Attachments in implant retained
overdentures
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentala...
Introduction
Many edentulous patients experience
problems with their dentures, especially
lack of stability and retention,...
The overdenture approach facilitates
the fabrication of different types of
prostheses depending on the number
of implants ...
Definition of attachment
A mechanical device for the fixation,
retention, and stabilization of a
prosthesis
www.indiandent...
Attachments used to retain overentures
• Ball attachments
• O – ring
• ERA attahcment system
• Spheroflex
• Locator attach...
• The decision as to what type of
overdenture is given is determined by
the following
• Patients expectations
• Financial ...
Attachment selection based on
number of implants and choice of
prosthesis
www.indiandentalacademy.com
Categorization of potential implant site in mandible –
By Carl E Misch
www.indiandentalacademy.com
Option One
• Supported by free
standing implants in
the B and D
position.
• Implants are
independent and
not splinted
www....
• Indications
•Indicated only when cost is the significant
patient factor
•When span between implants is too long
•When in...
• Most common type of attachment
used is a Ball, ring type attachment.
Eg: - O-Ring
ERA attachment
Spheroflex
www.indiande...
O – ring attachment
• They are doughnut
shaped, synthetic
polymer objects
that posses the
ability to bend with
resistance ...
advantages
• Ease in changing the attachment
• Wide range of movement
• Low cost
• Different degrees of retention
• Elimin...
ERA
• Resilient precision
overdenture
attachment
• Universal hinge with
vertical movement
• Metal jacket which
holds the m...
• Four angles to
accommodate
divergent implants
(0, 5, 11, 17
degrees)
• Two types standard
and micro. Selected
based on
i...
Spheroflex
• The Sphero Flex is a self paralleling
combination titanium implant abutment
and ball attachment. It is the ba...
Spheroflex
• Self paralleling
Implant abutment
overdenture system
with 2.5mm Ø
sphere.  
• Free rotation of 7.5º
for one a...
Loactor Implant attachments
• Supraradicular
design which
comes in a straight
abutment and 2
angle conncections
of 10 and ...
• The Self-Aligning
feature of the
LOCATOR attachment
allows a patient to
easily seat their
overdenture
• Different retent...
• Indicated when
• Interocclusal height is deficient
• Guide plane is necessary because of
minimal ridge height from alveo...
• Locator female
component on
implant
• Male component
placed on the
female component
www.indiandentalacademy.com
Zaag attachment systems
• In 1972 Zest anchor was introduced to
the dental profession. Initially used as
an attachment for...
components
• ZAAG implant
abutment of
different heights (3,
4, 5, 6mm). Female
matrix of the system
• Male retentive
eleme...
Female abutments in place
Male retentive part seated
Male retentive part placed
and cured in the denture
base
www.indiande...
Option two
• Implants are
positioned in
location B and D
and splinted
together with a bar
without any
cantilever.
www.indi...
• The attachment used here is a clip
which is used to engage the bar
• Bar is ovoid in shape and should be
placed 2mm away...
Hader bar
• Developed by
Hemet Hader in the
late 1960’s.
• Modified by English,
Staubli to EDS Hader
system. Height of
the...
Plastic form of Hader bar Retentice clip placed on cast bar
Retentice clip being inserted
into denture base
www.indiandent...
Option three
• Three root form
implants are used.
The superstructure
connects the three
implants but without
a distal cant...
• The posterior ridge form determines
the lateral movement of the
restoration
• Poor lateral stability places more
stresse...
• If posterior ridge
form is good ,
implants are placed
on A, C, E
• if posterior ridge is
poor, implants
placed in B, C, ...
Option four (Resilient Hybrid bar design)
• Four implants are
placed in A, B, D
and E position.
• A distal cantilever
appr...
• Attachments placed in the distal cantilever
end and the midline.
• Anterior attachment must allow prosthesis to
lift fro...
• Indicated in patients who have
• Poor posterior anatomy
• Attachment placed in the anterior
section is a clip and in the...
Zaag low profile bar attachment
ZAAG female part placed directly
on the abutment
Male retentive element placed on
the dent...
Option five (Rigid Hybrid bar design)
• Five implants are
placed in (A, B, C,
D, E).
• Superstructure is
cantilevered dist...
Loactor bar attachment
• Four evenly placed
Locator female
attachment cast on
superstructure in
overdenture option
- four
...
• Four to six retentive
elements are
included in the bar
design.
Attachments sually
used are Hader
clips, O – ring, ERA.
•...
Thank you
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
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Attachments in implant retained overdentures/ cosmetic dentistry training

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Attachments in implant retained overdentures/ cosmetic dentistry training

  1. 1. Attachments in implant retained overdentures INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Introduction Many edentulous patients experience problems with their dentures, especially lack of stability and retention, together with a decrease of chewing ability. one possibilty of solving this problem is the use of endosseous implants to which an overdenture can be attached. www.indiandentalacademy.com
  3. 3. The overdenture approach facilitates the fabrication of different types of prostheses depending on the number of implants placed. They are • Implant-supported fixed screw-retained prosthesis • Implant-supported removable overdenture • Combined implant-retained and soft tissue-supported overdenture prosthesis www.indiandentalacademy.com
  4. 4. Definition of attachment A mechanical device for the fixation, retention, and stabilization of a prosthesis www.indiandentalacademy.com
  5. 5. Attachments used to retain overentures • Ball attachments • O – ring • ERA attahcment system • Spheroflex • Locator attachment system • ZAAG attachment system • Bars • Dolder bar • Hader EDS bar • Hybrid bar system • Resilient • Rigid www.indiandentalacademy.com
  6. 6. • The decision as to what type of overdenture is given is determined by the following • Patients expectations • Financial considerations • Anatomic and morphologic condition of the bone • Shape of the alveolar ridge www.indiandentalacademy.com
  7. 7. Attachment selection based on number of implants and choice of prosthesis www.indiandentalacademy.com
  8. 8. Categorization of potential implant site in mandible – By Carl E Misch www.indiandentalacademy.com
  9. 9. Option One • Supported by free standing implants in the B and D position. • Implants are independent and not splinted www.indiandentalacademy.com
  10. 10. • Indications •Indicated only when cost is the significant patient factor •When span between implants is too long •When insufficinet space exists to accommodate attachment to bar •Arch form that is tapered anteriorly so that bar is cantilevered posteriorly www.indiandentalacademy.com
  11. 11. • Most common type of attachment used is a Ball, ring type attachment. Eg: - O-Ring ERA attachment Spheroflex www.indiandentalacademy.com
  12. 12. O – ring attachment • They are doughnut shaped, synthetic polymer objects that posses the ability to bend with resistance and then return back to their original shape. • The O-ring attaches to a post with a groove or undercut area. www.indiandentalacademy.com
  13. 13. advantages • Ease in changing the attachment • Wide range of movement • Low cost • Different degrees of retention • Elimination of time and cost of a superstructure of a prosthesis www.indiandentalacademy.com
  14. 14. ERA • Resilient precision overdenture attachment • Universal hinge with vertical movement • Metal jacket which holds the male attachments www.indiandentalacademy.com
  15. 15. • Four angles to accommodate divergent implants (0, 5, 11, 17 degrees) • Two types standard and micro. Selected based on interocclusal distance. www.indiandentalacademy.com
  16. 16. Spheroflex • The Sphero Flex is a self paralleling combination titanium implant abutment and ball attachment. It is the ball attachment of choice for all implants. www.indiandentalacademy.com
  17. 17. Spheroflex • Self paralleling Implant abutment overdenture system with 2.5mm Ø sphere.   • Free rotation of 7.5º for one abutment, 15º degrees for more than one. www.indiandentalacademy.com
  18. 18. Loactor Implant attachments • Supraradicular design which comes in a straight abutment and 2 angle conncections of 10 and 20 degrees for angled abutments. • Total height is 3.5 mm www.indiandentalacademy.com
  19. 19. • The Self-Aligning feature of the LOCATOR attachment allows a patient to easily seat their overdenture • Different retentive males that allow for choice of retention according to need of patient www.indiandentalacademy.com
  20. 20. • Indicated when • Interocclusal height is deficient • Guide plane is necessary because of minimal ridge height from alveolar bone loss. www.indiandentalacademy.com
  21. 21. • Locator female component on implant • Male component placed on the female component www.indiandentalacademy.com
  22. 22. Zaag attachment systems • In 1972 Zest anchor was introduced to the dental profession. Initially used as an attachment for overdentures on natural teeth. • Later modified as ZAAG(Zest Anchor Advanced Generation) • Allows upto 15 degees of divergence in female orientation www.indiandentalacademy.com
  23. 23. components • ZAAG implant abutment of different heights (3, 4, 5, 6mm). Female matrix of the system • Male retentive element which will seat into the female matrix www.indiandentalacademy.com
  24. 24. Female abutments in place Male retentive part seated Male retentive part placed and cured in the denture base www.indiandentalacademy.com
  25. 25. Option two • Implants are positioned in location B and D and splinted together with a bar without any cantilever. www.indiandentalacademy.com
  26. 26. • The attachment used here is a clip which is used to engage the bar • Bar is ovoid in shape and should be placed 2mm away from the soft tissue. www.indiandentalacademy.com
  27. 27. Hader bar • Developed by Hemet Hader in the late 1960’s. • Modified by English, Staubli to EDS Hader system. Height of the EDS hader bar is 3 mm. www.indiandentalacademy.com
  28. 28. Plastic form of Hader bar Retentice clip placed on cast bar Retentice clip being inserted into denture base www.indiandentalacademy.com
  29. 29. Option three • Three root form implants are used. The superstructure connects the three implants but without a distal cantilever. • Usually advocated in V shaped ridges www.indiandentalacademy.com
  30. 30. • The posterior ridge form determines the lateral movement of the restoration • Poor lateral stability places more stresses on the anterior implants www.indiandentalacademy.com
  31. 31. • If posterior ridge form is good , implants are placed on A, C, E • if posterior ridge is poor, implants placed in B, C, D regions. www.indiandentalacademy.com
  32. 32. Option four (Resilient Hybrid bar design) • Four implants are placed in A, B, D and E position. • A distal cantilever approximatly 1.5 times the A – P distance is made. www.indiandentalacademy.com
  33. 33. • Attachments placed in the distal cantilever end and the midline. • Anterior attachment must allow prosthesis to lift from the bar to permit rotation of distal attachments. www.indiandentalacademy.com
  34. 34. • Indicated in patients who have • Poor posterior anatomy • Attachment placed in the anterior section is a clip and in the distal cantilever ball type attachments might be placed. • Patient benefits because there is greater vertical support and lateral stability. www.indiandentalacademy.com
  35. 35. Zaag low profile bar attachment ZAAG female part placed directly on the abutment Male retentive element placed on the denture base www.indiandentalacademy.com
  36. 36. Option five (Rigid Hybrid bar design) • Five implants are placed in (A, B, C, D, E). • Superstructure is cantilevered distally a maximum of 2.5 mm the A-P distance or approx 15mm. www.indiandentalacademy.com
  37. 37. Loactor bar attachment • Four evenly placed Locator female attachment cast on superstructure in overdenture option - four www.indiandentalacademy.com
  38. 38. • Four to six retentive elements are included in the bar design. Attachments sually used are Hader clips, O – ring, ERA. • Typically four attachments are placed evenly. Two anterior and two posterior. www.indiandentalacademy.com
  39. 39. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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