• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.397-411
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• 2004

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-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, 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 photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.2
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• pp.150-156
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• 2015

As dental implant treatment becomes popular for both partial and complete edentulous patients, old people with complex systemic diseases also tend to prefer implant-assisted-overdenture or implant-supported-fixed prostheses to conventional complete denture. In this case, 77-year-old female who was on medication for hypertension and osteoporosis and paralyzed on right side due to stroke visited for implant-assisted-overdenture on lower jaw. After oral and radiographic examination, root-assisted magnet overdenture on upper jaw and implant-assisted magnet overdenture on lower jaw are planned. Consequently, overdentures using self-adjusting magnetic attachment(SA) system on both jaws resulted in recovering satisfying function and retention, which is enable to insert and remove with only one hand.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.249-255
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• 2011

Purpose: Placement of endosseous implants in the atrophic maxilla is often restricted because of the lack of supporting bone. In this article, augmentation of the maxillary sinus floor with deproteinized bovine bone to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. Methods: The procedure was used in 200 patients (839 implants), using deproteinized bovine bone. The mean follow-up was 28.5 months. No inflammation of the bone grafts nor of the maxillary sinus occurred. The patients received implant supported overdentures or bone-anchored bridges. Results: The survival rate of implant restoration of this study was 97.6%. The total average of marginal bone loss in radiographs was $0.20{\pm}0.38$ mm. Insufficient primary stability, bony quality, and infection were thought to be associated factors in the failed cases. Conclusion: This study documented that deproteinized bovine bone, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of a endosseous implant.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.12-17
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• 2013

The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.32-38
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• 2015

PURPOSE. The aim of this study was to compare the durability and retention of 4 types of attachments placed over computer aided design/computer aided manufacturing (CAD/CAM) titanium bars when subjected to different pH conditions. MATERIALS AND METHODS. Four commercially available attachments were investigated: Hader Yellow, Hader Red, Ackerman Gold and Ackerman Stainless Steel. These attachments and Ackerman CAD/CAM titanium bars were placed in 2 vessels containing different artificial saliva solutions (pH 7/pH 4) at $37^{\circ}C$ for one month to simulate corrosion conditions, and they were then subjected to mechanical testing (5400 cycles of insertion and removal). RESULTS. The results revealed that there were significant differences in the average values of insertion/removal force due to the pH (F (1, 24)=9.207, P<.05) and the type of attachment (F (3, 24)=11.742, P<.05). CONCLUSION. More acidic pH values were found to have a negative influence on the retention capacity of the attachments.

• The Journal of Advanced Prosthodontics
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• v.5 no.3
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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.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.1
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• pp.93-103
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• 1999

Stress distribution on mandibular implants supporting overdentures were registered in vitro experimental model by means of 4 rosette gauges which were placed around the implant. The overdenture attachments used in this study were the Resilient Dolder bar, Rigid Bolder bar, Round bar, Hader bar & Dal-Ro attachment. An occlusal jig was placed on the overdenture and the loading sites were 3 points which mimicked working, balancing, and median relations. With 5 and 10kg loading, strains were measured by strain indicator(P-3500, Measurement group, Raleigh, USA), and using these data, maximum and minimum principal stresses and Von Mises stress were calculated and evaluated. The results were as follows : There was a tendency of high stress concentration in the lingual side of the implant, and in the buccal side low stress was developed regardless of the attachment systems. The resilient Bolder bar concentrated highest stress among the attachment systems, and the Round bar and the Dal-Ro attachment provided comparatively low stresses around the implant. The rigid Bolder bar concentrated high stress in the mesial side, and the Dal-Ro attachment developed tensile stress patterns in the lingual and distal sides of the implant at the balancing relation.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.36-42
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• 2021

Even though implant overdentures are preferentially recommended to mandibular edentulous patients, many patients may select conventional complete dentures due to cost and general condition. Proper retention and stability of conventional complete dentures in patients with severe alveolar bone resorption is difficult to achieve. To overcome the limitations, mandibular suction dentures with the closed mouth impression technique have been used. However, the previous technique requires the Frame cut back tray, the Centric tray, and the Gnathometer M. This article introduces a technique for fabricating a mandibular suction denture with common dental materials.

• Journal of Technologic Dentistry
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• v.45 no.3
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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.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.1
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• pp.91-104
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• 2008

Recently, osseointegrated implants have been used to improve denture support, stability, and retention. Several studies have been revealed that mandibular two-implant overdentures significantly increase patient satisfaction with the function of their prostheses. Use of a wide variety of attachment systems, including stud, magnet, and bar attachments, has proven both clinically predictable and effective. This article presents that two-implant overdenture can become the standard of care for treatment of the edentulous mandible.