An overview of implant overdenture attachment systems
Keywords:Implant-retained overdentures, Attachment systems, Implant survival, Retention, Stress distribution, Complications, Patient satisfaction
Implant-retained overdentures have revolutionized dental prosthetics, addressing the limitations of traditional removable dentures. These overdentures rely on attachment systems to anchor them to dental implants or abutments, improving stability, retention, and functionality. Common attachment systems include locator attachments, bar attachments, magnets, Hader clips, ERA attachments, telescopic crowns, and OT equator attachments. Each offers unique benefits and retention levels. Implant survival rates are influenced by various factors, including attachment type, but overall, attachment choice may not be the primary determinant of implant success. Attachment systems that evenly distribute forces, like bar attachments, contribute to implant stability. Marginal bone loss can affect implant stability and is influenced by attachment systems. Precision attachments, such as telescopic crowns, have shown reduced marginal bone loss in practice. Soft tissue complications, including inflammation and mucositis, vary by attachment but can be managed with proper oral hygiene. Retention, crucial for function, varies with attachment type and implant number. More implants generally improve retention, although it may decrease over time. Bar attachments typically provide superior retention. Maintenance is essential, with some debate over whether bar or stud designs entail more upkeep. Patient satisfaction is high with both bar and ball attachments, while magnets may pose retention issues. The choice of attachment depends on patient needs and clinical factors, with regular follow-up and maintenance essential for long-term success.
Feine J, Carlsson G, Awad M, Chehade A, Duncan WJ, Gizani S et al. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Gerodontology. 2002;19(1):3-4.
Allen EP, Bayne SC, Brodine AH, Robert JC, Terence ED, John CK et al. Annual review of selected dental literature: report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthetic Dentistr. 2002;88(1):60-88.
Sadowsky SJ. Treatment considerations for maxillary implant overdentures: a systematic review. J Prosthetic Dentistr. 2007;97(6):340-8.
Kim H-Y, Lee J-Y, Shin S-W, Bryant SR. Attachment systems for mandibular implant overdentures: a systematic review. J Adv Prosthodontics. 2012;4(4):197-203.
Bilhan SA, Bilhan H, Bozdag E, Sunbuloglu E, Baykasoglu C, Kutay O. The Influence of the Attachment Type and Implant Number Supporting Mandibular Overdentures on Stress Distribution: An: In Vitro: Study, Part I. Implant Dentistry. 2013;22(1):39-48.
Tokuhisa M, Matsushita Y, Koyano K. ln Vitro Study of a Mandibular Implant Overdenture Retained with Ball, Magnet, or Bar Attachments: Comparison of Load Transfer and Denture Stability. Int J Prosthodontics. 2003;16(2).
Alqutaibi AY, Kaddah AF. Attachments used with implant supported overdenture. Int Dental Med J Adv Res. 2016;2(1):1-5.
Khalifa AK, Abdel-Khalek EA, El Mekawy N. Comparing Masticatory Efficiency Of Mandibular Bar-Supported Overdentures With Different Loading Protocols. Egypt Dental J. 2018;64(3):2593-601.
Raghavan R, PA S, AA M. Attachments Used with Implant Supported Overdenture: A Review. Int J Sci Healthcare Res. 2021;6(1):105-9.
Liao K-Y, Kan JY, Rungcharassaeng K, Lozada JL, Herford AS, Goodacre CJ. Immediate loading of two freestanding implants retaining a mandibular overdenture: 1-year pilot prospective study. Int J Oral Maxillofacial Implants. 2010;25(4):784-90.
Mirchandani B, Zhou T, Heboyan A, Yodmongkol S, Buranawat B. Biomechanical aspects of various attachments for implant overdentures: A review. Polymers. 2021;13(19):3248.
Shastry T, Anupama N, Shetty S, Nalinakshamma M. An in vitro comparative study to evaluate the retention of different attachment systems used in implant-retained overdentures. J Indian Prosthodontic Society. 2016;16(2):159.
Prasad D, Buch M. Selection of attachment systems in fabricating an implant supported overdenture. J Dental Implants. 2014;4(2):176.
Krennmair G, Weinländer M, Krainhöfner M, Piehslinger E. Implant-supported mandibular overdentures retained with ball or telescopic crown attachments: a 3-year prospective study. Int J Prosthodontics. 2006;19(2):164-70.
Taha NEKS, Dias DR, Oliveira TMC, Souza JAC, Leles CR. Patient satisfaction with ball and Equator attachments for single‐implant mandibular overdentures: A short‐term randomised crossover clinical trial. J Oral Rehabilitation. 2020;47(3):361-9.
Hakkoum MA, Wazir G. Telescopic denture. Open Dentistr J. 2018;12:246.
Trakas T, Michalakis K, Kang K, Hirayama H. Attachment systems for implant retained overdentures: a literature review. Implant Dentistr. 2006;15(1):24-34.
Naert I, Gizani S, van Steenberghe D. Rigidly splinted implants in the resorbed maxilla to retain a hinging overdenture: a series of clinical reports for up to 4 years. J Prosthetic Dentistr. 1998;79(2):156-64.
Engquist B, Bergendal T, Kallus T, Linden U. A retrospective multicenter evaluation of osseointegrated implants supporting overdentures. Int J Oral Maxillofacial Implants. 1988;3(2):129-34.
Bergendal T, Engquist B. Implant-supported overdentures: a longitudinal prospective study. Int J Oral Maxillofacial Implants. 1998;13(2):253-62.
Gotfredsen K, Holm B. Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study. Int J Prosthodontics. 2000;13(2):125-30.
Kourtis S, Madianos P, Patras M, Andrikopoulou E. Rehabilitation of the edentulous mandible with implant‐supported overdentures on telescopic abutments and immediate loading. A controlled prospective clinical study. J Esthetic Restorative Dentistr. 2018;30(4):369-77.
Chao Y-L, Meijer HJ, Van Oort RP, Versteegh PA. The incomprehensible success of the implant stabilised overdenture in the edentulous mandible: a literature review on transfer of chewing forces to bone surrounding implants. Eur J Prosthodontics Restorative Dentistr. 1995;3:255-62.
Naert I, Quirynen M, Theuniers G, van Steenberghe D. Prosthetic aspects of osseointegrated fixtures supporting overdentures. A 4-year report. J Prosthetic Dentistr. 1991;65(5):671-80.
Von Wowern N, Gotfredsen K. Implant‐supported overdentures, a prevention of bone loss in edentulous mandibles? A 5‐year follow‐up study. Clin Oral Implants Res. 2001;12(1):19-25.
Wismeijer D, Van Waas MA, Mulder J, Vermeeren JI, Kalk W. Clinical and radiological results of patients treated with three treatment modalities for overdentures on implants of the ITI® Dental Implant System. A randomized controlled clinical trial. Clin Oral Implants Res. 1999;10(4):297-306.
Davis DM, Packer ME. Mandibular overdentures stabilized by Astra Tech implants with either ball attachments or magnets: 5-year results. Int J Prosthodontics. 1999;12(3):222-9.
Merickske-Stern R. Clinical evaluation of overdenture restorations supported by osseointegrated titanium implants: a retrospective study. Int J Oral Maxillofacial Implants. 1990;5(4):375-83.
Rangert B, Jemt T. Forces and moments on Brånemark implants. Int J Oral Maxillofacial Implants. 1989;4(3):241-7.
Petropoulos VC, Smith W, Kousvelari E. Comparison of retention and release periods for implant overdenture attachments. Int J Oral Maxillofacial Implants. 1997;12(2):176-85.
Naert I, Quirynen M, Hooghe M, van Steenberghe D. A comparative prospective study of splinted and unsplinted Brȧnemark implants in mandibular overdenture therapy: A preliminary report. J Prosthetic Dentistr. 1994;71(5):486-92.
Walmsley AD. Magnetic retention in prosthetic dentistry. Dental Update. 2002;29(9):428-33.
Kenney R, Richards MW. Photoelastic stress patterns produced by implant-retained overdentures. J Prosthetic Dentistr. 1998;80(5):559-64.
Menicucci G, Lorenzetti M, Pera P, Preti G. Mandibular implant-retained overdenture: a clinical trial of two anchorage systems. Int J Oral Maxillofacial Implants. 1998;13(6):851-6.
Zarb G, Schmitt A. The edentulous predicament. I: A prospective study of the effectiveness of implant-supported fixed prostheses. J Am Dental Asso. 1996;127(1):59-65.
Zitzmann NU, Marinello CP. Implant-supported removable overdentures in the edentulous maxilla: clinical and technical aspects. Int J Prosthodontics. 1999;12(5):385-90.
Bidez M, Chen Y, McLoughlin S, English C. Finite element analysis (FEA) studies in 2.5-mm round bar design: the effects of bar length and material composition on bar failure. J Oral Implantol. 1992;18(2):122-8.
Bidez M, Chen Y, McLoughlin S, English C. Finite element analysis of four-abutment Hader bar designs. Implant Dentistr. 1993;2(3):171-6.
Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. The Journal of prosthetic dentistry. 1999;81(5):537-552.
Jemt T, Book K, Lindén B, Urde G. Failures and complications in 92 consecutively inserted overdentures supported by Brånemark implants in severely resorbed edentulous maxillae: a study from prosthetic treatment to first annual check-up. Int J Oral Maxillofacial Implants. 1992;7(2):162-7.
Johns RB, Jemt T, Heath MR. A multicenter study of overdentures supported by Brånemark implants. Int J Oral Maxillofacial Implants. 1992;7(4):513-22.
Wismeijer D, Vermeeren JI, van Waas MA. Patient satisfaction with overdentures supported by one-stage TPS implants. Int J Oral Maxillofacial Implants. 1992;7(1):51-5.
Karabuda C, Tosun T, Ermis E, Ozdemir T. Comparison of 2 retentive systems for implant‐supported overdentures: soft tissue management and evaluation of patient satisfaction. J Periodontol. 2002;73(9):1067-70.
Gotfredsen K. Implant supported overdentures-the Copenhagen experience. J Dentistr. 1997;25:S39-42.
Toljanic JA, Antoniou D, Clarkc RS, Graham L. A longitudinal clinical assessment of spark erosion technology in implant-retained overdenture prostheses: A preliminary report. J Prosthetic Dentistr. 1997;78(5):490-5.
Burns DR, Unger JW, Elswick Jr RK, Giglio JA. Prospective clinical evaluation of mandibular implant overdentures: Part II-Patient satisfaction and preference. J Prosthetic Dentistr. 1995;73(4):364-9.