Overdenture Attachments Research Articles

Fabrication of a retentive occlusal device with minimal soft tissue coverage for overdenture implant abutments.

Nocturnal parafunction is deleterious to the existing dentition and can create a unique dilemma when natural dentition opposes overdenture attachments. This situation can cause mutual destruction of the teeth and attachments, potentially making the attachments and prostheses unusable. This technique presents an innovative approach to protect overdenture attachments from the opposing natural dentition with a prosthesis that has less surface area coverage when compared to the daily prosthesis.

Effect Of Air-Abrasion And Er:Yag Laser On The Bond Strength Between The Metal Housing Of An Overdenture Attachment System And The Hard Relining Material

Objective. This study investigated the effect of air-abrasion and erbium:yttrium-aluminum-garnet (Er:YAG) laser treatments on push-out bond strength (PBS) between hard relining material and metal housing of an overdenture attachment system. Material and Methods. A total of 36 metal housings were randomly divided into 3 subgroups according to surface pretreatments (n=12): Control (no surface treatment; C), air-abrasion (A), and Er:YAG laser (L). Surface roughness (Ra) of specimens was determined using a profilometer. One additional specimen per group was evaluated by scanning electron microscopy (SEM). The hard relining material was bonded to metal housings, and a PBS test was performed using a universal testing machine. Data were statistically analyzed using 1-way analysis of variance (ANOVA), Tukey’s honestly significant difference (HSD), and Tamhane’s T2 tests (α=.05). Results. C and L groups showed the lowest and highest Ra values, respectively. The mean Ra of the A group was statistically different from the mean values of the C and L groups (P<.001). The L group showed higher PBS values than the C group (P<.05), whereas the A group exhibited statistically similar PBS values to both C and L groups (P>.05). Conclusions. Air-abrasion did not significantly increase the bond strength between the metal housing and hard relining material. Er:YAG laser irradiation noticeably improved the PBS but caused surface microcracks.

Marginal bone loss in ball versus locator attachments in implant-retained overdentures: systematic review and meta-analysis.

This systematic review compares the impact of ball and locator attachments on marginal bone loss in implant-retained overdentures in completely edentulous patients. Following PRISMA guidelines, health science librarians completed literature searches from inception to 17 March 2023 in seven databases. There were 15,686 items exported to EndNote from Embase.com, CINAHL (EBSCO), Cochrane Library, Ovid MEDLINE-ALL, PubMed, Scopus, and Web of Science. Hand-searching added four more articles. After deduplication, 6,756 items were screened for eligibility. Twenty-nine studies were assessed by full text, of which ten studies, involving 424 subjects, were included in the review. Risk of bias assessment was conducted using the Cochrane risk-of-bias tool and the Newcastle-Ottawa scale. A meta-analysis was performed to synthesize and analyze the collective data from the selected studies. The included studies used diverse methodologies, implant systems, and loading protocols. Most studies reported no significant difference in marginal bone loss between ball and locator attachments. The meta-analysis revealed high heterogeneity. The results of this systematic review suggest that ball and locator attachments exhibit similar performance in terms of marginal bone loss in implant-retained overdentures. However, the limited number, risk of bias, and heterogeneity of studies highlight the need for standardized research designs and larger sample sizes in future investigations to draw more definitive conclusions.

Mandibular Overdentures When Treating Failing Dentition With Immediate Prosthetic Loading.

Patients may present with failing mandibular dentition either involving the entire arch, partial arch that currently has a partial denture to replace the prior missing teeth or wearing a full denture. Finances may limit restoration of the arch with an All-on-X concept and the patient's goals are a stable prosthesis that does not move whenconcept and the patient's goals are a stable prosthesis that does not move when eating or speaking is the patient's expressed goal. Overdentures can fulfil that goal and provide a stable restored arch at a lower treatment cost than treatment with a fixed hybrid prosthesis. Traditionally, when these type cases have been treated, the remaining dentition has been extracted, depending on availability of bone, implants are placed. Those typically were left to osseointegrate and loaded several months later with a delayed loading approach. This requires relining the denture and the patient having a loose, non-stable prosthesis during that healing phase. An alternative approach utilizes immediate activation of the implants with overdenture attachments thus, providing an immediate stable retentive full arch mandibular removable prosthesis (overdenture) by immediate activation of overdenture attachments (ie.Locators) aids the patient in their goals without delays in treatment. This article will present two case examples of mandibular arches with failing dentition related to caries and periodontal issues and their treatment with immediate implant placement and loading with Locator attachments. Long-term follow-up of 1-year 8-months in one case and 33-months in the other case demonstrate crestal bone stability with this immediate overdenture loading protocol.

A comparative evaluation of retention capacity of different dental implant supported overdenture attachment systems- An in vitro study

The most common way to treat full edentulism is with a complete denture. In the mandible as opposed to the maxilla, there is greater worry over the durability and retention of a traditional complete denture. The mandibular arch's decreased surface area for support and retention is the main cause of this. For a fully edentulous mandible, implant-supported overdentures are a reliable course of treatment.This in-vitro study aimed at comparing the retentive capacity of Ball, Locator and OT Equator Implant supported overdenture attachment system when subjected to 14600 cycles of insertion and de-insertion.Fifteen mandibular dentures were fabricated with heat polymerized polymethyl methacrylate resin to test the retentive capacity of Ball, Locator and OT Equator attachment system. Metal housing with retentive nylon caps were picked up in all the sample using cold cure acrylic resin. The samples were subjected to fatigue testing and only monodirectional force was applied. Ball, Locator and OT Equator attachment system sample were subjected to 14,600 insertion/ de insertion cycle on Universal Testing Machine and data was recorded and statistical analysis was done. All the three groups showed significant differences. The retentive capacity of the Ball attachments lasts longer than that of the Locator and Equator attachments. After ten years of use, All three systems continue to have clinically acceptable retention.

Assessment of Retention of Implant Bearing Mandibular Overdentures with Various Attachments: A Three-Year Follow-Up.

Mandibular dentures are considered dubious in terms of retention in resorbed ridges. Implant bearing overdentures can be a solution to the abovesaid issue. Various attachments in use offer variations in retention and maintenance. The aim was to assess long term durability and retention of implant supported overdenture attachments. Two implant bearing overdentures were placed in 20 patients. Magnet and ball attachment were used and dentures were evaluated over a period of three years at different time intervals. Difference of attachments' performance between intervals was assessed with ANOVA test and Tukey HSD post hoc test and the level of significance was set at p<0.05. There was a decline in retention throughout research period in both categories; the ball and socket batch showed statistically significant (P<0.05) better retention force compared to that of magnet group. There was lesser decline in mean retention force of 10.97N±0.82 to 7.24N±0.903 from one month to three years in magnet attachment retained overdentures. Ball attachments offer better retentive forces than magnet category. Magnet bearing overdentures offer more durability in terms of retention.

Effect of Air-abrasion and Er:YAG Laser on the Bond Strength Between the Metal Housing of an Overdenture Attachment System and the Hard Relining Material

Effect of Air-abrasion and Er:YAG Laser on the Bond Strength Between the Metal Housing of an Overdenture Attachment System and the Hard Relining Material

Over-Denture Attachment Systems: Systematic Review with Meta-Analysis

Current scientific growths for implant over-denture attachments. We focused on the following topics: attachment systems, retention of various attachments, stress distribution with different attachments, the design and fabrication of attachments, digital techniques in over denture attachments, and the effects of attachments in two-implant health. We found that plastic resin is commonly used for ball and bar attachments, whereas nylon resin is commonly used in locator attachments. The locator system offers a valuable attachment option for implant-retained over denture. Attachment retention reduces while lateral force increases with implant inclination in over denture. The higher the retention of an over-denture attachment, the higher the transferred stresses. Additionally, clip loading produces more stress in implants and precision elements than bar-retained dentures.

Tooth-Supported Overdentures Revisited.

The goal of prosthodontics is to provide a functional prosthesis to restore aesthetics, functions, and masticatory efficiencies. Tooth-supported overdentures are one of the treatment options for removable dentures. This article aims to discuss the advantages and disadvantages of tooth-supported overdentures and the principles of using various overdenture attachments, including non-attachment overdentures. The common treatment options in preparing the overdenture abutment are either with or without abutment copingwith or without attachment systems, which were discussed and illustrated. A range of tooth-supported overdenture systems were addressed, from low to high financial implications and treatment complexities. The clinician can choose a system that best fits the patient's condition and expectations. This allows clinicians to decide and consider tooth-supported overdentures as a treatment option before full edentulism. A well-executed tooth-supported overdenture ensures the preservation of alveolar bone, optimizes patient satisfaction in denture treatment, and eventually improves the patient's adaptation when transitioning to complete dentures.

An overview of implant overdenture attachment systems

Implant-retained overdentures have revolutionized dental prosthetics, addressing the limitations of traditional removable dentures. These overdentures rely on attachment systems to anchor them to dental implants or abutments, improving stability, retention, and functionality. Common attachment systems include locator attachments, bar attachments, magnets, Hader clips, ERA attachments, telescopic crowns, and OT equator attachments. Each offers unique benefits and retention levels. Implant survival rates are influenced by various factors, including attachment type, but overall, attachment choice may not be the primary determinant of implant success. Attachment systems that evenly distribute forces, like bar attachments, contribute to implant stability. Marginal bone loss can affect implant stability and is influenced by attachment systems. Precision attachments, such as telescopic crowns, have shown reduced marginal bone loss in practice. Soft tissue complications, including inflammation and mucositis, vary by attachment but can be managed with proper oral hygiene. Retention, crucial for function, varies with attachment type and implant number. More implants generally improve retention, although it may decrease over time. Bar attachments typically provide superior retention. Maintenance is essential, with some debate over whether bar or stud designs entail more upkeep. Patient satisfaction is high with both bar and ball attachments, while magnets may pose retention issues. The choice of attachment depends on patient needs and clinical factors, with regular follow-up and maintenance essential for long-term success.

Evaluation of the amount of bone loss on CAD/CAM(milled framework) support two implant Telescopic mandibular overdenture attachments by splinting and Non splinting of two different impression materials (Vinyl Polyether Silicone and additional silic

Evaluation of the amount of bone loss on CAD/CAM(milled framework) support two implant Telescopic mandibular overdenture attachments by splinting and Non splinting of two different impression materials (Vinyl Polyether Silicone and additional silic

Removable complete denture with a metal base: Integration of digital design and conventional fabrication techniques.

Digitally-designed removable complete dentures are typically composed of a resin denture base without a metal framework. However, metal denture bases are preferable as resin bases are more susceptible to fracture. Therefore, this article introduces a unique technique that integrates computer-aided design (CAD) and conventional resin processing for the fabrication of removable complete dentures with a metal framework. A maxillary complete denture with a metal base and a mandibular implant-retained overdenture reinforced with a metal framework were fabricated. The dentures were designed using CAD software and a tooth library. The denture bases were milled from wax disks, and artificial teeth were placed to complete the wax dentures. The metal frameworks were also designed using CAD software and produced via casting of printed resin patterns. Finally, conventional denture processing techniques were applied to obtain dentures with metal frameworks. A digitally designed, removable complete denture with a metal base can be successfully fabricated using the described technique, which merges digital design and conventional methods. This article demonstrates the feasibility and potential advantages of this innovative approach in denture fabrication. The presented technique provides the following advantages: digital design features, precise space above implant overdenture attachments for a metal framework, convenience of esthetic evaluation with printed trial dentures, long-term data storage and duplication, reliable bond between the artificial teeth and denture base, and enhanced strength of the removable complete denture due to the metal reinforcement.

Revitalizing Worn-Out Overdenture Attachments in One-Piece Implant Cases using Silicone Matrix System: A Case Report

The case report discusses the use of a silicone matrix system for salvaging worn-out overdenture attachments in one-piece implant cases. It highlights the effectiveness of this technique and presents a detailed case study. One-piece or single-piece implant systems, where the intraosseous and abutment portions with the stud attachments consist of one unit, do not allow changing the worn-out abutment individually if required, thus ruling out any further use of implant and abutment once the attachment component faces extensive irreversible wearing. The ‘Retention. Sil’ – an additional curing elastomeric material in salvaging worn-out attachments of one-piece implants, emphasizes the revitalization process and effective use as an attachment for implant-retained overdenture, thereby extending the clinical use of one-piece implants and avoiding extensive invasive procedures in geriatric patients.

The Influence of Cleaning Solutions on the Retention of Overdenture Attachment Systems.

Dental-implant-supported reconstructions provide comfort and improvements in prosthetic function, adaptation, and stability over conventional treatment options. The objective of this study was to evaluate the effect of different denture cleansing solutions and their influence on the deterioration and loss of retention of overdenture attachments in a 12-month clinical-use simulation. In this way, ten specimens each of different brands of retentive caps made of Teflon (OT Equator® (Rhein83, Bologna, Italy), Locator® (Zest Anchors, Escondido, CA, USA), Kerator® (KJ Meditech, Gwangiu, Republic of Korea), and Locator R-Tx® (Zest Anchors, Escondido, CA, USA)) were immersed in five different cleaning solutions (Kukident® (P&G Tech, Oxford Parkway, UK), Benfix® (Laboratorios URGO S.L., Guipúzcoa, Spain), Corega® (Stafford Miller, Waterford, Ireland), and Protefix® (Neuhofer Weiche, Parchim, Germany)), and tap water was used as the control group, in a simulation that lasted 12 months. Data were analyzed using two-way ANOVA and a Tukey HSD. Furthermore, a Levene Test and Shapiro-Wilk tests were performed to assess the validation of the ANOVA assumptions. The statistical analysis was performed using R version 4.2.2 software with the significance level set to p < 0.05. There were significant statistical differences between the different manufacturers regarding the retention forces of the attachment's retentive caps (F = 322.066, p < 0.001). For the cleaning solution groups, different statistical results between Kukident® (P&G Tech, Oxford Parkway, UK) (p < 0.05) and Benfix® (Laboratorios URGO S.L., Guipúzcoa, Spain) (p < 0.05) were observed. There were no significant statistical differences between Corega® (Stafford Miller, Ireland), Protefix® (Neuhofer Weiche, Parchim, Germany), and tap water, even though the retention forces decreased in all of them.

Effect of implant angulation and patrice on the retention of overdenture attachment systems: An in vitro study.

To test the retention of two different overdenture attachment matrices and straight abutments when implants are placed at 0-, 15-, and 30-degree diverging angulations as well as the retention of 15-degree-angled abutments to correct the overall angulation to 0-degrees. Matching aluminum blocks were machined to incorporate two dental implants at 0-degree, 15-degree, and 30-degree relative angulations and overdenture attachments to simulate a two-implant overdenture. At 0-degree, 15-degree, and 30-degree implant angulation, straight abutments were studied. At 30-degree implant angulation, an additional group was compared utilizing 15-degree angulated abutments that corrected the overall implant angulation to 0-degrees. A custom-designed testing apparatus that allowed automated insertion and removal of the simulated overdenture was designed, with three independent testing stations, each consisting of one simulated arch and one simulated overdenture base. The baseline and residual retention forces after 30,000 dislodging cycles of the simulated overdenture were measured. One-way ANOVA was used to compare retention differences among different color patrices within the 0-, 15-, and 30-degree implant angulation groups followed by Tukey's multiple comparison test. Two sample t-tests were used to compare 0-degree versus 15-degree implant groups with straight abutments and 30-degree implant groups with straight abutments versus 30-degree implant groups with angulated abutments. Regardless of implant angulation or abutment correction, the change in retention exhibited by the Novaloc system after testing was not statistically significant for all patrice types (p > 0.05); however, the change in retention exhibited by the Locator system was statistically significant for the tested group (p = 0.0272). In both the Novaloc and Locator systems, the baseline and final retention values provided by the different patrices were significantly different except for the white and green Novaloc patrices in the 15-degree divergent implant group which did not meet the specified level of significance (p = 0.0776). Within the limitations of this study, implant angulations upto 15 degrees do not affect differential change in retention of Novaloc patrices. There is no difference between Novaloc white inserts (light retention value) and green inserts (strong retention values) when implants diverge upto 15 degrees. When Novaloc straight abutments were placed on implants diverging by 30 degrees, blue extra-strong retention inserts outperformed yellow medium retention inserts by maintaining a higher retention value after 30,000 cycles. When utilizing Novaloc 15-degree angulated abutments that correct the overall implant angulation to zero degrees, the red light retentive patrice provides steady retention. Finally, the Locator-green patrice system provides greater retention than the comparable Novaloc-blue patrice combination; however, it also loses more retention after 30,000 cycles.

Mechanical and microstructural analysis of a new model of attachments for overdentures retained by mini-implants obtained by 3D printing with three different polymers

Mechanical and microstructural analysis of a new model of attachments for overdentures retained by mini-implants obtained by 3D printing with three different polymers

Fatigue Resistance of Two Different Materials Used as Retentive Attachments in Implant Supported Overdenture after Immersion in Denture Cleansing Solution: An In Vitro Comparative Study

Aim: This in vitro study compared the fatigue resistance of two polymeric materials (Nylon and Polytetrafluoroethylene (PTFE)) used as retentive attachments in implant-retained overdentures after immersion in denture cleansing solution. Materials and Methods: A total of 24 samples (N=24), of which 12 capsule-shaped samples of commercially available nylon material from ADIN dental implants, India, and similar sized and shaped 12 PTFE (medical grade) capsules custom fabricated from AAA Industries, Mumbai was obtained. Six samples of each material were immersed in distilled water and six samples in Clinsodent denture cleanser, simulating an 8–h daily immersion of the denture for a period of 2 years. After completion of the immersion protocol, samples were subjected to 2900 fatigue cycles using the Universal Testing Machine (UTM), simulating 4 cycles per day of removal and insertion of the overdenture for a duration of 2 years. Before and after immersion, the wear of the samples was assessed for internal and external diameter changes using the Sipcon Inspection System. The statistical analysis of the obtained results was tested by applying the paired-t test, Fisher analysis of variance, and Tukey’s honest significant difference test, with a probability value less than 0.05 used as statistically significant. Results: Statistically significant differences were observed after immersion in denture cleanser for nylon and PTFE. The greatest fatigue for ID, IHL, and IVL was demonstrated in nylon immersed in Clinsodent at p = .000. ED and EHL of PTFE in distilled water showed greater deformation than others ( p = .000). Conclusion: PTFE attachments have shown better fatigue resistance after immersion in Clinsodent denture cleanser. Nylon material immersed in distilled water as well as in Clinsodent cleanser showed greater deformation after fatigue cycles.

Retentive force variations in three polyamide and a polyetheretherketone denture attachments for implant-supported overdentures: An in vitro study

Statement of problemThe loss in the retentive capability of implant-supported overdenture attachments has been related to the wear of the retentive inserts. Wear of the abutment coating material when following the replacement period for the retentive inserts requires investigation. PurposeThe purpose of this in vitro study was to compare the changes in retentive force of 3 polyamide and a polyetheretherketone denture attachments under repeated insertion and removal cycles in wet conditions while following their manufacturers’ replacement time recommendations. Material and methodsFour different denture attachments (LOCKiT, OT-Equator, Ball attachment, and Novaloc) with their retentive inserts were tested. Four implants were embedded into individual acrylic resin blocks, and 10 abutments for each attachment were used. Forty metal housings with their retentive inserts were attached to polyamide screws with autopolymerizing acrylic resin. A customized universal testing machine was used to simulate insertion and removal cycles. The specimens were mounted on a second universal testing machine at 0, 540, 2700, and 5400 cycles, and the maximum retentive force was recorded. The retentive inserts for LOCKiT (light retention), OT-Equator (soft retention), and Ball attachment (soft retention) were replaced every 540 cycles, while the Novaloc (medium retention) attachments were never replaced. All the abutments were weighed with a precision scale at 0, 2700, and 5400 cycles. The surface of every abutment was examined under a stereomicroscope at ×10 magnification. Data were analyzed with descriptive statistics. Two-way repeated measures ANOVA was used to compare the mean retentive force and mean abutment mass of all groups and time evaluation points. Bonferroni corrections were made to adjust for multiple tests (α=.05). ResultsThe mean retention loss for LOCKiT was 12.6% after 6 months and 45.0% after 5 years of simulated use. The mean retention loss for OT-Equator was 16.0% after 6 months and 50.1% after 5 years of simulated use. The mean retention loss for Ball attachment was 15.3% after 6 months and 39.1% after 5 years of simulated use. The mean retention loss for Novaloc was 31.0% after 6 months and 59.1% after 5 years of simulated use. The mean abutment mass difference was statistically significant (P<.05) for LOCKiT and Ball attachment but not statistically significant (P>.05) for OT-Equator and Novaloc at baseline, 2.5 years, and 5 years. ConclusionsAll tested attachments recorded retention loss under the experimental conditions, even when their manufacturers’ recommendations for replacement time for the retentive inserts were followed. Patients should be aware that implant abutments should be replaced after a recommended period since their surfaces also change over time.

Validation of maintenance requirements and patient satisfaction of classical implant locators versus customized attachments in mandibular implant-retained overdentures

Validation of maintenance requirements and patient satisfaction of classical implant locators versus customized attachments in mandibular implant-retained overdentures

Evaluation of Retention and Attachment Wear of CAD/CAM Versus Conventional Implant-Assisted Overdenture Frameworks.

Previous studies have demonstrated problems with implant-supported overdenture attachments, such as denture base fracture and retention loss of the attachment's nylon insert. In this study, three implants were surgically inserted at the anterior mandibular region of 16 completely edentulous men (mean age: 50 years), divided into two groups depending on the received mandibular complete overdenture: a conventional metal-reinforced framework with prefabricated metal housing (Group I) or a CAD/CAM metal-reinforced framework with custom metal housing (Group II). At 3 months (prostheses loading), 6 months, and 12 months after implant placement, the retention of the mandibular dentures and wear of O-ring attachments were evaluated. Data were collected, tabulated, and statistically analyzed using Student t test. Statistically significant differences were found between the two groups and within the same groups during the evaluation period (P < .05). Attachment housing incorporated within a CAD/CAM implant overdenture can be a better alternative to the manufacturer's metal housing, as it diminishes retention loss and attachment wear over time, thus increasing patient satisfaction and chewing efficiency.