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Product Focus:
Implant Overdentures with the
LOCATOR Attachment: Free-
Standing versus Bar Applications
Introduction
Implants have a long track record for use in stabilizing re-
movable prosthetics, and various attachments have been mar-
keted. The LOCATOR attachment (Zest Anchors, Inc) has
become the most widely used implant attachment currently
on the market and is available for most implant systems.
The LOCATOR attachment consists of a female and a
male component (Figure 1). The female component is ei-
ther situated on an abutment, as is used in free-standing
fixtures, or incorporated into a bar. The male consists of
a plastic portion situated within a metal housing. The
housing serves 2 purposes:
• It allows quick chairside changing of the male should
it become worn or the level of retention needs to be
increased or decreased
• It permits the male to float within the housing, allow-
ing some play in the system during insertion to help
overcome divergence between fixtures.
An added benefit is that free-floating allows some
stress distribution during function. The males are avail-
able in several levels of retention that are color coded as
Clear = 5 lb, Pink = 3 lb, Blue = 1.5 lb. Extended range
males are also available as Green = 3 lb and Orange = 1.5
lb for greater divergence between fixtures.
Incorporated into the attachment design is a “self-
aligning” aspect to the male component that aligns the
Gregori M. Kurtzman, DDS, MAGD, FPFA, FACD,
FADI, DICOI, DADIA
Private Practice
Silver Spring, MD
Phone: 301.598.3500
E-mail: dr-kurtzman@maryland-implants.com
Web site: www.maryland-implants.com
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male in the female before permitting the 2 components to
engage each other.
Selection of Attachments
When treating edentulous cases in which moderate to
severe hard-tissue loss has occurred, vertical height issues
do not typically complicate the prosthetic restoration. Yet,
in cases where there are restrictions in the available verti-
cal height between the crest of the arch being restored and
the opposing dentition, we may be compromising the
prosthetics because of decreases in the thickness of the
overdenture coronal to the fixed portion of the prosthet-
ics (ie, implant abutment or bar overdenture). Generally,
a minimum of 4 mm of material is required on the oc-
clusal aspect of the removable portion of the overdenture
to prevent premature breakage under masculatory loads.
This can be especially challenging when a bar is indicated
in the treatment.
With a wide selection of available attachments that
can be used in either free-standing or bar applications,
these attachments have varying height requirements (Fig-
ure 2). Attachments such as “O-ring” heads have the
Figure 1—LOCATOR
male within the metal
housing situated on a
LOCATOR female im-
plant abutment illustrat-
ing the vertical.
Dental Learning / March 2011 1
 Figure 2—
Comparison of
the relative
heights of var-
ious implant
overdenture
abutments (L-
R). LOCATOR,
ERA, Dal-Ro,
O-Ring, EDS.
greatest height requirements and may only be usable in
cases where severe hard-tissue loss has occurred, limiting
their clinical use. The LOCATOR attachment currently
has the least height required of the currently available at-
tachments, with a 3.14-mm height between the implant
platform or superior surface of the bar and the top of the
metal housing of the male portion of the attachment. Prac-
titioners should be aware that when a free-standing LO-
CATOR abutment will be used, implants with an external
hex connector will require 1 mm more of height compared
with internal connection implants. This is a result of the
abutment having to overlay the external hex, which has a
height itself of 1 mm. When planning implant treatment
in restricted height cases where a free-standing abutment
will be used, use of implants with internal connectors can
assist in increasing the amount of resin overlaying the at-
tachment in the denture.
When used as a free-standing implant abutment is avail-
able to fit most implant brands on the market. Abutment
heights (cuff height) are available in a 1-mm to 6-mm range,
depending on the thickness of the soft tissue at the fixture.
The abutment height selected should correspond to the
thickness of the tissue plus 0.5 mm so that when the male
component of the attachment is seated there should not be
gingival contact. Gingival contact by the metal housing of
the male may prevent engagement of the attachment (Fig-
ure 3).
Several options are available when using the LOCA-
TOR attachment in a bar overdenture approach. These
include cast-to components, laser weld attachments, and
drill/tap approaches. The LOCATOR attachment is pro-
vided with a nitride coating to decrease wear on the at-
tachment and increase its longevity. Unfortunately, when
a cast-to approach is to be used, the component is not ni-
2 Dental Learning / March 2011
Figure 3—Cuff
heights from 1
mm to 6 mm
are available for
the LOCATOR
Implant
Abutment.
tride coated as the pattern is incorporated into the wax-up
of the bar and cast along with the bar. This may create
long-term complications should wear of the female por-
tion of the attachment occur. Another potential compli-
cation that may occur with both the cast-to or laser-weld
components is that the bar must be returned to the lab to
have the attachment ground off and a new attachment
placed if the female portion of the attachment requires re-
placement as a result of wear or other factors. With the
drill/tap approach used with the LOCATOR attachment,
the lab drills and taps a hole into the bar into which a LO-
CATOR female with a threaded shaft is placed. Should
the female require replacement at any time, this can be
done intraorally chairside with no loss of the bar to the lab
or inconvenience to the patient. This approach can also
be used if an old attachment on the bar requires replace-
ment. The lab can grind off the old attachment and, rather
than laser welding a new attachment onto the bar, a hole
can be drilled and tapped allowing a LOCATOR to be
placed. This does require adequate thickness of the bar in
the buccal-lingual dimension, so it may not be applicable
in converting a worn Hader attachment.
Free-Standing Versus Use of a Bar
There are indications for both free-standing and bar
applications. Typically, if there is sufficient depth of the
vestibule and palatal vault, the ridge can prevent lateral
dislodgement of the overdenture, and free-standing at-
tachments can be used (Figure 4). These patients usually
have stable, nonimplant-retained dentures to lateral loads
but have movement of the denture in the vertical plane
when masticating or talking. A benefit of the LOCATOR
attachment in free-standing applications is that the at-
tachments will allow insertion and removal with up to a
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Figure 4—LOCATOR attachments as individual abutments on
free-standing implants.
Figure 5—LOCATOR attachments placed within an overdenture bar.
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40° total divergence between the individual fixtures. In
contrast, the ERA (Sterngold) will accommodate up to a
15° divergence before angled attachments need to be used.
“O-ring” heads are the least tolerant because of the
greater heights of the attachment; as divergence increases,
premature wear is seen with the rubber “O-ring,” and
tearing of the ring may be observed.
When there is inadequate ridge height to prevent lat-
eral displacement or the patient desires a palateless maxil-
lary prosthesis, then a bar should be considered (Figure 5).
Removal of the palatal coverage of the maxillary denture
eliminates the lateral support that helps limit loads on the
individual fixtures. The bar allows cross-arch bracing, bet-
ter distributing loads on the implant fixtures that can be
important in the poorer quality bone of the maxilla.
Conclusion
The LOCATOR attachment offers versatility in use in
removable implant prosthetic applications. Free-standing
abutments are available for a majority of the implant
brands on the market. They also can be incorporated into
bar applications, making them a good selection when de-
creased available height is present for the overdenture.
Dental Learning / March 2011 3