Removable prosthetic
options with dental
implant
by
Dr /Mohamed El-Gamal
Prosthetic phase
Fixed Prostheses
5
Cemented restorations
Screw retained restoration
Removable Prostheses
8
Attachments
• A retainer used in the construction of fixed and removable
dentures, consisting of a metal receptacle (female component,
matrix) and a closely fitting part (male component, patrix).
• An interlocking device, one component of which is fixed to an
abutment(s) and the other is integrated into a removable
dental prosthesis in order to stabilize and/or retain it.
I. Studs Attachment
• Patrix attached to the implant and matrix housed in the
overdenture eg. Ball and socket Spheroflex, O-ring
LOCATOR
Locator
Female
part :
titanium,
attached
to implant
plastic
male
part
Low Vertical Height
(3.17mm)
Self-Aligning Design
⮚ Patients can easily position
and place their overdenture
every time.
Flexibility in angulation
• up to 2o degrees (40
degrees with 2 implants)
with use of special nylon
males.
Pick-up of Locator Attachments
Spheroflex
• Male component is a 2.5mm ball and a Female
component is a soft nylon with a metal housing
• Used in cases with up to 15 degrees divergence
between implants
II Magnets
⮚ Solve the problem of non-parallel implants
⮚ In cases of limited vertical space
⮚ Simplicity
⮚ Indicated in patients with arthritis or parkinson’s
⮚ Disadvantages :
⮚ Retention
⮚ Corrosion
• III.BARS
• A metal bar that splints 2 or more abutments.
Riders
sleeves/clips
Types of Bar Attachment
• There are 2 types:
• Bar units which are the rigid type
• Bar joints which allow some
movement of the rotational type.
Prefabricated patterns
Milled bar
Telescopes
• They consist of an inner or
primary telescopic coping
permanently attached to the
abutment and a detachable
outer or secondary telescopic
coping attached to a removable
prosthesis
• The secondary coping engages
the primary coping forming a
telescopic unit that retains the
prosthesis
Types of attachments
used in implant dentistry
• Single elements
– Single retentive /studs
– Telescopes
• Splinted elements
– Bars
• Resilient (stress-breaking)
– Balls
– Magnets
– Telescopes
– Bar joint
• Non-resilient (rigid)
– U-shaped bars
– Milled bars
– Telescopes
implant overdenture
, overdentures could be classified
into:
Implant-supported: obtains its entire support
from implants(rigid anchorage systems similar to
fixed and hybrid prostheses in mechanism) eg.
milled bars and telescopes
• Implant-tissue-supported( implant
assisted ): gains its support from a combination
of tissues and implants (with resilient anchorage
systems alloying vertical and rotatory movement)
eg. Ball and round clip-bar.
Advantages of implant
overdenture
⮚ Improves Retention
⮚ improved Stability
⮚ Improved esthetics
⮚ Improved phonation
⮚ Improved chewing efficiency
⮚ Decrease soft tissue abrasion
⮚ Reduced prosthesis size
⮚ Decrease bone loss
Disadvantages of
Overdenture
⮚ More routine maintenance
⮚ Continued posterior bone loss
⮚ crown height space
DIASADVANTAGES OF REMOVABLE IMPLANT
SUPPORTED PROSRHESIS.
1. Removable not fixed like natural teeth.
2. Removable implant overdentures require greater maintenance and exhibit
more complications than fixed restorations
Problem of IODs :
Retention and adjustement problem(30%)
Clip or attachment fracture(17%)
Fracture of prosthesis (12%)
Reline(19%)
3. Mandibular overdenture often traps food below its flanges
4. Resorption of posterior bone especially in RP-5 mandibular prosth
Misch Classification
• A: Abundant Bone
B: Adequate bone to place narrow implants
C: Inadequate bone width or height (Compromised
bone)
D: Severely atrophied bone (Deficient bone)
Mandibular implant site selection
OD1
• Implants in the B &D positions
Second Option OD2
• Implants placed in the B&D positions and
rigidly joined by a bar
• Can we placed splinted implants in the A&E
Positions
Overdenture Option 3 OD3
⮚ Implants in the A,C&E positions and rigidly joined by a
bar with no distal cantilever
⮚ It is the first option for patient concerned with
retention and stability and can afford the moderate
cost
Overdenture option 4 (OD4(
• Implants are placed in A,B,D &E and joined by
• a bar with a distal cantilever about 10 mm
Overdenture Option 5 (OD5)
• 5 implants placed in A,B,C,D and E rigidly joined by a
bar with distal cantilever about 15 mm
Single implant placed in the midline
• Patient satisfaction appears to be equivalent to the 2
implant retained
Mini implants
Removable Restoration for
Edentulous Maxilla
Implant assisted overdentures
4-6 implants
Implant Supported Over denture
Implant Distribution 7-10
