Locator Attachments Research Articles

Effect of two different Overdenture attachments on the biting force and occlusal force distribution

Objective: This study compared and evaluated the effect of two different implant retained Mandibular Overdenture attachments on the biting force and occlusal force distribution. Materials and Methods: Fourteen completely edentulous male patients were selected and two implants were inserted for each patient. After 3 months of installation Patients were randomly divided into two equal groups: Group (I): Patients received conventional complete maxillary dentures opposed by Mandibular over dentures supported and retained by two conventional implants using ball attachment Group (II): Patients received conventional complete maxillary dentures opposed by Mandibular over dentures supported and retained by two conventional implants using locator attachment. Biting force was evaluated using I load star sensor. At time of prosthesis insertion, 3 months, 6 months, 9 months and 12 months. The T-Scan III digital occlusal system was used to record anterior and posterior percentage occlusal force (%OF) distribution. Results: The result was revealed that there was no statistically significant difference in biting force and occlusal force distribution between the two different attachments (locator attachment and ball attachment) in retained Mandibular Overdenture.

CLINICAL AND RADIOGRAPHIC EVALUATION OF TWO VERSUS FOUR IMPLANT SUPPORTED MANDIBULAR OVER-DENTURE. A ONE-YEAR PROSPECTIVE STUDY USING COMPUTER GUIDED PLANNING

Objectives: The current study was conducted to assess and compare 2 versus 4 implant supported mandibular over-denture using computer guided planning Material& methods: The study was conducted on 16 patients who had completely edentulous jaws. Patients were divided into 2 groups. Group A: 8 patients received 2-implant supported mandibular over-denture, and Group B: 8 patients received 4-implant supported mandibular over-denture using computer guided planning. After 4 months of healing, complete denture was connected to the implants with Locator attachment abutments. Clinical evaluation was performed through Visual Analogue Scale (VAS) to assess patients’ satisfaction after 12 months of loading. Radiographic evaluation was performed through CBCT to assess the marginal bone loss at 6, 12 months post-loading and posterior ridge resorption at 12 months post-loading. Statistical analysis of data was performed.Results: all patients were satisfied with range of 7-10 VAS with no difference between the study groups. Group A showed significant higher marginal bone loss than group B at 6, 12 months post-loading. Group A showed significant higher values of posterior ridge resorption at 12 months post-loading.Conclusion: increasing the number of implants from 2 to 4 in mandibular implant supported over-dentures leads to significant decrease in marginal bone loss, and residual posterior ridge resorption. But didn’t have significant influence on patient satisfaction after 12 months of function.

Stern snap angle versus locator attachment: In vitro strain analysis study around two inclined implants used To retain mandibular overdenture

Stern snap angle versus locator attachment: In vitro strain analysis study around two inclined implants used To retain mandibular overdenture

Electromyographic Connectivity of Masseter Muscle with Different Retentive Attachments for Implant Overdentures in Patients with Atrophied Mandibular Ridges: A Crossover Study.

The aim of this crossover study was to evaluate electromyographic (EMG) connectivity of masseter muscle with different attachments used to retain implant overdentures in patients with atrophied mandibular ridges. Twenty-four edentulous participants with atrophic mandibular ridges received conventional dentures (control). Three months after the adaptation period, two implants were placed in the canine areas of the mandible. After osseointegration, each participant was successively given the following prostheses in a crossover manner: (1) ball-retained overdentures, (2) bar-retained overdentures, and (3) -retained overdentures. The EMG parameters (amplitude, chewing area, chewing rate, duration of chewing cycle, duration of chewing burst, and chewing time) were measured 3 months after wearing the following prostheses: conventional dentures, ball overdentures, bar overdentures, and Locator overdentures. Measurements were made during chewing of hard (carrot) and soft (cake) foods. The highest EMG activity/amplitude, chewing area, duration of chewing cycle, and duration of chewing burst were noted with ball overdentures, followed by bar overdentures and Locator overdentures, and the lowest values were observed with conventional dentures. The highest chewing rate and masticatory time were noted with conventional dentures and the lowest values were observed with ball overdentures. With the exception of chewing area, no significant differences in all tested parameters between bar overdentures and Locator overdentures were observed. Except for duration of chewing cycle, all tested parameters were significantly higher during chewing of hard food than soft food. Within the limitations of this study, two-implant overdentures recorded higher muscle functions compared to conventional dentures regardless of the type of attachment used. For such overdentures, ball attachment may be recommended over bar and Locator attachments, as it was associated with improved muscle activity and function.

Oral hygiene maintenance of locator attachments implant overdentures in edentulous population: A longitudinal study

To investigate the oral hygiene status of edentulous patients with locator attachments implant overdentures (IOD) and to analyze the relationship among daily hygiene behavior, oral hygiene status and peri-implant diseases. Edentulous patients who received IOD treatment with locator attachments from January 2012 to May 2016 were recruited. Clinical and radiographic examinations were conducted to assess the peri-implant tissue status. Modified plaque index (mPLI), sulcus bleeding index (SBI), gingival index (GI), and probing depth (PD) were recorded and peri-implant marginal bone loss (MBL) was measured using paralleling projection technique. Patients' peri-implant oral hygiene maintainence habits were investigated. The correlation between peri-implant diseases and oral hygiene status and behaviors was analyzed. Fifty patients (125 implants) with an average follow-up time of 22 months (6-54 months) were enrolled. The mean values of mPLI, SBI, and GI were 1.4±1.2, 0.8±0.7, and 0.7± 0.6, respectively. Average PD was (2.2±0.7) mm. Mesial and distal maginal bone resorptions were (1.1±1.1) mm and (0.9±0.9) mm, respectively. The prevalance of mucositis and peri-implantitis of the implants were 49.6% and 0. The prevelance of mucositis in the patients with poor oral hygiene (mPLI≥2) was 11.9 times as much as that of those with adequate oral hygiene (mPLI<1). The patients who performed oral hygiene procedure on attachments at least twice a day achieved much lower mPLI scores than those who cleaned less than twice a day. Oral hygiene condition in the group of patients with implant overdentures was poor, and it contributed to increased risk of peri-implant mucositis. The prevelance of musositis of the paitients with poor oral hygiene was 11.9 times as much as that of those with proper oral hygiene. Patients wearing IOD should pay more attention to the hygiene of the attachments.

Three-dimensional finite element analysis of four-implants supported mandibular overdentures using two different attachments

Objective: To compare the biomechanical characteristics of four-implants mandibular overdentures supported by Locator attachment or bar-clip attachment under different mechanical loads using three-dimensional finite element analysis method. Methods: Two different models of four-implants supported mandibular overdentures using Locator attachment and bar-clip attachment (hereinafter called Locator model and bar-clip model) were established. Each model was subjected to five different mechanical loading conditions: 100 N vertical loading in central incisor (vertical load of incisor), 100 N vertical loading or oblique loading in canine (vertical or oblique loads of canines), 100 N vertical or oblique loading in mandibular first molar (vertical or oblique loads of mandibular first molar). The stress distributions in implants, peri-implant bone and mucosa were recorded under the above five conditions to evaluate the effects of different attachments on the biomechanical properties of implant-supported mandibular overdentures. Results: Regardless of loading conditions and types of attachments, the stress concentration in implants were located at the neck of implants, and the stress concentration in peri-implant bone was located in the cortical bone. The stress values in mucosa were always much smaller than those in implants and cortical bone. Regardless of loading positions (on canine or on mandibular first molar), the maximum stress at the bone interface around the implant under lateral loading was much higher than that under vertical loading. Under various loading conditions, the stress in implants and cortical bone of the Locator model (the highest von Mise stress value was respectively 79.5 and 22.3 MPa) were lower than that of bar-clip model (the highest von Mise stress value was 110.3 and 28.7 MPa respectively) while the maximum compressive stress in mucosa (0.198 MPa) in Locator model was slightly higher than that in the bar-clip model (0.137 MPa). Conclusions: In clinical practice, the lateral force applied to the implant-retained overdenture should be minimized to avoid complications caused by pathological loads. Under the same loading condition, the stress distributions in overdenture using Locator attachment are more dispersed, which is more conducive to long-term stability of implants.

Evaluation of Two Different Attachment Systems Used with Mandibular Implant-Retained Overdenture

Objectives: The aim of this study was to evaluate the effect of two different attachment systems on the retention and implant stability of implant retained mandibular Overdenture. Material and Methods: Fourteen completely edentulous patients with age ranged from 47-65 years planned to receive conventional complete denture. Following the treatment protocol, each patient received two implants in the mandibular anterior region and after insurance of the osseointegration, the patients were randomly divided into two groups; Group (A) received Ball/O-Ring attachment and Group (B) received Locator attachment. The retention of two groups were assessed by the digital forcemeter at 3 times (T); (T0) retention of the conventional complete denture, (T1) at time of insertion of implant retained mandibular overdenture and (T3) retention after three months of insertion of implant retained mandibular overdenture. The implant stability quotient (ISQ) was done using Magnetic Resonance Frequency Analyzer (Osstell, ISQ) at the time of loading then after 3 and 6 months. Results: The retention values before the insertion of overdenture (T0) were considerably low in comparison with those at time of insertion of overdenture (T1) and after 3 months from denture insertion (T3). Regarding the ISQ values, there were no significant difference between the two groups before and at the time of insertion of the implant while there was a significant difference between two groups with better stability resulted in the Locator attachment group after three months (p<0.05). Conclusion: Within the limitation of this study, both types of attachment systems; Ball/O Ring and Locator attachments, are reliable modalities for improving the retention and stability of implant retained mandibular overdenture with superior initial stability results for the Locator attachment.

Effect of denture cleansers with and without fatigue stress on retention of locator attachments: in-vitro study

Background To evaluate the effect of denture cleansers with and without fatigue stress on the retention of the locator attachments. Materials and methods Three dummy implants of length (13 mm) and a diameter of 4.2 mm with their locator abutments were embedded into three acrylic resin blocks. Seventy pink locator attachments were divided into three groups: 10 for group I, 30 for each group II and group III. Group I exposed to 600 cycles of insertion and removal equivalent to 6 months use, group II and group III was subdivided into three subgroups, A, B, C according to the type of cleaner which was soaked in water, chlorhexidine gluconate 2% and alkaline peroxide solution for a period equivalent to 6 months. Group III was soaked in water, chlorhexidine gluconate 2% and alkaline peroxide solution, then exposed to 600 cycles of insertion and removal. The pink locator was tested for load to dislodgment on universal testing machine with a load cell of 5 kN at a crosshead speed of two in/min. Retention of locator attachments were statistically analyzed using Mann–Whitney test. Difference of mean values between more than two groups was tested by Friedman χ2-test. Results Group I: The retention of pink locator attachments was significantly decreased after 600 cycles of insertion and removal P = 0.005. Group II: The retentive value for attachment soaked in chlorhexidine gluconate 2% and that soaked in alkaline peroxide solution was significantly lower than that soaked in water (P = 0.001). Group III: the locator soaked in water and chlorhexidine gluconate 2% and alkaline peroxide solution was significantly affected after 600 cycles of insertion and removal. Conclusion Chlorhexidine gluconate 2% and alkaline peroxide solution has significant decrease the retention of pink locator attachment. Fatigue has significant effect on the retention of locator attachment either with or without the use of denture cleansers.

Stress distribution around titanium-zirconium narrow-diameter implants retaining mandibular over dentures with Novaloc versus locator attachment systems. A three-dimensional finite element analysis

Statement of the problem: The use of narrow diameter implant to retain an implant overdenture could be the treatment of choice to restore resorbed mandibular ridge, however its success or failure depends on the amount of stresses transferred to the surrounding bone via the selected attachment system. The goal of this study was to evaluate the stress distribution around two narrow- diameter titanium-zirconium implants retaining mandibular overdenture with novel Novaloc attachment system in comparison with traditional locator attachment using 3 D finite element analysisMaterials and methods: Two 3D finite element models were prepared simulating completely edentulous mandibular ridge with complete overdentures supported by two narrow diameter implants in the canine region. Model 1,represented implants with locator attachment while Model 2, represented implants with Novaloc attachment. The models’ components were created on a commercial CAD/CAM package then imported to finite element software. Load of 100 N was applied on molar area of the mandible vertically and oblique Load of 50 N at 30o and 45o angle. Results: Within the limitations of this research, similar deformations and stresses distributions were reported in the bone and implant complex with a little more stresses in the Novaloc system. All values found were within acceptable physiological limits of the studied parts. Stress received by the PEEK matrix of the Novaloc attachment was significantly less than that of the locator nylon cap. Conclusion: Within the limitations of this in-vitro study it may be concluded that locator attachments may provide little less stress on the bone and implant complex in implant retained overdenture than did the Novaloc attachment. However, the lifetime of the flexible caps may be longer for Novaloc system in comparison to locator ones.

Stress distribution in implant supported mandibular ovedentures and surrounding bone using three different types of attachments – a 3D finite element analysis

Background: Since mandibular complete denture faces problems with retention, stability, support mandibular implant supported overdenture is a more successful and durable treatment option. Different types of attachments used with mandibular overdentures improve the retention and dissipate stress as well. It is of paramount importance for the success of the prosthesis. Finite element analysis (FEA) is a very precise method for stress assessment in the bone. Materials and Methods: Mandibular 2 implant supported overdenture was considered. Noble Biocare replace implant of diameter 4.3 mm, length 11.5 mm was used in the study. 3 models were considered: Model A – Implant overdenture with Ball/O-ring attachment, Model B – Implant overdenture with Locator Attachment, Model C – Implant overdenture with Ceka attachment. A detailed, precise 3D solid model of human mandible was obtained upon which FEA could be optimized using Autodesk NETFABB ver. 8.1, a software and MAYA 3D software tool. These models were subjected to vertical, oblique and horizontal forces of 35N, 70N and 10N, respectively. Stress was assessed at different sites namely silicon cap/ring, abutment, implant–abutment interface, implant body, surrounding bone. The amount of force required to uplift the dentures was assessed. Results and Conclusion: Results showed that locator attachment showed least amount of stress generation under all three types of loads. Within the limitations of the study, it was concluded that locator attachment was better in terms of stress generation in comparison to Ball and Ceka attachment. It was the most retentive attachment in comparison to the other two attachments.

A retrospective analysis of dental implants in patients who received a mandibular overdenture with locator attachment

Aim: The objective of this study is to retrospectively examine the relative superiorities of mandibular overdenture dental implants in terms of diameter, length, age and sex, and to determine the rate of implant survival. Material and Methods: The demographic data showing the age, sex and dental implant distribution by age of 138 patients who underwent dental implant treatment at our clinic between 2011 and 2016 were retrieved from the archival records. Patients who underwent mandibular overdenture with two implant-supported locater attachments were included in the study. The anatomical locations, diameter and length characteristics and rate of loss of the implants were analyzed by way of descriptive statistical analysis.Results: Of 138 patients, 69 were female (50%) and 69 were male (50%), and a total number of 276 dental implants were evaluated. When distribution of these implants was examined, it was found that they were mostly placed in the region of 33-43 (94.2%). The mean age of the patients was 63 with an age range of 40 to 87 years. It was found that the dental implants were applied mostly in patients ranging in age from 60 to 69 years (52.8%). The most common implant diameters were 4 mm (18%), 4.2 mm (18%) and 4.5 mm (17%), respectively. The most common implant lengths were 12 mm (32%) and 14 mm (30%). The rate of implant survival was found to be 97.8%.Conclusion: The mandibular two-implant retained overdenture prosthesis with a locator attachment is a successful treatment method with a high survival rate when factors such as diameter and length of the implant and age and sex of the patient are taken into consideration.

Comparison of changes in retentive force and wear pattern of two stud attachments for implant overdentures: An in vitro study

Context: Edentulous patients often complain about the instability of mandibular denture. To overcome that, implant-supported overdentures (IODs) have been applied as a good prosthetic option. Aims: The current study compared the changes in retentive force and patterns of surface wear of nylon rings of two stud attachments (ball and locator) upon cyclic loading. Subjects and Methods: Two implant analogs were fixed parallel to each other, 22 mm apart, in custom-made rectangular blocks for each attachment system. Ten nylon inserts of each attachment system were tested. Universal testing machine was used to measure the retentive force, and a low-value fatigue testing machine was used for cyclic loading of 2500 insertion–removal cycles. Surface changes of the components were evaluated by scanning electron microscope (SEM). Statistical Analysis Used: Paired Student's t-test was used to determine groups that were statistically significant. Results: The greatest retention loss rate, i.e., the difference between the initial retentive force and final retentive force was observed in the ball attachment (6.20 N) followed by locator attachment (3.70 N). The results were found to be statistically significant (d ≤ 0.001**). Upon SEM analysis, the nylon inserts of ball attachment revealed more surface wear compared to that of locator attachment. Conclusions: For greater retention and longer function, locator overdenture attachment should be preferred for implant overdentures over ball attachment.

Five-year Radiographic Changes of Residual Ridges under Maxillary Complete Denture and its Opposing Mandibular Two Implant-Retained Overdenture with Different Resilient Attachments

Aim: This study aimed to radiographically compare the effect of different resilient attachments on maxillary and mandibular residual ridge changes after 5 years of using mandibular 2-implant retained overdentures. Materials and methods: Eighteen completely edentulous male patients, with age ranging from 45 to 60 years, were included in the study. Maxillary complete dentures were constructed opposed to 2-implant retained mandibular overdentures. Patients were divided randomly into three equal groups according to type of attachment into; ball/socket (BOD) group, Locator attachment (LOD) group, and positioner attachment (POD) group. Maxillary and mandibular ridge resorption were determined by using the proportional area index method on the panoramic radiograph taken at time of overdenture insertion and at five years later.Results: The minimal rate of ridge resorption was recorded for posterior maxillary ridges (Max-PRRR) followed by that of posterior mandibular ones (Mand-PRRR), while the highest resorption rate was recorded for anterior maxillary ridges (Max-ARRR). The study did not reveal significant difference in ridge resorpion between the resilient attachment systems.Conclusion: Mandibular overdentures retained by two implants with the described attachment systems provide a similar and acceptable range of residual ridge resorption (RRR) after 5years of function. The reduced RRR with Locator attachments proved its ability to provide an equitable load on the implants and tissue bearing areas during function.

The Implant stability and bone height changes for immediately loaded single implant-retained mandibular overdentures with locator attachments

Aim: The aim was to evaluate the efficacy of attachment placement on initial stability and bone height changes for immediately loaded single-implants retaining mandibular overdentures.&#x0D; Methodology: Twenty edentulous patients were recruited for this study; 9 females (45.0%) and, 11 males (55.0%) (age ranged from 59.0 to 70.0 year). Single endoosseos implant was inserted in the mandibular midline region. Immediately after surgery; Locator abutment was secured on the implant and the male housing was connected intraorally using direct pick-up procedure. Marginal bone height measurements and implant stability values were assessed at the time of implant placement (baseline), 2,4,6,8, 12, 24 weeks then every 6-month interval up to 18 months post-implant placement. &#x0D; Results: The implant stability values decreased markedly from the baseline, during 4 weeks and, then increased gradually until reaching the initial values after 12 weeks followed by continuous increase to study’s end (p&lt;0.05). The peri-implant marginal bone level revealed an acceptable range of bone loss with a statistically significant differences between different follow-up times and it continued to the end of the study (p&lt;0.05).&#x0D; Conclusion: Retaining an overdenture by immediately loaded single implant could be a successful treatment option for mandibular edentulous arches, especially in people with limited financial resources. The use of Locator attachment seemed to have a favorable effect on implant stability and marginal bone around immediately loaded single implant mandibular overdenture after 18-months of function.

Multicenter Retrospective Analysis of Implant Overdentures Delivered with Different Design and Attachment Systems: Results Between One and 17 Years of Follow-Up.

Purpose: To analyze implant and prosthetic survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with implant overdentures (IOV) on splinted and nonsplinted implants and different attachment systems, in function for one to 17 years. Methods: This retrospective study evaluated data collected from patients rehabilitated with implant overdentures between January 2001 and December 2016 in nine different centers. Outcome measures were implant and prosthetic success rates, mechanical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results: A total of 581 implants were installed in 194 patients. Patients were followed for a mean period of 60.6 months (range 6–206). Eighty-nine patients received 296 low profile attachment (OT Equator), 62 patients received 124 ball attachments, and 43 patients received 107 Locator attachments. In eighty-three patients the implants were splinted with computer aided design/computer aided manufacturing (CAD/CAM) or casted bar. At the last follow-up, 10 implants failed in eight patients. Statistical significance was found for failed prostheses (P = 0.0723) and complications (P = 0.0165), with better values for splinted implants. No statistically significant differences were found in proportion of implant and prosthetic failure (P > 0.05). At a five-year follow-up, proportion of complications (P = 0.0289) and failed prostheses (P = 0.0069) were statistically higher for IOV on Locator attachments. No difference was founded in MBL at one- and two-year follow-up between different attachment systems (P > 0.05). Statistically significant improvement in all the OHIP categories was reported in all the patients, after one year of function. Conclusions: Implant overdenture showed high implant and prosthetic survival rates, low complications, high patient satisfaction, and good biological parameters in the long-term follow-up. Splinting the implants may reduce number of mechanical complications. Locator attachments showed higher number of complications. Further studies are needed to confirm these preliminary results.

In vitro variation measurement of mandibular denture displacement resistance involving 1 to 3 implants

Statement of problemSingle-implant–retained mandibular overdentures (1-IODs) may be an alternative to 2-IOD for maladaptive denture patients giving comparable satisfaction, lower cost, and shorter treatment times. However, studies evaluating the effect of the number of implants on the strain exerted around the implants of IODs using strain-gauge analysis are lacking. PurposeThe purpose of this in vitro study was to evaluate the effect of the number of implants on the strain in an IOD under various loading and dislodging conditions. Material and methodsA mandibular IOD with the Locator attachment system (pink nylon inserts) was fabricated on artificial mucosa. Three implant positions recorded the loading: 1-IOD (mid-anterior), 2-IOD (bilateral lateral incisor), and 3-IOD (mid-anterior and bilateral canine) were prepared. Strain gauges attached to the mid-anterior implant replica for the 1-IOD, the left lateral incisor replica for the 2-IOD, and the anterior and left canine replicas for the 3-IOD. Vertical loads of 50 N were applied to the experimental overdenture in the mid-anterior and right molar and left molar regions. Three dislodging tests were performed in 3 different areas: mid-anterior, posterior, and mid-anterior and bilateral molar. Six measurements were made under each loading and dislodging condition for each IOD (N=6). During the calibration test, the resultant strain measured by strain gauge was converted into a lateral force (F) value by using linear regression: Fanterior-posterior(N)=1.08×strain (με), Fposterior-anterior(N)=0.192×strain (με), Fleft-right(N)=0.590×strain (με), Fright-left(N)=0.560×strain (με). Statistical analysis was performed by using 1-way ANOVA and the Tukey honestly significant difference test (α=.05). ResultsThe 3-IOD demonstrated the significantly highest strain under loading and dislodging conditions (P<.05). The 1-IOD demonstrated the significantly highest strain during right-side loading (P<.05). Upon anterior and left-side loading, no significant difference was noted in strain between the 1-IOD and 2-IOD (P=.413, P=.272). Under dislodging conditions, the 1-IOD exhibited the significantly lowest strain (P<.05). ConclusionsWithin the limitations of this study, the 3-IOD demonstrated the highest lateral resistance force during load and dislodge testing, whereas the 1-IOD exhibited the lowest.

Multicenter retrospective analysis on survival rate, complications, patient satisfaction and biological parameters of implant overdentures delivered with different design and attachment systems‐ results between 1 and 17 years of follow‐up

Background Edentulism can lead to significant functional impairment and psychological changes in patients. The conventional method for treating edentulism is to provide complete dentures. An implant overdenture may improve oral function and patient satisfaction compared with a conventional complete denture. Nevertheless, evidence is lacking about the number of implants, prosthetic design and type of attachments. Aim/Hypothesis To report implant and prosthesis survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with an implant overdentures on splinted and non-splinted implants and different attachment systems, in function for a mean period of 5 years (1–17 years) Material and Methods The present retrospective multicenter study evaluated data collected from fully or partially edentulous patients rehabilitated with an implant overdenture between January 2001 and December 2016 in 9 different centers. The outcome measures were implant and prosthetic success rates, mechanical complications, oral health impact profile, marginal bone loss, bleeding on probing and plaque index. Results A total of 581 implants were installed in 194 patients, followed for a mean period of 60.6 months (range 6-206). Sixty-nine patients were rehabilitated in the maxilla+ while, 125 patients in the mandible. Eight-nine patients received 296 OT Equator attachments, 62 patients received 124 ball attachments, and 43 patients received 107 Locator attachments. In eighty-two patients the implants were splinted. At the last follow-up, 10 implants (1.7%) failed in 8 patients (4.1%). At 5-year follow-up, proportion of complications was statistically higher for not splinted overdenture (P = 0.0171). No statistically significant differences were founded in proportion of implant and prosthetic failure (P>. No difference between overdenture on splinted and not splinted implants for HOIP, MBL, BoP, PI at each time points, up to 5 years on function (P > 0.05). At 5-year follow-up, proportion of complications (P = 0.0289) and failed prostheses (P = 0.0069) were statistically higher for IOV on Locator attachments Conclusions and Clinical Implications Implant overdenture showed high implant and prosthetic survival rates, low complications, high patient satisfaction, and good biological parameters in the long term follow-up. Splinting the implants may reduce number of mechanical complications. Locator attachments showed higher number of complications. Further studies are needed to confirm these preliminary results.

Effect of Denture Cleansers on Retention Capability of Different Locator Attachments: In Vitro Study

Effect of Denture Cleansers on Retention Capability of Different Locator Attachments: In Vitro Study

Clinical and Radiographic Evaluation of Bar, Telescopic, and Locator Attachments for Implant-Stabilized Overdentures in Patients with Mandibular Atrophied Ridges: A Randomized Controlled Clinical Trial

The aim of this study was to evaluate the clinical and radiographic peri-implant tissues of bar, Locator, and resilient telescopic attachments for two-implant stabilized overdentures in subjects with mandibular atrophied ridges. Ninety edentulous individuals with mandibular ridge atrophy were randomly assigned into three equal groups and received two implants in the canine areas. Mandibular overdentures were constructed and attached to implants with Dolder bar attachments (BOD), resilient telescopes (TOD), and Locators (LOD). Plaque scores, gingival scores, pocket depths, implant stability, width of keratinized mucosa, vertical bone loss, and horizontal bone loss were evaluated at the time of prosthesis delivery and 6 months and 12 months after delivery. With the exception of pocket depth and implant stability, all parameters showed a significant increase from prosthesis delivery to 6 months. BOD recorded the highest plaque scores, gingival scores, and pocket depths followed by LOD, and TOD recorded the lowest values. No significant difference in implant stability and keratinized mucosa was observed between groups. TOD and BOD recorded the highest vertical and horizontal bone losses, respectively. LOD recorded the lowest vertical and horizontal bone losses. There was no difference in implant survival rate between groups. Bar, resilient telescopic, and Locator attachments can be used successfully for two-implant stabilized overdentures in subjects with mandibular atrophied ridges after a 1-year follow-up period. Telescopic attachments were associated with improved clinical peri-implant soft tissues compared with other attachments. However, Locator attachments may be advantageous in terms of peri-implant bone preservation.

CLINICAL OUTCOME OF WEARING IMPLANT RETAINED OVER DENTURE IN PATIENTS WITH ATROPHIC ANTERIOR MAXILLA RECONSTRUCTED BY SUB NASAL LIFTING (CLINICAL STUDY)

INTRODUCTION: Maxillary implant overdenture has improved the quality of life for edentulous patients especially patients with atrophic maxilla. Sub-nasal lifting was introduced to solve the problem of severely atrophic anterior edentulous maxilla to allow insertion of dental implants. The type of attachment may influence the retention and stability of the prosthesis and thus, masticatory efficiency. Especially locator attachment is used with great success for improvement of implant-assisted over dentureOBJECTIVES:To evaluate clinically and radiographically the effect of wearing implant- retained over denture in patients with atrophic anterior maxilla which was reconstructed by nasal lifting. Patient satisfaction was also evaluated.MATERIALS AND METHODS: This clinical trial was conducted on seven patients with edentulous atrophic anterior maxilla rehabilitated by Sub-Nasal Lifting, restored with bilateral two implants and grafted with Platelet-Rich Fibrin. For each patient an implant- retained over denture with locator attachments was constructed. Patient assessment was done using different three method including clinical, radiographic evaluation and patient satisfaction at three intervals: at time of over denture insertion, 3months and 6 months of denture use.RESULTS: All patients showed increased bone density around dental implants with slight decrease in marginal bone height, no mobility of each implant was detected .All patient showed increased well satisfaction throughout the follow up periods.CONCLUSIONS Two implant-assisted maxillary over denture is an acceptable treatment for patients with atrophic anterior maxilla and it showed increased patient satisfaction and favorable clinical and radiographic findings.