Principles of Attachment Selection for Implant Supported Overdentures
| Principles of Attachment Selection for Implant Supported Overdentures | Hamid Shafie, DDS* and George Obeid, DDS** |
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| Classification of Overdenture Implants Based on Attachment Design Features
Implants With a Male Attachment The OS™ (Biohorizons, Birmingham, AL; biohorizons.com) is a parallel sided implant, and the male part of the stud attachment is part of the implant body. The MDI ® Implant (3M ESPE; solutions3m.com) is tapered. The Z-Look3 Lock Ball implant (Z-systems USA, Inc., Halifax, MA; usa@z-systems.biz). This is an all Zirconia overdenture implant. Implants With a Female Attachment The ERA® implant (Zimmer Dental, Inc; www.zimmerdental.com) is a tapered implant and the female part of the stud attachment is part of the implant body. These types of implants make implant overdenture treatment more cost-effective and simpler. They are narrower than most narrow-diameter traditional implants, so they can be used in cases with a deficiency in the width of the bone, avoiding a horizontal bone augmentation procedure. Overdenture implants are used for two basic purposes: providing immediate stabilization and anchorage for an implant overdenture and acting as transitional implants during the initial healing phase of traditional implants. Although the FDA has never approved a dental implant under 3.0 mm in diameter for permanent use, overdenture implants are often used as a less expensive and simpler alternative to traditional implants for stabilizing an overdenture over a longer period |
of time. However, we strongly recommend utilizing overdenture implants that are 3 mm or more in diameter. Placement of
3 mm or wider implants should be limited to the anterior mandible between the two mental foramina unless the patient has no bone loss in the posterior region. When transitional implants are needed, using permanent overdenture implants is contraindicated. Use only mini-overdenture implants for this clinical scenario because their small size allows them to be placed between traditional implants. They often fit best if placed slightly lingual to traditional implants. If bone augmentation is part of the treatment plan, overdenture implants provide a positive vertical stop and lateral stability to limit the force applied to the augmented area. This procedure greatly improves the success of new bone growth and limits the amount of force applied to the traditional implants. After completion of the healing period for traditional implants, the overdenture implants have served their transitional purpose and should be unscrewed. The resulting small bony defects usually heal with no further treatment. With this treatment scenario, we strongly recommend using a machined surface instead of advanced surfaces, such as acid-etched or resorbable blast textured (RBT), because these latter surfaces enhance implant-bone interface, making implant removal more difficult than with a machined surface. The surgical procedure for overdenture implants usually consists of only a few simple steps. However, the same anatomical and |
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