Factors influencing retention and durability of attachments for overdentures - adverse effects of cleansings, pH, and temperature: A systematic review

The optimal design and three-dimensional finite element analysis of CAD/CAM integrated roach attachment

Objectives

To investigate the effect of different designs of movable parts and prosthetic materials on the stress distribution of supporting tissues in mandibular free end dentition defects using three-dimensional finite element analysis of digital Roach attachments.

Material and methods

A 3D model of a patient with Kennedy class I mandibular edentulous conditions was generated, and twelve prosthesis models were applied, combining two designs of removable parts and six types of CAD/CAM restorative materials with different elastic modulus (conventional zirconia, ultra-translucent zirconia, Polyetheretherketone (PEEK), Lithium disilicate, Nanoceramic resin, and resin composite (Paradigm MZ100, 3 M ESPE)). The stress distribution of abutment periodontal ligament, edentulousmucosa, and junction of attachment were analyzed using finite element analysis.

Results

The stress value of the buccal neck of the periodontal ligament and the maximum compressive stress of the distal periodontal ligament of the design with clasp arms were higher than those without clasp arms, while the stress on the junction of attachment and the displacement of the mucosa in the edentulous area were smaller. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended to be used as the fixed part of Roach attachment.

Conclusion

CAD/CAM Roach attachments with clasp arms are recommended for the protection of mucosal soft tissue. Restorative materials with high elastic modulus, such as conventional zirconia and ultra-translucent zirconia, are recommended as the fixed part of Roach attachment for patients with free end defect of mandibular dentition.

Clinical significance

This study provides references for the design with clasp arms and the selection of clinical fixed-movable prosthetic materials. Clinicians should consider the design of attachments and selection of appropriate manufacturing materials carefully to avoid negative impacts on patients' periodontal support tissues.

The Influence of Cleaning Solutions on the Retention of Overdenture Attachment Systems

Dental-implant-supported reconstructions provide comfort and improvements in prosthetic function, adaptation, and stability over conventional treatment options. The objective of this study was to evaluate the effect of different denture cleansing solutions and their influence on the deterioration and loss of retention of overdenture attachments in a 12-month clinical-use simulation. In this way, ten specimens each of different brands of retentive caps made of Teflon (OT Equator^® (Rhein83, Bologna, Italy), Locator^® (Zest Anchors, Escondido, CA, USA), Kerator^® (KJ Meditech, Gwangiu, Republic of Korea), and Locator R-Tx^® (Zest Anchors, Escondido, CA, USA)) were immersed in five different cleaning solutions (Kukident^® (P&G Tech, Oxford Parkway, UK), Benfix^® (Laboratorios URGO S.L., Guipúzcoa, Spain), Corega^® (Stafford Miller, Waterford, Ireland), and Protefix^® (Neuhofer Weiche, Parchim, Germany)), and tap water was used as the control group, in a simulation that lasted 12 months. Data were analyzed using two-way ANOVA and a Tukey HSD. Furthermore, a Levene Test and Shapiro-Wilk tests were performed to assess the validation of the ANOVA assumptions. The statistical analysis was performed using R version 4.2.2 software with the significance level set to p < 0.05. There were significant statistical differences between the different manufacturers regarding the retention forces of the attachment's retentive caps (F = 322.066, p < 0.001). For the cleaning solution groups, different statistical results between Kukident^® (P&G Tech, Oxford Parkway, UK) (p < 0.05) and Benfix^® (Laboratorios URGO S.L., Guipúzcoa, Spain) (p < 0.05) were observed. There were no significant statistical differences between Corega^® (Stafford Miller, Ireland), Protefix^® (Neuhofer Weiche, Parchim, Germany), and tap water, even though the retention forces decreased in all of them.