Locator Attachments Research Articles

Immediate Loading of Mandibular Overdentures Retained by Two Mini-Implants: A Case Series Preliminary Report.

This preliminary case series report sought to evaluate the efficacy of an immediate loading protocol for mandibular overdentures retained by two mini-implants with the outcome measures patient satisfaction, masticatory cycles, and masticatory efficiency at 1 year. A convenience sample of 11 patients was recruited, and the clinical protocol consisted of immediately loading two mini-implants (10 mm long and 2.4 mm or 2.9 mm in diameter) via a mandibular overdenture connection with Locator attachments. Each patient completed a satisfaction questionnaire and underwent masticatory cycle recordings and masticatory efficiency tests. Implant-related evaluations were carried out by assessing probing depth (PD), Plaque Index (PI), bleeding on probing (BOP), mobility, and pain. All tests and evaluations were carried out six times: before implant surgery (T0), just before implant surgery with patient under anesthesia (T1), following implant insertion with patient still under anesthesia (T2), and at 3 months (T3), 6 months (T6), and 1 year (T12) after implant insertion. Implant survival rate was 95%, and statistically significant increases (P < .05) in masticatory cycle patterns, masticatory efficiency, comfort, stability, and phonetics were also recorded. The employed treatment protocol suggests promise as a viable treatment option that in the short term provides improved prosthesis stability, comfort, and function while decreasing surgical invasiveness. Long-term follow-up outcomes in larger patient sample studies will be required to confirm and validate the merits of this preliminary report.

Impact of single implant versus two-implant mandibular retained overdentures on retention and success rate in totally edentulous patients. A Randomized Controlled Clinical Trial

Aim Purpose of this RCT was to evaluate the denture retention and success rate of totally edentulous patients in single median versus two inter-foraminal implant-supported mandibular over-dentures on.Material and methods Twenty-four totally edentulous patients were selected in this trial. The eligible patients were allocated randomly into two equivalent groups of 12 participants each. A single-implant (G I) or two inter-foraminal implants (GII) were located in the mandible. Three months later, pick up of the locator attachment wa performed to all implants and denture bases. Assessments of denture retention and success rate of implants were measured at the three, six, and twelve month's follow-up assessments. The study consists of twenty-four totally edentulous patients (14 males and 9 females) with age range of 59.6 years. Thirty six implants were inserted (12 in single-implant and 24 in the two inter-foraminal implants). All patients accomplished the twelve months period of follow-up.Results Regarding denture retention, the two inter-foraminal implant group (GII) showed statistically significant differences compared to the single-implant group (GI). Concerning success criteria of implants the results revealed insignificant differences between patients in both groups.Conclusion Single-implant mandibular over-dentures may be recommended as an alternate treatment option for the management of edentulous patients in populations with low economic status.

Three-dimensional finite element analysis of mandibular overdentures with different implant positions and attachment types

OBJECTIVE: This 3-D FEA study compared the stress distribution in two-implant mandibular overdentures as a function of implant position and attachment system (LA: locator attachment vs. BA: ball attachment).METHODS: Four models of mandibular overdentures were tested: M1-LA – with implants at the canine regions (standard implant position) and LA; M2-LA – with implants placed at the first premolar regions (distalized implant position) and LA; M1-BA – with standard implant position and BA; and M2-BA – with distalized implant position and BA. The geometric models were converted into finite element models. A 100 N axial load was applied at the first molar region. The von-Mises stress distribution was compared in selected points.RESULTS: The models with BA had pattern of stress distribution was more uniform along the implant axis than the ones with LA, although the stress magnitude was larger. The largest area of von Mises stresses on the alveolar ridge was in the models with standard implant distribution.CONCLUSION: The findings showed that the models with BA had better biomechanical behavior than the ones with LA. For both types of attachment, the models with increased inter-implant distance presented a smaller area of stress distribution in the perimplant cortical bone tissue than the standard implant position.

Retentive characteristics of individual and prefabricated polyvinylsiloxane overdenture attachments: alternative treatment options for geriatric patients.

Stud attachments are often too adhesive and too susceptible to damage for use in geriatric patients, especially when implants are angulated. This study aimed to evaluate alternative anchoring systems comprising individual and prefabricated polyvinylsiloxane (PVS) attachments. A total of 182 specimens with individual PVS (IPVS) attachments (Shore hardness [SH] 25, SH50, SH65], prefabricated PVS (PPVS) attachments (SM green, yellow, and red), and Locator attachments (LR blue) were fabricated (n = 7 per group). Retention force was measured using the following parameters: insertion/removal (100, 200, 500, 1000, and 5000cycles), thermal undulation (10,000cycles at 5-55°C; one implant per specimen), implant angulation (0°, 5°, and 10° convergence and divergence; two implants per specimen), and artificial saliva. Insertion/removal and thermal undulation caused no changes in retention force in SM green and IPVS subgroups; conversely, LR blue, SM red, and SM yellow attachments exhibited significant decreases in retention force of up to 66% (all P ≤ 0.001). Implant angulation produced relevant changes in retention force only in LR blue attachments. Artificial saliva caused a general decrease in retention force. Retention force of low-retentive PVS attachments proved to be comparatively immune to dislocation and thermal undulation, as well as to implant angulation up to 10°. Low-retentive PVS attachments could be a treatment option if reduced denture retention is required and/or if angulated implants are in place. Clinical studies are necessary to evaluate the materials' durability under oral conditions.

In Vitro Effect of Mastication on the Retention and Wear of Locator Attachments in a Flat Mandibular Ridge Model.

The effect of masticatory loads on the retention of overdenture attachments is poorly documented. The aim of this in vitro study is to assess the effect of simulated mastication on the retentive properties and dimensions of Locator inserts. 30 specimens simulating nonanatomic edentulous flat ridges with two implant replicas each were fabricated. Overdenture units were connected to the implants with Locator attachments and 3 types of inserts: transparent (Group T; n=10 pairs), pink (Group P; n=10 pairs), and blue (Group B; n=10 pairs). The overdenture units were subjected to simulated bi-axial masticatory loads of 68.6N. Locator retention was assessed using axial dislodging forces at baseline (T0) and following 100,000 (T1) and 200,000 (T2) masticatory cycles. The inner diameter of the insert (XY) and the diameter of the central core (AB) were measured under stereomicroscope at T0 and T2. Retention changes and dimensional variations of the inserts were statistically analyzed. The 3 groups showed significantly different retentions with the highest values recorded for group T followed by group P, and finally group B at T0, T1, and T2. Groups T and P were not affected by loading while group B showed a significant mean retention loss from T0 to T1. XY and AB were significantly different between the 3 color-coded inserts at baseline and at T2. No correlation could be established between retention changes and dimensional variations of the 3 types of inserts. Within the limitations of this in vitro study, simulated mastication seems to significantly affect the extra-light blue Locator inserts but not the more-retentive ones. The transparent and pink inserts may require less frequent replacements and could therefore be recommended under clinical conditions.

Study The Effect of Diffrent Two Materials Used to Secur Locator Attachments on Marginal Bone Loss of Implant Retained Mandibular Overdenture

This study was to evaluate the effect of two different types of housing securing materials on bone hight changes using Radiographic evaluation by using cone beam CT. of Locator retained mandibular overdenture. All patient received Locator attachments. The patients were divided into two groups according to resilient or hard the securing material.Radiographic evaluation by using cone beam CT was done for all patients after 12 months. After radiographic evaluation the securing materials were change for each group (The first group was used self-cure acrylic resin for securing the housing of locator. While, the second group used soft liner). The results of the study showed minimal marginal bone loss in soft liner group, at the end of 12 months follow-up period indicating a significant difference between the two groups.

Alcohol consumption, educational level and labour market participation: A prospective cohort study of transitions between work and unemployment

Introduction In Europe alcohol consumption is high. Heavy drinking is associated with adverse consequences on multiple levels and the socioeconomic costs are substantial. Also, alcohol plays a considerable role in the production of health inequalities. Despite a relatively even distribution of the overall alcohol consumption across socioeconomic positions in Denmark, the adverse consequences cluster among people of lower socioeconomic positions; from 2005–2009, alcohol accounted for 15% of socioeconomic differences in mortality among men and 7% among women. The literature refers to this phenomenon as the harm paradox of alcohol. Few have considered the social consequences of alcohol consumption related to labour market participation. In this study, we aim to test the hypothesis that heavy alcohol consumption and problem drinking is associated with a higher risk of unemployment as well as a lower chance of returning to work and whether this effect differs on different educational levels. Methods A sample of 84,671 men and women aged 18–60 years from the Danish National Health Survey 2010 participated in the study. Alcohol consumption was measured by number of drinks per week and problem drinking was measured by six items from the CAGE-C questionnaire (Cut down, Annoyed, Guilty, Eye-opener - Copenhagen). The CAGE-C score was specified based on the number of positive answers and problem drinking was defined as 4–6 positive answers. Information on educational level and labour market participation was obtained from national administrative registers. Data were analysed by use of Cox proportional hazards models and adjusted for age, gender, cohabitation status, geographic location, comorbidity, smoking habits and labour market attachment. Results High weekly alcohol consumption and problem drinking (CAGE-C score of 4–6) were both associated with a higher risk of unemployment as well as a lower chance of returning to the labour market. For example, hazard ratios (HRs) of becoming unemployed and returning to work were 1.48 (95% CI: 1.37–1.60) and 0.85 (95% CI: 0.76–0.94) among individuals drinking 28+ drinks per week as compared to individuals drinking 1–6 drinks per week. Low educational level was associated with higher risks of unemployment and lower chances of returning to work compared to a high educational level. For example, the HR of becoming unemployed was 2.30 (95% CI: 2.20–2.40) among individuals with a low level of education in comparison to individuals with a high educational level. However, at all educational levels, heavy alcohol consumption and problem drinking was associated with a higher risk of unemployment and a lower chance of returning to work. Conclusions Heavy drinking and alcohol problems have adverse consequences on labour market participation and were associated with a higher risk of unemployment and a lower chance of becoming employed. This was consistently observed at all educational levels, which indicates that alcohol problems are of importance for labour market participation across all socioeconomic positions.

PD050: Immediate loading prostheses by using locator attachment: 2 year result

PD050: Immediate loading prostheses by using locator attachment: 2 year result

A Novel Extended Range Attachment System to Retain Implant Overdentures: A Clinical Report.

Various attachment systems have been used to facilitate the retention, stability, and support of overdentures. The low profile design, pivoting technology, and durability of the Locator attachment made it one of the commonly used tissue-supported implant-retained overdentures. It has been successfully used to retain overdentures as well as partial dentures. This article describes the uses of the new Locator R-Tx abutment and illustrates both the direct and indirect techniques used to process the denture attachment housing into the prosthesis to retain overdentures and partial dentures.

A Five-Year Retrospective Assay of Implant Treatments and Complications in Private Practice: Restorative Treatment Profiles of Long-Span, Implant-Supported Fixed and Removable Dental Prostheses.

To describe the restorative treatment profiles of long-span (> three units), implant-supported dental prostheses (LIDPs) prescribed in 27 private practices in the state of Victoria, Australia, during the period from January 1, 2005, to December 31, 2009. The restorative treatment profiles of these prostheses refer to the framework/veneering materials, number of prosthetic units/supporting implants, location in the oral cavity, retention methods, and cantilever designs. LIDPs refer to implant-supported prostheses of fixed or removable design; namely, fixed partial dentures (IFPDs), fixed complete dentures (IFCDs), removable partial dentures (IRPDs), and complete overdentures (IODs). Private dental practitioners providing implant treatment in Victoria, Australia, were invited to enroll in this study, which was conducted through a dental practice-based research network (the eviDent Foundation). The enrolled practitioners' clinical records of the implant treatments provided during the specified period were accessed for data collection. Descriptive statistics, cross-tabulations, and linear mixed models were conducted for data analyses. During the study period, 627 LIDPs were prescribed to 556 patients by 18 general dentists and 5 prosthodontists. LIDPs were more common in the maxilla than in the mandible except in the case of IODs. Of the fixed prostheses, 60% replaced missing teeth in more than one sextant, 33% in the anterior sextant, and 7% in the posterior sextant. The average number of prosthetic units per implant was higher in mandibular compared to maxillary IFPDs/IFCDs (2.5 vs 1.9, respectively, P < .001). Cantilever pontic(s) were present in 68% of IFCDs (more often in the mandible than in the maxilla) compared to 28% of IFPDs (use of cantilever pontics was about the same in the maxilla and mandible). Screw retention was the most commonly reported retention method in IFPDs/IFCDs (95%). Locator attachment was used for the majority of IRPDs/IODs (83%). The clinicians enrolled in this study preferred fixed over removable LIDPs for partially dentate and maxillary edentulous cases. For mandibular edentulous patients, IODs were prescribed more often than IFCDs. A retrievable retention design was favored for IFPDs/IFCDs. IFPDs were predominantly metal-ceramic, and metal-acrylic designs were more popular for IFCDs.

Locator versus bar attachments for immediately loaded implants supporting mandibular overdentures. A short term clinical and radiographic study

Locator versus bar attachments for immediately loaded implants supporting mandibular overdentures. A short term clinical and radiographic study

Ball versus Locator Attachment for Three-Implant Assisted Mandibular Overdenture: Comparison of retention within Patient

Ball versus Locator Attachment for Three-Implant Assisted Mandibular Overdenture: Comparison of retention within Patient

Evaluation of retention and peri-implant outcomes on quadrilateral four locator attachment retained mandibular overdenture

Evaluation of retention and peri-implant outcomes on quadrilateral four locator attachment retained mandibular overdenture

Effect of Implant Position on Clinical and Radiographic Outcomes of Locator-Retained Mandibular Overdentures: A 1-Year Prospective Study.

To evaluate the influence of implant position on clinical and radiographic outcomes of Locator-retained mandibular overdentures MATERIALS AND METHODS: Fifteen edentulous participants with compromised bone at canine regions of the mandible were given 2 implants in the premolar areas (study group, PM). The control group (CA) consisted of 15 participants who received 2 implants in the canine regions, matched to PM and assigned as historical control. For study and control groups, mandibular dentures were constructed and attached to the fixtures with Locator attachments using the delayed loading protocol. Clinical (plaque scores, gingival scores, pocket depth, and implant stability) and radiographic (marginal bone loss) outcomes were assessed after denture delivery (T0), 6 months (T6), and 12 months (T12) later. The survival rate was 100% in both groups. All clinical and radiographic parameters increased significantly with time. No significant difference in plaque scores, gingival scores, or implant stability between groups was observed. PM group recorded significantly higher pocket depth and marginal bone loss than CA group at T6 and T12. Within the limits of this short-term clinical study, canine position for implants retaining mandibular overdentures with Locator attachments is preferred over the first premolar position, as it was associated with reduced peri-implant pocket depth and marginal bone loss after 1 year.

Effect of position of single implant with two different attachments on stress distribution of mandibular complete overdenture (in-vitro study)

Objective The aim of this in-vitro study was to evaluate the effect of position of single implant with two different attachments on stress distribution of mandibular complete overdenture using electrical resistance strain gauge. Materials and methods One acrylic mandibular edentulous model was constructed with 2 mm thickness of artificial mucosa. Four finished denture were obtained one denture for each group. Group 1: single implant at midline region with ball attachment. Group 2: single implant at midline region with locator attachment. Group 3: single implant at left canine region with ball attachment. Group 4: single implant at left canine region with locator attachment. Four strain gauges were cemented at distal, buccal, mesial, lingual aspect of midline and canine single implant to monitor the effect of the applied 50 N static. Unilateral vertical and oblique loads at three different sites central fossa of right first molar, midline and central fossa of left first molar over each implant inserted in the acrylic model. Results Midline single implant with locator attachment (group 2) during vertical and oblique load had lower stresses than ball attachment (group 1), but when implant at canine area with locator attachment (group 4) during vertical and oblique load had lower stresses than ball attachment (group 3). Comparing between midline and canine implant the lowest stresses obtained with (group 2). Conclusion (a) The locator attachment showed reducing stress on implant body ability to distribute the load than ball attachment in midline and canine region. (b) Single implant at midline region showed less stress than implant at canine region with both attachments. (c) Vertical load applied over mandibular overdenture retained by single implant showed less stress than oblique force for both attachments. Less strain value were recorded with the locator attachment in the midline region.

Comparative Study of Implant Supported Overdenture Retained with Two Types of Attachments

Objectives: This study was conducted to compare implant retained mandibularoverdenture with two different attachments (ball and socket and locator).Subject and methods:7 edentulous patients were selected according to certain criteria.Each patient received two platform switched implants placed in the mandibular canine-premolar region bilaterally. GROUP I: Locator attachments were used to retain the implant-supported overdentures. Locator abutments were loaded after 2-3 months. All patients received conventional maxillary dentures. After follow up periods we removedthe attachment with wash period 1month then we used ball and socket attachmentGROUP II. The two groups were evaluated for retention, masticatory efficiency and EMG at 0, 3 and 6 months after loading of each attachment. Results: regarding the effect of time on retention of both groups in ball group there was a significant increase in retention at base line till 3 months and decrease from 3-6 months, while locator group there was increase of retention through all periods. Regarding the effect of time on both groups the masticatory efficiency of both ball and locator group have no significant difference through all periods. Comparing the two groups the masticatory efficiency has no significant difference except on chewing carrots the numbers of strokes till first swallow increase in ball group, and on chewing peanut after 6 months the ball group show higher time till first swallow than locator as well as the time to empty mouth. Regarding the effect of time on both groups the electromyographic activity of both masseterand temporalis muscles has no significant difference through all periods except in locator group decrease the activity of masseter after 3 months. Conclusions: the ball attachment at the beginning has a higher retention quality than locator attachment, by time ball attachment loss some of its retention rather than locator attachment. The electromyographic activities and the masticatory efficiency of temporalis and masseter muscles of both ball attachment and locator attachment were comparable.

THE IMPACT OF IMPLANT NUMBER ON CLINICAL AND RADIOGRAPHIC OUTCOMES OF IMPLANT-SUPPORTED MAXILLARY OVERDENTURE WITH LOCATOR ATTACHMENTS: 2-YEARS OUTCOMES

Statement of problem: Patient perspectives on the treatment options for maxillary edentulism, which debate include fixed or removable implant-supported prostheses, may help eliminate current uncertainty as to the best choice of treatment plan.Purpose: This study intended to evaluate the impact of implant number placed in fully edentulous maxilla on the clinical as well as the radiographic outcomes of implant-supported maxillary overdentures with locator attachments over two years of investigation. Materials & methods: For this clinical research study held between May 2015 and May 2017, twenty-four fully edentulous patients received new maxillary and mandibular complete dentures prior to implant placement. After common denture delivery modifications, every patient was instructed to use the denture in a conservative manner for three months, with a follow-up appointment every two week. During this period, arrangements for implant placement were processed. Following the three months of adaptation; patients were randomly categorized into two main groups: In the first group (of twelve patients), every patient received six implants in the maxilla (three in each quadrant) utilizing a pre-fabricated computer-aided surgical stent. In the second group (of twelve patients), every patient received four implants in the maxilla (two in each quadrant) utilizing a pre-fabricated computer-aided surgical stent. After six months of implants placement (to ensure complete implants osseointegration), patients of the two groups had completed the procedures of fabricating Implant-supported maxillary overdenture with locator attachment. the clinical & the radiographic outcomes of the Implants supporting the overdentures had been calibrated at time of implants insertion, 6 months, 12 months, 18 months and 24 months respectively. Noting that: Forcemeter measurements started at the time of overdenture insertion Not at the time of implants insertion (i.e. only four readings were obtained). Results: Repeated measures ANOVA test was used to study the changes by time inside each group as well as to compare between the two groups. Moreover, Student’s t-test was used to compare between quantities of bone loss or improvement in the two groups. Those studies exhibited that; there was a statistically significant difference in clinical & radiographic outcomes between the two groups of study throughout the investigation period.Conclusion: Maxillary Overdentures supported by six implants exhibited a more reliable and better treatment option than those supported by only four implants, in terms of clinical as well as radiographic outcomes.Keywords: Overdenture, Edentulism, Clinical outcome, Implant Number, Maxillary Denture, Locators.CLINICAL IMPLICATIONSCompletely edentulous patients often have problems with their complete dentures; a treatment modality of using four to six implants to support a maxillary overdenture has been proposed to improve the retention as well as the stability of the maxillary denture, in addition to preserving the residual alveolar bone.

Influence on residual ridge by different retention force of mandibular implant overdenture in locator attachment

Influence on residual ridge by different retention force of mandibular implant overdenture in locator attachment

Bone height changes around hybrid implants in three implant retained mandibular Overdentures

Objective: The purpose of this RCL was to evaluate bone height changes around hybrid implants in three implant- retained mandibular overdenture with locator attachment.Materials & Methods: Ten completely edentulous male patients were enrolled in this study. Preoperative Cone beam computed tomography (CBCT) had been made to evaluate bone height & density in areas for implant installation. Patients had received three hybrid implants installed in midline & mandibular canine areas following flapless technique. Implants were early loaded; two weeks after implant installation. Overdentures were functionally fitted onto the locator attachment of the hybrid implants by direct pick-up technique.Evaluation: Bone height changes were evaluated with the aid of CBCT at the time of implants’ loading, six months and twelve months later. Mesial & distal crestal bone heights were calculated from reconstructed corrected sagittal views.Results: The results had revealed that there was no significant difference in peri-implant bone level throughout the follow-up periods on comparing the three implant sites. However, there was slightly higher bone resorption around the distal implants than the midline ones.Conclusions Three implant retained overdentures with locator attachments may preserve peri-implant bone in the anterior mandibular area. Midline implant in three implant overdentures may not be subjected to more stresses than the two distal implants

Clinical Evaluation of Implant Retained Overdenture with Locator vs Equator Attachments at fixed Inter-Implant Distance.

Clinical Evaluation of Implant Retained Overdenture with Locator vs Equator Attachments at fixed Inter-Implant Distance.