THE EFFECTS OF DIFFERENT ATTACHMENT SYSTEMS ON STRESS IN 2-IMPLANTRETAINED OVERDENTURES

Öz

Osseointegrated implants have been used to improve denture support, stability and retention. Currently, the placement of 2 implants and the fabrication of an implantretained overdenture is considered by some to be the standard of care. The influence of various types of attachments on stress distribution of 2-implant-retained mandibular overdenture designs has not been sufficiently assessed. The purpose of this study was to compare the load transfer characteristics of 5 attachment systems for 2-implant-retained mandibular overdenture designs. One photoelastic model was fabricated having 2 screw-type implants (3.75 X 13 mm) embedded in the interforaminal region and implants were parallel to each other and vertically oriented. Five retention mechanisms were studied on model; a bar with yellowcolored clips, a milled galvanoformed bar, a bar with two clear distal locator attachments, a bar with two distal ceka attachments, clear locator attachments. For measurements of stress a vertical load 135 N was applied unilaterally to the central fossa of the right first molar. The resultant stresses that developed in the supporting structure were monitored photoelastically and recorded photographically. A bar with two clear distal locator attachments and,clear locator attachments showed higher stress than other attachments

Anahtar Kelimeler

• Attachment systems
• Galvanoformed bar
• Implant
• Overdentures
• Stress analysis

FARKLI TUTUCU SİSTEMLERİN 2-IMPLANT TUTUCULU OVERDENTURE UYGULAMALARINDA STRESLER ÜZERİNE ETKİSİ

Öz

Osseointegre implantlar protezin destek, stabilite ve tutuculuğunu geliştirmek için kullanılmışlardır. Günümüzde 2 implant ve üzerine yapılan implant tutuculu overdenture uygulamaları standart tedavi olarak kabul edilir. Farklı tip tutucuların, 2-implant tutuculu mandibular overdenture tasarımları üzerindeki stres dağılımına etkisi yeterince değerlendirilmemiştir. Bu çalışmanın amacı; 5 tutucu sistemin, 2 implant tutuculu mandibular overdenture tasarımlarında yük transferini kıyaslamaktır. 2 adet vida tipi implantın (3.75 X 13 mm) interforaminal bölgeye, vertikal düzleme ve birbirine paralel olarak yerleştirildiği 1 fotoelastik model üretilmiştir. Modelde 5 tutucu mekanizma değerlendirilmiştir; Bar-sarı klips, bargalvano, bar-distal locator (şeffaf), bar-distal ceka, locator (şeffaf). Stres ölçümü için, tek teraflı olarak sağ birinci molar dişin santral fossasına 135 N vertikal yük uygulanmıştır. Destek yapıda gelişen stresler fotoelastik olarak izlenmiş ve fotoğraf olarak kaydedilmiştir. Bar-distal locator (şeffaf) ve locator (şeffaf) tutucu diğer tutuculardan daha yüksek stres göstermişlerdir.

Anahtar Kelimeler

• Tutucu Sistemler
• Galvano Bar
• Implant
• Overdenture
• Stres Analizi

Kaynakça

1. Al-Ghafli, S.A., Michalakis, K.X., Hirayama, H., Kang, K., 2009. The in vitro effect of different implant angulations and cyclic dislodgement on the retentive properties of an overdenture attachment system. J Prosthet Dent, 102, 140-147.
2. Alsiyabi, A.S., Feiton, D.A., Cooper, L.F., 2005. The role of abutment-attachment selection in resolving inadequate interarch distance: A clinical report. J Prosthodont, 14, 184-190.
3. Bergendal, T., Engquist, B., 1998. Implant-supported overdentures: A longitudinal prospective study. Int J Oral Maxillofac Implants, 13, 253-262.
4. Bueno-Samper, A., Hernandez-Aliaga, M., Calvo- Guirado, J.L., 2010. The implant-supported milled bar overdenture: A literature review. Med Oral Patol Oral Cir Bucal, 15, 375-378.
5. Burns, D.R., Unger, J.W., Elswick, R.K., Beck, D.A., 1995. Prospective clinical evaluation of mandibular implant overdentures: Part I. Retention, stability and tissue response. J Prosthet Dent, 73, 364-9.
6. Celik, G,, Uludag, B., 2014. Effect of the number of
7. supporting implants on mandibular photoelastic
8. models with different implant-retained overdenture

9. designs. J Prosthodont, 23, 374-80.
10. Cune, M., van Kampen, F., van der Blit, A., Bosman, F., 2005. Patient satisfaction and preference with magnet, bar-clip and ball socket retained mandibular implant overdentures: A cross-over clinical trial. Int J Prosthodont, 18, 99-105.
11. Fanuscu, M.I., Caputo, A.A., 2004. Influence of attachment systems on load transfer of an implant- assisted maxillary overdenture. J Prosthodont, 13, 214-20.
12. Feine, J.S., Carlsson, G.E., Awad, M.A., Chelade, A., Duncan, W.J., Gizani, S., et al. 2002. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as the first choice standart of care for edentulous patients. Gerodontology, 19, 3- 4.
13. Evtimovska, E., Masri, R., Driscoll, C.F., Romberg, E., 2009 The changes in retentive values of locator attachments and hader clips over time. J Prosthodont, 18, 479-483.
14. Ichikawa, T., Horiuchi, M., Wigianto, R., Matsumoto, N., 1996. In vitro study of mandibular implant-retained overdentures: The influence of stud attachments on load transfer to the implant and soft tissue. Int J Prosthodont, 9, 394-399.
15. Kenney, R., Richards, M.W., 1998. Photoelastic stress patterns produced by implant- retained overdentures. J Prosthet Dent, 80, 559-64.
16. Menicucci, G., Lorenzetti, M., Pera, P., Preti, G., 1998. Mandibular implant-retained overdenture: Finite element analysis of two anchorage
17. J Oral Maxillofac Implants, 13, 369-376.
18. systems. Int Ochiai, K.T., Williams, B.H., Hojo, S., Nishimura, R., Caputo, A.A., 2004. Photoelastic analysis of the effect of palatal support on various implant-supported overdenture designs. J Prosthet Dent, 91, 421-7.
19. Porter, J.A., Petropoluos, V.C., Brunski, J.B., 2002. Comparison of load distribution for implant overdenture attachments. Int J Oral Max Imp, 17, 651- 662.
20. Sadowsky, S.D., Caputo, A.A., 2000. Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures. J Prosthet Dent, 84, 327-334.
21. Tokuhisa, M., Matsushita, Y., Koyano, K., 2003. In vitro study of a mandibular implant retained with Ball, Magnet, or Bar Attachments: Comparison of load Transfer and Denture Stability. Int J Prosthot, 16, 128- 134.
22. Trakas, T., Michalakis, K., Kang, K., Hirayama, H., 2006. Attachment
23. overdentures: A literature review. Implant Dent, 15, 24-34. for implant
24. retained Uludag, B., Sahin, V., Celik, G., 2007. Fabrication of a maxillary implant-supported overdenture retained by two cemented bars: A cilinical report. J Prosthet Dent, 97, 249-251.
25. Van Waas, M.A., Jonkman, R.E., Kalk, W., et al. 1993. Differences two years after tooth extraction in mandibular bone reduction in patient treated with immediate overdentures as with immediate complete dentures. J Dent Res, 72,1001-1004.
26. Walton, J.N., Ruse, N.D., 1995. In vitro changes in clips and bars used to retain implant overdentures. J Prosthet Dent, 74, 482-486.
27. Williams, B.H., Ochiai, K.T., Hojo, S., Nishimura, R., Caputo, A.A., 2001. Retention of maxillary implant overdenture bars of different designs. J Prosthet Dent, 86, 603-7.