• Journal of Periodontal and Implant Science
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• 제53권3호
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• pp.194-206
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• 2023

Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.

• The Journal of Advanced Prosthodontics
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• 제8권2호
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• pp.85-93
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• 2016

PURPOSE. The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-retained overdenture. MATERIALS AND METHODS. Maxillary implant-retained overdentures with 4 implants placed in the anterior region of edentulous maxilla were converted into a 3-D numerical model, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional finite element analysis. RESULTS. In all experimental models, the highest stress was concentrated on the most distal implant and implant supporting bone on loaded side. The stress at the most distal implant-supporting bone was concentrated on the cortical bone. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant and implant supporting bone on loaded side. CONCLUSION. It could be suggested that when making maxillary implant retained overdenture, using Hader bar instead of milled bar and full palatal coverage rather than partial palatal coverage are more beneficial in distributing the stress that is applied on implant supporting bone.

• 대한치과보철학회지
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• 제41권6호
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• pp.747-761
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• 2003

Statement of problem. The proper materials of attachments for implant retained overdenture are unknown, such as the correlation between retention and abrasion, as well as the types of materials that are suitable for patrix and for matrix individually. Purpose of this study. The aim of this study was to select a proper clinical attachment system for a successful treatment as well as patient satisfaction. Methods. Retention and abrasion of 14 commercial attachments were measured during 15,000 removes. Results. A retentive part (matrix) which requires elasticity has to be made of gold while the patrix part which does not require elasticity has to be made of titanium. This gold matrix / titanium patrix combination showed the most retentive force and the least retention loss.

• 구강회복응용과학지
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• 제33권4호
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• pp.321-328
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• 2017

무치악은 총의치나 임플란트 보철물로 수복이 가능하며 임플란트를 이용한 피개의치는 총의치보다 유지와 안정이 우수하고, 임플란트 고정성 보철물에 비해 저렴하고 심미적이다. CM $LOC^{(R)}$ $Pekkton^{(R)}$ 어태치먼트는 여자부가 poly-ether-ketone-ketone으로 마모저항성이 뛰어나다. 한편, SR Ivocap system은 가압주사성형법으로 의치의 수직고경 변화가 적고 강도가 우수하다. 본 증례에서 상악은 4개의 임플란트 식립 후 CM $LOC^{(R)}$ $Pekkton^{(R)}$ 어태치먼트와 SR Ivocap system을 이용한 임플란트 유지 피개의치를, 하악은 가철성 국소의치를 제작하였고 심미적 및 기능적으로 만족스러운 결과를 얻었기에 이를 보고하는 바이다.

• 대한치과기공학회지
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• 제45권3호
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• pp.61-66
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• 2023

Purpose: The current study examined the retention and wear resistance of stud-type attachments made of high-performance polyetheretherketone (PEEK) or polyetherketoneketone (PEKK) from the polyaryletherketones (PAEKs) family. Methods: The study sample included 10 PEEK or PEKK attachments that were mounted onto their male parts, designed on the upper aspect of the attachment, with a load of 30 N. Tensile stress was applied using an Instron machine to separate the male and female parts, and the maximum tensile stress to be applied was determined based on the retention force observed. The wear resistances of PEEK and PEKK were evaluated by measuring the inner diameter of the inserted female part 10 times. Results: The maximum tensile stresses of PEEK and PEKK were 56.26±0.58 and 69.12±0.92 N, respectively, with the maximum stress required to remove the PEKK specimens from the abutment being 12.86 N higher than that required to remove the PEEK specimens. Furthermore, PEKK exhibited higher wear resistance than PEEK. Conclusion: This study evaluated custom-made removable implant-retained attachment components for overdentures, wherein the female parts were made of PEEK or PEKK. The retention stress and wear resistance were evaluated based on the type of attachment material, and the results showed that both types of attachment inserts demonstrated clinically acceptable results in terms of retention.

• The Journal of Advanced Prosthodontics
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• 제5권3호
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• pp.333-340
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• 2013

PURPOSE. This study was accomplished to assess the biomechanical state of different retaining methods of bar implant-overdenture. MATERIALS AND METHODS. Two 3D finite element models were designed. The first model included implant overdenture retained by Hader-clip attachment, while the second model included two extracoronal resilient attachment (ERA) studs added distally to Hader splint bar. A non-linear frictional contact type was assumed between overdentures and mucosa to represent sliding and rotational movements among different attachment components. A 200 N was applied at the molar region unilaterally and perpendicular to the occlusal plane. Additionally, the mandible was restrained at their ramus ends. The maximum equivalent stress and strain (von Mises) were recorded and analyzed at the bone-implant interface level. RESULTS. The values of von Mises stress and strain of the first model at bone-implant interface were higher than their counterparts of the second model. Stress concentration and high value of strain were recognized surrounding implant of the unloaded side in both models. CONCLUSION. There were different patterns of stress-strain distribution at bone-implant interface between the studied attachment designs. Hader bar-clip attachment showed better biomechanical behavior than adding ERA studs distal to hader bar.

• 구강회복응용과학지
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• 제29권2호
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• pp.153-162
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• 2013

이번 연구는 2개의 임플란트 식립 후 로케이터를 이용한 하악 임플란트 유지 피개의치를 한 20명의 환자를 대상으로 임플란트 생존율, 변연골 흡수량, 보철적 합병증을 알아보았다. 진료 기록부를 조사하고 방사선 사진을 계측하여 후향적 임상연구를 하였으며, 임플란트는 95%의 누적 생존율을 보였고, 평균 94주 후 방사선 사진에서 임플란트는 평균 1.21 mm($SD{\pm}0.20mm$)의 골소실을 보였다. 보철적 합병증으로는 피개의치 파절, 의치상 이장 또는 개상, 메일의 탈락 또는 유지력 감소로 인한 메일 교체 등이 있었다. 그러나 의치상 이장 및 개상, 메일 인써트의 간단한 교체로 인해 장기적으로 임플란트 및 임플란트 유지 피개의치가 환자에게 유지되고 있었다. Locator를 이용한 하악 임플란트 유지 피개의치는 최소침습적인 수술, 간단한 보철 과정 및 수리 과정의 장점으로 인해 장기적으로 안정적인 치료법으로 사료된다.

• The Journal of Advanced Prosthodontics
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• 제15권4호
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• pp.214-226
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• 2023

PURPOSE. This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. MATERIALS AND METHODS. A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. RESULTS. It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. CONCLUSION. Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

• 대한치과보철학회지
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• 제36권4호
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• pp.581-586
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• 1998

무치악환자의 Implant보철수복 방법은 식립된 Implan의 수에 따라 다양하다. 많은 수의 Implant가 식립된 경우에는 고정성 보철물로 수복이 가능하지만 시술이나 기공상의 복잡성, 고가의 치료비, 보철물과 잔존치조제사이의 빈 공간으로 인한 비심미성, 발음의 어려움과 같은 여러 가지 문제점이 존재한다. 적은 수의 Implant가 식립된 경우는 Bar Retained Overdenture를 사용하지만 역시 기공과정이 복잡하며, Bar와 잔존치조제사이의 공간으로 인한 점막지지 면적의 감소와 보수가 어려운 단점이 있다. 여기에 비해서 O-ring Attachment를 이용하면 기공과정이 쉽고, 잔존치조제와 보철물 사이에 공간이 없으므로 점막지지 면적을 많이 얻을 수 있다. 또한 Implant식립의 수도 최소화할 수 있어 경제적이며, 문제가 발생한 경우에 쉽게 대처할 수 있는 장점을 지니고 있다. 본 증례들은 Steri-Oss Implant System의 O-ring Attachment를 이용하여 무치악환자를 보철 수복한 예로서 술후 기능적, 심미적으로 만족할 만한 결과를 얻었기에 문헌고찰과 더불어 발표하는 바이다.

• 대한치과보철학회지
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• 제49권4호
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• pp.283-290
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• 2011

연구 목적: 현대의학의 발달로 평균 수명이 증가하고 고령의 환자가 늘어남에 따라 무치악 환자의 비율도 증가하고 있다. 특히 심하게 흡수된 하악골에선 기존의 총의치로는 환자가 사용하기에 유지, 지지의 부족으로 사용상에 어려움이 있다. 하악에 2개의 임플란트 식립하여 피개의치를 제작하면 환자에게 좀 더 사용하기가 편한 의치를 제작해 줄 수 있다. 간단한 보철과정과 추후 수리가 쉽다는 이유로 현재 Locator가 보편적인 유지장치로 사용되고 있다. Locator를 이용한 하악 임플란트 유지 피개의치에서 임플란트와 보철물의 장기적인 성공률을 알아보았다. 연구 재료 및 방법: 대구가톨릭대학병원 치과 구강외과에서 2004년부터 2010년까지 총 10명의 환자(남 4명, 여 6명)의 하악에 2개의 임플란트(총 20개)를식립후Locator를 이용한 조직-유지 피개의치를 하였다. 본 연구는 최근 7년간 시술된 10명의 환자들을 대상으로 진료 기록부를 조사하고 방사선 사진을 계측하여 후향적 임상연구를 하였으며, 임플란트의 생존률 및 보철적인 합병증에 대해 알아보았다. 결과:임플란트는 100%의 누적 성공률을 보였고, 1년후(평균 58주) 방사선 사진에서 임플란트는 평균 1.03 mm ${\pm}$ 0.20 mm의 골소실을 보였으며, 임플란트의 기능에는 이상을 보이지 않았다. 피개의치는 의치파절, 의치상 이장 또는 개상, 메일의 탈락 또는 유지력 감소로 인한 메일 교체 등 다양한 합병증을 보였다. 그러나 의치상 이장 및 개상, 메일 인써트의 간단한 교체로 인해 장기적으로 임플란트 및 임플란트 유지 피개의치가 환자에게 유지되고 있었다. 결론: 하악 전방부위에 임플란트 2개를 식립 후 Locator를 이용한 임플란트 유지 하악 피개의치는 최소침습적인 수술, 간단한 보철 과정 및 수리 과정의 장점으로 인해 장기적으로 안정적인 치료법으로 사료된다.