically suffered from failed in-person planning meetings. Surgeons had emergencies, periodontists had family commitments, and cases languished on laboratory benches while patients called asking about their treatment timeline.

Modern technology enables asynchronous collaboration through virtual workspaces. Platforms such as Straumann Loop, Smile Cloud, Dropbox, and laboratory-specific systems allow team members to access shared photographs, radiographs, STL files, and CBCT data. Individual review and electronic communication keep cases progressing without requiring simultaneous availability.

Video recordings deserve special mention as planning tools. They capture functional movements and natural expressions that static photography cannot provide, offering valuable information for prosthetic design.

Digital Surgical Planning

The laboratory merges CBCT data with STL files from scanned setups in planning software. Programs such as Codiagnostics and RealGuide provide visualization tools for implant positioning within bone. Both the restorative clinician and the surgeon must approve the plan, typically through online meetings where modifications can be made collaboratively.

RealGuide offers practitioners personal accounts where laboratory uploads remain accessible for review, screenshot capture, and long-term archival.

The planning process generates comprehensive documentation: implant summaries specifying diameters and lengths, component ordering lists, and surgical recipes detailing drill sequences and depths. This documentation ensures that surgery day proceeds according to the virtual plan without scrambling for components or improvising sequences.

Surgical Planning Conclusions for Rosa

The maxillary arch anatomy precluded immediate implant placement. Treatment would proceed with extractions, immediate denture, bone grafting, delayed implant placement, and eventual prosthesis fabrication.

The mandibular arch would receive four surgically guided implants with immediate loading of a fixed prosthesis, which would be converted to Locator Fixed after healing.

Understanding AP Spread and Cantilever Limitations

Measuring and Applying AP Spread

AP spread measures the distance between the anterior-most and posterior-most implants. This measurement determines allowable cantilever extension.

For conventional screw-retained prostheses, cantilevers may extend up to 1.5 times the AP spread, though this guideline should be modified based on implant length, opposing dentition type, bone quality, and parafunction. Locator Fixed allows only one time the AP spread because the insert connection provides less rigidity than screw retention.

Tilting distal implants increases the AP spread, which explains why surgeons angle posterior implants in full-arch cases. A greater AP spread permits longer cantilevers and greater posterior tooth coverage.

When the AP spread differs between sides, the shorter side accommodates fewer teeth. Patients should understand this preoperatively rather than asking after delivery why their prosthesis has fewer teeth than their previous denture. Solutions include accepting the asymmetry or adding an implant to extend the arch form.

Implant Parallelism Considerations

Locator Fixed accommodates up to 20 degrees of implant divergence, but more parallel implants ease insertion and removal. This practical consideration favors guided surgery, which positions implants optimally rather than relying on freehand placement.

The recently introduced 15-degree angled Locator Fixed abutment allows direct-to-implant connection for divergence correction without requiring an MUA intermediary. Guided surgery can position implants precisely at 15 degrees when planned, ensuring all components work together optimally.

Torque Specifications

Standard Locator abutments follow the implant manufacturer's torque recommendations. When using Locator components on MUA abutments, the torque value is 20 Ncm regardless of the implant system's standard MUA torque specification.

Impression Technique for Locator Fixed

Fixture-Level Impression Protocol

Rosa's Locator Fixed impression began with the removal of the SRA abutments retaining her provisional prosthesis. Closed tray fixture-level impression copings were placed directly on the implants.

Closed-tray impressions inherently sacrifice some accuracy compared to splinted open-tray techniques. Because housing pickup demands a precise fit, an impression jig fabricated from DuraLay was employed. The jig was sectioned and reconnected intraorally to compensate for polymerization shrinkage before the impression was made.

A custom tray captured all anatomical landmarks using light body Impregum injected beneath the jig. The resulting master model accurately represented implant positions and tissue topography.

Locator Abutment Selection and Placement

Tissue depths measured from the master model determined appropriate Locator abutment heights. Abutments were torqued to 25 Ncm both on the model and clinically to ensure identical seating between laboratory and clinical environments.

Record Taking Challenges on Compromised Anatomy

Baseplate Instability and Solutions

Rosa's flat mandibular ridge prevented stable baseplate seating. During the initial bite registration, something moved, resulting in an inaccurate mounting.

The solution involved placing Locator abutments on the cast, blocking out the two anterior locators, relieving the baseplate, and picking up housings with acrylic. This created a snap-in stable baseplate that could be returned to the mouth for accurate re-registration. The case was remounted, setup completed, and a successful final try-in achieved.

At the try-in appointment, the tooth display appeared slightly short, noted for potential adjustment in the final prosthesis.

Laboratory Prescription and Communication

Detailed Laboratory Instructions

Clear laboratory communication prevents misunderstandings and remakes. The prescription for Rosa's case specified:

Scan the mandibular setup and design a Locator Fixed prosthesis.
Measure the AP spread and ensure distal extensions do not extend beyond one times the AP spread.
Design struts extending from the prosthesis to buccal and lingual land areas to allow precise positioning during housing pickup.

The struts serve a critical function. Without flanges to seat against tissue, the prosthesis needs reference points that establish correct vertical dimension and occlusal position during housing pickup. These fingers contact the land areas of the cast, preventing over-seating or off-center positioning.

Online Design Review

Before milling, an online meeting with the laboratory allows collaborative review of the digital design against the original wax setup. Modifications can be made in real time, ensuring the milled prosthesis aligns with clinical intentions.

Material Selection and Milling Specifications

The prosthesis was milled in Ivotion monoblock, specifically an all-white block without pre-incorporated pink. This selection allowed shade matching to the conventional upper denture rather than accepting the standard Ivotion pink shade. The laboratory would apply pink material after housing pickup.

Ivotion is a double-crosslinked PMMA material that is significantly lighter than zirconia. It does not require a reinforcing bar for strength, though one can be designed in and cemented if desired.

Critical instruction: struts must not be removed, and pink must not be applied until after housing pickup on the model. One case required a complete remake when the struts were prematurely removed.

Processing Sequence

The laboratory workflow followed a specific sequence: mill the prosthesis in white, pick up Locator housings on the model using the opposing wax setup on the articulator, apply pink Crea.line material, then process the upper denture last. Delaying the upper denture allowed final occlusal refinement after the lower was milled, ensuring cusps seated properly in fossae.

Extended Tooth Setup Rationale

Setting teeth beyond the planned prosthesis extent, even though those teeth would not be included in the final restoration, helped establish proper arch form along the ridge and positioned two-thirds up the retromolar pad. The additional teeth also improved bite confirmation during try-in.

Material Options for Locator Fixed Prostheses

Locator Fixed accommodates multiple material systems, each with distinct characteristics:

Monolithic zirconia offers maximum strength and wear resistance at a higher cost.
Processed acrylic with chromium cobalt framework provides a traditional approach with proven longevity.
Ivotion, in its standard pink-and-white configuration, delivers monolithic strength in a lighter-weight material.
Polymer bars such as Crystal Ultra or Grafenite offer alternative framework options.
Printed resins, including OnX Tough, can be fabricated with or without frameworks.
Milled PMMA provides another viable option.

Each laboratory may have preferred materials based on their experience with strength, longevity, and handling characteristics. The treating clinician and laboratory should discuss options based on case-specific requirements.

For housing pickup, different cements work optimally with varying materials of prosthesis. Zirconia and acrylic each have preferred bonding protocols.

Laboratory Housing Pickup Protocol

Preparation Steps

With the prosthesis milled and struts intact, housing pickup proceeds on the master model. Abutments on the model must be torqued identically to clinical torque, 25 Ncm, ensuring a precision match between laboratory and clinical fit.

Before attempting pickup, the prosthesis is verified to fit the cast with struts contacting land areas and no gaps present. White blocking rings contain cement and prevent flash. Occlusal indicator spray applied to the housings reveals any binding against the prosthesis intaglio. If binding exists, the prosthesis is relieved until passive seating is achieved. This verification may require several adjustment cycles.

Proceeding to cementation without confirming passive fit would result in scrambling to remove the prosthesis and clean out the cement before it sets.

Articulator Verification

After initial fit confirmation, the prosthesis returns to the articulator against the wax try-in. The incisal pin must contact the platform. If the shim stock pulls through freely, the occlusion requires adjustment. Marking with articulating paper identifies the interfering contacts. Adjustment should enhance anatomy by creating grooves and ridges rather than flattening cusps.

Retention Enhancement

Optional but recommended steps improve housing retention:

Drill retention holes through the intaglio to provide mechanical retention and pressure release during cementation.
Sandblast the housings to improve the bonding surface.
Apply Monobond or equivalent metal bonding agent.
Create mechanical undercuts in the housings using an inverted cone bur.
Apply ENT material internally before cementation with ReliX Unicem or color-stable acrylic under pressure.

These steps prevent housing dislodgement during hygiene removal procedures when significant force is applied to the prosthesis.

Cementation Technique

Apply cement material to housing tops, avoiding air bubble entrapment. Consider extending the cement around the housing sides into the undercut areas. Seat the prosthesis on the model, place it on the articulator, and close to verify alignment. Remove excess material with brushes before light curing.

Finishing the Prosthesis

Strut Removal and Surface Preparation

After housing pickup and cure confirmation, struts are removed. Fine discs enhance embrasures and anatomy. The tissue surface is shaped with defined finish lines where pink meets white, creating 90-degree junctions for cleanliness and appropriate bulk.

Pink material must not come into contact with the intaglio surface. The milled PMMA resists saliva penetration and staining, while pink materials are more porous and plaque-retentive.

Application of Pink Characterization

A bonding agent prepares the surface for the pink material to adhere. Crea.line materials come in multiple formulations that create depth, mimic attached tissue appearance, and characterize cervical bulge. Skilled technicians layer these materials to develop natural-appearing soft tissue aesthetics with a clear distinction between teeth and gingiva.

Final glazing with Optic Glaze provides stain resistance and color stability.

Clinical Delivery Protocol

Transition from Provisional Prosthesis

Rosa arrived wearing her SRA-retained provisional prosthesis. The SRA abutments were removed and replaced with Locator abutments torqued to 25 Ncm, matching the laboratory model exactly.

Fit Verification with Processing Inserts

The laboratory must deliver the prosthesis with black processing inserts in place. These inserts allow fit verification and occlusal adjustment before committing to permanent inserts. If significant adjustments are needed or the patient expresses concerns, modifications are straightforward with processing inserts. Changing permanent inserts requires the removal tool and substantially more time.

Insert Exchange and Final Seating

After confirming fit and occlusal contact with black inserts, the dual-function Locator tool removes the processing inserts. One end expands when turned, gripping the insert for removal.

Insert selection depends on the implant number:

Four implants receive four green inserts, which provide maximum retention appropriate for this implant count.
Five implants receive tan inserts anteriorly and posteriorly, with blue inserts in the middle positions.
Six implants receive tan inserts at both ends with blue inserts at the middle four positions.

This graduated retention prevents excessive removal force during hygiene appointments while maintaining adequate retention for function.

Seating Technique

Initial seating uses finger pressure to locate the attachments and partially engage them. The prosthesis will not fully seat with finger pressure alone. The seating tip attachment for the Locator tool provides controlled force. Working from posterior on one side with three clicks, then posterior on the opposite side with three clicks, then progressing to each implant position with three clicks each, the prosthesis progressively seats fully.

After seating, occlusion is verified with articulating paper and shim stock, confirming that the contacts match the laboratory mounting.

Patient Instructions for Hygiene Appointments

The removal tool engages the posterior cantilever and creates a "pop" as each attachment releases. Patients should be warned about this sound before the first removal. Progression moves anteriorly through each implant position until the prosthesis releases. Some cases release in two or three pops, while others require engagement at each position.

Case Outcome and Final Evaluation

Mandibular Success

Rosa's Locator Fixed prosthesis was delivered successfully with excellent fit, function, and aesthetics. Final adjustments brought the upper teeth down slightly for improved tooth display.

Clinical evaluation confirmed proper phonetics with incisal edges contacting the wet-dry line during "F" sounds and appropriate closest speaking space where lower teeth just clear upper teeth during speech.

Maxillary Outcome

The maxillary arch followed a different trajectory. Despite successful bone grafting and implant placement, two implants ultimately failed. Rosa declined replacement surgery. Her final maxillary prosthesis is a two-implant snap-on overdenture, which she has worn successfully.

Functional Outcome

Rosa transformed from a patient with severe dental compromise, collapsed vertical dimension, and no posterior occlusion to a patient with stable fixed mandibular teeth and functional maxillary prosthesis. Her facial proportions improved with restored vertical dimension, and her smile aesthetics meet both her expectations and clinical standards.

Key Principles for Locator Fixed Success

This case illustrates several principles that determine full-arch treatment success:

A thorough diagnostic workup prevents problems from being discovered at delivery. Mounted models, putty matrices, and systematic evaluation identify space issues, occlusal discrepancies, and anatomical limitations before fabrication begins.
Centric relation records are non-negotiable for full-arch treatment. Habitual occlusion records introduce errors that manifest as significant problems during surgical delivery.
Communication across the interdisciplinary team must be clear, documented, and verified. Virtual platforms enable collaboration without requiring simultaneous physical presence.
Laboratory prescriptions must be detailed and specific. Assumptions create misunderstandings.
Verify every step before proceeding. Passive fit confirmation before cementation, articulator verification before strut removal, and occlusal confirmation before permanent insert placement all prevent complications that are far more difficult to address after the fact.
Anatomical realities sometimes dictate treatment changes. Rosa's flat mandibular ridge and high floor of mouth made a removable prosthesis success unlikely. Recognizing this and adapting the treatment plan served her better than persisting with a predetermined approach.
Patient financial constraints are real, but should not force patients into treatment modalities destined to fail. Locator Fixed provided Rosa with a fixed treatment option at a price she could afford, delivering function and satisfaction that a struggling mandibular overdenture would never have achieved.

Conclusion

The Locator Fixed system occupies a valuable position in the full-arch treatment spectrum, offering the benefits of fixed prosthesis at an accessibility level between removable overdentures and traditional screw-retained hybrids. Rosa's case demonstrates that treatment planning must remain adaptable, responding to anatomical findings, patient preferences, and financial realities while maintaining commitment to predictable clinical outcomes.

Success depends less on learning parts and pieces than on mastering the diagnostic, planning, and communication processes that ensure those parts and pieces come together correctly. The detailed workflow documentation in this case provides a template for practitioners incorporating Locator Fixed into their treatment offerings, emphasizing that shortcuts in workup create complications at delivery. At the same time, thorough preparation produces predictable, satisfying results for both practitioner and patient.

Additional Resources

For more information concerning the ZEST Locator Fixed:

Contact Information

For help with a Locator Fixed solution for your next case, contact ROE Dental Laboratory:

Phone: (216) 663-2233
Email: info@roedentallab.com

Patient Case Study: Rosa