• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.4
• /
• pp.566-580
• /
• 1998

Implant-supported overdenture is known as a useful appliance, instead of using the conventional complete denture, for better retention and stability. In this study 4 types of materials such as, gold bar/plastic clip(group AuP), gold bar/metal clip(group AuM), palladium bar/plastic clip(group PdP), and palladium bar/metal clip (group PdM) were used to evaluate the retention forces according the type of clips and alloys used for bar fabrication, in the Hader bar system. Repeated insertions and removals of overdenture were conducted in each group. and the retention forces were measured and compared the data of each group according to the number of insertion and removal. The obtained results were as follows, 1. In the comparison of retention forces according to type of bar-clip, retention was increased in the order of group AuM, PdM, PdP AuP. and the retention force of group AuM was significantly increased compared with those of others (p<0.05). 2. In the comparison of retention forces according to the number of insertion, only group PdP showed significant decrease in retention(p<0.05). 3. In the comparison of retention forces according to the type of bar and clip. there was no significant difference in the type of bar, but the retention of plastic clip was significantly higher than that of metal clip when Au bar was used(p<0.05). 4. In the observation of the bar surface, group AuM using Au bar and metal clip showed the most scratches among bar groups.

• The Journal of Korean Academy of Prosthodontics
• /
• v.40 no.5
• /
• pp.507-524
• /
• 2002

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.1
• /
• pp.55-62
• /
• 2021

The mandible has a smaller support area than the maxilla, and in particular, in patients with generalized alveolar bone resorption, the stability of the denture and the masticatory efficiency are significantly low in the case of conventional complete denture, due to the movement of the tongue and mandible. In these patients, implant overdenture is evaluated as a highly predictable treatment method with high retention and stability, and excellent pronunciation and masticatory force. In this clinical case, patient had an edentulous maxilla and generalized alveolar bone resorption in mandible. Therefore, complete denture was placed in the maxilla and implant overdenture using milled bar attachment on 4 implants was placed in the mandible. During the 12-year follow-up period, changes in periodontal tissue and denture around the implants were periodically managed and observed.

• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.1
• /
• pp.1-17
• /
• 1998

두개의 임플랜트로 지지되는 overdenture를 이용한 하악무치악환자의 치료법은 경제적이면서, 실용적인 치료로 인정을 받고 있다. 하지만 해부학적인 조건으로 임플랜트를 설측 혹은 후방에 식립해야 되는 경우에는 일반적인 bar설계는 bar가 구강저 상방을 지나게 되어 혀운동, 발음, 위생관리 등에 많은 문제점을 부여한다. 이에 대한 해결방법으로 전방부 치조제 상에 보철물의 회전을 허용하는 angular bar를 설계할 수 있다. 하지만 이 설계는 임플랜트에 불리한 moment를 유발한다. 그럼에도 불구하고 뛰어난 유지력과 지지능력, 경제적인 면 때문에 angular bar는 임상에서 많이 사용되고 있다. 이에 본 연구는 angular bar의 전방 cantilever양을 달리하여 임플랜트 및 주변조직에 미치는 영향을 삼차원 유한요소분석법을 통해서 알아보고자 하였다. 이공사이의 하악골을 단순화시킨 준하악골모형에 직경 3.75mm인 브로네마르크 임플랜트 2개를 길이가 13,15mm인 경우로 설정하여 제 1소구치 부위에 식립하였다. 두 임플랜트를 연결하는 bar는 전방부 cantilever양을 0-5mm, 1mm씩 하여 6가지 경우를 가정하고 제작하였다. 각각 bar 중앙부에 수직압 (90도) 35N, 경사압(120도) 70N, 수평압(0도) 10N을 가하였으며 이때 나타나는 응력 분산형태와 임플랜트의 골유착에 불리하게 작용하는 최대주응력(인장력)과 변위량을 살펴보았다. 연구결과 다음과 같은 결론을 얻었다. 1. Cantilever양이 증가할수록 주변피질골과 임플랜트로 응력이 집중되었으며 상부 보철물의 변위량도 커졌다. 2. Cantilever양에 대한 수평압의 영향은 크지 않았으며 임플랜트 길이가 긴 것이 변위량과 응력이 작았다. 3. 경사압에 대한 응력의 변화는 cantilever양의 증가에 따라 급격히 증가하는 양상을 띠었으며 임플랜트길이가 응력 및 변위의 양에 미치는 영향은 없었다. 4. 수직압에 대한 응력의 변화는 초기에는 완만한 증가를 보이다가 일정 시점 지난 후에는 증가율이 커지는 경향을 띠었다. 증가현상이 두드러지기 전에는 길이의 증가가 응력의 분산효과는 가져왔으나 이후에는 길이의 응력분산 효과는 없었다. 5. 응력분포양상은 cantilever양이 증가할수록 골조직을 통한 분산정도는 작아지고 특정부위의 피질골과 임플랜트, 상부보철물에 집중되는 경향을 보였다. 6. 임플랜트와 주변 골조직으로의 응력분산능력이 예후를 좌우한다는 점에서 angular bar는 적합치 못하며 부득이한 경우는 임플랜트 길이를 길게 하고 최대한 3mm이내로 cantilever양을 제한하는 것이 추천된다.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.1
• /
• pp.41-48
• /
• 2016

Edentulous patients with severe alveolar bone resorption have trouble with using traditional complete denture. In order to overcome these problems, implant-retained overdenture was developed. SFI-bar$^{(R)}$ system can save time and cost compared to other existing bar systems which need complicated laboratory procedures because it can be adjusted directly in a patient's mouth. A 55-year-old male, who had experienced a fractured lower old implant-retained overdenture, wanted a durable and painless denture. The fractured Locator$^{(R)}$ attachments were removed and edentulous mandible was restored with SFI-bar$^{(R)}$. A 77-year-old female with a medical history of the Parkinson's disease and severely absorbed alveolar bone of mandible, wanted to wear a retentive mandibular denture without pain. After placing two implants in front of mental foramen, two adaptors were connected to two implants and a tube bar was connected to the adaptors. A female part fitted to the bar was attached to the new denture. These clinical reports describe two-implant-retained overdenture using the SFI-bar$^{(R)}$ system in mandibular edentulous patients. Since the patients were satisfied esthetically and functionally during 2 years' observation, we would like to report cases.

• The Journal of Advanced Prosthodontics
• /
• v.6 no.4
• /
• pp.245-252
• /
• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

• 대한치과보철학회:학술대회논문집
• /
• 2003.04a
• /
• pp.33-33
• /
• 2003

• 대한치과보철학회:학술대회논문집
• /
• 2004.04a
• /
• pp.70-70
• /
• 2004

• The Journal of the Korean dental association
• /
• v.55 no.7
• /
• pp.457-466
• /
• 2017

In the case of failed fixed implant prosthesis accompanied by abutment screw fracture, fractured screw fragment must be removed to use the existing implant fixtures. A 61-year-old male patient, who had a failed maxillary fixed implant prosthesis accompanied by three abutment screw fracture, hoped to reconstruct the maxillary implant prosthesis, while maintaining the existing implant fixtures. To use the existing implant fixtures, fractured screw fragments were removed. A maxillary implant overdenture using available existing implants was planned. Bar-attachment with Locator was used for implant splinting, denture stability, and retention. Final impression was taken after treatment of peri-implantitis. Jaw relation registration was taken to evaluate available interarch space for bar-attachment. After fabricating bar-attachment, centric relation was taken. Implant overdenture using bar-attachment with Locator was delivered after wax-denture evaluation. This case report showed that a satisfactory clinical result was achieved by implant overdenture using existing implant fixtures in a maxillary edentulous patient.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.2
• /
• pp.85-93
• /
• 2016

PURPOSE. The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-retained overdenture. MATERIALS AND METHODS. Maxillary implant-retained overdentures with 4 implants placed in the anterior region of edentulous maxilla were converted into a 3-D numerical model, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional finite element analysis. RESULTS. In all experimental models, the highest stress was concentrated on the most distal implant and implant supporting bone on loaded side. The stress at the most distal implant-supporting bone was concentrated on the cortical bone. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant and implant supporting bone on loaded side. CONCLUSION. It could be suggested that when making maxillary implant retained overdenture, using Hader bar instead of milled bar and full palatal coverage rather than partial palatal coverage are more beneficial in distributing the stress that is applied on implant supporting bone.