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Wakam R, Mawussi KB, Benoit A, Gorin C. Initial retention force of three attachment systems for implant retained-mandibular overdentures: An in vitro study. J Prosthodont 2024; 33:475-483. [PMID: 37439403 DOI: 10.1111/jopr.13729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/06/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023] Open
Abstract
PURPOSE To evaluate and compare the initial retention force of three resilient unsplinted attachment systems for implant-retained mandibular overdentures: two cylindrical attachment systems (Locator R-Tx® and Novaloc®), and one ball attachment system (Ball System). MATERIALS AND METHODS For each attachment system, initial retention is measured as the average of the maximal dislodging forces during 10 insertion-removal cycles. For the Ball System, three activation degrees of the matrix are included versus four and six color-coded retention devices for the Locator R-Tx® and the Novaloc®, respectively, to represent the complete regular retention devices panel. For each retention device or activation degree, eight samples are tested. RESULTS The initial retention range is similar between the Ball System (7.7 ± 3.4 N - 19.9 ± 4.6 N) and the Novaloc® (2.0 ± 0.5 N - 18.9 ± 1.4 N) and broader for the Locator R-Tx® (3.3 ± 5.0 N - 60.2 ± 6.0 N). In each attachment system, the initial retention of each retention device is significantly different from the others, except for the two most retentive Novaloc® ones. Retention devices were also classified according to their initial retention (low, medium, and maximum). In each retention group, the Novaloc® and the Ball System provided similar retention values lower than the Locator R-Tx®. CONCLUSION Most of the retention devices tested provided an initial retention force of over 5 N for all three attachment systems. The Locator R-Tx® had the most comprehensive range, and the Novaloc® seemed to provide the most reproducible values, unlike the Ball System due to the activation required by the operator.
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Affiliation(s)
- Raphael Wakam
- Unité de Recherche Biomatériaux Innovants et Interfaces, Faculty of odontology, Université Paris Cité, Montrouge, France
- Prosthetics Department, Oral Medicine Service, Pôle des Spécialités médico-chirurgicales, CHU Lille, France
| | - Kwamivi B Mawussi
- Unité de Recherche Biomatériaux Innovants et Interfaces, Faculty of odontology, Université Paris Cité, Montrouge, France
- Université Sorbonne Paris Nord, Bobigny, France
| | - Aurélie Benoit
- Unité de Recherche Biomatériaux Innovants et Interfaces, Faculty of odontology, Université Paris Cité, Montrouge, France
| | - Caroline Gorin
- Laboratory URP2496 Orofacial Pathologies, Imaging and Biotherapies, Faculty of odontology, Université Paris Cité, Montrouge, France
- Oral Medicine Service, Prosthetics Department, AP-HP/GH Nord, Paris, France
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Abdelaziz MS, Tella EAESAEM. Digital fabrication of polyetheretherketone retentive bar attachment inserts as overdenture maintenance: A dental technique. J Prosthet Dent 2024; 131:1034-1037. [PMID: 35606181 DOI: 10.1016/j.prosdent.2022.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022]
Abstract
A technique for the virtual designing of retentive attachment inserts for bar-retained 2-implant mandibular overdentures is described. The bar attachment is scanned intraorally, the retentive insert designed with the MESHMIXER software program, and the file 3D printed in resin, which is replicated in polyetheretherketone (PEEK). The technique offers high-quality inserts with good retention that can replace the conventional nylon inserts and reduce the number of maintenance visits and the frequency of changing the bar attachment.
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Affiliation(s)
- Medhat Sameh Abdelaziz
- Assistant Lecturer, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt.
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Girundi ALG, Ribeiro MCDO, Vargas-Moreno VF, Borges GA, Magno MB, Maia LC, Del Bel Cury AA, Marcello-Machado RM. Patient-reported outcome measures and clinical performance of implant-retained mandibular overdentures with stud and ball attachments: A systematic review and meta-analysis. J Prosthet Dent 2024; 131:197-211. [PMID: 35931572 DOI: 10.1016/j.prosdent.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 10/16/2022]
Abstract
STATEMENT OF PROBLEM Evidence regarding the retention system for a mandibular overdenture is important for treatment planning. However, the clinical performance of stud and ball attachments for mandibular overdenture retainers is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the clinical performance and self-reported patient outcomes of ball and stud attachments as mandibular overdenture retainers. MATERIAL AND METHODS Randomized (RCTs) and nonrandomized (N-RCTs) controlled clinical trials were selected based on the eligibility criteria. The risk of bias was assessed by using the Cochrane Collaboration Tools, and the certainty of the evidence (COE) by using the grades of recommendation, assessment, development, and evaluation (GRADE) workshop approach. Meta-analyses according to the follow-up period were performed for implant survival, prosthetic maintenance and complications, bleeding on probing (BoP), marginal bone loss (MBL), satisfaction, and oral health-related quality of life (OHRQoL). RESULTS Thirteen RCTs and 4 N-RCTs were included. Twelve studies presented a high risk of bias. The stud demonstrated a lower risk ratio (RR) (P<.001) for maintenance and complications concerning the need for matrix activation (RR 7.12 [2.65, 19.15]) (very low COE) and new overdentures (RR 2.47 [1.02, 5.96]) (moderate COE), ranging from 1 to 5 years of follow-up. Mean difference (MD) for MBL after 1 (MD 0.40 [0.28, 0.52]; P<.001) and 5 years (MD 0.18 [0.16, 0.20]; P<.001) was higher for ball attachments than that for stud (very low COE) attachments. Stud attachments also improved satisfaction (P<.001) when compared with ball attachments (very low COE). Implant survival rate (high COE), BoP (very low COE), and OHRQoL (low COE) were similar for the attachments. CONCLUSIONS Stud and ball attachments are clinically appropriate options as mandibular overdenture retainers and are capable of restoring OHRQoL. Nevertheless, the stud showed greater improvement in satisfaction and less prosthetic aftercare and MBL.
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Affiliation(s)
- Ana Luíza Gonçalves Girundi
- Master student, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Michele Costa de Oliveira Ribeiro
- PhD student, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Vanessa Felipe Vargas-Moreno
- PhD student, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Guilherme Almeida Borges
- PhD student, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Marcela Baraúna Magno
- PhD student, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Full Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Altair Antoninha Del Bel Cury
- Full Professor, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Raissa Micaella Marcello-Machado
- Postdoctoral Researcher, Department of Prosthodontics and Periodontology, University of Campinas Piracicaba Dental School, Piracicaba, SP, Brazil.
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Wakam R, Ramalingam S, Mawussi KB, Gorin C, Benoit A. Retention loss and wear assessment of three attachment systems for implant retained-mandibular overdentures: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106269. [PMID: 38043259 DOI: 10.1016/j.jmbbm.2023.106269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The stud-shaped attachment systems (AS) with different shape designs (ball, cylindrical, conical) and materials (metallic, plastic, or a combination of both) are commonly used to provide better retention and stability in implant-retained mandibular overdentures (IRMO). PURPOSE The purpose of the present study was to evaluate and compare the retention loss and the wear (patterns, location, material loss) of three resilient unsplinted AS: a well-established ball attachment system (BAS) and two more recent cylindrical attachment systems (CAS), Locator R-Tx® and Novaloc®. MATERIALS AND METHODS The implants, their corresponding abutments, the color-coded or position-coded retention devices (RD), the matrix metal housing were incorporated within CAD/CAM resin blocks and cyclically loaded with 19.6 N along the implant axis in a chewing machine to simulate 10,000 insertion-removal cycles (IRC). At cycle 10, 100, 1,000, 5,000, and 10,000, the retention force was measured using a universal testing machine. The wear was qualitatively examined using a binocular magnifier for both systems, and quantitatively assessed from micro-computed tomography acquisitions for CAS. Material loss exceeding 50 μm was considered significant. RESULTS The three AS showed different retentive behavior along time. All the Locator R-Tx® RD lost more than 50 % of their retention after 10,000 IRC. The retention of the Ball System slightly varied over time, the final retention loss in Bmed and Bmax groups being lower than 25 % of the initial retention. Wear was located at the tip of their gold RD and at the equator area of their ball abutment. For Locator R-Tx®, the more retentive the plastic RD, the greater its wear and retention loss. Only Novaloc® maintained a stable retention with even a slight tendency to increase and showed a negligible wear. Implant abutments of the CAS showed no significant wear. CONCLUSION After 10,000 IRC, corresponding to approximately 5-years clinical use, almost all RD provided retention force over 5 N, which could be sufficient to maintain satisfaction in most of the patients. The retention loss observed most prominently for the Locator R-Tx®, then for the Ball System, seemed to correlate with the wear observed on their RD. The practitioner may expect less RD maintenance with the Novaloc® stable retention overtime.
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Affiliation(s)
- Raphaël Wakam
- Département de Prothéses, Faculté de Chirurgie Dentaire, Université de Lille, France; Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Srilakshmi Ramalingam
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Kwamivi Bernardin Mawussi
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Sorbonne Paris Nord, Bobigny, France
| | - Caroline Gorin
- Département de Biologie Orale, Faculté de Chirurgie Dentaire, URP2496, Pathologie, Imagerie et Biothérapies Orofaciales, Université Paris Cité, Montrouge, France; Service d'Odontologie, Département de Prothèses, AP-HP / GH Nord, Paris, France.
| | - Aurélie Benoit
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France.
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El Charkawi HG, Abdelaziz MS. Novel CAD-CAM fabrication of a custom-made ball attachment retentive housing: an in-vitro study. Eur J Med Res 2023; 28:520. [PMID: 37968756 PMCID: PMC10652503 DOI: 10.1186/s40001-023-01498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE This study aims to evaluate the digitally designed ball attachment housing in its initial retentive force and after 2 years of simulated clinical use and to compare it with the regular nylon ball attachment housing. MATERIALS AND METHODS Twenty implants with their corresponding ball abutments (diameter 4.5 × 4.0 mm) were inserted in resin blocks. They were divided into two groups. In Group I, ten ball abutments each received their corresponding conventional attachment with nylon rings. In Group II, ten ball abutments received the novel CAD-CAM polyetheretherketone ball attachment housing. A universal testing machine was used to measure the retention force. The achieved maximum values of retention force were recorded at the beginning of the study (initial retention) and after 2 years of artificial ageing (2000 cycles of insertion and removal). Results were statistically analyzed using an independent sample T test. RESULTS The PEEK attachment housing showed high retention forces (25.12 ± 0.99 N) compared to the conventional attachment with a nylon ring (15.76 ± 0.93 N) in the initial dislodgement test. There was a statistically significant difference in mean retention at the initial retention test and after 2 years of stimulated usage between the two studied groups, p = 0.000. CONCLUSIONS Within the limitations of this study, the novel CAD-CAM-PEEK attachment showed high retention characteristics compared to the conventional attachment with nylon rings, initially and after simulated long-term use.
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Affiliation(s)
- Hussein G El Charkawi
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University, Fifth Settlement, End of 90 Street, Cairo, Egypt.
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University, Fifth Settlement, End of 90 Street, Cairo, Egypt
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Abdelaziz MS, Fawzy AM, Ghali RM, Nassar HI. Retention of Different Attachment Systems for Digitally Designed Mandibular Implant Overdenture. J Prosthodont 2023; 32:162-169. [PMID: 35344237 DOI: 10.1111/jopr.13516] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Primary retention and gradual loss of retention of different attachment systems are important key factors in proper attachment selection; however, studies on attachment retention show a wide range of retention values concerning the same attachment system. This in vitro study uses a novel approach that utilizes a digitally designed and 3D-printed reinforced overdenture, which has a digitally determined geometric center, in order to standardize results for future research and clinical work. This study aims to evaluate initial retention along with the gradual loss of retention at different time intervals between three types of stud attachments, retaining a digitally designed, reinforced mandibular overdenture after 5475 cycles simulating 5 years of attachment usage. MATERIALS AND METHODS An epoxy model of an ACP Class I (American College of Prosthodontists) edentulous mandible was constructed. A fully computer-designed surgical guide was employed after virtual denture design to place two implants according to prosthetically driven implant placement protocol. A metal meshwork with tissue stops was designed digitally to reinforce the denture and to carry the geometric center. The meshwork was incorporated into the denture-intaglio surface, which was planned for attachment pickup. Forty-eight digitally designed and metal-reinforced 3D-printed dentures were divided into four groups (12 dentures for each group). Loss of retention was measured to compare two novel Locator attachments (12 pairs of Locator R-TX, 12 pairs of Locator F-TX medium and low retention, with 12 pairs of ball and socket). Each group was subjected to an insertion and removal fatigue test resembling 5 years of patient usage. Retention values were recorded using a universal testing machine. RESULTS Locator F-TX medium and low retention showed loss of retention by 91.93% and 92.91%, after fatigue testing equivalent to 2 and 3 years of use, respectively. Ball and socket and Locator R-TX showed loss of retention by 19.87% and 26.31%, respectively, after fatigue testing equivalent to 5 years of use. CONCLUSIONS Locator R-TX attachment systems showed promising retention for implant overdentures compared to ball and socket attachments. The proposed digital technique of denture reinforcement is capable of standardizing results for research and clinical work.
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Affiliation(s)
- Medhat Sameh Abdelaziz
- Faculty of Oral and Dental Medicine, Department of Prosthodontics, Future University in Egypt, Cairo, Egypt
| | - Aya Mohamed Fawzy
- Faculty of Oral and Dental Medicine, Department of Prosthodontics, Future University in Egypt, Cairo, Egypt
| | - Rami Maher Ghali
- Faculty of Dentistry, Department of Prosthodontics, Ain Shams University, Cairo, Egypt
| | - Hossam I Nassar
- Faculty of Oral and Dental Medicine, Department of Prosthodontics, Future University in Egypt, Cairo, Egypt
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Campos MRD, Marcondes Agnelli JA, Cândido dos Reis A. Factors influencing retention and durability of attachments for overdentures - adverse effects of cleansings, pH, and temperature: A systematic review. Heliyon 2022; 8:e12411. [PMID: 36582682 PMCID: PMC9793270 DOI: 10.1016/j.heliyon.2022.e12411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/26/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Aim The objective of this systematic review is to show the current state of the art on which type of attachment loses retention the most and has reduced durability and which factor causes these problems the most. Material and methods This review followed the Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) guidelines and it was registered with the Open Science Framework (OSF) (osf.io/2e3q5). The databases used for the electronic search of articles were Pubmed, Science Direct, Embase, and Scopus. Articles were selected by 2 independent reviewers according to the inclusion criteria. The risk of bias was analyzed by using the Joanna Briggs Institute (JBI) adapted quasi-experimental study evaluation tool. Results The studies included in this review indicate that the use of cleansing solutions, high temperatures, and a more acidic pH decrease the durability of the attachments, mainly due to the loss of retention that occurs in different models and materials of the attachments, which requires their replacement in a shorter period. Conclusion Of all the factors studied, the cleansing solutions proved to be the factor that most altered attachment retention. Different saliva compositions did not influence retention values. Aging changes retention values for attachments, mostly with loss of values.
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Affiliation(s)
- Murilo Rodrigues de Campos
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Andréa Cândido dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil,Corresponding author. Av. Do Café, s/n 14040-904, Ribeirão Preto - SP, Brazil.
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Nassar HI, Abdelaziz MS. Retention of bar clip attachment for mandibular implant overdenture. BMC Oral Health 2022; 22:227. [PMID: 35681163 PMCID: PMC9178882 DOI: 10.1186/s12903-022-02262-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip). MATERIALS AND METHODS An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data. RESULTS There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N. CONCLUSION The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use. CLINICAL RELEVANCE Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.
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Affiliation(s)
- Hossam I Nassar
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Fifth Settlement, End of 90 Street, Cairo, New Cairo City, Egypt
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Fifth Settlement, End of 90 Street, Cairo, New Cairo City, Egypt.
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Evaluation of Retention, Wear, and Maintenance of Attachment Systems for Single- or Two-Implant-Retained Mandibular Overdentures: A Systematic Review. MATERIALS 2022; 15:ma15051933. [PMID: 35269164 PMCID: PMC8911844 DOI: 10.3390/ma15051933] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 12/04/2022]
Abstract
Attachment systems (AS) enhance retention and stability by anchoring the overdentures to implants. Since 2002, the McGill consensus statement recommends the 2-implant-retained overdentures as the standard choice for edentulous mandible (2-IRMO). Considering the large number of AS available, it remains difficult for a practitioner to make a reasoned choice. A systematic review was conducted in PubMed/Medline and carried out independently by three authors, on retention, wear, and maintenance of AS used clinically or in vitro specifically for 1- or 2-IRMO. The 45 selected studies include 14 clinical and 31 in vitro studies. The risk of bias was evaluated according to the revised Cochrane risk of bias tool for randomized trials (RoB 2). The initial retention force of the cylindrical system is higher than the ball system. The retention loss, related to the wear of the retention device, is responsible for the most common need of maintenance, requiring activation or replacement. Plastic retention devices wear out faster and more significantly than metal ones, implying a worse time behavior of cylindrical systems, but their maintenance rate is similar. Neither system appears categorically superior. Cylindrical systems provide higher initial retention than ball ones; this advantage reduces over time with wear without affecting their need for maintenance.
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Abdelrehim A, Abdelhakim A, ElDakkak S. Influence of different materials on retention behavior of CAD-CAM fabricated bar attachments. J Prosthet Dent 2021; 128:765-775. [PMID: 33773770 DOI: 10.1016/j.prosdent.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Loss of retention with implant overdentures is a problem that might be addressed with materials such as a recently introduced biocompatible high-performance polymer (BioHPP). However, in vitro studies investigating this product are lacking. PURPOSE The purpose of this in vitro study was to assess the retentive behavior of implant overdentures and the loss of retention from clip wear when used with computer-aided design and computer-aided manufacturing (CAD-CAM) fabricated bar attachments from cobalt-chromium (Co-Cr), zirconia (ZrO2), and BioHPP to identify the optimal material in terms of minimal loss of retention and minimal wear. MATERIAL AND METHODS Three CAD-CAM bar attachments were fabricated from the different materials and cemented to a completely edentulous mandibular model for testing. Twelve plastic clips were allocated to each material and subjected to 1095 dislodgement cycles to simulate a year of clinical use. A universal testing machine was used to measure the retentive force of dislodgement of each clip for each material before and after cycling. An inverted optical measuring microscope was used to quantify the amount of wear on each clip. One-way repeated-measures ANOVA was used to analyze the results among the materials and the decrease in retention force. The paired t test was used to compare clip measurements before and after testing (α=.05). RESULTS BioHPP bars retained retention significantly better than Co-Cr or ZrO2, with a lower percentage decrease in mean retentive force. Clips used with BioHPP bars also exhibited the least wear. However, Co-Cr and ZrO2 displayed similarly higher initial retentive values in comparison with BioHPP, with Co-Cr displaying the highest final retention. CONCLUSIONS BioHPP appears to be a strong candidate to replace Co-Cr or ZrO2 for fabricating bar attachments as it displayed minimal loss of retention and led to the least wear of the clip, thereby reducing replacement frequency.
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Affiliation(s)
- Aly Abdelrehim
- Assistant lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ahmed Abdelhakim
- Professor, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Sherif ElDakkak
- Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Savabi O, Nejatidanesh F, Savabi G, Razavi M. How the initial retentive force of implant-supported overdentures can be affected with splinted and unsplinted attachments systems. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.332095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Retention and wear of resin matrix attachments for implant overdentures. J Mech Behav Biomed Mater 2020; 110:103901. [PMID: 32957206 DOI: 10.1016/j.jmbbm.2020.103901] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of the present laboratory study was to investigate the retentive properties and the wear of three different resin matrix attachments for implant overdentures as well as to assess the effects of implant angulation. METHODS AND MATERIALS Three attachment systems with either polyetheretherketone inserts (PEEK; Novaloc, Straumann, Basel, Switzerland), polyetherketoneketone inserts (PEKK; CM Loc, Cendres + Métaux, Biel, Switzerland) or nylon inserts (Locator R-Tx, Zest Dental Solutions, Escondido, California, USA) were evaluated. The patrices were connected to their implant analogues and fixed in a resin cast at implant angulations of 0° and 15°. The corresponding matrices with inserts were fixed in a stylized unilaterally removable dental prothesis. To simulate masticatory forces 30,000 insertion and removal cycles with an eccentric load of 100 N at a distance of 12 mm were performed in a chewing simulator. The retention forces were measured. The wear patterns were examined using a scanning electron microscope (SEM). The statistical analysis was performed using a one-way ANOVA followed by a Games-Howell test and a Friedman test. RESULTS All attachment systems revealed a significant decrease in retention after testing, except PEEK 0°/0° and PEEK 15°/15°. PEEK and PEKK attachment systems showed significantly higher retentive forces than the nylon attachment system between 5000 and 30,000 cycles. The implant angulation did not significantly influence the retention behavior for any of the three attachment systems. Patrices showed no signs of wear, whereas the matrix inserts displayed signs of deformation. CONCLUSION Within the limitations of the present study, attachments with PEEK and PEKK inserts combined with titanium patrices are favorable for long-term use, both for orthogonal and tilted implants. All three attachment systems showed a high variability of the retentive forces at baseline and for subsequent cycles. This should be taken into consideration for clinical use.
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