This study measured and compared the stress transmitted to implants from different attachments for mandibular implant overdentures. An edentulous mandibular model with implants in the canine regions was fabricated. Strain gauges attached to the implants measured stress under vertical pressure applied to the denture. A locator attachment transferred more stress to the working side implant than a bar/clip attachment. Stress on implants decreased as the denture base length was reduced. The bar/clip attachment distributed stress more evenly between working and non-working side implants.
Journal Club Presentation on Overlay Removable Partial DentureNeerajaMenon4
Overlay removable partial dentures (ORPDs), a subset of overdentures, are often referred to as an RPD that has part of their components covering the occlusal surface of the abutment teeth to restore them into a functional occlusion
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
journal cub presentation on Bps denture/biofunctional prosthetic systemNAMITHA ANAND
watch video links below for better understanding
https://www.youtube.com/watch?v=_sR2Ip5p9RE
its a series of videos 1-7 beautiful videos explaining the construction of BPS DENTURES - step by step
Recent advances in prosthodontics / crown & bridge courses by indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Indirect Bonding is technique in which orthodontic brackets and other attachments are transferred from dental casts (working models) and placed on to the dentition using a transfer device
This presentation covers the methods of indirect bonding, limitations and also compares direct and indirect bonding
Journal Club Presentation on Overlay Removable Partial DentureNeerajaMenon4
Overlay removable partial dentures (ORPDs), a subset of overdentures, are often referred to as an RPD that has part of their components covering the occlusal surface of the abutment teeth to restore them into a functional occlusion
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
journal cub presentation on Bps denture/biofunctional prosthetic systemNAMITHA ANAND
watch video links below for better understanding
https://www.youtube.com/watch?v=_sR2Ip5p9RE
its a series of videos 1-7 beautiful videos explaining the construction of BPS DENTURES - step by step
Recent advances in prosthodontics / crown & bridge courses by indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Indirect Bonding is technique in which orthodontic brackets and other attachments are transferred from dental casts (working models) and placed on to the dentition using a transfer device
This presentation covers the methods of indirect bonding, limitations and also compares direct and indirect bonding
Techniques for anchorage control in lingual orthodonticsParag Deshmukh
various techniques used in lingual orthodontics for anchorage control are described here.. and various cases of lingual orthodontics in which different techniques were used for anchorage control are discussed here..
Myanmar Society of Oral Implantology collaborates with Dental Implant system using in Myanmar and celebrates Two days seminar. At this event, as the President of MSOI, I present this topic on Astra Tech Dental Implant System. It was sponsored by Biosys Company.
Dental and Skeletal changes after intraoral molar distalization with sectiona...Maen Dawodi
Dental and Skeletal changes after intraoral molar distalization with sectional jig
The present study as conducted on 10 subjects to evaluate dental and skeletal changes after intraoral molar distalization. The maxillary molars were distalized with a sectional jig assembly. Sentalloy open coil springs were used to exert 150gm of force for a period of 12 weeks . A modified Nance appliance was the main source of anchorage. The pre-and postdistalization records included dental study casts clinical photographs and cephalograms.
A total of 665 readings recorded from lateral cephalograms and dental casts were subjected to statistical analysis . The mean distal movements of the 1st molar was 2.78mm, which was highly significant (p<0.001). It moved distally at the rate of 0.86mm/month. There was clinically some distal tipping (3.50degree) and distopalatal rotation (2.40 degree). These changes were statistically significant. This was the result of molar extrusion
(AJODO 1998 Vol 114: 319-27)
Class II malocclusion with mild to moderate space deficiency in the upper jaw can be treated in many different ways. One possibility is to distalize the maxillary 1st molars and to create space in the buccal segments for retraction of cuspids and anterior teeth.
Conventionally, extraoral traction has been used successfully for the correction of Class II malocclusion by restraining the forward growth of the maxilla, threby correcting the skeletal discrepancy.
These extraoral appliances are also capable of distalizing the maxillary molars to correct the dental discrepancies. These methods require considerable patient compliance. The forces exerted by this appliance are intermittent and hence require a prolonged treatment time.
In recent years , intraoral techniques have been found to be successful for maxillary molar distalization. Gianelly et al. reported distalization of maxillary molars using repelling magnet along with modified Nance appliance for anchorage control .He reported a rate of molar movement of 0.75 to 1mm./month.
Gianelly et al. also used Japanese Niti open coil spring in continuous arch wires and reported a mean molar movement of 1 to 1.5mm/month.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Orthodontic retraction biomechanics for space closure and distalization using...Vishnu Patel Ortho
Centre of Resistance Simulator is an Innovative Customized Orthodontic Appliance for Retraction of Protruded dentition especially proclined upper front Teeth.
Biomechanics of Extraction Space Closure with Sliding Mechanics has been elaborated mathematically using Equilibrium Force Diagram.
Comparatively Simple and Statically determinate Force system using the Centre of Resistance Simulator (CRS) has been described.
Vertical Anchorage Control has been challenging task in patients having Long Faces and high Mandibular Plane Angle (Vertical Growers). This concept of Simulating Centre of Resistance facilitates vertical Anchorage control during Extraction Space Closure without Temporary Anchorage Devices (Microimplants or Bone Screws). Judicious use of TADs is definitely required for En Masse Distalization cases and absolute Anchorage demanding extraction cases e.g. extreme long faces where maximum extraction space is to be utilized for Retraction of Anterior Teeth Segment.
Bodily Retraction of Upper Anterior Teeth without bite deepening and without Molars extrusion ( i.e.opening of Mandibular Plane Angle) is also possible with the concept.
This appliance may also be used in patients having lingual braces and clear aligners for improving outcome.
This Orthodontic Force System provides Frictionless and Loopless Retraction Mechanics for Extraction Space Closure.
Designing of the appliance on Cephalometric Tracing and then accordingly locating estimated Centre of Resistance on Models has been mentioned stepwise in the video.
Techno Savvy young Orthodontists can design and fabricate CRS by CAD-CAM using 3D designing softwares and DMLS 3D Printing.
Biomechanical explanation of each minute sense has been described in this video. Please watch and listen carefully from start to finish in one go.
I humbly request to all Orthodontists especially those affiliated with Institutes to explore the concept. I will be more than happy to be involved in such work.
Please feel free to contact me on vishvadental@gmail.com for detailed insight.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Similar to journal club presentation on prosthodontics (20)
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
journal club presentation on prosthodontics
1.
2. INTRODUCTION
AIM
MATERIALS AND METHODS
RESULTS
DISCUSSION
RELATED ARTICLES
CONCLUSION
REFERENCES
3. 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 -GPT
Over denture treatment is a notion which precludes inevitability of floating
plastic in edentulous mouth - George Zarb
4. higher levels of
patient satisfaction,
comfort and quality
of life
improved chewing
ability
less surgically
invasive
economically
reasonable
better masticatory
force
According to the 2002
McGill consensus and
2009 York consensus
2-IOD was
recommended as first-
line therapy for
edentulous mandible
6. SINGLE ELEMENTS(UN
SPLINTED)
SINGLE BALL
ABUTMENTS
SINGLE MAGNET
ABUTMENTS
INDIVIDUALLY CAST
TELESCOPIC
COPINGS
CONNECTED
ELEMENTS(SPLINTED)
EGG SHAPED
DOLDER BAR
ROUND CLIP BAR
U SHAPED BAR
CUSTOMISED
PRECISIONMILLED
BAR
STRESS
BREAKING
MECHANISM
RIGID
MECHANISM
STRESS
BREAKING
MECHANISM
RIGID
MECHANISM
9. To determine the appropriate attachment
and design of a denture base for mandibular
implant overdenture (IOD), the oral mucosa
pressure caused by mandibular implant
overdentures was measured using
edentulous jaw models with various
attachments.
10. An experimental mandibular edentulous jaw model
with a 1.5mm
thick artificial oral mucosa
Two dental implants (3.75 11.5 mm)
were placed at the position of the
bilateral canines, perpendicular to a
tentative occlusal plane
11. Experimental 2-IODs were fabricated
• Mainly made of acrylic resin denture base material
Each attachment was inserted
• connected to the experimental 2-IOD with chemical
cure resin material
shape of 2-IODs were similar to the record
base with occlusion rim morphology that was
made according to the standard protocol
12. • performing retentive forces 0.7 kg ,
locator abutment, Bmk RP 2.0 mm,
Nobel Biocare),
Locator
attachments with
retention discs (LA)
• ball abutment, Bmk RP 1 mm, Nobel
Biocare
Ball
attachments(BA)
• MA, MAGFIT IP-DXFL, Aichi Steel,
Aichi, Japan
Magnetic
attachments(MA)
• NobelProcera Impl Bar Overdenture Ti
2 Impl, Nobel Biocare
resilient round-bar
attachments (R-
BA)
15. The load on the experimental dentures was
set at 50 N by referring to the masticatory
force of CD wearer
• The load points were either an area
equivalent to the center of the model
which should represent equivalent
mastication on both sides
Bilateral
load
• an area equivalent to the left first molar
which should represent unilateral
mastication
Unilateral
load
17. Precision universal
testing machine
(Instron 8874, Instron,
Norwood, MA, USA).
dynamic repetitive loads of 1 Hz were applied perpendicularly to the tentative
occlusal plane by precision universal testing machine
18. The experiments were repeated 5 times each In the CD and the
experimental 2-IOD
LA BA MA R-BA
The oral mucosa pressure values were defined as average values of the
load with the precision universal testing machine during 5 continuous
cycles.
Pressure distributions during the loading were measured with 6-channel
frequency sensors
200 Hz sampling rate
recorded via a sensor
interface
19. Example of a waveform during the dynamic
repeated load.
The oral mucosa pressure values were defined as average values of the load with the
precision universal testing machine during 5 continuous cycles
20. Differences in oral mucosa
pressure values between CD
and 2-IOD
Oral mucosa
pressure value
exerted by 2-IOD
was significantly
lower in the left
buccal premolar
region than that of
CD Under the unilateral load condition
21. On the non-
loading side, oral
mucosa pressure
values exerted by
all attachments
were extremely
low and did not
exceed 8.0 kPa
in the right buccal
premolar region
and the right
buccal shelf
22. Changes in oral mucosa pressure values
with different attachments
•Pressure on the residual ridge exerted by CD was
compared to that of 2-IOD with various attachments.
•Oral mucosa pressure value exerted by 2-IOD was
significantly lower in all sites than that of CD
23. The oral mucosa
pressure value exerted by
R-BA was significantly
higher in the right lingual
molar region than those
of other attachments
24. 2-IOD reduced the oral mucosa pressure
value of 37– 190 kPa at the supportive site.
The oral mucosa pressure value exerted by
2-IOD in the left lingual molar region was not
always lower than that of CD.
The oral mucosa pressure value was
increased significantly by MA and LA, but
decreased significantly by BA
25. Significant decrease in oral mucosa pressure
value and increase in support and bracing
ability were observed when 2-IOD was applied,
compared with CD.
Effect of BA on the reduction of oral mucosa
pressure is greater than LA, MA and R-BA in
the supportive and bracing regions
BA could be the first choice to reduce oral
mucosa pressure value during mastication.
27. to investigate how several commonly used
attachments of the IOD affect the load on the
supporting implants and the residual ridge
beneath the denture base in a model study
applying those measuring systems.
28. An acrylic resin mandibular edentulous
model was modified
Two implants were inserted in the canine
region both sides of the edentulous
residual ridge, perpendicular to the
occlusal plane of the experimental IOD
An artificial mucosa made using a silicone
impression material approximately 2-mm
thick,was affixed to the edentulous molar
area, posterior to the two supporting
implants of the mandibular model
Experiment device development
29. A film pressure distribution
measurement tactile sensor was
placed on the artificial mucosa on
the right side
The artificial mucosa was molded by
initially fixing the film sensor to the
basal surface of the experimental IOD,
followed by polymerizing the silicone
under the application of a 5-N load to
the occlusal surface of the IOD.
The experimental IOD was made using
acrylic resin for the denture base
material
The basic form of the experimental IOD
was a ready-made record base with an
occlusal rim The occlusal table of the
denture was fabricated parallel to the
occlusal plane.
30. • Piezo electric force
transducers
LOAD ON
IMPLANTS
• film pressure distribution
measurement tactile
sensor
LOAD ON
RESIDUAL
RIDGE
Devices for simultaneous measurement of
three-dimensional (3D) loads on the
supporting implants and the load on the
residual ridge beneath the denture base
were developed.
31. To measure the
load on the
implants, three
types of
attachments were
fabricated to be
fitted accurately
onto the
piezoelectric force
transducers:
LOCATOR
TYPE
ATTACHMENT
LA
ROUND BAR
ATTACHMENT RA
BALL TYPE
ATTACHMENT
BA
32.
33.
34.
35. Loads on the implants and the residual ridge beneath the denture base were
measured when static and dynamic repeated loads of 100 N were applied vertically
to the right first molar region of the occlusal table of the denture by a universal
testing machine
The load measurement
was repeated five times
for each of the three
different attachments in
the order BA, LA, and
RA
36. • assumed to be the occlusal
force
• applied to the right first
molar area
• crosshead speed of 15
mm/s
• continued for 10 s
Static load
100N
• to simulate a masticatory
force
• Same area
• Cross head speed of 30
mm/s
• loading cycle of 2 Hz
Dynamic
repeated
load
100 N
38. • Lateral direction
• coincident with the occlusal surface of the IODX axis
• Antero-posterior direction
• coincident with the occlusal surface of the IODY axis
• vertical direction, which was defined to be
perpendicular to the occlusal surface of the
denture
• same in the implant inserted direction.
Z axis
39. Regardless of the
attachment type, the
direction of the load
exerted on both
implants was
consistently in a
posterior direction.
Force vector on the
non loading side
implant for the three
attachments occurred
in an upward direction.
40. LOADING SIDE
• BA>LA>RA
NON LOADING
SIDE
• BA>RA>LA
The horizontal
component, that
is, the resultant
force value of the
load on the
implants in the X-
and Y-axes when
a static load of
100 N was
applied,
41. LOADING SIDE
• BA>RA>LA
NON LOADING
SIDE
• Little
difference
among 3
• LA
Significantly
low
BOTH LOADING
AND NON
LOADING SITES
• BA>RA>LA
42. With all
attachments-
higher load in
the distal parts
of the sensor
area.
load centers of
the three
attachments in
similar position,
loci of the load
center were
different among
the three
attachments.
shows the typical pattern of load distribution on the residual
ridge beneath the denture under a static and dynamic repeated
load of 100 N
44. load on the residual ridge
beneath the denture base
when a static load of 100
N was applied
• RA>LA>BA
45. shows an example of the
calculated 3D resultant
force data for the three
attachments when a
dynamic repeated load of
100 N was applied five
times. The three
attachments showed
different wave patterns.,
but this was
• plateau phase
between the peaks
of the waves
BA AND
RA
• not evident on the
loading side
implant.
LA
46. 1. This model experiment using piezoelectric 3D
force transducers and a tactile sheet sensor
enabled us to clarify the effects of the
attachments used in an IOD on loading to
implants and the underlying residual ridge.
2. Using RA in an IOD is effective for reducing the
load to the supporting implants.
3. The load on the residual ridge beneath the
denture in IODs can be efficiently reduced
using a BA.
48. The design of the attachment must provide
an optimum stress distribution around the
implant. In this study, for implant
overdentures with a bar/clip attachment or a
locator attachment, the stress transmitted to
the implant in accordance with the change in
the denture base length and the vertical
pressure was measured and analyzed.
49. For the strain gauge to have a tight contact with the surface of the implant, buccal and
mesial threads of the #43 implant and lingual and distal threads of the #33 implant were
properly adjusted, and flat surfaces were obtained.
model base was created with epoxy resin
Tissue-level Straumann implants were used (diameter 4.1 mm, length 10 mm,
to reproduce the implant mandibular overdentures
A ridge replication plastic model made for an actual patient was impressed with silicone.
alveolar mucosa (2 mm thick) was reproduced with a previously taken
impression and polyether impression material
50. STRAIN GAUGES were
attached to the implants
using an adhesive
In the replicated epoxy model, holes 8 mm
in diameter were made at both canine sites
and implants were placed. Resin cement
was used to represent the osseo
integration of actual implants. The
maxillary and mandibular dentures on the
replication model were fabricated in a
conventional manner, and the same
dentures were used repeatedly in the
experiment by modifying their bases.
POSITION
OF STRAIN
GAUGES
CLOSE TO
NECK OF
IMPLANT
BUCCAL
SIDE
LINGUAL
SIDE
CLOSE TO
APEX
MESIAL
SIDE
DISTAL
SIDE
51. A universal testing machine was used to exert a vertical pressure on the
mandibular implant overdenture. To measure the strain rate of the
implants placed in the replication epoxy model, a strain gauge was used.
An A/D converter was connected to a personal computer to amplify and
quantify the electrical signal from the gauge.
52. • RN synOcta abutment
• RN synOcta gold coping
• SCS occlusal screw
• CM bar
• female component of 10 mm length
BAR/CLIP
ATTACHMENT
• RN Locator abutment
• BLUE replacement male piece
LOCATOR
ATTACHMENT
55. DENTURES BASED ON LENGTH OF
DENTURE BASE
GROUP 1:
pressure with no
modification (intact
denture)
GROUP 2:
pressure after
eliminating the
denture base distal
to mandibular
second molar
GROUP
3:pressure after
eliminating the
denture base distal
to the mandibular
first molar.
56. Vertical pressure, 0.5 mm/min up to 50 N,
was placed on the three types of complete
denture
repeated 10 times
Whenever the attachment was replaced or
the length of the denture base was modified,
20 minutes were given for recovery
Results measured with the four strain
gauges were analyzed statistically
57.
58. • vertical pressure on the mandibular right
first molar (A) and the mandibular right
posterior area (B), the implants on the
working side generally showed higher
strain than those on the non-working
side
LOCATOR
ATTACHMENT
• vertical pressure on the mandibular right
first molar (A) and the mandibular right
posterior area (B), the implants on the
both non-working and working sides
showed high strain
BAR/CLIP
ATTACHMENT
59. For the mandibular
right first molar, the
mandibular right
posterior area, and the
whole mandibular
denture base, the
strain was statistically
significantly different
between the locator
attachment and the
bar/clip attachment
60.
61. TENSILE
FORCE
• Applied on
mesial surface
of the implant
on the working
side
COMPRESSIVE
FORCE
• applied to the
buccal surface
and on the
surfaces of the
implant on the
non-working
side
all surfaces except the
mesial surface of the
implant on the non-
working side showed a
compressive force
when applying vertical pressure at
three different areas (cases A, B,
and C), the bar/clip attachment
generally showed a higher strain
than the locator attachment
For both attachments, the shorter denture base
resulted in a higher strain on the implants
62. For mandibular implant overdentures, locator
attachments result in lower strain on implants
than do bar/clip attachments. Longer denture
bases have the same effect. Therefore, to
minimize the strain on implants in mandibular
implant overdentures, this study may provide
the clinical implication that the use of locator
attachment would be more preferable in regard
of strain on implants than bar /clip attachment,
and the denture base needs to be extended as
much as possible.
64. This in vitro study investigated the effect of
attachment installation conditions on the load
transfer and denture movements of implant
overdentures, and aims to clarify the
differences among the three types of
attachments, namely ball, Locator, and
magnet attachments.
65. Three types of attachments, namely ball,
Locator, and magnetic attachments were
used.
An acrylic resin mandibular edentulous
model with two implants placed in the
bilateral canine regions and removable
overdenture were prepared.
The two implants and bilateral molar ridges
were connected to three-axis load-cell
transducers
66. Universal testing machine was used to apply a
50N vertical force to each site of the occlusal
table in the first molar region.
Thedenturemovement was
measured using a G2 motion
sensor.
Three installation conditions, namely, the
application of 0, 50, and100 N loads were used
to install each attachment on the denture base.
The load transfer and denture movement were
then evaluated.
67. X axis-
along
length
Y axis-
along
width
Z axis-
as
vertical
direction
Twelve signals from the four
transducers and one signal from
the load cell were digitized by a
digital data recorder with 14-bit
accuracy at a rate of 50 Hz, and
then transferred to a computer
resultant force (FR) was calculated using
the following:
FR=(M2 x +M2 y +F2 z)
68. The output of the G2 motion sensor was calculated from the flexibility of
the Euler angles (i.e., the pitch, yaw, and roll) using original software
with a C-based synthesis system
69. A 50 N static load was applied to the loading points of
the first molar regions on the right side by a universal
testing machine with a 2.0 mm/min crosshead speed.
The magnitude of the applied load was based on the
bite force of edentulous patients with complete
dentures.
Six complete experimental dentures were
fabricated,and six artificial mucosal materials
modified for the respective denture bases were also
prepared.
The recording was repeated five times for each
experimental condition, allowing intervals of at least 5
minutes for recovery
70. shows the time patterns of the resultant forces acting on the implant and residual ridges
on the loading side.The time patterns were obtained by averaging the signal at the onset
of the universal testing machine measurements for each condition. The resultant force
acting on the implants on the loading side of the magnetic attachment exhibited a two-
phase pattern
71. For the residual ridges on the loading side,
the direction of the forces for all attachments
changed to downward with increasing
installation load. Furthermore, the yaw Euler
angle increased with increasing installation
load for the magnetic attachment
72. The resultant force acting on the implants on the loading
side for the ball and Locator attachments transmitted
homogeneous increases without a two-phase pattern.
When the attachments were installed using a 50N load,
which was the same as the resultant force acting on the
implants on the loading side, all the attachments
transmitted a homogeneous increase with out a two-phase
pattern. The increase in the resultant force acting on the
residual ridges on the loading side was greater for a 50 N
installation load than for 0 N, especially for the Locator
attachment. No distinctive pattern was observed in the
resultant force acting on the implant residual ridges on the
non loading side.
73. The resultant force on th
implants decreased with
increasing installation
load for all attachments
The resultant force
acting on the
residual ridges on
the loading side
increased with
increasing
installation load for
all the attachments.
The resultant force acting on the residual ridges on the non loading side was not
greater than that acting on the ridges on the loading side for all attachments
74. • The resultant force acting on
the implant on the nonloading
side significantly decreased
when the installation load was
increased from 0 to 50 N
BALL AND
LOCATOR
ATTACHMENT
• smaller resultant force than
the ball and Locator
attachments for all installation
loads
MAGNETIC
ATTACHMENT
• significantly
decreased when the
installation load was
increased from 0 to
50 N
Locator
attachment
• significantly
decreased when the
installation load was
increased from 50 to
100 N
Magnetic
attachment
75. • 18.1 to
23.9 N
0 N
• 4.01 to
15.9 N
50
N
• 0.44 to
11.0 N
100
N
The resultant force acting on the implants
on the loading side
The resultant force acting on the residual
ridge on the loading side
• 0.87 to
1.15 N0 N
• 1.22 to
2.21 N
50
N
• 1.65 to
2.43 N
100
N
78. ON INCREASING
INSTALLATION
LOAD
LOCATOR AND
MAGNETIC
ATTACHMENTS
DOWNWARDS
TO BACKWARDS
AND AGAIN TO
DOWNWARDS
BALL
ATTACHMENTS
DOWNWARDS
The direction of the forces of all the
attachments changed to downward with
increasing installation load.
None of the forces of
the attachments acting
on the residual ridges
on the nonloading side
had a distinctive
direction.
when the
installation load
was 0 N, the
forces of the ball
and Locator
attachments were
horizontal and
large compared to
that of the
magnetic
attachment.
79.
80. The magnetic attachment had a high yaw Euler
angle compared to the ball and Locator
attachments for all installation loads.
The yaw Euler angle increased with increasing
installation load for the magnetic attachment, and
particularly increased significantly when the
installation load was increased from 50 to 100 N.
Simultaneously, the Euler angles of pitching and
rolling slightly increased in the negative
direction.The ball and Locator attachments did not
exhibit this distinctive movement
81. Subject to the limitations of this study, the use of
any installation load greater than 0N is
recommended for the installation of ball and
Locator attachments on a denture base. Regarding
magnetic attachments, our results also recommend
installation on a denture base using any installation
load greater than 0N, and suggest that the resultant
force acting on the implant can be decreased by
increasing the installation load; however, a large
installation load of 100 N should be avoided when
installing the attachment on the denture base to
avoid increasing the denture movement
83. to compare the effects of mucosal thickness
on the stress pattern around implants and
movement of implant-supported
overdentures with ball/female and three
different types of magnetic attachments.
84. Two rootform implants were inserted into
mandibular model
Surface of the model was covered with a 1.5- or
3-mm layer of impression material to simulate the
oral mucosa
removable overdentures were fabricated on each
model
A 50-N vertical force was applied to the right first
molar
the resultant stress distribution and denture
movement were measured
85. Each experiment was repeated five times under the same conditions.
Each sequence of strain data was used to calculate the axial force and the
bending moment transmitted to the implant
Loads from 0 to 50N were applied gradually
to simulate a moderate level of biting force on an implant-retained overdenture
Autograph applied a load to the occlusal surface of the right first molar region
Point to receive the load with the largest force during function
86. Experimental Mandibular Model. An
edentulous mandibular acrylic resin model
Two implants were
placed bilaterally in
the canine region
vertical to the residual
ridge.
They were set at 22
mm apart, similar to
the distance between
two natural canines.
The implants were
retained using resin
cement
87. A 1.5-mm layer was removed from the denture-
supporting surface of the resin model and replaced
with polyvinyl siloxane impression material to
simulate the resilient edentulous ridge mucosa.
An experimental acrylic resin denture was
conventionally fabricated on the model.
In the same way, a 3-mm layer of impression
material and a denture were fabricated on the
same mandibular model.
All experiments for the four attachments were
carried out with one model of each mucosal
thickness.
88. Four strain gauges were attached to the
mesiodistal and buccolingual sides of the
neck part of each implant to measure the
strain on the implants
The electric signals from the
strain gauges were
amplified, transmitted, and
recovered by a personal
computer following A/D
conversion
The sensor used
electromagnetic fields to
determine the position and
orientation of a remote object.
The output of the movement
sensor was input into a
computer and a mathematic
algorithm calculated the
position of the receiver
relative to the transmitter and
recorded the results.
89. denture movement at
the loading side (right
first molar region) was
measured by vertical
displacement of
Autograph .
90. The ball attachment consisted of an anchor
head and a metal female component
91. The flat type was a typical magnetic attachment,whilethedome-shaped
type had a dome-shaped surface of the magnet and keeper, and the
cushion type had a stress distributor with a magnet
95. 1.5mmmodel3mmmodel
the ball attachment showed a significantly
higher axial force on the implants than all the
magnetic attachments at both the loading and
non-loading sides
ball attachment had a lower vertical force than all
the magnetic attachments at the loading side and
had a tensile stress at the non-loading side.
dome-shaped type caused the highest axial force
at the loading side.
no significant differences among the three
magnetic attachments in the 3-mm mucosal
model at the non-loading side.
96.
97. 1.5mm3mm
all the magnetic attachments showed
significantly lower bending moments on the
implants than the ball attachment at both the
loading and non-loading sides
the magnetic attachments were higher than that of the
ball attachment at the loading side. At the non-loading
side, all the magnetic attachments showed lower
bending moments than the ball attachment. The dome-
shaped type caused the largest bending moment at the
loading side, while it caused the lowest bending
moment at the non-loading side. The flat type made a
smaller bending moment than the dome-shaped type
and cushion type at the loading side in each mucosal
model.
99. 1.5mmmucosalmodel3mmmucosalmodel
denture base movements were larger on the
ball attachment at both the loading and non-
loading sides. At the loading side, the denture
movement was the lowest on the flat type. On
the other hand, at the non-loading side, the
denture movement was very small on the
magnetic attachments
Denture base movement was larger on the
cushion type. At the non-loading side on the
3-mm mucosal model, upward movement was
shown on the magnetic attachments.
100. In the 1.5-mm mucosal model, the magnetic
attachments showed significantly lower bending
moments than did the ball attachment.
The denture base displacement was the lowest
on a magnetic attachment.
In this study, use of magnetic attachments
could be advantageous for mandibular implant-
supported overdentures based on lower stress
and better denture stability especially in the thin
mucosalmodel.
101. Within the limits of this study, the findings
indicated that the magnetic attachments were
more favorable than the ball attachment in
terms of the stress distribution and the denture
base stability on a thin mucosa. For a thick
mucosa, the flat type caused the smallest
bending moment and denture base movement
among all the attachments, suggesting that the
flat type was the most favorable for this
condition.
102. H. Sato, et al., Oral mucosa pressure caused by
mandibular implant overdenture with different types
of attachments, J Prosthodont Res (2019)
Goto T, Nagao K, Ishida Y, Tomotake Y, Ichikawa T.
Influence of matrix attachment installation load on
movement and resultant forces in implant
overdentures. J Prosthodont 2015;24:156–63
Yoda N, Ogawa T, Gunji Y, Kawata T, Kuriyagawa T,
Sasaki K. The analysis of the load exerted on the
implants supporting an overdenture based on in
vivo measurement. Prosthodont Res Pract
2008;7:258–60.
103. Yoda N, Matsudate Y, Abue M, Hong G, Sasaki K.
Effect of attachment type on load distribution to
implant abutments and the residual ridge in
mandibular implant-supported overdentures. J Dent
Biomech 2015;6:1–10
Assunção WG, Barão VA, Tabata LF, de Sousa EA,
Gomes EA, Delben JA. Comparison between
complete denture and implant-retained
overdenture: effect of different mucosa thickness
and resiliency on stress distribution. Gerodontology
2009;26:273–81.
Editor's Notes
(P9-EP.30-L, Nissin, Tokyo, Japan)
Bränemark System1 Mk III, Groovy RP, Nobel Biocare, Kloten, Switzerland)
Generally, retention discs of lower retentive forces were applied when new IOD was installed. Thus, we chose 0.7 kg LA to compare with other attachments in this study.
PS-10KD, Kyowa Electronic Instruments, Tokyo, Japan) Six miniature pressure sensors were placed in the bilateral buccal premolar regions, the bilateral buccal shelves, and the bilateral lingual molar regions to measure pressure values on the oral mucosa when the experimental dentures were loaded (Fig. 3). An experimental CD without attachment was prepared as a control.
PCD-400A, Kyowa Electronic Instruments, Tokyo, Japan
Under the unilateral load condition, the oral mucosa pressure values exerted by BA and R-BA were significantly lower in the left buccal premolar region and the left buccal shelf than those of other attachments
Additionally, the length of the screw part of both BA and LA was configured to properly fit into our measuring device. For the female parts of these attachments, an elliptical matrix (Straumann AG) was used in BA, and pink-colored extended range replacements (Zest Anchors Inc.) were used in LA
contact area between the model and the fitting surface of the denture was exclusively set at the attachment and on the artificial mucosal area.
side in order to prevent the interference of each other
COMPOSED OF
with the SPSS software (ver. 12.0 for Windows; SPSS Inc., Chicago, IL, USA). T-tests and one-way ANOVA tests were used, and Tukey’s range test was also performed to confirm the results
The data were expressed as mean and standard deviations. Statistical comparisons were carried out using two-way analysis of variance (P<.05) and
Prefabricated ball and magnetic attachments were used to attach the denture to the implants.