Stress Distribution in Splinted and Unsplinted Implant-Supported Maxillary Overdentures

Geramy, Allahyar; Habibzadeh, Sareh

doi:10.1097/id.0000000000000708

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…It has been suggested that implants supporting maxillary overdentures should be splinted to obtain mechanical advantages such as distributing forces across multiple implants, providing cross‐arch stabilization and preventing the potential overload of single implants. Although bar attachments are beneficial to the stress distribution of implants by splinting (Geramy & Habibzadeh, ), limitations exist regarding the health maintenance of the peri‐implant tissue (Sadowsky & Zitzmann, ). Elsyad et al reported no difference in the survival rate of implants depending on the type of attachment, but the bar attachment group reported higher clinical parameters such as PI, GI and depth of probing than other solitary attachment groups (MA, Denewar, & Elsaih, ).…”

Section: Discussionmentioning

confidence: 99%

“…Zembic, Tahmaseb, Jung, and Wismeijer (2017) reported that maxillary overdentures retained by two implants should be used with caution based on the results of a 1-year prospective clinical study. The types of attachments used in implant overdentures can be categorized based on the splinting of implants, which is considered beneficial for stress distribution during function compared to non-splinted implant attachment systems (Geramy & Habibzadeh, 2018). However, despite some laboratory studies, clinical studies have reported that splinted and non-splinted attachments may be used without significant differences in patient satisfaction (Al-Zubeidi, Alsabeeha, Thomson, & Payne, 2012), surgical outcomes (Ma, Tawse-Smith, et al, 2016) and prosthodontic outcomes (Ma, Waddell, Atieh, Alsabeeha, & Payne, 2016).…”

mentioning

confidence: 99%

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Bar versus ball attachments for maxillary four‐implant retained overdentures: A randomized controlled trial

Park

Shin

Lee

2019

Clinical Oral Implants Res

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Objectives To compare the clinical treatment outcomes of maxillary four‐implant retained overdentures with either splinted (bar) attachments or non‐splinted (ball) attachments. Material and Methods Forty participants who were dissatisfied with their existing conventional maxillary complete dentures were included in this randomized controlled trial. Six months after implant placement, a definitive prosthesis was inserted. Implant success, condition of peri‐implant tissue, prosthodontic maintenance and complications, and patient satisfaction were assessed. Outcomes were recorded at baseline, prosthesis delivery, and at 3 and 12 months following prosthesis delivery, and a statistical analysis was performed. Results Thirty‐two of the forty patients completed the 1‐year follow‐up and had their treatment outcomes evaluated. The mean marginal bone loss after 1 year of loading was 0.34 ± 0.88 mm, and there were no significant differences between the two groups. Plaque index, gingival index and bleeding on probing were significantly higher in the bar group (p<.001), and the implant success rate of the bar group was significantly lower than that of the ball group (p=.028). The most frequent prosthodontic maintenance and complication issue was the need to change the bar clip or O‐ring as a result of retention loss. Patient satisfaction did not differ between the two groups except for aesthetics at 3 months. Conclusions Within the limitations of this study, the maxillary 4‐implant retained overdenture exhibited predictable results regardless of the attachment systems (ball or bar) in the 1‐year follow‐up period. The bar group was more vulnerable than the ball group with respect to maintaining peri‐implant tissue health.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Bar versus ball attachments for maxillary four‐implant retained overdentures: A randomized controlled trial

Park

Shin

Lee

2019

Clinical Oral Implants Res

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“…The types of attachments used in implant ODs can be categorized as splinted and non-splinted systems. The use of a splinted implant attachment system is considered more beneficial for stress distribution during function compared to the non-splinted system [2]. However, the findings of some clinical studies have shown that the use of either splinted or non-splinted systems does not result in any significant differences in the surgical [3] or prosthodontic outcomes [4].…”

Section: Introductionmentioning

confidence: 99%

Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures

et al. 2020

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The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.

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“…A similar observation was noted in a recent study 22 in which the authors compared marginal bone loss of maxillary implant overdentures retained bars or locator attachments and found than bone loss of locator group was higher than bar group after one year follow up period. This may be due to stress levels in surrounding bone tissues are significantly higher for four-implant maxillary overdentures with a solitary attachment system compared to a bar system 42 . The splinting of the implants by bars provide greater surface area and prevent implant micromotions 43 .…”

Section: Discussionmentioning

confidence: 99%

Bar versus Locator attachments for maxillary implant overdentures opposed by implant supported mandibular overdentures. Clinical and radiographic evaluation

Shawky

Allah

2020

Egyptian Dental Journal

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Purpose: The aim of this short-term clinical trial was to evaluate clinical and radiographic outcomes of Bar and Locator attachments used to retain maxillary implant overdentures opposed by implant supported mandibular overdentures. Material and methods:Ten patients wearing conventional maxillary denture and implant supported mandibular overdentures received 4 implants in the maxillary arch using 2 stage surgical approach. Six months later maxillary overdentures were connected to the implants with locator (group 1) or bar (group 2) attachments. Plaque index, bleeding index, probing depth, implant stability, and marginal bone loss (using Cone beam computerized tomography) were evaluated at time of overdenture delivery, 6 months and 12 months later.Results: Plaque and gingival indices increased significantly with time in bar group only. Bar overdentures recorded significant higher plaque and gingival scores than locator overdentures. No significant difference in pocket depth and implant stability was noted between time intervals or groups. Total marginal bone loss for locator group was significantly higher than bar group after 6 and 12 months. For both groups, marginal bone loss around canine implants was significantly higher than bone loss around premolar implants Conclusion: Within the limits of this study, it could be concluded that both locator and bar retained maxillary overdentures are successful treatment options for patients complaining from instability of maxillary dentures opposed by implant retained mandibular denture. However, locator attachments are advantageous in terms of peri-implant soft tissue health and bar attachments are advantageous regarding peri-implant alveolar bone preservation.

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Stress Distribution in Splinted and Unsplinted Implant-Supported Maxillary Overdentures

Abstract: Splinting maxillary overdentures implants is associated with significant lower stress levels in the surrounding bone tissue.

Cited by 12 publications

References 26 publications

Bar versus ball attachments for maxillary four‐implant retained overdentures: A randomized controlled trial

Bar versus ball attachments for maxillary four‐implant retained overdentures: A randomized controlled trial

Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures

Bar versus Locator attachments for maxillary implant overdentures opposed by implant supported mandibular overdentures. Clinical and radiographic evaluation

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