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PubMedDate not supplied

Effects of attachment clips on occlusal force transmission in removable implant-supported overdentures and cantilevered superstructures.

Attachment clips are commonly used to provide retention for removable implant-supported overdentures. In this study, the effects of attachment clips on occlusal force transmission in four implant-supported overdentures with cantilever extensions were investigated using beam theory. Distributions of moments and of forces in overdenture, clips, cantilevered superstructure, and implants were calculated as functions of position, number, and stiffness of attachment clips. Three-, four-, and five-attachment clip configurations were analyzed. Results showed that maximum bending moments and forces in all components are strong functions of position, number, and retention of attachment clips, while the effects of attachment clip stiffness are negligible. Increasing the number of attachment clips from three to five results in a significant decrease of maximum bending moments in the superstructure and implant. For a wide range of attachment clip positioning, the maximum tensile force on the implants is as high as half the applied load. At least one attachment clip for all configurations is also subjected to tensile force, which can cause it to slip out from the superstructure and increase maximum bending moment in the superstructure and implants.

Acrylic Resins↗
PubMedDate not supplied

The root-supported overdenture using the Locator overdenture attachment.

This article reviews the rationale for the use of overdentures in the partially edentulous and fully edentulous maxilla and mandible. Treatment options, prosthetic designs, indications, and fundamental principles for the successful applications of overdentures are discussed. A detailed step-by-step procedure and technique for the construction of overdentures is provided.

Adult↗
PubMedDate not supplied

A stress-releasing intracoronal attachment for extension base removable partial dentures.

Intracoronal retainer systems incorporated into splinted abutment restorations help force distribution. The additional torque introduced by the extension-based removable partial denture is applied over multiple abutments rather than to single abutment teeth. A fixed-removable prosthesis is proposed as a solution to this situation. The Thompson dowel nonlocking semiprecision attachment system is the intracoronal retainer of choice for distal extension denture bases. It allows controlled rotation or stress relief of the removable component by minimizing detrimental transfer of traumatic forces to the abutment teeth. The design and fabrication of the manufactured version of this retainer system is described.

Dental Abutments↗
PubMed2004

Resin bonded attachments for maxillary obturator retention: a clinical report.

This clinical report describes the prosthetic rehabilitation of a maxillary defect with an obturator retained by extracoronal resilient attachments. Resin-bonded cast-metal units were used to retain and stabilize the obturator through abutment contour modification, addition of retentive elements, and primary abutment splinting. The resulting rehabilitation conserved tooth structure and satisfied both esthetic and functional needs.

Adult↗
PubMed1998

Rigidly splinted implants in the resorbed maxilla to retain a hinging overdenture: a series of clinical reports for up to 4 years.

STATEMENT OF PROBLEM: The results of the implant overdenture treatment in the maxilla remains inferior to those in the mandible. Different reasons have been alluded to, such as bone quality and quantity, number of implants, as well as the prosthesis design. PURPOSE: To investigate the latter, a new design for the rehabilitation of the resorbed maxillae was set up. MATERIAL AND METHODS: Thirteen patients were selected and provided with four endosseous maxillary implants, splinted with a rigid-cast bar. RESULTS: After a mean loading time of 3 years, six implants were lost; three at abutment and another three shortly after abutment connection, resulting in a cumulative success rate of 88.6% at year 4. A mean marginal bone loss of 0.3 mm was observed within the first year. After the first year, the marginal bone level, the attachment level, and the Periotest scores hardly changed. The main prosthetic complication was the frequent need to renew or to activate the attachments. A strong improvement in patient satisfaction was observed when compared with the old conventional denture. CONCLUSIONS: Within the limits of this study, the outcome confirmed that, on a medium-term base, implant-retained hinging overdentures on four implants were promising.

Adult↗
PubMed1999

In vitro study of the retention and mechanical fatigue behavior of four implant overdenture stud-type attachments.

This study sought to determine the influence of mechanical fatigue on four varieties of implant overdenture studtype attachments (Supra-Snap, O'Ring, TSIB, ZAAG). Measurements of the initial vertical retentive force and the weight of the implant abutment were recorded. The same procedure was performed after the equivalent of 2 months, 6 months, and 12 months of clinical wear. For the four attachments, weight variation of the abutment between 0 and 1,080 cycles demonstrated no significant difference. Results indicated the TSIB to be significantly most retentive; next most retentive was the O'Ring, followed respectively by Supra-Snap and ZAAG.

Dental Prosthesis Design↗
PubMed2004

Comparative study of retentive anchor systems for overdentures.

OBJECTIVES: This study aimed to evaluate the retention on two or four implants of eight resilient and nonresilient retentive anchors used in overdentures. METHOD AND MATERIALS: Eight groups of retentive anchors were used: Dyna and Shiner (magnets); Dalla Bona and O-Ring (balls); Ceka Revax and Zaag attachments (studs); the cast bar (Dolder type) system with plastic clips; and the milled bars system. These specimens with their respective overdentures were prepared on two similar acrylic resin models with four implants (3.75 x 13 mm). Ten tensile strength tests (Instron) were performed on each group at a speed of 3 mm per minute. The statistical analysis (one-way analysis of variance, Tukey's HSD test) was considered significant. RESULTS: The pull force values ranged between 0.400 and 3.800 daN (International System of Units). There was a significant difference in retention in favor of the milled bars in comparison with the Ceka Revax, Hader bars, Zaag attachments, O-Ring, and Dyna groups, and a marginally significant difference compared with the Dalla Bona group. There was a highly significant difference with the Shiner magnets. CONCLUSION: The milled bar system was the most retentive anchor, with the Dalla Bona, Ceka Revax, Hader Bar, Zaag attachment, and O-Ring groups being the second most retentive. The least retentive groups were the Shiner and Dyna magnets. Proper abutment placement in the mandible and the correct selection of the retentive anchor will improve overdenture retention.

Analysis of Variance↗
PubMed1984

Attachment retained overdentures: a report on their maintenance requirements.

Twenty-three patients who received attachment retained overdentures between 1964 and 1977 are reviewed. One third of the patients examined had carious abutment teeth, oral hygiene was poor, and periodontal disease prevalent. Overdentures opposed by natural teeth required more extensive prosthetic maintenance than overdentures opposed by a conventional complete denture. Three quarters of the teeth retaining the prostheses were functioning adequately after a mean period of 7 years.

Adult↗
PubMed1997

Implant supported overdentures--the Copenhagen experience.

OBJECTIVES: To evaluate the functional and biological effect of implant-supported overdenture treatment in the lower jaw. METHODS AND MATERIALS: Thirty-two patients were consecutively treated with Astra Tech implants in the lower jaw for retaining overdentures. All implants had a diameter of 3.5 mm and all but two of the implants were longer than 10 mm. For the implant supported overdentures two methods of attachment were used, a bar or a ball. RESULTS: One of 69 fixtures was lost during the 4-5 year observation period. The mean bone loss for all fixtures was less than 0.2 mm per year. Complications included 15 fractures of the ball attachment and 26 episodes of looseness of the matrices holding the screw in place. Patient satisfaction with the treatment of the lower jaw was high although 7 patients found that control of the upper denture was poor following treatment. CONCLUSIONS: When the bone quality and quantity is sufficient, two implants can support an overdenture in the lower jaw, providing prosthesis which functions well.

Aged↗
PubMed1996

A new attachment system for removable partial dentures.

How a removable partial denture (RPD) attaches to its abutment teeth is the most important aspect of partial denture design. The reason is obvious: Many critical requirements for optimal design are dependent on the way the removable segment is related and secured to the abutment teeth. To appreciate the importance of the attachment design, it is necessary to understand several principles of overall RPD design. State-of-the-art RPD design is often the most effective means for achieving long-term maintainable health of the remaining teeth. Even weakened teeth with compromised bone support can, with good design, often be used effectively as abutments for RPDs while benefitting from the removable partial.

Denture Design↗
PubMed1991

Osseointegrated implants in the oral habilitation of a boy with ectodermal dysplasia: a case report.

The most characteristic oral feature in ectodermal dysplasia is hypodontia. Children and adolescents suffering from ectodermal dysplasia often need extensive and complicated prosthetic treatment. The development of techniques for osseointegrated implants offers new possibilities for the oral habilitation of these children. This paper describes the oral habilitation of a boy with severe ectodermal dysplasia and where Brånemark osseointegrated implants have been used as part of the treatment. The patient was seen at the dental department at the age of 1.5 years. Two conically-shaped upper incisors were at that time the only teeth that had erupted. The treatment was planned in a multidisciplinary odontological group involving paediatric dentistry, orthodontics, prosthodontics, oral surgery and maxillofacial radiology. At the age of 3 years it was verified that the boy had four primary teeth (53, 51, 61, 63) and four permanent teeth (16, 11, 21, 26). There were no teeth in the lower jaw. The alveolar ridges in the edentulous areas were low or missing. During the period 3-6 years of age the boy used an upper partial denture adapted to allow the mesial drift of the 16 and 26 teeth. At the age of 6 years, two Brånemark implants were inserted in the lower front-cuspid region. A specially designed overdenture for the lower jaw was constructed. The overdenture was retained in contact with the male attachments by two cuffs of heat-polymerized resilient silicone. Over the next 4 years the dentures were modified due to the eruption of permanent teeth and growth. However, only minor corrections were necessary concerning the retention system of the lower denture. The implants are well osseointegrated and stable and allow the boy to use a lower denture without any complications.

Anodontia↗
PubMed1998

The management of implant-retained overdenture treatment with custom-made metallic attachment housing.

A technique using a custom-made cast alloy attachment housing for an implant-retained overdenture prosthesis is presented. Common problems encountered in implant-tissue bar-retained overdentures are discussed. Details of the modified laboratory procedure are described. This technique provides the clinician with an alternative for predictably treating patients with implant-retained overdentures.

Acrylic Resins↗
PubMed2002

Cleansability of and patients' satisfaction with implant-retained overdentures: a retrospective comparison of two attachment methods.

BACKGROUND: Two important factors in the use of implant-retained overdentures are cleansability and patients' satisfaction. Limited research has been published concerning the cleansability of these overdentures On the other hand, studies have compared patients' satisfaction with conventional dentures and various designs of implant overdentures. However, no studies have compared overdentures retained by Hader bars (Sterngold, Attleboro, Mass.) and direct ERA attachments (Sterngold) in terms of both cleansability and patients' satisfaction. PURPOSE: The authors' aim was to determine the cleansability of and patients' acceptance of overdentures retained by direct ERA attachments and overdentures supported by a Hader bar with distal ERA attachments and a Hader clip. MATERIALS AND METHODS: Two groups of 10 subjects each were evaluated: Group A, consisting of patients with overdentures retained by direct ERA attachments, and Group B, consisting of patients with overdentures retained by Hader bars. The authors evaluated the subjects between 18 and 24 months after the delivery of the overdentures by means of a questionnaire and a clinical examination to score each patient on gingival, plaque and calculus indexes. RESULTS: Group A exhibited better results than Group B on calculus, plaque and gingival indexes, but the difference was not statistically significant. The authors found no significant difference between the two experimental groups in satisfaction. CONCLUSIONS: When evaluated in terms of subjects' satisfaction and calculus, plaque and gingival index scores, implant-retained overdentures supported by direct ERA attachments were similar to those supported by a Hader bar. CLINICAL IMPLICATIONS: The two types of overdentures studied are equally satisfactory and easy to clean. Other factors such as biomechanics, patients' preference and previous experience may be more critical when selecting the retention design for an overdenture supported by four implants.

Dental Plaque Index↗
PubMed1997

Clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses.

STATEMENT OF PROBLEM: It is important to evaluate the long-term clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses. PURPOSE: A prospective, long-term clinical study was conducted to evaluate the success of resin-bonded fixed partial dentures since 1985 and of resin-bonded extracoronal attachments from 1987. METHODS: Until 1993, a total of 130 resin-bonded fixed partial dentures had been seated in 101 patients, as well as 12 removable partial dentures (RPDs) with 24 extracoronal retainers in 10 patients. The clinical treatment protocol and the laboratory procedures were standardized. By the end of 1993, it was possible to reexamine 98 patients with a total of 127 resin-bonded fixed partial dentures and all 10 patients with removable partial dentures. The average time in function for the resin-bonded fixed partial dentures at the time of examination was 3.4 years and 2.3 years for the removable restorations. RESULTS: During the period of observation, one retainer failed on six of the resin-bonded fixed partial dentures, which represents a failure rate of 4.7%. Debonding of extracoronal attachments was recorded for 8.3% of the total number of retainers. CONCLUSION: The resin-bonded fixed partial denture technique can be considered to be a clinically reliable method of treatment, and permits the expansion of indications beyond a classical three-unit resin-bonded fixed partial denture. Long-term clinical success of removable partial dentures with resin-bonded extracoronal retainers warrants additional clinical studies.

Adolescent↗
PubMed1998

Implant-supported prosthesis in a child with hereditary mandibular anodontia: the use of ball attachments.

This report describes the provision of an implant-supported hybrid overdenture in an 8-year-old child with mandibular anodontia. An interdisciplinary approach to treatment planning was employed. Two implant fixtures were placed in the canine regions and ball attachments connected to provide support and retention for the prosthesis. There was only one implant-related complication during the first follow-up year. Close follow-up during the child's growing years is essential for the maintenance of the peri-implant tissues and to replace the prosthesis as mandibular growth occurs.

Anodontia↗
PubMed1990

Custom overdenture retainer.

A simple technique for fabricating stud overdenture retainers in the form of custom attachment castings with teflon retention discs has been described. This system allows for selective placement of the retention sphere on the root surface and control of retention through the size of the retention sphere. Using transfer location projections, exact transfer of the castings to the working model is possible. When necessary, the teflon discs may easily be replaced at the chairside.

Acrylic Resins↗