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Objective: To report on the use of a mandibular 3-implant overdenture with a novel implant distribution opposing a maxillary complete denture for the rehabilitation of an older edentulous patient., Background: The use of oral implants with attachment systems of various numbers and designs to support removable partial and complete dentures is well documented with success and predictability., Materials and Methods: An older edentulous patient with a mandibular implant-assisted removable partial denture was presented with failing remaining dentition. Teeth were extracted and a single midsymphyseal implant was placed. A mandibular overdenture on three implants with ball attachments in a tripod distribution was constructed to oppose a new maxillary complete denture made using a modified impression technique., Results: Over 2 years of follow-up, no significant biological or mechanical complications were reported, and denture retention and stability remained optimum., Conclusion: Mandibular overdentures on three implants with ball attachments in a tripod distribution, opposing a maxillary complete denture, could be an alternative treatment option for the older edentulous patients., (© 2021 Gerodontology Association and John Wiley & Sons Ltd.)

Objectives: The aim of the study was to determine differences between Locator and CM LOC attachment systems regarding patient satisfaction and wear of the abutments and their inserts. Plaque accumulation onto the polyetherketoneketone (PEKK) framework and polymethylmethacrylate (PMMA) was investigated for the implant-supported overdentures., Methods: Seventeen edentulous patients were randomised to receive either Locator or CM LOC system for the first year. The total number of implants was 53. After the randomisation, 25 implants received Locator system, and 28 implants received CM LOC system in the first year. After a period of 12 months, the attachment system was exchanged from either Locator to CM LOC or vice versa. Oral Health Impact Profile (OHIP-14) questionnaires were used to evaluate patient satisfaction, chewing comfort, and pressure lesions. Prosthesis hygiene on the PMMA and PEKK surfaces was evaluated by using Stark plaque index. After the exchange of the abutments, they were stored until the end of the 24 months, and the surface wear of the abutments was analysed using a scanning electron microscope., Results: Three patients (10 implants) died shortly before the end of the first year. Two patients (7 implants) received only Locator system since CM LOC was not indictable for their implant system. Patient's satisfaction was increased when the attachment system was changed from Locator to CM LOC after 12 months of wearing time. Chewing ability and comfort were increased when the attachment system was changed from CM LOC to Locator after 12-month wearing time. There was no influence of the change of the attachment system on pressure lesions. The observed plaque accumulation was higher on the PMMA than on the PEKK surface. For the 8 investigated Locator abutments, the wear was within low and middle level. For the 28 investigated CM LOC abutments, the wear was within middle and high level for the terminal implants and between low and middle for the central implants (for patients who received 4 implants)., Conclusions: Patient's satisfaction and wearing comfort can be improved with implant-supported overdentures with CM LOC abutments in comparison to Locator. There was no clear difference between both attachment systems concerning the chewing ability of the patients. Plaque accumulation was observed on both attachment systems in different areas. Plaque accumulation on PEKK surface was less than on PMMA surface., Clinical Relevance: The CM LOC attachment system offers stable and comfortable wearing conditions for implant-supported overdentures. The use of PEKK as a framework material could reduce the incidence of pressure lesions., (© 2021. The Author(s).)

Objectives: The aim of the present laboratory study was to investigate the retentive properties and the wear of three different resin matrix attachments for implant overdentures as well as to assess the effects of implant angulation., Methods and Materials: Three attachment systems with either polyetheretherketone inserts (PEEK; Novaloc, Straumann, Basel, Switzerland), polyetherketoneketone inserts (PEKK; CM Loc, Cendres + Métaux, Biel, Switzerland) or nylon inserts (Locator R-Tx, Zest Dental Solutions, Escondido, California, USA) were evaluated. The patrices were connected to their implant analogues and fixed in a resin cast at implant angulations of 0° and 15°. The corresponding matrices with inserts were fixed in a stylized unilaterally removable dental prothesis. To simulate masticatory forces 30,000 insertion and removal cycles with an eccentric load of 100 N at a distance of 12 mm were performed in a chewing simulator. The retention forces were measured. The wear patterns were examined using a scanning electron microscope (SEM). The statistical analysis was performed using a one-way ANOVA followed by a Games-Howell test and a Friedman test., Results: All attachment systems revealed a significant decrease in retention after testing, except PEEK 0°/0° and PEEK 15°/15°. PEEK and PEKK attachment systems showed significantly higher retentive forces than the nylon attachment system between 5000 and 30,000 cycles. The implant angulation did not significantly influence the retention behavior for any of the three attachment systems. Patrices showed no signs of wear, whereas the matrix inserts displayed signs of deformation., Conclusion: Within the limitations of the present study, attachments with PEEK and PEKK inserts combined with titanium patrices are favorable for long-term use, both for orthogonal and tilted implants. All three attachment systems showed a high variability of the retentive forces at baseline and for subsequent cycles. This should be taken into consideration for clinical use., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

To analyze the implant overdentures components as following: morphology and composition aspects of several small diameter systems, evaluating both the implant and the retention system (1); biomechanical characteristics of some of the polymers used for manufacturing the overdenture base (2). An experimental in vitro study was carried out through optic microscopy to analyze the metallic structure of dental implants components and anchor systems. The marketed products analyzed were mini1SKY (Bredent) and 3M ESPE MDI Mini dental implant (3M ESPE). A Zeiss microscope with Kohler illumination was used. Samples from polymeric materials commonly used for overdenture based (i.e. Duracryl and Superacryl) were analyzed by 3 point bending test by Tira device. In the case of the mini1SKY system (Bredent), the dental implant has the typical structure of marketed pure titanium that went through thermomechanical processing, resulting in a higher rate of granulation, and the matrix has a completely different structure, as it is a monophasic structure specific to materials that crystalize in the cubic system of the stainless steels. In the case of the 3M ESPE MDI system, the implant and the matrix have a similar microstructure, specific to a Ti-6Al-4V beta alloy annealed with an extremely fine rate of granulation. Duracryl and Superacryl samples fractured variable (frequently close to the midline) and were similar in regard to the value of breaking force. Knowledge of the materials of the components of implant overdenture guide their selection from the point of view of biocompatibility, resistance and ensuring denture retention. [ABSTRACT FROM AUTHOR]

Objectives: Numerous different attachments are used to retain overdentures on implants. The purpose of this study was to evaluate a new chairside attachment system based on polyvinylsiloxane (PVS). Material and methods: A total of 250 specimens were fabricated ( n = 10) to measure the retention force (RF) in dependence of the following parameters: fatigue (after 100, 200, 500, 1,000, and 5,000 cycles of dislodging), thermal undulation (10,000 cycles between 5 and 55 °C), implant angulation (0°, 5°, and 10°), and disinfection (three different agents). Three different PVS materials (shore hardness (SH), SH25, SH50, and SH65) were evaluated; locator attachments (LR blue) served as controls. Data were imported into a statistical program and analyzed at a 5 % level of significance. Results: Initial RFs were dependent on the shore hardness ( p ≤ 0.001, ANOVA). No changes in RFs were observed for PVS groups after repeated dislodging and thermal undulation. Locator attachments revealed a significant decrease in retention force of up to 58 % ( p ≤ 0.001, Fig. 3). No significant changes in RFs were induced by implant angulation. Retention force was decreased in some PVS groups after storage in disinfection solution. Conclusions: Polyvinylsiloxane attachments provide an alternative to locator attachments, exhibiting better stability of the retention force. Clinical relevance: The presented directly fabricated chairside attachment system represents RFs superior to existing attachment systems after artificial aging. [ABSTRACT FROM AUTHOR]

Dental specialists today are facing a major influx of completely edentulous patients and patients with generalized compromised teeth who ask for cost-effective full mouth rehabilitation. The choice of overdenture as a treatment modality is significantly less expensive and is within the reach of many patients who are on a limited financial support. Various types of attachment systems are currently available to restore implant-supported over-denture. Clinicians have selected various attachment systems based on factors such as durability, patient demand, cost-effectiveness, technical simplicity, and retention. The decision-making process to select certain types of attachment system still remains unclear. This article explains about various attachment system available, their advantages and disadvantages and their use in different clinical conditions. [ABSTRACT FROM AUTHOR]

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Background: There is a lack of clinical studies on the self-aligning attachment system (Locator®; Zest Anchors, Inc. homepage, Escondido, CA, USA) for two-implant-retained overdentures in the edentulous mandible. Therefore, a comparison of the Locator with two traditional designs (a rotational gold matrix and a rubber O-ring type) in clinical 1-year use was conducted. Materials and Methods: From 2003 to 2007, 60 patients received two Osseotite® TG Standard implants (BIOMET 3i Implant Innovations, Palm Beach Gardens, FL, USA) in the intraforaminal area of the edentulous mandible. The implants were left unloaded for 3.5 months, randomized to three different attachment systems, and loaded through a mandibular overdenture. Twenty-three patients received a self-aligning attachment system (Locator) and 33 patients a ball attachment (Dal-Ro®[BIOMET 3i Implant Innovations] n = 25; TG-O-Ring®[Cendres & Metaux SA, Biel-Bienne, Switzerland] n = 8). After 12 months of delivery of the overdentures, the oral situation was evaluated: prosthodontic maintenance and biologic complications, subjective patients' experience, and oral health-related life quality (Oral Health Impact Profile [OHIP-G 49]). Results: After 1-year of clinical service, 8 of 120 implants were lost (9.6%). The Locator system brought up 34 prosthetic complications, especially the need for change of the male parts or activation because of loss of retention. The TG-O-Ring patients showed 14 complications, most of them the change of the O-Rings. The patients with the Dal-Ro abutment had seven minor complications in 12 months of clinical use. Biologic complications and patients' oral health-related life quality showed no significant difference among the three experimental groups. Conclusions: Prosthodontic maintenance was restricted to loss of retention for all systems. Within the observation period of this study, the self-aligning attachment system showed a higher rate of maintenance than the ball attachments. The patients' oral health-related life qualities as well as the biologic parameters do not differ when using the three abutment systems. [ABSTRACT FROM AUTHOR]

Objectives: To review the literature on mandibular single-implant overdentures (opposing complete maxillary dentures), and present surgical and prosthodontic perspectives of a novel approach for this treatment option. Material and methods: An electronic search through the databases of Pubmed, Embase and Medline using the linked key words ‘mandibular single implant overdentures’ was performed. The search was limited to English language articles published up to August 2008. Hand searches through articles retrieved from the electronic search, peer-reviewed journals and recent conference proceedings were also conducted. Results: A limited number of reports were identified on mandibular single-implant overdentures (opposing maxillary complete dentures). They comprised of case-series reports, short-term prospective trials and current randomized-controlled clinical trials. Different loading protocols with different implant systems have been used, but always with regular diameter implants. Specific anatomical and vascular dangers of the mandibular midline symphysis are identified including a novel surgical approach using a currently available short, wide diameter tapered implant. In addition, the prosthodontic rationale for using a larger attachment system (incorporating a platform switch) for mandibular single-implant overdentures is described. Conclusion: The review reveals that there is a lack of published randomized clinical trials using mandibular single-implant overdentures, opposing maxillary complete dentures. Without the evidence from randomized clinical trials, routine use of this novel approach cannot be recommended, compared with using regular diameter implants and matching attachment systems. [ABSTRACT FROM AUTHOR]