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Background - Mandibular implant supported overdentures (IOD) overcome the difficulties faced by conventional mandibular dentures. Due to increased load and lesser thickness, they often fracture. In this case report, we present a metal reinforced mandibular IOD to overcome this drawback. Case description - An elderly, completely edentulous patient with a severely resorbed mandibular ridge reported to the department for a prosthesis. After a thorough study, it was decided to fabricate a mandibular IOD, reinforced with metal mesh to increase its strength. Discussion - Mandibular dentures are known to be prone to frequent fractures. In an attempt to increase its strength and longevity in function, we reinforce it with metal mesh. This case report is unique since, a metal reinforced mandibular implant supported overdentures are extremely rare. Conclusion - A regular follow-up of the patient revealed satisfactory patient outcome. [ABSTRACT FROM AUTHOR]

Introduction: Fracture of maxillary complete denture is a common problem for dentists and denture wearers, occurring especially when it is opposing mandibular natural teeth or fixed and implant-sustained restorations; to prevent it, various methods and materials are available.

The aim of this study was to describe a technique of fabrication of two implant-supported mandibular overdentures. There are several treatment modalities for completely edentulous patients including conventional complete dentures (CDs), implant-supported overdentures (IODs), and implant-supported fixed prosthesis. Patients with a severely resorbed mandible often experience problems with their conventional CDs. Treatment concepts involving IODs have proven to be as satisfactory as implant-supported fixed prosthesis with added advantage of ease in hygiene maintenance and less cost. This clinical report summarizes a simplified and accurate method of fabricating two implant-supported mandibular overdentures. In this case, two implants were placed in the intercanine region of mandibular ridge and conventional CD was installed. Three months later, this CD was converted into implant-supported mandibular overdenture. Conventional CDs have shown less satisfaction rates by patients over a period of time in terms of function. Moreover, there are researches showing increased rate of resorption with these dentures. Thus, IODs are used routinely to provide a better quality of life to edentulous patients. [ABSTRACT FROM AUTHOR]

Background: It is uncertain, which is the optimal attachment for a mandibular 2‐implant overdenture (2IOD). Purpose: To assess 5 years clinical implant outcome, prosthetic maintenance, cost, and PROMs of two cohorts receiving 2IOD on ball or stud abutments in a comparative study. Materials and Methods: Ninety edentulous individuals were treated with balls (n = 34) or locator (n = 56). Implant survival, bone‐to‐implant level, prosthetic outcome, technical maintenance, and OHIP‐14 were assessed. Statistics to compare between baseline and 1/5 years and between groups were t‐test or Mann‐Whitney (P < .05); chi‐square was adopted to analyze plaque and technical maintenance or interventions between groups. Results: Five years implant survival was 98.7%, irrespective of attachment. Overall mean bone loss was 1.1 mm, probing pocket depth 1.92 mm, bleeding score 0.60, plaque score 1. Plaque accumulated more on locators (P =.023). OHIP‐14 declined from 18.1 to 2.7 irrespective of attachment. Retention for balls was better (P < .005), locators required more maintenance (P < .001), caused by retention‐adjustment (P < .001) or ulcers/pain (P =.014). Five years maintenance‐cost was 11% of initial cost, irrespective of attachment. Conclusions: Balls and locators yield stable 5‐years implant outcome and improved Oral Health Related Quality of Life (OHRQoL). Locators required more maintenance and resulted in a lower retention. Maintenance costs are minimal but may affect OHRQoL at least for stud abutments. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this prospective clinical study was to compare the maintenance interventions required for solely implant‐retained overdentures (I‐OD) with that of overdentures retained by a combination of telescopic crowns and implants (T/I‐OD). Materials and methods: The participants in this study were 22 patients who initially presented either with a removable complete denture (n = 11) or with an overdenture retained by 1 to 2 telescopic crowns on natural teeth (n = 11). Subsequently, the total number of abutments was increased to 5 to 6 (maxilla) or 4 to 5 (mandible) by placing implants in strategically advantageous regions, generating two distinct groups: I‐OD and T/I‐OD. Ball attachments were connected to the implants and integrated into the existing denture. The maintenance aspects were analyzed according to the type of treatment (preventive, biological, and technical) and to the severity of treatment (minimal, moderate, and extensive). Results: During a mean observation time of 6.5 years, the tooth survival rate was 89% (T/I‐OD) and the implant survival rate 100% (both groups). The survival rates of the overdentures ranged from 90.9% (I‐OD) to 100% (T/I‐OD). A mean number of 0.6 (I‐ODs) and 2.0 (T/I‐OD) treatments were performed for biological reasons; and 8.2 (I‐ODs) and 9.6 (T/I‐OD) for technical reasons, per patient, during the observation time. From biological aspects, significantly more extensive maintenance was found to be necessary in the T/I‐OD group than in the I‐OD group. Conclusions: The therapeutic concept of implant placement under existing prostheses was promising when performed in indicated cases. [ABSTRACT FROM AUTHOR]

This in-vivo study aimed to investigate the load on the working-side implant and on the edentulous distal mucosa of the nonworking side in a mandibular implant-retained overdenture (MIR-OVD) anchored to 2 implants by either a ball- or a clips-and-bar attachment. Three female patients were provided with duplicate dentures anchored in the 2 ways. Strain on the implant was investigated using a strain-gauged abutment, and load on the mucosa was measured using a suitably placed load cell. Ball attachments appeared to provide greater stability to the MIR-OVD, since load was more evenly distributed onto the distal mucosa of both sides. When the MIR-OVD was bar-anchored, axial load on the working-side abutment increased. [ABSTRACT FROM AUTHOR]

Background: There is a lack of studies evaluating the wear of the male components of the ball attachment systems of implant‐retained overdentures. Purpose The purpose of this study was to compare the volumetric wear patterns four commercially used ball abutments. Materials and Methods: Forty‐eight identical polyethylene and acrylic blocks were fabricated and four groups consisting of 12 polyethylene blocks with two implants and 12 acrylic blocks, which were used as overdentures, were generated (two groups with plastic females, one group with gold and one group with titanium females). Every specimen underwent 5000 insertion and removal cycles (~4.5 years) and retention forces were measured. For the evaluation of volumetric wear, all the ball abutments were scanned before and after the 5000 cycles using a three‐dimensional scanner and the data were analyzed using the software supplied by the manufacturer. Results: Statistically significant retention force differences were observed between the groups at each cycle (P < .05). Among the four groups, retention force was lowest in the group with titanium females (5.59 ± 2.27) and highest in the group with gold females (43.0 ± 6.3) at the end of 5000 cycles. Statistically significant dimensional changes in the male components were observed between the groups (P < .05). Volumetric losses were 11%‐13% in Group I and II, 1% in Group III, and 25% in Group IV. Group III showed significantly lower volumetric wear whereas Group IV showed significantly higher volumetric wear than all the other groups (P < .001). No significance was detected between Group I and II (P > .05). Conclusion: Within the limitations, it can be concluded that although clinical studies are needed to ensure the findings of the present study, due to severe retention loss and volumetric abutment wear, ball attachments with titanium female components should be used with caution. [ABSTRACT FROM AUTHOR]

A modified polyetheretherketone (PEEK) framework material in combination with heat‐polymerized denture base acrylic resin was used for the fabrication of an overlay prosthesis for a patient sensitive to base metals. High noble metal was used for the fabrication of the post/coping/ball attachment assemblies to promote retention and stability. These protruding attachments into the acrylic resin could result in stress concentration; therefore, a framework is often used to strengthen the prosthesis. PEEK frameworks could be a treatment alternative to high noble or Ti frameworks since they combine good mechanical properties with biocompatibility, reduced cost, and common laboratory procedures. [ABSTRACT FROM AUTHOR]

Abstract: Background: Implant‐supported overdenture is one of the most predictable treatment options used in complete edentulism. However, differences have been reported between bar and ball attachments used to retain overdentures in terms of patient satisfaction and prosthesis retention. Purpose: The purpose of this study is to compare the effectiveness of bar and ball attachments for conventionally loaded implant‐supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention. Materials and methods: We conducted the review according to the Cochrane methods and following MECIR standards. We searched Cochrane Oral Health Group Trial register, Cochrane Central Register of Controlled Trials, MEDLINE, and the WHO ICTRP (March 31, 2017). Two review authors assessed trials for inclusion and risk of bias, extracted data, and checked for accuracy. We have expressed results as risk ratio or mean differences, together with their 95% confidence intervals. Results: We included 10 trials (465 participants). After 5 y, one trial reported higher patient satisfaction when bar attachment was used (MD 1.30, 95% CI 0.20–2.40), and reported no difference between both systems in prosthesis retention (MD −0.90, 95% CI −1.90 to 0.10). Two trials reported no implant failures after 1 and 5 y in both attachments. Downgrading of evidence was based on the unclear risk of bias of included studies and the wide CI crossing the line of no effect. Conclusions: There is insufficient evidence to support bar or ball attachment to be used with implant‐supported overdentures in completely edentulous patients to improve patient satisfaction and prosthesis retention (PROSPERO 2014:CRD42014014594). [ABSTRACT FROM AUTHOR]

Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index). Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced. Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials.

Copyright of dentalTarget is the property of dentalTarget and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Implant supported overdenture is one of the primary treatment options for completely edentulous patients. Many attachment systems are available for clinical application with implant supported overdenture, ball attachments were considered the simplest type. This case report describes the rehabilitation of a patient with generalized bone loss and the teeth with compromised crown root ratio. A clinical approach was formulated to replace the lower arch with implant supported overdenture and upper removable partial denture. Entire lower teeth were removed followed by immediate placement of 4 implants of 3.5 diameter and 11.5 length in the inter foraminal region. Locator attachment system was attached to the implants, and the implants were loaded by which patients was able to enjoy a normal, comfortable chewing function with an unparalleled confidence in the secure fit of their overdenture. [ABSTRACT FROM AUTHOR]

Objective One aim of this prospective clinical study was to measure the effects of strategicimplant placement under removable partial dental prostheses ( RPDPs) and among removable complete dental prostheses ( RCDPs) on oral health-related quality of life ( OHRQo L). Materials and methods Twenty-three patients participated in this study restored with RCDPs ( n = 12) or RPDPs retained by telescopic crowns with 1-2 abutment teeth ( n = 11). The total number of abutments was increased to 5-6 (maxilla) or to 4 (mandible) by placing implants in strategically advantageous regions. Ball attachments were attached to the implants and integrated in the existing denture. The Oral Health Impact Profile (49 questions) was completed by patients before implant placement, at baseline (integration of ball attachments), and during 12- and 24-month follow-up visits. Results There were marked reductions of impacts in both groups when comparing pre-treatment scores and scores at baseline ( P < 0.0001), 12-month ( P < 0.0001), and 24-month follow-up visits ( P < 0.0001), respectively. For none of the visits, a significant difference between the two groups was detected ( P > 0.05). Conclusion It can be concluded that a strategic placement of implants under the existing dental prostheses improves OHRQoL in both treatment groups. [ABSTRACT FROM AUTHOR]

Replacement of multiple missing teeth mainly in the Kennedy's class I and class II condition is a challenge for the clinician and the patient in terms of retention, masticatory efficiency, esthetics, comfort and importantly economics. Here, a case using implants in the distal denture bearing area with ball attachments and fabricating a cast partial denture over it utilizing the best of all benefits has been presented. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate the oral health-related quality of life (OHRQoL) of implant-retained overdenture users. Methods: 63 patients aged 50–90 years treated with at least one implant overdenture at the Complutense University (Madrid) in 2000–2010 were included. Of those, 42 answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. The additive method was used in the OHIP analysis. Data regarding sociodemographic background, overdenture features, and clinical factors were recorded. Sociodemographic and overdenture-related variables for the lost patients (n =21) were also gathered from their history files. Descriptive probes, Mann–Whitney and Kruskal–Wallis tests, and the Spearman correlation coefficient were applied (p ≤0.05). Results: The predominant participants’ profile was that of a 71–80-year-old woman wearing a mandibular overdenture with a bar retention system and a complete denture in the opposite jaw. 71.4% of the respondents suffered from some kind of impact on OHRQoL, showing an average score of 2.7±3.0 (range: 0–13). 100% of respondents reported no impact for the “social disability” and “handicap” dimensions. The most prevalently affected domain was “physical pain”, followed by “functional limitation” and “psychological discomfort”. Variables such as the overdenture location or the retention system affected specific OHIP subscales (p ≤0.05). The greatest total score was achieved when the antagonist was a complete denture (p <0.01). Conclusions: Implant-retained overdentures provide a seemingly acceptable quality of life in the elderly population studied, irrespective of the influence of the location, retention system, and antagonist. Clinical significance: Although further research is necessary, mandibular implant overdentures are more comfortable than maxillary ones. Ball-retained prostheses facilitate eating the most, whereas the presence of oral ulcers and/or candidiasis was only detected in the case of bars, thus impairing OHRQoL. A complete denture as antagonist decreases the patient overall satisfaction. [Copyright &y& Elsevier]

Summary The objective of this systematic review was to assess the influence of splinted and unsplinted oral implants in the mandibular and maxillary implant-supported overdenture therapy, concerning the implant survival, the peri-implant parameters, the prosthetic complications and the patient satisfaction. An electronic MEDLINE search complemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on implant-supported overdentures with a mean follow-up of at least 3 years. Twelve studies from an initial yield of 1022 titles were finally selected and data were extracted. After an observation period of more than 3 years, there was no difference in implant survival rates between splinted and unsplinted design. From most of the investigations included in this study, it was mentioned that the unsplinted design needs more prosthetic maintenance. In more of the studies that were dealing with the satisfaction of the patients wearing implant-supported overdentures, no significant difference in the preference of the patients was reported. No significant difference in the peri-implant outcome between splinted and unsplinted design was found. Within the limits of this systematic review, it is concluded that there was no significant difference between the two different designs of implant-supported overdentures with respect to the soft tissue health status or patient satisfaction, although the bar-supported overdentures have been shown to need less prosthetic maintenance. [ABSTRACT FROM AUTHOR]

Copyright of Implant Dentistry is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Thirty-six completely edentulous patients were enrolled for a 5-year prospective study testing the treatment outcome between splinted and unsplinted implants retaining a mandibular hinging overdenture. The patients were randomized into 3 groups of equal size depending on the attachment system used such as: magnets, ball attachments or bars (reference group). Only 1 implant out of the 72 had failed at the abutment stage. Not a single implant failed during the 5-year loading period. The accumulation of plaque was significantly higher for the Magnet than for the Ball group. Bleeding on probing, as well as marginal bone level, attachment level and Periotestg values did not statistically differ among the groups, neither at year 1 nor at year 5. However, the Periotestm values were significantly lower at year 5 compared to year 1 for all groups, which indicates a higher rigidity at the bone-implant interface. No correlation was found between bleeding on probing and marginal bone loss. We conclude that the connection state of 2 implants retaining a hinging overdenture did not influence the peri-implant outcome. [ABSTRACT FROM AUTHOR]

Attachment-retained removable partial dental prostheses (RPDPs) may be lost. Although in such situations, the RPDP should be remade, no method has yet been described for replacing lost attachment-retained RPDPs. This report describes a method for fabrication of a replacement for a lost maxillary RPDP using ball-attachment analogs. [ABSTRACT FROM AUTHOR]

The position and support of abutment teeth in partially edentulous patient orientates to choose the overdenture attachments. Ball systems and telescopic crowns can be used for removable prostheses retention, depending on clinical case peculiarity. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index). Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced. Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials. [ABSTRACT FROM AUTHOR]