Harder Bar vs Locator Bar

JonnyLathe

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Hey all, I'm working in a clinic with two docs and one is treatment planning for locator bar overdentures. I've successfully made one and the patient is very happy with it!

However, I was talking to the technician who trained me and he suggested we treatment plan for hader bar instead. He suggests that locator bar puts too much stress on the denture and will likely cause them to break, and a hader bar is the superior option as they're easier, more economic, and causes less stress on the denture.

Can anyone with long term experience with bar overdentures chime in on this? Thanks!
 
JMN

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I like Locator over Hader. The clips are a pannini in the asterisk if there isn't exactly enough room, the edges can get bungled and sometimes become an impediment to seating.

For longevity of the prosthesis, I always suggest a metal frame internal to the denture. It will never wear kut and can be retoothed, relined and completely redone without worrrying about getting the implant locations right but one time.

If that's not a financialky feasible option, using a Dentarum .4mm steel grid strengthener is next best. Holes cut in it at the implant sites. Then the implants which are transferring the force break only the areas not reinforced. This allows a fracture/crack to stay mainly at the attachmsnt and repair can be handled chairside by grinding out the old acrylic and picking up the attachment all in one visit. Happy pt dance.

The wire mesh is near useless in most cases. It will extend the time a crack takes to become a fracture. But when it tears the denture has to be reline or rebased to replace it. Dude then will see days without denture and higher cost. Dinnertime without your denture sucks.

Image is the Dentaurum strengthner

Dentaurum%20Grid%20Strengtheners%20318-004-00%202-420x420.jpg
 
JonnyLathe

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I like Locator over Hader. The clips are a pannini in the asterisk if there isn't exactly enough room, the edges can get bungled and sometimes become an impediment to seating.

For longevity of the prosthesis, I always suggest a metal frame internal to the denture. It will never wear kut and can be retoothed, relined and completely redone without worrrying about getting the implant locations right but one time.

If that's not a financialky feasible option, using a Dentarum .4mm steel grid strengthener is next best. Holes cut in it at the implant sites. Then the implants which are transferring the force break only the areas not reinforced. This allows a fracture/crack to stay mainly at the attachmsnt and repair can be handled chairside by grinding out the old acrylic and picking up the attachment all in one visit. Happy pt dance.

The wire mesh is near useless in most cases. It will extend the time a crack takes to become a fracture. But when it tears the denture has to be reline or rebased to replace it. Dude then will see days without denture and higher cost. Dinnertime without your denture sucks.

Image is the Dentaurum strengthner

Dentaurum%20Grid%20Strengtheners%20318-004-00%202-420x420.jpg
So you suggest a metal frame being made at the time of bar fabrication with the locator bar design in mind?
 
JMN

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So you suggest a metal frame being made at the time of bar fabrication with the locator bar design in mind?
Cast mesh frame internal to the denture attaching to a bar if you go for a bar. You can skip the bar and attach this directly to implants also as the frame takes the place of the bar in some philosophies.

The frame should have the attachment parts as a part of the frame.

I'm not typing clearly right now. Catch me tomorrow when I've had more sleep if you don't understand what I can't quite say.
 
JonnyLathe

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Cast mesh frame internal to the denture attaching to a bar if you go for a bar. You can skip the bar and attach this directly to implants also as the frame takes the place of the bar in some philosophies.

The frame should have the attachment parts as a part of the frame.

I'm not typing clearly right now. Catch me tomorrow when I've had more sleep if you don't understand what I can't quite say.
I think the docs want to go with a bar specifically to splint for the health of the implants, they're pretty set on using a bar. Do you perhaps have an example of a metal framework that works over the locator bar? I'm trying to conceptualize how it works with the locator caps and locator bar.

Edit: something like this? IM-12_F_DentOffRev-900x900_W.jpg
 
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JMN

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Hader bar requires less vertical since the bar is the attachment. Use the gold riders instead of plastic. Yes, definitely a a cast chrome frame regardless of Hader or locator bar
I forget about the gold ones. Everyone here uses plastic.
 
JMN

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I think the docs want to go with a bar specifically to splint for the health of the implants, they're pretty set on using a bar. Do you perhaps have an example of a metal framework that works over the locator bar? I'm trying to conceptualize how it works with the locator caps and locator bar.

Edit: something like this? View attachment 39851
Pretty much. Think of the mesh that is in the area where you put the teeth on a partial. Now have the entire coverage area in mesh.

I have no pictures of this. Sorry.
 
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Hey all, I'm working in a clinic with two docs and one is treatment planning for locator bar overdentures. I've successfully made one and the patient is very happy with it!

However, I was talking to the technician who trained me and he suggested we treatment plan for hader bar instead. He suggests that locator bar puts too much stress on the denture and will likely cause them to break, and a hader bar is the superior option as they're easier, more economic, and causes less stress on the denture.

Can anyone with long term experience with bar overdentures chime in on this? Thanks!
On the contrary hader clips are fixed 100% where locators can move up to 30* all the way around if I am not mistaken for a better path of insertion. So clipping the edge is minimized.
 
bigj1972

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Oh boy..,here we go again. I assume the patient came to the clinic for a new denture. So the high educated bunch wants to screw in some implants, tack on a bar, pop in some attachments, JMN is correct about cast framework substructure........Has anybody considered where the denture teeth are gonna go yet?????

Or after all the big money has been spent, are you supposed to grind teeth to fingernails and angle in too buccal to create an infinate repair denture that the patient hates the look of? I hope they have 1/2" vertical above the ridge crest to work in.
 
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TheLabGuy

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Oh boy..,here we go again. I assume the patient came to the clinic for a new denture. So the high educated bunch wants to screw in some implants, tack on a bar, pop in some attachments, JMN is correct about cast framework substructure........Has anybody considered where the denture teeth are gonna go yet?????

Or after all the big money has been spent, are you supposed to grind teeth to fingernails and angle in too buccal to create an infinate repair denture that the patient hates the look of? I hope they have 1/2" vertical above the ridge crest to work in.
Great Intel...need 13+mm's of interocclusal space...and that space decides what type of bar,hybrid, framework you have. Sometimes this can't be measured correctly till you have already done the baseplate/OCC.rims and wax try-in for patient acceptance.
 
PCDL

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Go with the locator bar, and use the threaded, torque-able locators for a bar. Hader bars wear out after a while, and then the retention is toast. With a milled TI bar and threaded locators, you are creating a strong, reliable, and modular design that will last for a long time, and will allow you to easily rehab or replace components. As others have said, a cast mesh, or cast substructure is the ideal way to go for a long lasting restoration. I personally like to have a metal finish line on the lingual, as it adds a nice touch, and creates a smooth transition from palate to appliance.

Photos courtesy of Panthera. They are arguably the best bar manufacturer in the Industry at this point.
 

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JKraver

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I don't get the hype about locator bars. They are huge and rarely allow space for teeth.
 
bigj1972

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I don't get the hype about locator bars. They are huge and rarely allow space for teeth.
It's about upselling pure and simple. It serves absolutely no benefit except to compromise the appliance, which was the reason the patient showed up to start with.
Pantera does nice work though.
 
Denturepropgh

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I think locator bars are pretty great actually, mainly because of the splinting of the implants. But what it really comes down to is interocclusal space, and it should be properly planned for with the oral surgeon for most success. Should plan for crestal bone augmentation and have it flattened before implant placement by the oral surgeon so that you have enough space for the bar/substructure/acrylic/teeth for the best results and least frustration. I like bar designs with a lot of curves that follow the shape of the ridge and give enough room for me to do my job right.
 
JonnyLathe

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I think locator bars are pretty great actually, mainly because of the splinting of the implants. But what it really comes down to is interocclusal space, and it should be properly planned for with the oral surgeon for most success. Should plan for crestal bone augmentation and have it flattened before implant placement by the oral surgeon so that you have enough space for the bar/substructure/acrylic/teeth for the best results and least frustration. I like bar designs with a lot of curves that follow the shape of the ridge and give enough room for me to do my job right.
These patients were treatment planned for standard maxillary overdentures, so I'm struggling with limited space due to little to no alveoloplasty unfortunately. I have started using Panthera Dental who makes a dolder micro bar which I've been using. Most of our patients love them and they've given me a lot more prosthetic space to work with. They're a little more of a hassle to process than locator bars have been this far but it's worth it IMO.
 
Denturepropgh

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These patients were treatment planned for standard maxillary overdentures, so I'm struggling with limited space due to little to no alveoloplasty unfortunately. I have started using Panthera Dental who makes a dolder micro bar which I've been using. Most of our patients love them and they've given me a lot more prosthetic space to work with. They're a little more of a hassle to process than locator bars have been this far but it's worth it IMO.
I'll have to check them out! That other case you posted about titled Best way to process Locator Bar Denture from a year ago, turned out beautiful! I just watched a Youtube video today by Jim Ellison, CDT about how to fabricate a new overdenture on an old worn bar using Hader/ERA attachments. He's a really great teacher!
 
JonnyLathe

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I'll have to check them out! That other case you posted about titled Best way to process Locator Bar Denture from a year ago, turned out beautiful! I just watched a Youtube video today by Jim Ellison, CDT about how to fabricate a new overdenture on an old worn bar using Hader/ERA attachments. He's a really great teacher!
Oh man, I wish I had that video when I was scratching my head trying to make a new overdenture over a 20 year old hader bar last month!! Thanks for the link though I'll definitely be following him.
 
bigj1972

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Thousands spent and now the finished product, you gotta figure it out...Fit a king size bed into a twin bedroom.. And don't charge too much.
 
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JonnyLathe

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Thousands spent and now the finished product, you gotta figure it out...Fit a king size bed into a twin bedroom.. And don't charge too much.
The benefits of working at an in house lab I suppose, doctor pays the expense for mistakes (as they should).
 

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