Aim:
To evaluate the survival rate, tissue response, and patient satisfaction of different attachments used in implant overdenture.
Settings and Design:
Systematic Review and Meta-analysis.
Materials and Methods:
Electronic search of peer-review articles published between 2001 and 2019 assessing the attachments used for implant-supported overdentures was done according to PRISMA Guidelies. The review evaluated sixteen articles related to survival of the attachments, the reaction of the soft and hard tissues along with repair and maintenance of the attachments, and overall performance of the overdenture attachments.
Statistical Analysis Used:
There is statistically significant heterogeneity (Q =374.7403, df = 15, and
P
< 0.0001). The statistics of fixed-effect model reported an MD of − 0.0880 (95% CI = −0.1536; 0.0225).
Result:
The review evaluated the 16 articles that met with the inclusion and search criteria. The studies were the combination of bar and ball attachments and their subtypes, magnetic and bar attachments, and locator in combination with other attachments. The meta-analysis of combined 16 studies reported acceptable heterogeneity among 16 studies (I 2 = 96%) and reported to be statistically significant (
P
< 0.01).
Conclusion:
The survival rate of attachments was in the range of 95.8%–97.5% for bar, 96.2%–100% for ball, 90%–92% for magnet and locator attachments were in the range of 97% after a mean follow-up period of 3 years. The bar attachments reported moderate tissue reaction in the form of mucosal changes, gingival inflammation, and bone resorption. The locator attachments require higher maintenance and repair. The magnetic attachments produce higher bone resorption and readily displace under functional force. Patient satisfaction and compliance was higher for ball, locator, and bar attachments as well as low for magnetic attachment. Thus, the ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction.
Adaptive response of the bone to mechanical loading, related to stress/strain ratio has seen increased activity in the last decade, have been developed in an attempt to quantify the contribution of mechanical stimulus from daily loading to bone homeostasis via mechano-transduction [1]. The techniques that develops the mechanical stimuli are electromagnetic loading and vibrational loading on the bone. However, the electromagnetic loading is invasive procedure [2], Hence the vibrational method has been popular to develop mechanical stimuli and vibrational therapy has many clinical applications apart from bone stimulation such as in endocrinology, diabetes and obesity [3]. It promotes bone and muscle strength. The vibrational loading on orthodontics tooth movements has extensively studied with the main aim of an increasing the rate of orthodontic tooth movement by accelerating the periodontal and bony tissue modelling and remodeling process [4]. Similarly, the vibrational loading on dental implant Osseo integration was studied as stimulation of osteoblast at implant surface [5]. The purpose of the review to evaluates the method of vibrational loading on bone stimulation, orthodontic tooth movements and implant osseointegration.
Denture Characterization means 'Modification of the form and colour of the denture base and the teeth to produce more lifelike appearance.' Different techniques and materials are used since ages for tinting of the denture bases. Keeping in account the pros and cons of the explained techniques, very feasible and a simplified modification of the age old, most popular Pound's 'sift in' technique was attempted. The result thus obtained was significantly satisfying for the patient as well as the operator and every possible effort was made to make the Complete Denture experience worthwhile.
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