Two-implant mandibular overdentures: simple to fabricate and easy to wear

Success rates for titanium dental implants in the anterior mandible are very high. Because of these success rates, as well as lower costs, it is common to treat edentulous patients with just 2 implants and ball anchors for retention of the overdenture, instead of 4 implants and a bar. In this paper the fabrication of 2-implant overdentures is described. In a controlled clinical trial (to be reported elsewhere), 30 subjects received a 2-implant overdenture for the mandible and a conventional prosthesis for the maxilla. The 30 control patients received conventional complete dentures for both jaws. The stability of the overdentures was excellent, and the lingual dimensions of the denture could be reduced to the level of the mylohyoid line to provide more space for the tongue. In patients with tense labial musculature or a limited amount of attached gingiva, it was important to elevate the shoulder of the implant and ball abutment above the gingival level to avoid peri-implant problems. Significantly fewer visits for adjustment related to post-placement pressure spots were required for mandibular overdentures than for conventional mandibular prostheses.

The milled bar-retained removable bridge implant-supported prosthesis: a treatment alternative for the edentulous maxilla

Restoration of the edentulous jaw with dental implants can be achieved using either an implant-supported prosthesis, such as a fixed bridge, or an implant-retained prosthesis, such as a traditional overdenture. The implant-retained prostheses use edentulous ridges as primary stress-bearing regions, and through stress-breaking mechanisms, the implants are not loaded during function. However, the success rates of maxillary overdentures do not appear to be as good as for mandibular overdentures; this may be attributable to the adverse loading conditions, short implant length, poor quality of bone, number of implants used, flexible bar design, or poor treatment planning. Many articles have also described the numerous problems and multiple visits required in maintaining a traditional bar-retained overdenture restoration, often making it more expensive in the long term than a fixed restoration. The milled bar implant-supported prosthesis offers the benefits of both fixed and removable restorations. Its infrastructure provides the same rigidity as the fixed restoration, owing to the precise fit to the superstructure, which is removable, to promote adequate access for hygiene, yet it still provides lip support and maintains close contact with the soft tissues. These advantages enhance phonetics, esthetics, correct lip support, maintenance, and patient comfort.

Removable partial denture design: a study of a selected population in Saudi Arabia

Determination of the incidence of various classes of removable partial dentures (RPDs) including their designs and their comparison with previous studies provide clinically useful information for dental training and continuing education. The purpose of this study is to determine the pattern of partial edentulism, the major connector, clasping, and design of 740 cobalt chromium RPD frameworks constructed for a selected population in Saudi Arabia. RPD framework design information and patient personal data were obtained from the work authorization form and the dental records respectively. The relationship among age, sex, nationality, and various Kennedy classes of the RPDs was determined by chi-square statistical analysis. Results indicate that Kennedy Class III removable partial dentures were the most frequently constructed. Although gender had no significant relationship, age and nationality had statistically significant relationship with the distribution of various Kennedy classes of removable partial dentures. Lingual bars and anterior posterior palatal straps were the most commonly used mandibular and maxillary major connectors. Lingual and palatal plates, however, were more frequently used than any major connectors for distal extension RPDs. Comparison with previous findings confirms the established variation in designing RPDs. The distribution of partially edentulousness revealed the influence of the general pattern of tooth loss, which could be modified by patient's demands and socio-economic status. Practitioners need to avail themselves fully of basic RPD design principles concerning the most commonly encountered classes of RPDs.

A clinical overview of removable prostheses: 1. Factors to consider in planning a removable partial denture

This is the first article in a series on the prescription of removable partial dentures. It addresses basic clinical and patient-related factors involved in decision-making before commencing active prosthodontic treatment. Further papers will outline a variety of impression techniques for primary and definitive impression, discuss designing principles, give an overview of some technological aspects of removable partial denture-making and provide guidelines on how to diagnose and manage common clinical problems associated with removable partial dentures.

[Establishment of two-dimensional magnetic field finite element analysis model of cup-yoke-type magnetic attachment]

OBJECTIVE

The purpose of this study was to establish two-dimensional magnetic field finite element analysis model of cup-yoke-type magnetic attachment for optmizing the design of magnetic attachments.

METHODS

Because the magnetic field of cup-yoke-type magnetic attachment is stable axial-symmetrical, the authors only analyzed two-dimensional magnetic field of 1/2 section. The Maxwell stress between magnet and keeper was integral analyzed using the finite element method, and the attractive force between magnetic attachments was obtained.

RESULTS

Compared the value of calculated attractive force with that of examined, the authors found that the procedure veritably reflected influencing trend of variable factors on attractive force, and the value of former one was 10% less than the later one.

CONCLUSION

This procedure can be used in magnetic field calculation of cup-yoke-type magnetic attachments.

Laboratory study on abutment movement of the combined clasp, the extension clasp and the telescopic crown

OBJECTIVE

To study the influence of three kinds of retainers on the abutment movement of removable partial dentures (RPDs) for restoring the dentition with unilateral distal-extended tooth missing.

METHODS

The combined clasp, the extension clasp and the telescopic crown were designed to retain RPDs. When food chip was masticated between dentitions, the displacement of abutments was measured by a high-sensitive-laser-transferring-detector, and then the data was statistically analyzed.

RESULTS

All of abutments showed the inclination, torsion and vertical translocation. Of them, abutments with telescopic crowns had the lowest horizontal torsion (P < 0.01) and the highest vertical translocation (P < 0.01).

CONCLUSIONS

Compared with the combined clasp and the extension clasp, the telescopic crowns enable abutments to bear the load more axial and the stress to be distributed more even, so the design of the telescopic crown may be considered more favourable for the health of abutments.

Comparison of 2 Retentive Systems for Implant-Supported Overdentures: Soft Tissue Management and Evaluation of Patient Satisfaction

BACKGROUND

The aim of the present study was to compare the peri-implant soft tissue health status of implants supporting overdentures with bar attachments or ball attachments in the mandible, as well as patient satisfaction with these attachment types.

METHODS

The study included a Dolder bar group with 18 cases (43 implants) and a ball attachment group with 18 cases (51 implants). The mean function period in the Dolder bar group was 49 months (range: 12 to 72 months) and in the ball attachment group, the mean was 23 months (range: 12 to 40 months). Implants were clinically evaluated by using a modified plaque index (mPI), modified sulcus bleeding index (mSBI), and probing depths. Patient satisfaction with the treatment was recorded using a questionnaire.

RESULTS

mPI, probing depth, and mSBI did not statistically differ between groups (Mann-Whitney U test, P > 0.05). Patient satisfaction was similar with both retentive systems.

CONCLUSION

Within the limits of this study, we concluded that there was no significant difference between the 2 attachment types used for implant-supported overdentures with respect to the soft tissue health status or patient satisfaction.

Finite element analysis of deflections in major connectors for maxillary RPDs

PURPOSE

The effect of major connector design on deflection in maxillary removable partial denture (RPD) frameworks under simulated occlusal loading was analyzed by means of three-dimensional finite element models.

MATERIALS AND METHODS

Thirteen maxillary major connectors were produced for a Kennedy Class II case. Eleven frameworks consisted of posterior palatal straps with different anteroposterior widths at the midline. Anteroposterior and horseshoe bars were also constructed for comparison. In each framework, the occlusal rest on the abutment adjacent to the edentulous ridge was fixed in a vertical direction, and the rest on the contralateral side was fixed in all directions. A biting force of 20 N was vertically distributed simultaneously on each of the three missing posterior teeth locations.

RESULTS

For the posterior palatal straps, the maximum vertical displacement at the saddle and the buccal displacement at both the saddle and the rest adjacent to the saddle decreased as their connector width increased from 6 to 29 mm, whereas maximum distal displacements were insensitive to the connector width. The posterior straps with anteroposterior widths of more than 18 mm revealed comparable rigidity to the anteroposterior bar. The horseshoe bar and the posterior straps with smaller widths demonstrated greater displacements than the other frameworks.

CONCLUSION

The rigid connectors proved to be the most effective in transmitting applied occlusal forces to the contralateral side of the framework.

Magnetic attachment for esthetic management of an overdenture

Magnetic attachments are a popular means of retaining removable overdentures and maxillofacial prostheses.(1) When used in anterior regions, these attachments often are not esthetic because the metallic color of the cast coping or attachment can be seen directly or through the denture base. An esthetic magnetic attachment with a composite facing can be fabricated to overcome this problem.

Cleansability of and patients' satisfaction with implant-retained overdentures: a retrospective comparison of two attachment methods

BACKGROUND

Two important factors in the use of implant-retained overdentures are cleansability and patients' satisfaction. Limited research has been published concerning the cleansability of these overdentures On the other hand, studies have compared patients' satisfaction with conventional dentures and various designs of implant overdentures. However, no studies have compared overdentures retained by Hader bars (Sterngold, Attleboro, Mass.) and direct ERA attachments (Sterngold) in terms of both cleansability and patients' satisfaction.

PURPOSE

The authors' aim was to determine the cleansability of and patients' acceptance of overdentures retained by direct ERA attachments and overdentures supported by a Hader bar with distal ERA attachments and a Hader clip.

MATERIALS AND METHODS

Two groups of 10 subjects each were evaluated: Group A, consisting of patients with overdentures retained by direct ERA attachments, and Group B, consisting of patients with overdentures retained by Hader bars. The authors evaluated the subjects between 18 and 24 months after the delivery of the overdentures by means of a questionnaire and a clinical examination to score each patient on gingival, plaque and calculus indexes.

RESULTS

Group A exhibited better results than Group B on calculus, plaque and gingival indexes, but the difference was not statistically significant. The authors found no significant difference between the two experimental groups in satisfaction.

CONCLUSIONS

When evaluated in terms of subjects' satisfaction and calculus, plaque and gingival index scores, implant-retained overdentures supported by direct ERA attachments were similar to those supported by a Hader bar.

CLINICAL IMPLICATIONS

The two types of overdentures studied are equally satisfactory and easy to clean. Other factors such as biomechanics, patients' preference and previous experience may be more critical when selecting the retention design for an overdenture supported by four implants.

Early intraoral splinting and loading of one-stage dental implants in the edentulous mandible: literature review and case report

Recent studies of immediately loaded screw-retained dentures, bar overdentures, and single-tooth replacements have demonstrated success rates comparable to similar restorations using a two-stage procedure. An international study of immediately loaded bar overdentures on a novel single-stage implant is currently being conducted in the United States and Europe. This article presents a case report that illustrates the intraoral construction of an overdenture bar pattern at the time of implant placement, followed by soldering and immediate loading. The elimination of transfer procedures may significantly reduce treatment time and enhance the passive fit of the bar.

The root-supported overdenture using the Locator overdenture attachment

This article reviews the rationale for the use of overdentures in the partially edentulous and fully edentulous maxilla and mandible. Treatment options, prosthetic designs, indications, and fundamental principles for the successful applications of overdentures are discussed. A detailed step-by-step procedure and technique for the construction of overdentures is provided.

Comparative study of circumferential clasp retention force for titanium and cobalt-chromium removable partial dentures

STATEMENT OF PROBLEM

The interest in using titanium to fabricate removable partial denture (RPD) frameworks has increased, but there are few studies to support its use.

PURPOSE

The objective of this study was to compare circumferential RPD clasps made of commercially pure titanium and identical clasps made of 2 different cobalt (Co)-chromium (Cr) alloys by testing insertion/removal and radiographically inspecting the casts for defects.

MATERIAL AND METHODS

On refractory casts that represent a partially edentulous mandibular right hemi-arch segment, 36 frameworks were cast from commercially pure titanium (n = 12) and 2 Co-Cr alloys (n = 12 each) with identical prefabricated patterns and the manufacturer-designated investment and casting technique. Each group was divided into 2 subgroups, corresponding to .25-mm and .50-mm undercuts, respectively. No polishing procedures were performed to ensure uniformity. Only nodules and burs were carefully removed with tungsten burs under magnification when necessary. The specimens were radiographed and subjected to an insertion/removal test simulating 5 years of framework use. The data were subjected to analysis of variance and the Tukey complementary test (P<.01) to compare the retentive forces of RPDs made with the different materials. The Student t test (P<.01) was used to compare the retentive forces of RPDs fabricated with the same alloy with different undercuts.

RESULTS

A total of 20% of the titanium specimens demonstrated porosity, showing casting difficulties, and any defect detected on the clasps determined the sample replacement. For Co-Cr alloys, casting difficulties were not found. The data were subjected to analysis of variance and the Tukey complementary test to compare materials for the same undercut. For the .25-mm undercut, no significant difference was found between Magnum and Rematitan alloys; they were both different from the Remanium alloy (P<.01). For the.50-mm undercut, no significant difference was found between Co-Cr alloys; they were both different from Rematitan alloy (P<.01). The Student t test used to compare the same alloys with different undercuts showed no significant difference between Remanium with .25-mm and .50-mm undercuts. For Magnum and Rematitan alloys, there was a significant difference between different undercuts (P=.01).

CONCLUSION

Within the limitations of this simulation study, the results suggest that commercially pure titanium clasps maintained retention over a simulated 5-year period, with lower retention force than identical Co-Cr clasps.

Prosthodontic rehabilitation with a swing-lock removable partial denture and a single osseointegrated implant: a clinical report

This article details the use of a swing-lock removable partial denture and single osseointegrated dental implant in the prosthodontic rehabilitation of a partially dentate patient. Used together, these treatment options solved a difficult clinical problem with a satisfactory outcome.

Internal porosity of cast titanium removable partial dentures: Influence of sprue direction on porosity in circumferential clasps of a clinical framework design

STATEMENT OF PROBLEM

Although internal porosity is a potential risk factor for clasp fracture, little is known about its frequency in the clasps of titanium removable partial dentures.

PURPOSE

This study investigated the influence of the direction of auxiliary sprues on porosity in the circumferential clasps of a pressure-cast titanium removable partial denture.

MATERIAL AND METHODS

Wax patterns of a removable partial denture framework were made on 10 identical refractory casts of a Kennedy class II, modification 1, mandibular partially edentulous arch. For the auxiliary sprues directed to the circumferential clasps, 2 designs were used: straight and curved. Casting was performed in a 1-chamber pressure casting machine. Pore number and size were assessed on radiographs of the castings. The data were analyzed with the 2-tailed Student t test (P <.05). Randomly selected specimens were sectioned for morphologic observation of the internal surface of the pores.

RESULTS

The number of pores >or=0.5 mm diameter and the total number of pores were significantly lower in the molar lingual arms of the curved sprue group than in the corresponding clasp arms of the straight sprue group (P =.03 and P =.009, respectively). No significant differences between the 2 groups were found for pores of any size in other locations. The pores had smooth internal surfaces.

CONCLUSION

Within the limitations of this study, the curved sprue design produced significantly less porosity in the circumferential clasp arms of a cast titanium removable partial denture than the conventional straight design. The results suggest that internal porosity in titanium castings can be controlled through sprue design.

Removable partial denture design: a need to focus on hygienic principles?

PURPOSE

The purpose of this study was to critically analyze important hygienic/secondary prophylactic and biomechanical aspects of removable partial denture (RPD) design.

MATERIALS AND METHODS

The literature related to traditional biomechanical design and open/hygienic design of RPDs was discussed by the authors at a 2.5-day workshop. The written report was circulated among the authors until a consensus was reached.

RESULTS

There is little scientific support for most of the traditional design principles of RPDs, nor has patient satisfaction shown any correlation with design factors. However, there is evidence that an open/hygienic design is more important than biomechanical aspects for long-term oral health. The biomechanical importance of some components is questioned, e.g., indirect retention and guiding planes. Alternative connector designs that reduce risks of tissue injury are described. Direct retainers and pontics are discussed in relation to the possibilities they offer for gingival relief.

CONCLUSION

Greater attention should be paid to RPD design principles that minimize the risks of tissue injury and plaque accumulation in accordance with modern concepts of preventive dentistry.

Maximum dislodging forces of implant overdenture stud attachments

PURPOSE

The aim of this study was to compare the retention and stability of the Nobel Biocare standard ball (NBS), Nobel Biocare 2.25-mm-diameter ball (NB2), Zest Anchor (ZA), Zest Anchor Advanced Generation (ZAAG), Sterngold ERA orange (SEO), and Sterngold ERA white (SEW) attachments on an implant-retained overdenture model.

MATERIALS AND METHODS

The attachments were tested using 2 permanently placed Brånemark System implants on a test model that was attached to an Instron machine (crosshead speed 50.8 mm/minute). Each attachment had one part embedded in a denture-like housing and the other part screwed into the implants. Dislodging tensile forces were applied to the housings in 3 directions simulating function: vertical, oblique, and anterior-posterior. Eight tests were done in 3 directions with 6 samples of each attachment. The dislodging forces generated measurements of the peak load (maximum dislodging force). A 1-way analysis of variance followed by the Tukey studentized range test was used to determine groups that were significantly different. All tests for significance were carried out at the .05 level of significance.

RESULTS

Results showed the ZAAG attachment to be the most retentive for the peak load measurement when subjected to vertically directed forces, with mean values and standard deviations of 37.2 +/- 5.5 N. The next most retentive attachment was the NBS, followed by the SEO, NB2, SEW, and ZA. For obliquely directed forces, the ZAAG attachment was the most retentive, with mean values and standard deviations of 27.2 +/- 4.2 N. The next most retentive was the NBS, followed by the NB2, SEO, ZA, and SEW. For anterior-posteriorly directed forces, results showed the NBS had the highest measured retentive force, with mean values and standard deviations of 34.6 +/- 18.8 N, but this was not statistically different from the NB2 and ZAAG; this was followed by the SEO, SEW, and ZA.

DISCUSSION

There has been a marked resurgence in the treatment of patients with overdentures using implant attachments as retentive devices. The maximum force developed (a measure of retention) as the implant stud attachments were resisting removal from the implant abutments was determined.

CONCLUSIONS

Based on the present study, the clinician may be able to make empirical decisions on attachment selection, depending on the amount of retention desired and the specific clinical situation.

Does a prosthodontist spend more time providing mandibular two-implant overdentures than conventional dentures?

PURPOSE

In this article, the time taken by a prosthodontist to fabricate and maintain mandibular overdentures retained by two implants and conventional dentures is compared.

MATERIALS AND METHODS

Sixty edentulous patients between the ages of 65 and 75 completed a randomized clinical trial. All received new maxillary conventional dentures and either a mandibular conventional denture (n = 30) or a two-implant overdenture on ball attachments (n = 30). The time spent by the prosthodontist and the number of visits required for treatment, including both scheduled and unscheduled visits, were recorded for each patient from preliminary impressions to 6 months following delivery. Data from the two groups were compared using Mann-Whitney U tests.

RESULTS

The prosthodontist spent a mean total time of 296 minutes in treating an implant overdenture patient and 282 minutes on a conventional denture patient during the period from preliminary impressions to the 6-month follow-up. The mean numbers of appointments were 10.1 (implant group) and 10.8 (conventional group). These differences were not significant.

CONCLUSION

Although additional knowledge is required to treat patients with implant prostheses, the time required by the prosthodontist to provide two-implant mandibular overdentures with ball attachments was not significantly different than the time needed for conventional denture treatment.

A long-term follow-up study of non-submerged ITI implants in the treatment of totally edentulous jaws. Part I: Ten-year life table analysis of a prospective multicenter study with 1286 implants

In this prospective multicenter study, non-submerged ITI implants were followed in order to evaluate their long-term prognosis in fully edentulous jaws. A total of 1286 implants were inserted in 233 consecutive patients and, after a healing period of three to six months, the successfully integrated implants were restored with 163 overdentures and 95 fixed full-arch bridges. This prospective study not only calculated the 10-year cumulative survival and success rates for the 1286 implants by life table analysis, but also evaluated the actual survival and success rates for 498 implants after at least five years of functional loading. In addition, cumulative success rates were calculated for implant subgroups according to implant length and location. Additional analyses were performed to evaluate the estimated and actual survival and success rates of the implants in relation to various prosthetic rehabilitation techniques. The 10-year cumulative survival and success rates were 95.9% and 92.7%, respectively. The actual 5-year survival and success rates of the first 498 implants that were inserted were 97.7% and 95.0%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93%), in comparison to 10 mm and 8 mm long implants (91.6% and 89.6%, respectively). The cumulative success rate for mandibular implants (approximately 94%) was also more favourable than that for maxillary implants (approximately 91%). Patients who were loaded with both maxillary and mandibular prostheses maintained success rates well above 90%; while only implants that were inserted to support maxillary overdentures that were retained by Dolder bars showed a success rate below 90%.

Vibration analysis of maxillary removable partial denture frameworks

The purpose of this study was to investigate the vibratory characteristics of three designs of the Class I Kennedy maxillary removable partial denture frameworks as the basic study. Their major connectors comprised a U-shaped palatal connector (UPC), single palatal bar (SPB), and anterior-posterior palatal bars (APB). Frequency response functions were measured when the framework was impacted. The modal shape was observed and the decay rate was calculated using modal analysis software. The results showed that the vibratory properties of each framework differed from each other. Within the range of frequencies from 10 to 2000 Hz, the UPC type had seven natural frequencies, while the SPB and the APB types had six. The UPC type had a greater number of natural modes accompanied by elastic deformation, including fluttering and twisting, than the other type, and the UPC type was considered to be unfavourable. The decay rate of the APB type was significantly higher than those of the UPC and the SPB types (P < 0.01).

The effects of loading locations and direct retainers on the movements of the abutment tooth and denture base of removable partial dentures

The purpose of this study was to evaluate the degree and amount of movement of the abutment tooth and denture base influenced by the direct retainer of distal extension removable partial denture and the location of functional loading, then to suggest direct retainer design with minimal adverse effect and with optimum functional loading location for residual tissue. The displacement of the abutment tooth and inclination of the denture base were determined, with 30 N as work load utilizing simulation model and strain gauge system, about two types of direct retainers with mesial or distal rest and nine loading points on denture base. Displacement and inclination was determined with the one-way analysis of variance and Scheffe's multiple test was performed. The results revealed that type of direct retainer influenced on the magnitude rather than direction of the abutment tooth displacement. The distal displacement of abutment tooth was significantly less in Type M clasp (with mesial rest and connection) than in Type D clasp (with distal rest and connection) (p<0.05). The location of loading points influenced both of the magnitude and direction of the abutment tooth and denture base movement. Posterior and lingual loading resulted in significantly distal displacement of abutment tooth (p < 0.05).

[A study of tarnish induced by Streptococcus sobrinus serotype g on Co-Cr, Ni-Cr and casting titanium alloys]

OBJECTIVE

The objective of this study was to investigate the tarnish induced by Streptococcus sobrinus serotype g on Co-Cr, Ni-Cr and casting titanium alloys.

METHODS

Co-Cr, Ni-Co and casting titanium alloys were respectively machined into a size of 10 mm x 10 mm x 1 mm in tablets, and totally 90 specimens with 30 of each were prepared for the test. The 30 specimens of each alloy were randomly and equally divided into three subgroups, including the blank control group, the media control group and the inoculated media group. Under the aerobic condition, the surfaces of the sucrose agar media were inoculated with Streptococcus sobrinus serotype g. The labeled sterile specimens were placed on the surface of the media for 10 weeks. The specimens were changed to a new sucrose media with bacteria each week. The specimens were removed after 10 weeks of incubation, immersed in 0.05% glutaraldehyde solution to eliminate AaY4, rinsed with distilled water. After 2 weeks, the specimens were removed and observed visually or examined by MINOLTA CR-100 color apparatus.

RESULTS

Compared with the blank control, the control media without bacteria did not influence the alloy specimens (P > 0.05). Streptococcus sobrinus serotype g caused tarnish on specimens. There was significant difference between the control media group and the blank control group with inoculated media group on all the specimens (P < 0.05).

CONCLUSION

Streptococcus sobrinus serotype g affects the color of Co-Cr, Ni-Cr and casting titanium alloys, but the color does not change from yellow-green range to red-yellow range.

Implant-supported denture in a patient with Huntington's disease: interdisciplinary aspects

Patients with extrapyramidal diseases often cannot maintain independent, efficient oral hygiene due to restricted motor ability of the upper extremities and lack of coordination. The hermetic closure of the mouth and lips, and the associated ability to keep liquid and toothpaste in the mouth, can become so weak that effective oral hygiene cannot be maintained. Over a period of many years, this illness leads to loss of teeth and the need for complete prosthodontic care. Dyskinesia and hyperkinesia of the tongue and the peri-oral musculature, combined with xerostomia and pooling of saliva, make it impossible for the patient to wear a conventional complete denture, despite an anatomically-adequate bearing area. In such cases, an implant-supported prosthesis is a better therapeutic measure, although some aspects of oral hygiene must initially be disregarded. Two ITI implants were inserted into the anterior mandibular region of a patient with Huntington's chorea, because a complete denture could not be retained on the alveolar ridge, despite adequate vestibule depth, due to tongue dyskinesia. A bar joint was used to anchor this mucosal-borne denture. This implant-supported complete denture led to a clear improvement in the patient's chewing function when observed over a period of a year.