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Wakam R, Ramalingam S, Mawussi KB, Gorin C, Benoit A. Retention loss and wear assessment of three attachment systems for implant retained-mandibular overdentures: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106269. [PMID: 38043259 DOI: 10.1016/j.jmbbm.2023.106269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The stud-shaped attachment systems (AS) with different shape designs (ball, cylindrical, conical) and materials (metallic, plastic, or a combination of both) are commonly used to provide better retention and stability in implant-retained mandibular overdentures (IRMO). PURPOSE The purpose of the present study was to evaluate and compare the retention loss and the wear (patterns, location, material loss) of three resilient unsplinted AS: a well-established ball attachment system (BAS) and two more recent cylindrical attachment systems (CAS), Locator R-Tx® and Novaloc®. MATERIALS AND METHODS The implants, their corresponding abutments, the color-coded or position-coded retention devices (RD), the matrix metal housing were incorporated within CAD/CAM resin blocks and cyclically loaded with 19.6 N along the implant axis in a chewing machine to simulate 10,000 insertion-removal cycles (IRC). At cycle 10, 100, 1,000, 5,000, and 10,000, the retention force was measured using a universal testing machine. The wear was qualitatively examined using a binocular magnifier for both systems, and quantitatively assessed from micro-computed tomography acquisitions for CAS. Material loss exceeding 50 μm was considered significant. RESULTS The three AS showed different retentive behavior along time. All the Locator R-Tx® RD lost more than 50 % of their retention after 10,000 IRC. The retention of the Ball System slightly varied over time, the final retention loss in Bmed and Bmax groups being lower than 25 % of the initial retention. Wear was located at the tip of their gold RD and at the equator area of their ball abutment. For Locator R-Tx®, the more retentive the plastic RD, the greater its wear and retention loss. Only Novaloc® maintained a stable retention with even a slight tendency to increase and showed a negligible wear. Implant abutments of the CAS showed no significant wear. CONCLUSION After 10,000 IRC, corresponding to approximately 5-years clinical use, almost all RD provided retention force over 5 N, which could be sufficient to maintain satisfaction in most of the patients. The retention loss observed most prominently for the Locator R-Tx®, then for the Ball System, seemed to correlate with the wear observed on their RD. The practitioner may expect less RD maintenance with the Novaloc® stable retention overtime.
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Affiliation(s)
- Raphaël Wakam
- Département de Prothéses, Faculté de Chirurgie Dentaire, Université de Lille, France; Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Srilakshmi Ramalingam
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Kwamivi Bernardin Mawussi
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Sorbonne Paris Nord, Bobigny, France
| | - Caroline Gorin
- Département de Biologie Orale, Faculté de Chirurgie Dentaire, URP2496, Pathologie, Imagerie et Biothérapies Orofaciales, Université Paris Cité, Montrouge, France; Service d'Odontologie, Département de Prothèses, AP-HP / GH Nord, Paris, France.
| | - Aurélie Benoit
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France.
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ELsyad MA, Abdraboh AE, Denewar MM, Mohamed SS. Prosthetic complications and maintenance of different attachments used to stabilize mandibular 2‐implant overdentures in patients with atrophied ridges. A 5‐year randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:497-509. [DOI: 10.1111/cid.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 04/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Prosthodontics, Faculty of Dentistry Mansoura University Eldakahlia Egypt
| | | | - Mohamed Mahmoud Denewar
- Department of Removable Prosthodontics, Faculty of Dentistry Delta University for Science and Technology Eldakahlia Egypt
| | - Shahinaz Sayed Mohamed
- Department of Removable Prosthodontics, Faculty of Dentistry Beni Suef University Beni Suef Egypt
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Alshenaiber R, Barclay C, Silikas N. The Effect of Number and Distribution of Mini Dental Implants on Overdenture Stability: An In Vitro Study. MATERIALS 2022; 15:ma15092988. [PMID: 35591322 PMCID: PMC9104554 DOI: 10.3390/ma15092988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/09/2022] [Accepted: 04/16/2022] [Indexed: 02/05/2023]
Abstract
The rotational movement of mini dental implants (MDIs) overdenture disturbs the function of the prosthesis. Many dentists place more MDIs to improve the overdenture stability; however, the influence of the MDIs number and distribution on the overdenture resistance to para-axial dislodgment has not been investigated. Seven resin models simulating atrophic mandibles housed twenty MDIs placed according to seven arrangements. Acrylic overdentures were fabricated for each cast and were dislodged five times in lateral, anterior and posterior directions, and the peak load dislodgment was measured. Each overdenture underwent 540 axial removal/placement cycles. The para-axial dislodgments were measured again, and data were compared. Dislodgment force values were measured in all directions, and the data were analysed using analysis of variance ANOVA and post hoc (p < 0.05). After six months of simulated placement/removal, increasing the MDI number showed a difference in resistance to para-axial dislodgment. The distribution affected the resistance to dislodgment in some directions. The inter-implant distance of 27 mm provided better resistance to posterior dislodgment than placing two MDIs close together at 19 mm. The placement of three MDIs at any distribution showed no significant difference except for resistance to posterior dislodgment. FourMDIs placed at any distribution showed a significant difference in all groups in all tested directions. The resistance to the para-axial dislodgment of MDI overdenture could improve with the increasing MDIs number and careful planning of MDI distribution.
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Affiliation(s)
- Rafif Alshenaiber
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
- Prosthetic Dental Sciences Department, College of Dentistry, Prince Sattam Bin Abdulaziz University, AlKharj 16278, Saudi Arabia
- Correspondence: ; Tel.: +44-7477426007
| | - Craig Barclay
- Restorative Dentistry, University of Manchester Dental Hospital, Manchester M15 6FH, UK;
| | - Nick Silikas
- Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
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Evaluation of Retention, Wear, and Maintenance of Attachment Systems for Single- or Two-Implant-Retained Mandibular Overdentures: A Systematic Review. MATERIALS 2022; 15:ma15051933. [PMID: 35269164 PMCID: PMC8911844 DOI: 10.3390/ma15051933] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 12/04/2022]
Abstract
Attachment systems (AS) enhance retention and stability by anchoring the overdentures to implants. Since 2002, the McGill consensus statement recommends the 2-implant-retained overdentures as the standard choice for edentulous mandible (2-IRMO). Considering the large number of AS available, it remains difficult for a practitioner to make a reasoned choice. A systematic review was conducted in PubMed/Medline and carried out independently by three authors, on retention, wear, and maintenance of AS used clinically or in vitro specifically for 1- or 2-IRMO. The 45 selected studies include 14 clinical and 31 in vitro studies. The risk of bias was evaluated according to the revised Cochrane risk of bias tool for randomized trials (RoB 2). The initial retention force of the cylindrical system is higher than the ball system. The retention loss, related to the wear of the retention device, is responsible for the most common need of maintenance, requiring activation or replacement. Plastic retention devices wear out faster and more significantly than metal ones, implying a worse time behavior of cylindrical systems, but their maintenance rate is similar. Neither system appears categorically superior. Cylindrical systems provide higher initial retention than ball ones; this advantage reduces over time with wear without affecting their need for maintenance.
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Fera M, Goncharuk-Khomyn M, Fera O, Bokoch A, Keniuk A, Kryvanych A. Does the Use of Surface Electromyography Could Improve Quality of Life among Patients Rehabilitated by Mandibular Overdentures on Different Attachments? PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Brandt S, Lauer HC, Fehrenz M, Güth JF, Romanos G, Winter A. Ball versus Locator ® Attachments: A Retrospective Study on Prosthetic Maintenance and Effect on Oral-Health-Related Quality of Life. MATERIALS 2021; 14:ma14041051. [PMID: 33672382 PMCID: PMC7926925 DOI: 10.3390/ma14041051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 01/23/2023]
Abstract
Locator® and ball attachments are well-established systems to attach overdentures to two inter-foraminal implants. This study aimed to evaluate differences between the two systems regarding prosthetic maintenance and patients’ oral-health-related quality of life (OHRQoL). Dental records of patients with a mandibular implant-retained overdenture were retrospectively analyzed. Prosthetic maintenance measures involving the denture suprastructure and attachment matrix and patrix were analyzed. Furthermore, the Oral Health Impact Profile-G14 (OHIP-G14) was used to evaluate OHRQoL. Results were analyzed by means of Kaplan–Meier analysis and Student’s t- and log-rank tests. The records of 122 patients were evaluated. Kaplan–Meier survival analysis revealed a significant difference between ball attachments (Group B; n patients = 47) and Locator® attachments (Group L; n patients = 75) regarding the occurrence of denture fractures (p < 0.001) and events affecting the matrix (p = 0.028) and patrix (p = 0.030). Group L had a significantly lower total OHIP-G14 score than Group B (p = 0.002). The most common maintenance events were matrix-related and denture relining for both attachment systems. Group B required more maintenance measures than Group L. Moreover, patients in Group L had better OHRQoL than patients in Group B.
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Affiliation(s)
- Silvia Brandt
- Department of Prosthodontics, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany;
- Correspondence: ; Tel.: +49-177-8286781
| | | | - Michael Fehrenz
- Clinic for Oral and Maxillofacial Surgery, Saarland University Hospital, Kirrberger Str. 100, 66424 Homburg, Germany;
| | - Jan-Frederik Güth
- Department of Prosthodontics, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany;
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Rockland Hall 106, Stony Brook, NY 11794-8700, USA;
- Department of Oral Surgery and Implant, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Anna Winter
- Department of Prosthodontics, Julius Maximilian University Würzburg, Pleicherwall 2, 97070 Würzburg, Germany;
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Retentive Characteristics of a Polyetheretherketone Post-Core Restoration with Polyvinylsiloxane Attachments. Polymers (Basel) 2020; 12:polym12092005. [PMID: 32899168 PMCID: PMC7563112 DOI: 10.3390/polym12092005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/22/2022] Open
Abstract
A new application of a polyetheretherketone (PEEK) post-core restoration combined with polyvinylsiloxane (PVS) attachments was proposed and substantiated. This study aimed to evaluate retentive characteristics of the PEEK post-core restoration with PVS attachment systems. Specimens with PVS attachments were fabricated to evaluate retention force during 10,000 cyclic dislodgements. Additionally, the retention forces of PVS attachments with three different values of Shore hardness were further measured before and after aging treatments. The results of cyclic dislodgement test indicated a strong negative linear relationship between the cyclic times and retention force (p < 0.0001, r = −0.957). Furthermore, the retention forces of the PVS were significantly improved with Shore hardness increased, which was also affected by the aging treatment (F (2, 138) = 10.95, p < 0.0001). Therefore, the PEEK post-core restoration with PVS attachments exhibited the favorable retention force, which could be a promising alternative for dental prostheses.
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Retentive Characteristics of a New Attachment System for Hybrid Dentures. MATERIALS 2020; 13:ma13153434. [PMID: 32759744 PMCID: PMC7436147 DOI: 10.3390/ma13153434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/20/2022]
Abstract
Removable implant-anchored dentures have become an established treatment concept especially for older, multimorbid patients. This study investigates the retention force (RF) of two different attachment systems. A total of 96 specimens (n = 8 for each condition) were fabricated and RF was measured under different conditions: fatigue (10,000 cycles dislodging), thermal undulation (5/55 °C, 5000 cycles) and implant-angulation (0°, 5°, 10°, 15°, 20°). The Novaloc system ((N), 0° and 15° abutments, yellow matrix (Y)) was compared to the Locator system ((L), pink (P) and orange (O)). Initial RFs (8.57 ± 0.99 N (NY), 19.39 ± 8.10 N (LP), 8.8 ± 5.28 N (LO)) were reduced by ageing simulation (26% (NY), 66% (LP), 89% (LO); p < 0.001). After thermocycling, Novaloc’s RFs decreased by 33% (p < 0.001) while the Locators’ RFs increased by 34% (LP: p = 0.002, LO: p = 0.148). In contrast to LP, the RFs of Novaloc abutments and LOs predominantly showed no clinically relevant dependence on implant angulation. Ageing processes tended to result in lower RFs at higher implant angulation. Thus, the Novaloc attachment system offers an alternative to Locator attachments. It is characterized by a comparatively continuous RF-curve over the entire wearing period. Future clinical studies have to be conducted to verify the in vitro demonstrated advantages of the Novaloc system.
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Retention and wear of resin matrix attachments for implant overdentures. J Mech Behav Biomed Mater 2020; 110:103901. [PMID: 32957206 DOI: 10.1016/j.jmbbm.2020.103901] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of the present laboratory study was to investigate the retentive properties and the wear of three different resin matrix attachments for implant overdentures as well as to assess the effects of implant angulation. METHODS AND MATERIALS Three attachment systems with either polyetheretherketone inserts (PEEK; Novaloc, Straumann, Basel, Switzerland), polyetherketoneketone inserts (PEKK; CM Loc, Cendres + Métaux, Biel, Switzerland) or nylon inserts (Locator R-Tx, Zest Dental Solutions, Escondido, California, USA) were evaluated. The patrices were connected to their implant analogues and fixed in a resin cast at implant angulations of 0° and 15°. The corresponding matrices with inserts were fixed in a stylized unilaterally removable dental prothesis. To simulate masticatory forces 30,000 insertion and removal cycles with an eccentric load of 100 N at a distance of 12 mm were performed in a chewing simulator. The retention forces were measured. The wear patterns were examined using a scanning electron microscope (SEM). The statistical analysis was performed using a one-way ANOVA followed by a Games-Howell test and a Friedman test. RESULTS All attachment systems revealed a significant decrease in retention after testing, except PEEK 0°/0° and PEEK 15°/15°. PEEK and PEKK attachment systems showed significantly higher retentive forces than the nylon attachment system between 5000 and 30,000 cycles. The implant angulation did not significantly influence the retention behavior for any of the three attachment systems. Patrices showed no signs of wear, whereas the matrix inserts displayed signs of deformation. CONCLUSION Within the limitations of the present study, attachments with PEEK and PEKK inserts combined with titanium patrices are favorable for long-term use, both for orthogonal and tilted implants. All three attachment systems showed a high variability of the retentive forces at baseline and for subsequent cycles. This should be taken into consideration for clinical use.
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Yilmaz B, Ozkir E, Johnston WM, McGlumphy E. Dislodgement force analysis of an overdenture attachment system. J Prosthet Dent 2020; 123:291-298. [DOI: 10.1016/j.prosdent.2018.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/03/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022]
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Abou-Ayash S, Enkling N, Srinivasan M, Haueter M, Worni A, Schimmel M. Evolution of in vivo assessed retention forces in one-piece mini dental implant-retained mandibular overdentures: 5-Year follow-up of a prospective clinical trial. Clin Implant Dent Relat Res 2019; 21:968-976. [PMID: 31313455 DOI: 10.1111/cid.12816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/19/2019] [Accepted: 06/20/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND The evolution of retention forces in one-piece mini dental implants (MDIs) retaining implant overdentures (IODs) is of major importance, as the male parts cannot be exchanged, due to the implant design. PURPOSE To report the evolution of retention forces of one-piece MDIs, retaining mandibular IODs with ball/ O-ring attachments during 5 years assessed in vivo. MATERIALS AND METHODS Four MDIs were installed in the interforaminal region and immediately loaded using the existing mandibular complete denture. Directly post-op, at the 1-year and the 5-year follow-up, the retention forces were assessed with a validated strain gauge at each implant site separately. RESULTS At the male part, changes could only be observed at implant site 34: During the first year, there was a statistically significant increase, whereas the retention forces were decreased at the 5-year follow-up. At the female part, retention forces decreased significantly over time. Baseline values could be reestablished by exchanging the O-rings. The changes of the retention forces were more obvious in the posterior, compared to the anterior implants. CONCLUSIONS Retention forces at the female part decrease significantly over time, when retaining mandibular IODs by MDIs with ball/ O-ring attachments. Baseline values can be reestablished by exchanging the O-rings. At the male part, changes of retention forces depend on the implant location.
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Affiliation(s)
- Samir Abou-Ayash
- Section for Digital Implant- and Reconstructive Dentistry (DIRecD), Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Department of Prosthodontics, University of Bonn, Bonn, Germany
| | - Murali Srinivasan
- Clinic for General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marius Haueter
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | | | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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Salehi R, Shayegh SS, Johnston WM, Hakimaneh SMR. Effects of interimplant distance and cyclic dislodgement on retention of LOCATOR and ball attachments: An in vitro study. J Prosthet Dent 2019; 122:550-556. [PMID: 31027962 DOI: 10.1016/j.prosdent.2018.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/22/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Evaluation of the long-term retentive behavior of overdenture attachments is necessary for successful treatment. Interimplant distance (IID) could affect the retention of these attachments. PURPOSE The purpose of this in vitro study was to assess the effects of IID and cyclic dislodgement on the retention of LOCATOR and ball attachments. MATERIAL AND METHODS Ball and LOCATOR attachments were connected to corresponding implant analogs. Metal housings were connected to each attachment. Thirty-six pairs of acrylic resin blocks were fabricated for 3 IIDs (19, 23, and 29 mm) and 2 attachments (n=6). Each pair consisted of 2 attachment assemblies parallel to each other with a specified IID. Overall, 1440 dislodgement cycles were applied by using a universal testing machine, and the maximum dislodging force was recorded after 0, 120, 360, 720, and 1440 cycles. Dislodging force data were analyzed by using repeated-measures 3-way analysis of variance, with the number of cycles as the within-subject factor for each specimen. Bonferroni-corrected Student t tests were used to resolve effects that were statistically significant. Moreover, dislodging force data were fit into an exponential decay model to determine the extent and rate of force decay for each attachment and IID studied. RESULTS The initial retention of LOCATOR attachments was significantly higher than that of ball attachments with IIDs of 23 and 29 mm, but no significant difference was noted with the 19-mm IID. After 1440 cycles, the retention was statistically similar with that of the 23-mm IID but was significantly higher for ball attachments with IIDs of 19 and 29 mm. CONCLUSIONS The IID is one of the factors that affect the retention of ball and LOCATOR attachments. The mean retention of both attachments was sufficient for all 3 IIDs at insertion and after 1440 cycles.
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Affiliation(s)
- Reyhane Salehi
- Dental student, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Sayed Shojaedin Shayegh
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - William M Johnston
- Professor Emeritus, Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio
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Varshney N, Aggarwal S, Kumar S, Singh SP. Retention and patient satisfaction with bar-clip, ball and socket and kerator attachments in mandibular implant overdenture treatment: An in vivo study. J Indian Prosthodont Soc 2019; 19:49-57. [PMID: 30745754 PMCID: PMC6340082 DOI: 10.4103/jips.jips_281_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/29/2018] [Indexed: 11/25/2022] Open
Abstract
Aim: The aim of this in vivo study was to evaluate and compare the retention and patient satisfaction in implant supported mandibular overdenture with three different attachment system. Materials and Methods: After evaluation of prosthetic space, fifteen edentulous subjects received two implants in the inter-foramina region of the mandible and were divided into 3 groups with 5 subjects each, delayed loading protocol was followed in all the patients. The retention force and satisfaction level with the attachments at baseline and after 6 months was measured in a standardised way using retentive device and VAS questionnaire. The study was based on evaluation of retention and patient satisfaction. 15 subjects were included in the study. The results obtained were statistically analyzed using one-way ANOVA test, and multiple comparisons were carried out using the Bonferroni tests. Results: At the end of six months, the retention force and satisfaction level was higher in Group 3 (Kerator attachment) as compared to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment) and patient satisfaction was equal in groups 1, 2 and 3 but the total number of interventions is significantly higher in the attachment bar. Analysis of variance with repeated measures showed significant differences in retention force among the three attachment types. Conclusion: (1) Group 3 (kerator attachment) exhibit higher retentive capacities than Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment). (2) patient satisfaction was higher in Group 3 (Kerator attachment) in compare to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment).
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Affiliation(s)
- Nitish Varshney
- Department of Prosthodontics and Crown and Bridge, ITS - CDSR, Ghaziabad, Uttar Pradesh, India
| | - Sumit Aggarwal
- Department of Prosthodontics and Crown and Bridge, ITS - CDSR, Ghaziabad, Uttar Pradesh, India
| | - Shalabh Kumar
- Department of Prosthodontics and Crown and Bridge, ITS - CDSR, Ghaziabad, Uttar Pradesh, India
| | - S P Singh
- Department of Prosthodontics and Crown and Bridge, ITS - CDSR, Ghaziabad, Uttar Pradesh, India
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Marin DOM, Leite ARP, Oliveira Junior NMD, Paleari AG, Pero AC, Compagnoni MA. Retention Force and Wear Characteristics of three Attachment Systems after Dislodging Cycles. Braz Dent J 2018; 29:576-582. [DOI: 10.1590/0103-6440201802074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/10/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.
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de Albuquerque RF, Fromentin O, Lassauzay C, Conceição Pereira Saraiva MD. Patient satisfaction versus retention of implant overdentures with two attachment systems: A randomized trial. Clin Implant Dent Relat Res 2018; 21:21-31. [DOI: 10.1111/cid.12675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/28/2018] [Accepted: 08/09/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Rubens Ferreira de Albuquerque
- Department of Dental Materials and Prosthodontics; Faculty of Dentistry of Ribeirão Preto, University of São Paulo; São Paulo Brazil
| | - Olivier Fromentin
- UFR d'Odontologie; Université Paris Diderot, Rothschild Hospital; Paris France
| | - Claire Lassauzay
- Centre de Recherche en Odontologie Clinique; Clermont Université, Université d'Auvergne; Clermont-Ferrand France
- Département de Prothèse; Faculté de Chirurgie Dentaire de l'Université Nice Sophia Antipolis; Nice France
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Retentive characteristics of individual and prefabricated polyvinylsiloxane overdenture attachments: alternative treatment options for geriatric patients. Clin Oral Investig 2018; 23:1425-1434. [PMID: 30032470 DOI: 10.1007/s00784-018-2568-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Stud attachments are often too adhesive and too susceptible to damage for use in geriatric patients, especially when implants are angulated. This study aimed to evaluate alternative anchoring systems comprising individual and prefabricated polyvinylsiloxane (PVS) attachments. MATERIALS AND METHODS A total of 182 specimens with individual PVS (IPVS) attachments (Shore hardness [SH] 25, SH50, SH65], prefabricated PVS (PPVS) attachments (SM green, yellow, and red), and Locator attachments (LR blue) were fabricated (n = 7 per group). Retention force was measured using the following parameters: insertion/removal (100, 200, 500, 1000, and 5000 cycles), thermal undulation (10,000 cycles at 5-55 °C; one implant per specimen), implant angulation (0°, 5°, and 10° convergence and divergence; two implants per specimen), and artificial saliva. RESULTS Insertion/removal and thermal undulation caused no changes in retention force in SM green and IPVS subgroups; conversely, LR blue, SM red, and SM yellow attachments exhibited significant decreases in retention force of up to 66% (all P ≤ 0.001). Implant angulation produced relevant changes in retention force only in LR blue attachments. Artificial saliva caused a general decrease in retention force. CONCLUSIONS Retention force of low-retentive PVS attachments proved to be comparatively immune to dislocation and thermal undulation, as well as to implant angulation up to 10°. CLINICAL RELEVANCE Low-retentive PVS attachments could be a treatment option if reduced denture retention is required and/or if angulated implants are in place. Clinical studies are necessary to evaluate the materials' durability under oral conditions.
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Yabul A, Dayan C, Geckili O, Bilhan H, Tuncer N. Evaluation of volumetric wear of abutments on the retention loss of ball attachment systems in implant-retained overdentures: An in vitro study. Clin Implant Dent Relat Res 2018; 20:778-784. [DOI: 10.1111/cid.12644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Cagatay Dayan
- Program of Dental Technicians; Istanbul University; Istanbul Turkey
| | - Onur Geckili
- Department of Prosthodontics, Faculty of Dentistry; Istanbul University; Istanbul Turkey
| | - Hakan Bilhan
- Department of Prosthodontics, Faculty of Health; School of Dentistry, Universitat Witten/Herdecke; Witten Nordrhein-Westfalen Germany
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Tehini G, Baba NZ, Majzoub Z, Nahas P, Berberi A, Rifai K. In Vitro Effect of Mastication on the Retention and Wear of Locator Attachments in a Flat Mandibular Ridge Model. J Prosthodont 2018; 28:e744-e751. [DOI: 10.1111/jopr.12940] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Georges Tehini
- Department of Prosthodontics; Lebanese University; Beirut Lebanon
| | - Nadim Z. Baba
- Advanced Education Program in Prosthodontics; Loma Linda University; Loma Linda CA
| | - Zeina Majzoub
- Department of Periodontics; Lebanese University; Beirut Lebanon
| | - Paul Nahas
- Department of Restorative Dentistry; Lebanese University; Beirut Lebanon
| | - Antoine Berberi
- Department of Oral and Maxillofacial Surgery; Lebanese University; Beirut Lebanon
| | - Khaldoun Rifai
- Department of Prosthodontics; Lebanese University; Beirut Lebanon
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Tehini G, Baba NZ, Berberi A, Majzoub Z, Bassal H, Rifai K. Effect of Simulated Mastication on the Retention of Locator Attachments for Implant-Supported Overdentures: An In Vitro Pilot Study. J Prosthodont 2017; 29:74-79. [PMID: 28913855 DOI: 10.1111/jopr.12670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Limited information is currently available relative to the effect of masticatory loads on the retentive properties of Locator attachments. The aims of this in vitro study were to assess and compare the effect of simulated mastication on the retention of white, pink, and blue Locator inserts for overdentures retained by 2 implants. MATERIALS AND METHODS Thirty specimens simulating a nonanatomic edentulous flat ridge with two implants and an overdenture were divided into 3 groups according to the color of the fitted insert: transparent clear group (n = 10), pink group (n = 10), and blue group (n = 10). Retention forces were measured in an axial direction initially and after 100,000 cycles of simulated masticatory loads. One-way ANOVA followed by Tukey's post hoc tests were used to compare retention values and percentage retention loss between the 3 groups with significance set at p = 0.05. RESULTS The 3 groups presented significant differences in retention at baseline (9.95 ± 1.91 N, 15.43 ± 4.08 N, and 41.73 ± 9.29 N for the blue, pink, and clear groups, respectively) and after simulated mastication (6.37 ± 2.64 N, 14.00 ± 3.89 N, 38.20 ± 5.11 N for the blue, pink, and clear groups, respectively). Within the same group, cyclic loading did not significantly affect retention in the clear and pink groups, while the blue inserts showed a significant retention loss (-37%) after loading. CONCLUSIONS The results suggest that short-term simulated mastication affects the extra-light blue inserts but not the more-retentive inserts.
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Affiliation(s)
- Georges Tehini
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadat, Lebanon
| | - Nadim Z Baba
- Hugh Love Center for Research and Education in Technology, Loma Linda University, Loma Linda, CA
| | - Antoine Berberi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Hadat, Lebanon
| | - Zeina Majzoub
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadat, Lebanon
| | - Hussein Bassal
- Doctorate School for Science and Technology, Faculty of Dental Medicine, Hadat, Lebanon
| | - Khaldoun Rifai
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadat, Lebanon
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ELsyad MA, Elhaddad AA, Khirallah AS. Retentive Properties of O-Ring and Locator Attachments for Implant-Retained Maxillary Overdentures: An In Vitro Study. J Prosthodont 2016; 27:568-576. [PMID: 27589487 DOI: 10.1111/jopr.12534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate and compare retentive properties of O-ring and Locator attachments for implant-retained maxillary overdentures. MATERIALS AND METHODS Four implant analogs were inserted in canine and second premolar areas of an acrylic edentulous maxillary model. A metal-reinforced experimental acrylic overdenture was constructed and connected to the analogs using either O-ring (group I) or Locator (group II) attachments. Locators were divided into 3 subgroups according the degree of retention of the patrix nylon insert: Locator extra-light retention (group IIa), Locator light retention (group IIb), and Locator medium retention (group IIc). Vertical and oblique (lateral, anterior, and posterior) dislodging forces were measured at the beginning of the study (initial retention) and after 540 cycles of denture insertion and removal (final retention). RESULTS For vertical, lateral, and anterior dislodging, group IIc recorded the highest initial and final retention, and group I recorded the lowest retention. For posterior dislodging, group I recorded the highest retention, and group IIa recorded the lowest retention. For group II, vertical dislodging recorded the highest initial and final retention, and lateral dislodging recorded the lowest retention. For group I, posterior dislodging recorded the highest initial and final retention, and lateral dislodging recorded the lowest retention. For all dislodging forces (except posterior dislodging), the highest retention loss was recorded in group I, and the lowest retention loss was recorded in group IIa. CONCLUSION Locator medium attachment was associated with favorable retention during axial (vertical) and nonaxial (anterior and lateral) dislodging compared to other types of Locator inserts and O-ring attachments after a simulated 6-month period of overdenture use.
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Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Mansoura, Eldakahlia, Egypt
| | | | - Ahmed Samir Khirallah
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Mansoura, Eldakahlia, Egypt
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Aroso C, Silva AS, Ustrell R, Mendes JM, Braga AC, Berastegui E, Escuin T. Effect of abutment angulation in the retention and durability of three overdenture attachment systems: An in vitro study. J Adv Prosthodont 2016; 8:21-9. [PMID: 26949484 PMCID: PMC4769886 DOI: 10.4047/jap.2016.8.1.21] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 12/02/2015] [Accepted: 12/14/2015] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This in vitro study investigated and compared the durability and retention of three types of attachments. MATERIALS AND METHODS Three commercially available attachments were investigated: Clix®, Dalbo-Plus® and Locator®. In total, 72 samples of these attachments were placed in the acrylic resin forms and subjected to mechanical testing (5400 cycles of insertion and removal) over the respective ball or Locator abutments immersed in artificial saliva at pH 7 and 37℃. The abutments were placed at angulations of 0°, 10° and 20°. The retention force was recorded at the beginning and after 540, 1080, 2160, 3240, 4320 and 5400 insertion-removal cycles. RESULTS The results revealed that there were significant differences in the average values of the insertion/removal force due to angulation (F (2.48) = 343619, P<.05) and the type of attachment (F (7.48) = 23.220, P<.05). CONCLUSION Greater angulation of the abutments was found to influence the retention capacity of the attachments, and the fatigue test simulating 5 years of denture insertion and removal did not produce wear in the metal abutments.
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Affiliation(s)
- Carlos Aroso
- Department of Oral Rehabilitation, Instituto Universitario de Ciencias da Saude (IUCS), Portugal
| | - Antonio Sergio Silva
- Department of Oral Rehabilitation, Instituto Universitario de Ciencias da Saude (IUCS), Portugal
| | - Raul Ustrell
- Industrial Engineer, Chairman of Idearum, Enginyeria i Innovació de Producte, Igualada, Barcelona, Spain
| | - Jose Manuel Mendes
- Department of Oral Rehabilitation, Instituto Universitario de Ciencias da Saude (IUCS), Portugal
| | - Ana Cristina Braga
- Department of Production and Systems Engineering, University of Minho (UM), Braga, Portugal
| | - Esther Berastegui
- Department of Endodontics, Faculty of Odontology, University of Barcelona, Barcelona, Spain
| | - Tomas Escuin
- Department of Rehabilitation and Maxillofacial Prostheses, Faculty of Odontology, University of Barcelona, Barcelona, Spain
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Chiu LPY, Vitale ND, Petridis H, McDonald A. The Effect of Different Water Temperatures on Retention Loss and Material Degradation of Locator Attachments. J Prosthodont 2016; 26:537-544. [PMID: 26861254 DOI: 10.1111/jopr.12440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Lillian Pui Yuk Chiu
- Prosthodontics Unit, Department of Restorative Dentistry, UCL; Eastman Dental Institute; London UK
| | - Nicola Di Vitale
- Prosthodontics Unit, Department of Restorative Dentistry, UCL; Eastman Dental Institute; London UK
| | - Haralampos Petridis
- Prosthodontics Unit, Department of Restorative Dentistry, UCL; Eastman Dental Institute; London UK
| | - Ailbhe McDonald
- Prosthodontics Unit, Department of Restorative Dentistry, UCL; Eastman Dental Institute; London UK
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Long-term retention behaviour of resin matrix attachment systems for overdentures. J Mech Behav Biomed Mater 2015; 57:88-94. [PMID: 26705935 DOI: 10.1016/j.jmbbm.2015.11.038] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/27/2015] [Accepted: 11/30/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The purpose of this laboratory study was to evaluate the long-term retention behaviour of two resin matrix attachment systems for overdentures and the influence of the implant angulation. METHODS Sixteen titanium patrices of each attachment system were connected to their corresponding implant analogues and fixed in an auto curing resin either orthogonally (n=8) or 20° tilted (n=8). The corresponding matrices, one made from polyetherketoneketone (PEKK; CM LOC, Cendres+Métaux, Biel, Switzerland), one made from polyethylene (PE; Locator, Zest Anchors, Escondido, California, USA), were fixed in a stylised unilaterally removable dental prosthesis resulting in 4 groups with 8 specimens in each group. Overall, 30,000 joining and separating cycles of the matrix were performed in a chewing simulator. After each joining movement, the unilaterally removable dental prosthesis was loaded eccentrically with 100N at a distance of 12mm from the attachment to simulate clinical loading conditions. Retentive forces were measured during the test using force transducers. The statistical analysis was performed using Tukey-HSD. RESULTS Both attachment systems showed a significant decrease in retention over time, which occurred earlier in the tilted groups than in the orthogonal groups. After 5000-30,000 joining and separating cycles the PE matrix attachment provided significantly lower retention than the PEKK matrix attachment system. CONCLUSION Within the limitations of this investigation, the combination of a titanium patrix and a matrix made from polyetherketoneketone seems to be a promising material combination for long-term retention, also on tilted implants.
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