This document discusses implant supported overdentures. It begins by defining an overdenture and explaining how implants can enhance support, retention and stability of dentures. Some key advantages of implant supported overdentures are presented, such as preventing bone loss and improved function. Classification systems for prosthesis movement are covered, along with different types of overdenture attachments like ball attachments and O-rings. The document concludes by outlining two treatment options for implant supported overdentures.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
The patient who requires a single denture opposing a natural or restored dentition challenges the clinician even more than the completely edentulous patient does. This is due to the biomechanical differences in the supporting tissues of the opposing arches. So a proper evaluation, correction of the existing factors and proper sequence of denture construction is necessary to give a more stable prosthesis.
The benefits of implant dentistry can be realized only when the prosthesis is first discussed and determined. An organized treatment approach based on the prosthesis permits predictable therapy results. Five prosthetic options postulated by Misch are available in implant dentistry. Three restorations are fixed and vary in the amount of hard and soft tissue replaced; two are removable and are based on the amount and type of support for the restoration. The amount of support required for an implant prosthesis should initially be designed similar to traditional tooth-supported restorations. Once the intended prosthesis is designed, the implants and treatment surrounding this specific
result can be established.
One of the best seminar of the author. Covered in detail regarding the increasing vertical dimension, centric relation, methods to record centric relation, philosophies of occlusion and in detail everything about full mouth rehabilitation.
Prosthesis is one of the most important component of an implant. There are various prosthetic factors that must be considered for a successful implant. Few of them include prosthesis type and material, the connection between abutment and prosthesis, occlusal factors, etc.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
The patient who requires a single denture opposing a natural or restored dentition challenges the clinician even more than the completely edentulous patient does. This is due to the biomechanical differences in the supporting tissues of the opposing arches. So a proper evaluation, correction of the existing factors and proper sequence of denture construction is necessary to give a more stable prosthesis.
The benefits of implant dentistry can be realized only when the prosthesis is first discussed and determined. An organized treatment approach based on the prosthesis permits predictable therapy results. Five prosthetic options postulated by Misch are available in implant dentistry. Three restorations are fixed and vary in the amount of hard and soft tissue replaced; two are removable and are based on the amount and type of support for the restoration. The amount of support required for an implant prosthesis should initially be designed similar to traditional tooth-supported restorations. Once the intended prosthesis is designed, the implants and treatment surrounding this specific
result can be established.
One of the best seminar of the author. Covered in detail regarding the increasing vertical dimension, centric relation, methods to record centric relation, philosophies of occlusion and in detail everything about full mouth rehabilitation.
Prosthesis is one of the most important component of an implant. There are various prosthetic factors that must be considered for a successful implant. Few of them include prosthesis type and material, the connection between abutment and prosthesis, occlusal factors, etc.
Definition
Types of rotation
Etiology of rotation
Winging and counter winging rotation
Advantages of derotation
Biomechanics of rotation correction
Methods of correction rotation
Management of molar derotation
Retention of rotated tooth
Methods to prevent relapse
Active retention
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
4. Introduction
4
According to GPT 9:-
overdenture o΄var-dĕn΄chur n: any removable dental prosthesis that covers
and rests on one or more remaining natural teeth, the roots of natural teeth,
and/or dental implants; a dental prosthesis that covers and is partially
supported by natural teeth, natural tooth roots, and/or dental implants;
5. 5
The consequences of total tooth loss includes bone resorption, changes in
orofacial morphology, and psychological effects.
Treatment with conventional complete denture is successful when residual
alveolar ridges are favorable.
But, such treatment will not be successful when,
1. Residual alveolar ridges are resorbed
2. Movement of denture leads to discomfort, pain, poor function
3. The patients have poor neuromuscular control
6. 6
These difficulties can be overcome by the use of osseointegrated implants
to support, retain and stabilize dentures.
The placement of implants enhances the support, retention, and stability of
an overdenture.
8. ADVANTAGES OF IMPLANT SUPPORTED
PROSTHESES8
Prevents anterior bone loss
Improved aesthetics
Improved stability (reduces or
eliminates prosthesis movement)
Improved occlusion (reproducible
centric relation occlusion)
Decrease in soft tissue abrasions
Improved chewing efficiency and
Increased occlusal efficiency
Improved prosthesis retention
Improved prosthesis support
Improved speech
Reduced prosthesis size (reduces
flanges)
Improved maxillofacial prostheses
9. IMPLANT OVERDENTURE ADVANTAGES
VERSUS FIXED PROSTHESIS
9
Fewer implants (RP-5)
Less bone grafting required before
treatment
Less specific implant placement
Soft tissue drape replaced by acrylic
Improved peri-implant probing
(follow-up)
Hygiene
Reduced stress
Nocturnal parafunction (remove
prosthesis at night)
Lower cost and laboratory cost (RP-
5)
Less bone grafting (RP-5)
Easy repair
Laboratory cost decrease (RP-5)
Transitional device is less
demanding than a fixed restoration
10. DISADVANTAGES OF MANDIBULAR
OVERDENTURE10
Psychological (need for non-removable teeth)
Greater abutment crown height space required
More long-term maintenance required
Attachments (change)
Relines (RP-5)
New prosthesis every 7 years
Continued posterior bone loss
Food impaction
12. Classification Of Prosthesis Movement
12
PM 0 : No movement of prosthesis, requires implant support similar to fixed
prosthesis
PM 2: Prosthesis with hinge motion
PM 3: Prosthesis with hinge and apical motion
PM 4: Allows movement in four directions
PM 6: All ranges of prosthesis movement
13. Overdenture Attachment
13
An overdenture attachment permits movement during function and removal
from the mouth.
The attachment should offer the possibility of controlling the degree of
retention.
A loose attachment used at initial delivery ensures prosthesis movement and
decreases screw loosening during the first few months.
A gradual increase in retentive capability may be achieved later by replacing
the component within the encapsulator by a more retentive one.
14. O-Ring or Ball Attachments
14
O-rings are doughnut-shaped, synthetic polymer gaskets that possess
the ability to bend with resistance and then return to their approximate
original shape .
In part, this feature results from a three-dimensional network of flexible
elastomeric chains.
15. 15
The O-ring originally was made of natural rubber. The latex was heat treated
with sulfur (vulcanization) to improve its properties.
The resultant polymer, known as polyisoprene.
The advantages of O-rings are ease in changing the attachment, the wide
range of movement, low cost, different degrees of retention, and possible
elimination of the time and cost of a superstructure for the prosthesis
16. O-Ring Versus Prosthesis Movement
16
An O-ring is compressed radially between two mating surfaces consisting of
a post and a metal encapsulator into which the O-ring is installed
In situations that require few or no moving parts or movement, the O-ring is
classified as static (e.g., gasket or washer).
In situations involving reciprocation, rotation, or oscillating motion relative to
the O-ring, it is classified as dynamic.
17. 17
O-rings may allow motion in six different directions.
However, if a superstructure connects the implants, the range of motion
decreases
18. Metal Encapsulator
18
A metal or plastic encapsulator
permits the easy replacement of the
O-ring after wearing or damage.
This eliminates the need for
chairside cold curing of a new
attachment in place.
19. 19
Virtually every O-ring encapsulator has an undercut region that houses the
O-ring, called the internal cavity.
The overall size of the encapsulator is larger than the O-ring and should be
placed on the O-ring post during fabrication of the prosthesis to ensure
adequate room is present for the volume of the restoration
20. O-Ring Post
20
The O-ring post usually is made of machined titanium alloy when used as an
independent attachment or a delrim post that is waxed and cast in precious
metal along with the connecting superstructure bar joining root forms. The
post has a head, neck, and body.
The head is wider than the neck and the O-ring is compressed over the head
during insertion.
Under the head the post has an undercut region called the neck or groove,
which the ring engages after it stretches over the head
21. O-Ring Size
21
O-rings and posts may come in a variety of diameters depending on the
space available within the volume of the prosthesis.
Typically three sizes of O-rings are used in implant prostheses.
The internal diameter (hole diameter) of the O-ring must be smaller than the
post neck and fit snugly in the groove diameter.
The O-ring inside diameter will be stretched to 1% to 2% (not to exceed 5%)
when in place against the post neck .
22. O- Ring Hardness
22
O-ring hardness is measured with a durometer , which measures surface
resistance to the penetration of an indentation point.
The resultant numerical rating of hardness ranges from 0 to 100 in a Shore A
Scale.
The softest O-rings are usually 30 to 40, and the hardest are 80 to 90.
Color is not indicative of hardness. In fact, most O-rings are black.
Sometimes, however, for production coding or cosmetic reasons,
nonstandard colors are desired
23. O-Ring Material
23
The U.S. Food and Drug Administration has issued guidelines for O-rings
used in medicine.
The elastomeric materials meeting these requirements include (1) silicone,
(2) nitrile, (3) fluorocarbon, and (4) ethylene-propylene.
The materials are available from a variety of industrial manufacturers.
24. Hader Bar and Clip
24
Helmut Hader developed the Hader bar and rider system in the 1960s.
Its present form has been used for almost 30 years. English, Donnel, and
Staubli modified the system in 1992 to form the Hader EDS system.
The EDS bar system is only 3 mm high, whereas the original was 8.3 mm in
height.
Three different retention strengths and a 20-degree clip rotation, which
greatly improves the flexibility of the system for a range of patient needs or
desires.
25. 25
The standard or EDS Hader bar has a round superior aspect and an apron
toward the tissue below.
The apron acts as a stiffener to improve the strength of the bar and limit its
flexibility.
The length of the apron or stiffener is related to the amount of clearance
between the bar and gingiva.
26. 26
The total height of the Hader bar and clip assembly may be as low as 4 mm,
rather than the 5 to 7 mm required for an O-ring system .
Therefore a lesser moment of force is placed on the bar during rotation, and
less clearance is required under the denture base.
30. Patient selection criteria – OD 1
30
Opposing a maxillary full denture
Anatomical conditions are good to excellent (division A or B anterior and
posterior bone.
Posterior ridge form is an inverted U shape.
Patient’s needs and desires are minimal, primarily related to lack of
prosthesis retention.
Edentulous ridge, not square with a tapered dentate arch form
Cost is the primary factor.
Additional implants will be inserted within 3 years.
35. 35
The ultimate goal in the treatment plan is to convert OD-1 patients to a RP-4
or fixed prosthesis with more implant support and stability before the loss of
the posterior bone in the mandible occurs behind the foraminae.
As soon as the patient can afford two more implants, the implants should be
placed in the A and E position, and all four ABDE implants should be
connected with a bar that may be cantilevered to the posterior and help
reduce the posterior bone loss.
36. 36
If an additional implant may be inserted (after the initial two), it may be
positioned in the C position, or if bone height and width distal to one mental
foramen are adequate, the additional implant may be positioned in one of
the first molar regions.
With implants in the A, B, C, D, E position or A, B, D, E, and molar position,
the connected implants and cantilevered bar will result in a RP-4 or fixed
restoration and will help maintain posterior bone.
The bar may be cantilevered to provide posterior support because of the
greatly improved anteroposterior distance (A-P spread) between splinted
38. Patient selection criteria – OD 1
Opposing arch is a maxillary denture.
Anatomical conditions are good to excellent (division A or B bone in anterior
and posterior regions).
Posterior ridge forms an inverted U shape.
Patient’s need and desires are minimal, primarily related to lack of retention.
Patient can afford new prosthesis and connecting bar.
Additional implants will not be inserted for more than 3 years.
Low patient force factors (e.g., parafunction)
38
44. Disadvantages of A and E Splinted Implants
(First Premolar to First Premolar)44
Implants joined with straight bar are lingual to ridge.
• Difficulty with speech
• Anterior tipping of overdenture
• Five times greater bar flexure than B and D positions
Implants are joined with anterior curved bar.
• Greater bar flexibility (nine times the B and D positions)
• Increased screw loosening
• Increased moment forces on anterior aspect of prosthesis
45. 45
• Attachment of curved bar may prevent prosthesis movement
• Bite force is higher than for B and D positions.
• Greater lateral load from prosthesis to implants than B and D positions
46. Disadvantages of OD2
46
not indicated in C-h or D bone and are not indicated when opposing anterior
or posterior natural teeth.
The increase in crown height and the poorer posterior ridge form or the
increase in bite forces and rigid opposing arch place additional stresses on
the implant system and increase complications.
Tissue hyperplasia under the bar, more difficult hygiene under the bar
(compared with option 1), and a more expensive initial treatment option
compared with option 1 (because a bar and retentive elements are
included).
48. Advantages
48
6 times less bar flexure compared with
A and E positions
Less screw loosening
Less metal flexure
Three implant abutments
Less stress to each implant compared
with A and E implants
Greater surface area
More implants
Greater anteroposterior distance
One-half moment force compared with A
and E implants
Less prosthesis movement
One implant failure still provides
adequate abutment support
53. 53
The OD-3 treatment option is usually the first option presented to a patient
with minimal complaints who is concerned primarily with retention and
anterior stability of the IOD when cost is a moderate factor.
The posterior ridge form should be evaluated because it determines the
posterior lingual flange extension of the denture, which limits lateral
movement of the restoration in this treatment option.
55. Patient selection criteria OD-4
Moderate to severe problems with traditional dentures
Needs or desires are demanding
Need to decrease bulk of prosthesis
Inability to wear traditional prostheses
Desire to abate posterior bone loss
Unfavourable anatomy for complete dentures
55
56. Problems with function and stability
Posterior sore spots
Opposing natural teeth
C–h bone volume
Unfavourable force factors (parafunction, age, size six, crown height space
>15 mm)
56
60. Patient selection criteria : OD-5
60
Moderate to severe problems with
traditional dentures
Needs or desires are demanding
Need to decrease bulk of prosthesis
Inability to wear traditional prostheses
Desire to abate posterior bone loss
Unfavourable anatomy for complete
dentures
Problems with function and stability
Posterior sore spots
Moderate to poor posterior anatomy
Lack of retention and stability
Soft tissue abrasion
Speech difficulties
More demanding patient type
69. DISCUSSION
Treatment option OD-1 - one-legged chair. A one-legged chair can support
your weight but provides very little stability.
OD-2 or OD-3 - two-legged chair. The prosthesis provides some vertical
support but can still rock back and forth and provides limited stability in the
posterior regions.
93
70. Option OD-4 with four implants is compared to a three-legged chair. This
system provides improved support and has improved stability.
A four-legged chair provides the greatest support and stability and is similar
to OD-5, which is maximum for prosthesis support and stability because it is
a RP-4 design.
94
72. A Functional Impression Technique For
An Implant-supported Overdenture: A
Clinical Report
Uludağ B1, Sahin V. A functional impression technique for an implant-
supported overdenture: a clinical report. J Oral Implantol.
2006;32(1):41-3.
96
73. 97
A 50-year-old woman - poor retention of her mandibular complete denture
initial clinical examination - the lack of retention of the mandibular denture
due to the resorption of the alveolar ridges
a treatment plan - placement of 2 implants in the interforaminal region to
provide retention for the mandibular denture.
75. Summary
99
A functional impression procedure is described to fabricate an implant-
supported mandibular overdenture.
Two stage impression technique records the alveolar mucosa in a functional
state and the implant components accurately.
76. Complications Associated With The
Ball, Bar And Locator Attachments
For Implant- Supported
Overdentures
Cakarer S, Can T, Yaltirik M, Keskin C. Complications associated with the ball, bar and
Locator attachments for implant-supported overdentures. Med Oral Patol Oral Cir
Bucal. 2011 1;16(7):e953-9.
100
77. 101
The purpose - to evaluate the complications associated with the different
attachments used in implant-supported overdentures, including prosthetic
problems and implant failures.
A comparison of ball, bar and Locator attachments, in completely edentulous
patients with two, three or four implants, was conducted.
A total of 36 edentulous patients (20 female, 16 male)
The patients were treated with 95 implants
The mean follow-up time was 41.17 months.
78. 102
Prosthetic complications including, fractured overdentures, replacements of
O-ring attachment and retention clips, implant failures, hygiene problems,
mucosal enlargements, attachment fractures, retention loss and
dislodgement of the attachments were recorded and evaluated.
The recall visits at 3, 6, 12 months and, annually thereafter.
79. 103
14 complications - ball attachment group
7 complications - bar group
No complications were observed in the locator group.
Conclusion:- locator system showed superior clinical results than the ball
and the bar attachments, with regard to the rate of prosthodontic
complications and the maintenance of the oral function.
80. Circumferential Bone Loss Around Splinted And
Non-splinted Immediately Loaded Implants
Retaining Mandibular Overdentures: A
Randomized Controlled Clinical Trial Using Cone
Beam Computed Tomography
Elsyad MA, Khirallah AS. Circumferential bone loss around splinted and nonsplinted
immediately loaded implants retaining mandibular overdentures: A randomized
controlled clinical trial using cone beam computed tomography. J Prosthet Dent
104
81. 105
The purpose - to assess circumferential bone loss around splinted and non-
splinted immediately loaded implants retaining mandibular overdentures,
using cone beam computed tomography (CBCT).
30 completely edentulous participants were allocated to 2 groups and
received 2 implants in the canine region of the mandible.
Implants were either left nonsplinted (with ball attachment [BA]) or splinted
(with bar attachment [RA]). Mandibular overdentures were connected to the
implants 1 week later.
83. 107
CBCT was used to evaluate vertical bone loss (VBL) and horizontal bone
loss (HBLo) bone loss at the distal (D), buccal (B), mesial (M), and lingual
(L) sites of each implant upon overdenture insertion (baseline, T0), 1 year
(T1) and 3 years (T3) after insertion.
Repeated measures ANOVA was used for statistical analysis (a=.05).
84. 108
No significant difference in the survival rate
VBL and HBLo increased significantly at T3 compared with T1 for both
groups (P<.005).
At T1 and T3, BA had more significant VBL than RA (P<.001), while HBLo did
not differ significantly between groups.
For both groups, a significant difference was found in VBL and HBLo
between implant sites (P<.001).
The B site recorded the highest VBL, and the L site recorded the lowest VBL.
The M and D sites recorded the highest HBLo, and the B and L sites
recorded the lowest HBLo.
85. 109
Conclusion :- Two nonsplinted immediately loaded implants retaining
mandibular overdentures were associated with significantly higher vertical
and horizontal circumferential bone loss than those associated with splinted
implants after a follow-up of 3 years
86. BITING FORCE AND MUSCLE ACTIVITY IN
IMPLANT-SUPPORTED SINGLE
MANDIBULAR OVERDENTURES OPPOSING
FIXED MAXILLARY DENTITION.
Wafa'a R, Abbas NA, Amer AA, Abdelkader AA, Bahgat B. Biting force and muscle activity in
implant-supported single mandibular overdentures opposing fixed maxillary dentition. Implant
dentistry. 2016;25(2):199-203.
110
87. 111
Aim :- to investigate the relation between biting force and
masticatory muscle activity in patients treated by 3 modalities
of single mandibular dentures.
Forty implants were placed in 10 patients with completely edentulous
mandibles.
The study was divided into 3 treatment stages. Initially, each patient received
a conventional mandibular complete denture.
At the second stage, 4 mandibular implants were placed and the denture
was refitted to their abutments.
88. 112
Third stage comprised connecting the denture to the implants through ball
attachments.
During each treatment stage, maximum biting force and muscle activity were
measured during maximum clenching and chewing of soft and hard food.
Biting force demonstrated a statistically significant increase by time for the 3
treatment stages.
89. 113
The highest muscle activity was recorded for the conventional denture
followed by the implant-supported overdenture without attachment, whereas
the lowest values were recorded for the implant-supported overdenture with
attachment.
Conclusion :- Biting force was related mainly to the quality of denture
support. Muscle activity was higher in patients with conventional denture
than with implant-supported prostheses (with or without attachments).
90. Summary
114
Implant overdentures borrow several principles from tooth supported
overdentures.
The advantages of implant overdentures relate to the ability to place rigid,
healthy abutments in the anterior positions of choice.
The number, location, superstructure design, and prosthetic range of motion
can be predetermined to base these factors on a patient's expressed needs
and desires.
91. REFERENCE
115
Misch CE: Dental Implant prosthetics, 2005, Mosby, Inc. Page no : 206-251
Misch CE: Dental Implant prosthetics, 2005, Mosby, Inc. Page no : 573-599,
753-828
Uludağ B1, Sahin V. A functional impression technique for an implant-
supported overdenture: a clinical report. J Oral Implantol. 2006;32(1):41-3.
Cakarer S, Can T, Yaltirik M, Keskin C. Complications associated with the
ball, bar and Locator attachments for implant-supported overdentures. Med
Oral Patol Oral Cir Bucal. 2011 1;16(7):e953-9.
92. 116
Elsyad MA, Khirallah AS. Circumferential bone loss around splinted and nonsplinted
immediately loaded implants retaining mandibular overdentures: A randomized
controlled clinical trial using cone beam computed tomography. J Prosthet Dent
2016;116(5):741-8.
Wafa'a R, Abbas NA, Amer AA, Abdelkader AA, Bahgat B. Biting force and muscle
activity in implant-supported single mandibular overdentures opposing fixed
maxillary dentition. Implant dentistry. 2016 Apr 1;25(2):199-203.
Implants 3.5 mm *12 mm. After a 3-month healing period, the implants were exposed and O-ring abutments were inserted.
Preliminary impressions were made with irreversible hydrocolloid and custom acrylic resin trays were prepared for the fabrication of the dentures.
A mandibular custom acrylic resin tray was prepared with minimal relief and without perforations to record the alveolar mucosa in a functional state; openings only in the region of the implants were prepared for the impression of the attachments.
The difference was found to be as statistically significant (p=0,009).
Six of the 95 implants had failed. Totally 39 implant overdentures were applied. Three prostheses were renewed because of fractures.