• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.12-21
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• 2022

PURPOSE. The purpose of this study was to investigate changes in retention and wear pattern of Locator^® and ADD-TOC attachments on a digital milled bar by performing chewing simulation and repeated insertion/removal of prostheses in fully edentulous models. MATERIALS AND METHODS. Locator (Locator^®; Zest Anchors Inc., Escondido, CA, USA) was selected as the control group and ADD-TOC (ADD-TOC; PNUAdd Co., Ltd., Busan, Republic of Korea) as the experimental group. A CAD-CAM milled bar was mounted on a master model and 3 threaded holes for connecting a bar attachment was formed using a tap. Locator and ADD-TOC attachments were then attached to the milled bar. Simulated mastication and repeated insertion/removal were performed over 400,000 cyclic loadings and 1,080 insertions/removals, respectively. Wear patterns on deformed attachment were investigated by field emission scanning electron microscopy. RESULTS. For the ADD-TOC attachments, chewing simulation and repeated insertion/removal resulted in a mean initial retentive force of 24.43 ± 4.89 N, which were significantly lower than that of the Locator attachment, 34.33 ± 8.25 N (P < .05). Amounts of retention loss relative to baseline for the Locator and ADD-TOC attachments were 21.74 ± 7.07 and 8.98 ± 5.76 N (P < .05). CONCLUSION. CAD-CAM milled bar with the ADD-TOC attachment had a lower initial retentive force than the Locator attachment. However, the ADD-TOC attachment might be suitable for long-term use as it showed less deformation and had a higher retentive force after simulated mastication and insertion/removal repetitions.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.153-162
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• 2013

This study compared the marginal bone loss around dental implants that were placed in the canine areas of the mandibles and finded the survival rate of the implants, marginal bone loss around implants and prosthetic complications in 20 patients treated with overdentures retained with Locator attachments. Implants placed in this study showed a 95% survival rate and the average marginal bone loss was 1.21 mm($SD{\pm}0.60mm$) in 94.3 weeks of functional loading. Implant-retained overdentures had various prosthetic complications such as male change, metal cap loosening, Locator attachment loosening, denture teeth change, relining and denture fracture. Implant-retained overdentures using two implants and Locator attachments in the edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.1
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• pp.90-99
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• 2023

Implant overdentures are widely used as a treatment method to restore oral function in completely edentulous or partially edentulous patients with severe bone resorption. Using a milled bar, it is mechanically advantageous as the implant fixtures are splinted. Applying additional attachments to the bar has the advantage of dispersing the stress applied to the implant. In this case, a patient who used implant overdentures using 4 implants wanted to fabricate a new prosthesis due to repeated fractures of the denture and weakened retention. Milled bar with ADD-TOC attachment and zirconia prosthesis were fabricated by CAD-CAM method and mechanically and aesthetically satisfactory results were obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.4
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• pp.331-337
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• 2014

In conventional bar- and clip-retained overdentures, all errors during impression making and cast fabrication result in non-passive fit of bars. SFI bar is prefabricated and assembled in the patient's mouth without the use of soldering, laser welding or conventional bonding techniques, thus reducing stress transmission to, bone loss around the implants and leading to fewer errors and lower costs. A clinical case will be presented below to demonstrate the use of the SFI Bar (Stress Free on Implant Bar) to restore an severe atrophy edentulous maxilla. In this case, no lateral stress could be applied to the implants due to the telescopic design of the bar joints. However, periodic recall check is necessary and long-term clinical results are required.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.113-118
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• 2013

When losing many of the remaining teeth, the relation among them can be put into dynamically unfavorable situation. In the case that the patient without any incompatibilityto the denture, overdenture can be considered. Moreover, we can overcome the dynamical disadvantage, and improve the support, stability, and retention of the partial denture by using implant at the edentulous area. In this case, patient with crossed occlusion between few remaining teeth was treated with maxillary and mandibular partial denture. Single implant fixture was placed at the edentulous space, opposing to the maxillary teeth occluded, and $Locator^{(R)}$ attachment was connected. The patient's esthetic satisfaction was improved by ideally adjusting the tilted occlusal plane. Since the patient was satisfied both esthetically and functionally, and maintained stable during the clinical observation for 6 months after the treatment, we would like to report about it.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.325-332
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• 2014

PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.21-29
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• 2016

This in vitro study investigated and compared the durability and retention of three types of attachments. MATERIALS AND METHODS. Three commercially available attachments were investigated: $Clix^{(R)}$, Dalbo-$Plus^{(R)}$ and $Locator^{(R)}$. In total, 72 samples of these attachments were placed in the acrylic resin forms and subjected to mechanical testing (5400 cycles of insertion and removal) over the respective ball or Locator abutments immersed in artificial saliva at pH 7 and $37^{\circ}C$. The abutments were placed at angulations of $0^{\circ}$, $10^{\circ}$ and $20^{\circ}$. The retention force was recorded at the beginning and after 540, 1080, 2160, 3240, 4320 and 5400 insertion-removal cycles. RESULTS. The results revealed that there were significant differences in the average values of the insertion/removal force due to angulation ($F_{(2.48)}=343619$, P<.05) and the type of attachment ($F_{(7.48)}=23.220$, P<.05). CONCLUSION. Greater angulation of the abutments was found to influence the retention capacity of the attachments, and the fatigue test simulating 5 years of denture insertion and removal did not produce wear in the metal abutments.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.2
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• pp.173-180
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• 2021

Purpose: The purpose of this study was to evaluate the retentive characteristics of the additional attachments used with implant bar attachment under repeated insertion/removal cycles. Materials and methods: The newly developed attachment and the commercially available attachment were investigated: ADD-Lock (AL), Locator blue (LB). Two fixtures were placed parallel to each other on the custom lower mounting, and patrix of each attachment was fixed to the fixture. Also, the matrix of each attachment was placed on the opposing upper mounting. A universal testing machine was used to measure the retentive force during initial, 100, 250, 500, 1000, 2000, and 2500 repeated insertion/removal cycles. Wear and deformation of the attachment s were observed by scanning electron microscopy (SEM). Mann-Whitney U test (α=.05) and wilcoxon signed-rank test (α=.05) were performed to compare retentive force between each group and before and after 2500 repeated insertion/removal cycles. Results: In terms of initial retentive force and retentive force after 2500 repeated insertion/removal cycles, the AL group (15.24 ± 1.46 N and 9.74 ± 1.16 N) showed significantly smaller values than the LB group (43.53 ± 12.39 N and 22.99 ± 4.77 N) (P<.05). Also, in the loss of retentive force, the AL group (5.50 ± 1.08 N, 36.08%) showed a smaller value than the LB group (20.54 ± 11.89 N, 47.19%) (P<.05). Based on SEM analysis, The AL group showed noticeable wear and deformation in the patrix and the LB group in the matrix. Conclusion: Locator showed a higher initial retentive force than newly developed attachment, while the loss of retentive force was also higher. Both additional attachments are considered to have sufficient retentive force after repeated insertion/removal cycles.

• The Journal of Advanced Prosthodontics
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• v.7 no.4
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• pp.329-337
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• 2015

PURPOSE. This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS. In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS. One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: $5.9{\pm}2.2years$), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION. Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.267-272
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• 2016

This case report describes the treatment of two fully edentulous patients with mini-implant overdentures using different implant systems on narrow mandibular alveolar bone ridge. They were complaining about discomfort and pain wearing mandibular conventional complete dentures caused by insufficient retention. Each patient received four miniimplants in the interforaminal area of the mandible using the non-submerged flapless surgical approach. One-body type implant (Slimline, Dentium, Seoul, Korea) was used for a patient and loaded immediately after surgery. Metal housings of O-ring were attached by direct technique. For the other patient, two-piece type implant (LODI, Zest Anchors, Escondido, CA, USA) was used and impressions were made for attachment connection of the Locator's metal housings after 8 weeks of surgery. Within this case report, mandibular miniimplant overdentures using different implant systems showed improvement of patient satisfaction with favorable peri-implant tissue response 6 months after attachment connection. However, long-term follow-up is needed for further evaluation.