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Edentulism and Complete Dentures Background of Overdentures Attachments of Overdentures Clinical Consideration
Edentulism and Complete Dentures Background of Overdentures Attachment of Overdentures Clinical Application
16%
16%
48% 44%
14%
Chewing?
Chewing? Speaking?
Will there be a need for complete dentures in the United States in 2020?
Will there be a need for complete dentures in the United States in 2020? Population: 35 million(2000) 38 million(2020)
Will there be a need for complete dentures in the United States in 2020? Population: 35 million(2000) 38 million(2020) Denture Needs: 1~2 per person
Will there be a need for complete dentures in the United States in 2020? Population: 35 million(2000) 38 million(2020) Denture Needs: 1~2 per person Denture Counts: 56 million(2000) 61.0 million (2020)
180 / 20 = 9 months
Newly Extracted
8 years
15 years
20 years + Mandibulectomy
Denture stomatitis
Headache
Angular cheilitis
Emotional stress
Epulis fissuratum
Traumatic ulcer
Edentulism and Complete Dentures Background of Overdentures Attachments of Overdentures Clinical Consideration
Fenton, 1998
Ridge Preservation
Cost
Repairability
Ridge Preservation
Support
Cost
Stability
Repairability
Retention
Psychological Comfort
Vertical Height
Following cost
Psychological Comfort
Faster Turnover
Vertical Height
Attachment Wear
Following cost
More visits
Studies suggest that when conventional dentures are replaced with implant retained overdentures , patients enjoy a higher quality of life, greater self-confidence, and a better nutritional state.
Henry K., Q&A on the future of implants, Dental Equipment & Materials, 2006
When I received the denture with solid attachment underneath, I became a different person; I feel wonderful; and I am very happy with myself and how others compliment the way I look."
Safe to go?
Check pt expectation
Edentulism and Complete Dentures Background of Overdentures Attachments of Overdentures Clinical Consideration
Bar Attachment
Stud Attachment
Magnet Attachment
HADER BAR
CLIPS (RIDERS)
METAL HOUSING
RESILIENCE DESIGN
Cost Rigid Splinting Malalignment Correction More Space Cleansibility Screw Fracture
OVERCONSTRUCTED
BAR BREAKAGE
LOCATOR
ERA
BALL/O-RING
BALL
COMBINATION
STUD SYSTEM
Faster wear-off Cost Friendly minimal Repairability Easy Resilient Connection More Working Space Malalignment Correction Frequent Replacement
MAGNET
VARIOUS SELECTION
Facts about Complete Dentures Background of Overdentures Attachments of Overdentures Clinical Consideration
Why Removable?
100
edentulous arches Fixed: 4-8 implants, 13-17 yrs Overdenture: 2-4 implants 4-15 yrs Annual recalls: Osseointegration, perio indices Subjective evaluation Fixed: 38/45 V.S. Removable: 37/39
20
pts with edentulous maxilla Fixed: 8-10 implant, 40 months Bar Retained Overdenture: 5-8 implants, 27 months Check prosthodontic tx outcome, clinical parameters Comparable treatment outcome
Zitzmann, 2000
SPACE AVAILABILITY
2.5mm
3.0mm
Maxilla
4
implants to eliminate distal cantilever on ant. 2 implants Lewis, 1992 Rigidly splinting implant for 4 yrs
Naert, 1998
4 4
Mandible
2
Stern, 1998
Mandible
21
edentulous pts, 74.2 y/o Single implant at Mandible midline Great oral comfort and functionality
Where to Place?
Maintenance
Replace Attachments Replace Attachments Replace Attachments Accidental Breakage Accidental Breakage Denture Reline
Which Design?
More favorable with a spread-out implant arrangement than with a concentrated implant arrangement and cantilever restoration.
Bruxer? Clencher?
Ku, 2002
Questions??