T E C H N O L O G Y T R A N S F E R I N D E N T I S T R Y

Magnetic Retention in
Prosthetic Dentistry
A. DAMIEN WALMSLEY

‘soft’ – easy to magnetize or

Abstract: Magnets are a popular method of attaching removable prostheses to either demagnetize – or ‘hard’ – they retain
retained roots or osseointegrated implants. This paper reviews the development of
their magnetic properties (i.e. can be
magnets in dentistry and describes the different types of magnetic attachments that are
available. The clinical applications of magnets in prosthetic dentistry are illustrated made into permanent magnets). Whether
and future technological advancements indicated. Whilst different magnetic materials a material is hard or soft depends on
that mirrored the developing technology have been used, the main drawback to their whether it retains its magnetic properties
use is the potential of corrosion of the magnetic material in the mouth. However, newly after the removal of an applied magnetic
emerging technologies may provide a solution to this problem, allowing the continued field.
use of magnets in prosthetic dentistry. Within dentistry the two main uses of
magnets are in the fields of orthodontics
Dent Update 2002; 29: 428–433 and prosthetic dentistry. A review on
Clinical Relevance: Magnetic retention is a useful method for retaining removable the use of magnets in orthodontics may
prosthetic dentures. The newer generation of magnets are used with dentures retained be found elsewhere.2 It is the aim of this
by either natural teeth or osseointegrated implants. They are simple to use and offer paper to review the technological
many advantages over other types of precision attachments. advancements of magnets with regard to
prosthetic dentistry.

BACKGROUND
Various devices such as springs,

S ignificant technological developments

in magnetic materials have been
transferred into clinical dentistry. The
main magnetic material in use today in
both medical and dental applications is
the rare earth material neodymium iron
boron (Nd-Fe-B), which was developed
in the mid 1980s and is the most
powerful commercially available
magnetic material. Another rare earth
alloy is samarium cobalt (Sm-Co), which
was developed in the late 1960s and has
also been employed in dental
applications. The Nd-Fe-B magnets
combine extremely high magnetic
saturation with good resistance to
demagnetization. They have the highest
A. Damien Walmsley, BDS, MSc, PhD, FDS RCPS,
Professor of Restorative Dentistry, School of
Dentistry, Birmingham.
value of energy product of any known
magnetic material, are less costly than
the Sm-Co alloys and are the main rare
earth permanent magnet material in use
today. Their excellent properties allow the
production of small magnets for use in
retention applications, magnetomotive
hearts and in MRI scanners.1 Ongoing
research has identified samarium-iron-
nitride as a promising new candidate for
such applications owing to its high
resistance to demagnetization, high
magnetization potential, and better
resistance to temperature change and
corrosion than Nd-Fe-B magnets. Its
development is still ongoing, but Sm-Fe
could be the material of choice in future
biomedical applications. Further
information on magnetic materials and
their applications in medicine can be
found in other work.1
Magnetic materials may be either
suction cups, clips and studs have all
been used to retain dentures. Magnets
have been used for such retention as
they are easy to incorporate within the
denture and both clinical handling and
technical procedures are simplified.
Other advantages of their use are
described later in this article.
However, there are limitations to the
use of magnets in dentistry, and this is
mainly related to their low corrosion
resistance within the mouth.3
Early attempts at using magnets for
denture retention were unsuccessful,
mainly due to the large size of the
magnets at that time and the inadequate
forces they provided. However, since
the introduction of Sm-Co and Nd-Fe-B
materials it has become possible to
produce magnets that are small enough
for use in dental applications but still
provide the necessary force.

428 Dental Update – November 2002

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 T E C H N O L O G Y T R A N S F E R

magnets and a similar keeper was built

Figure 1. Open (a) and closed (b) field designs. In a closed field system high-permeability materials
are used to concentrate the flux so that contact force is increased. However, forces decrease as the
separation between the magnet and root keeper increases.4
Open Field Systems
Owing to fears over the effects of
magnetic fields on the soft tissues,
magnetic systems have been developed
using only one magnet, which is
retained in the prosthesis. A soft
magnetic material, palladium-cobalt-
platinum alloy, is generally used for the
root keeper because it has a
combination of good physical properties
and corrosion resistance. This material
has soft magnetic properties and the
permanent magnet in the denture is
attracted to it. The root element
possesses no permanent magnetic
properties and therefore no magnetic
fields are experienced within the oral
environment once the dentures are
removed (Figure 1). The palladium-
cobalt alloys are still used as keeper
materials in many commercial systems
although other materials (including
magnetic stainless steels, Permendur –
an alloy of iron and cobalt – and
chromium-molybdenum alloys) are
available.5
denture is in situ.
Attachment of these magnets is more
efficient as both the north and south
poles can be used for attachment to the
keeper (in open field systems only one
pole is used) and the keepers can
contain the magnetic flux. Although
these systems generally provide a
higher retentive force than a similar-
sized open field system, the retention
reduces rapidly with increasing
separation.6
The first design of this type was the
split pole design,7 consisting of two
magnets arranged with opposite poles
adjacent to each other. A soft magnetic
keeper was attached to the top of the
a b
into the root.
Finite element analysis has been used
to improve the design of these
attachments to maximize the force they
provide. In general, a closed field design
consisting of a magnet in a soft
magnetic cup, which in turn is placed in
an outer cup, will provide a higher
retention force than a simple open field
system incorporating a similar-sized
magnet. However, a circular closed field
sandwich-type design will provide
greater retention. If the keeper materials
are made ellipsoidal, retention will
increase further still.4
CLINICAL USAGE
Magnetic attachments have most
commonly been used for the retention of
mandibular overdentures.4 Magnetic
retention offers many advantages as it
serves to dissipate lateral functional
forces. There is less need for parallel
abutments as a rigid line of insertion is
not as critical. Furthermore, the
technique is simple, involving minimal
time at the chairside and in the
laboratory. However, careful laboratory
handling is required so as not to damage
the outer metal coating.

Closed Field Systems

Many commercial systems are now of c d
the closed field type, which attempt to
reduce the magnetic field effects in the
oral cavity. The magnetic attachment
itself incorporates soft magnetic
materials (such as ferritic or martensitic
stainless steel or a palladium-cobalt-
nickel alloy), which connect the two
poles of a magnet so the external field is
shunted through the path of less Figure 2. (a) Ferromagnetic material cast as a root keeper. (b) The keepers are cemented into
the root face. (c) The magnets are seated onto the keepers and the denture is prepared for self-
resistance. These assemblies thus curing the magnets into position. (d) The magnets incorporated into the denture.
minimize any external fields whilst the

Dental Update – November 2002 429

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 T E C H N O L O G Y T R A N S F E R
a b
Figure 3. (a) A ferromagnetic keeper cast into a gold coping. (b) The magnet seated onto the
keeper (note the small size of the magnet).
a b
Figure 4. (a) Example of a direct root keeper system with an ellipsoidal magnet. (b) The keeper is
cemented with glass ionomer or composite into the root face and the magnet is seated onto the
keeper ready to be incorporated into the denture.
Casting Incorporated Within
Keeper
Generally, a reversed split pole magnet is
used, in contact with a ferromagnetic
keeper. The technique consists of
constructing the keeper in a similar
manner to a gold coping. This is
cemented into the root face, which is
then ready for the magnets (Figure 2),
and the magnet is placed in the denture.
Technological advancement has led to
systems that use a small keeper cast into
the coping, thus reducing the amount of
soft magnetic material (Figure 3).
Root Keeper System
A novel development is the root keeper
system (Aichi Steel, Nagoya, Japan),
which provides a convenient way of
keeper insertion without the
involvement of a laboratory stage. The
root is prepared to accept the preformed
keeper, which is cemented into place
with either composite or glass ionomer
cement.8 The magnet is then placed in
the denture with autopolymerizing
acrylic. The overdenture is placed with
430
holes cut into the denture over the area
of the keepers. The magnets are placed
into position and then self-cured into
the denture (Figure 4). This direct pick-
up technique allows the easy
replacement of worn out magnets.
Implant-Retained
Overdentures
Another important usage of magnets is
as a retentive element for implant-
retained overdentures.9 The magnetic
retention may have different
a b
Figure 5. (a) A keeper has been placed on an osseointegrated implant. The right keeper has a
magnet placed on it. (b) A heat-cured baseplate with the magnets seated on the implant-retained
overdenture keepers.
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combinations but generally the implant
supports a keeper and the split pole
magnet is retained in the denture. For
magnetic retention two to four implants
are placed in the anterior region in an
area devoid of major anatomical
structures. Impressions are taken of the
keeper and the magnets are initially tried
into the mouth supported by a heat-
cured baseplate (Figure 5). Once the
magnets are placed into position the
construction of the denture follows
traditional complete denture
construction.
The magnets may be added at the
stage of final insertion of the denture,
as demonstrated in Figure 2. Holes are
cut into the denture, through which
the magnets are placed. The magnets
are cured into position using
autopolymerizing acrylic. The final
cure of the resin should occur outside
the mouth to prevent accidental
setting of the denture into undercuts,
which could lead to the embarrassing
situation of having to cut the magnets
out of the denture in situ!
Durability Problems
There are few studies on the use of
magnets in the clinical environment but
those that have been followed over
several years have demonstrated the
poor durability of magnets. In a 5-year
study9 on 21 patients with implant-
retained overdentures, most of the
magnets required replacement (19 of 21
patients) owing to corrosion followed
by loss of magnetism (the remaining two
patients did not appreciate the loss of
magnetism that had occurred). The
success of the implants was unaffected
Dental Update – November 2002
 T E C H N O L O G Y T R A N S F E R
a b
Figure 6. These magnets have corroded after several years’ use.
by the problems associated with the
magnets.
ADVANTAGES OF THE
CLINICAL USE OF
MAGNETS
l Magnets tend to be easier to insert
than other precision attachments, as
alignment is not as critical.
l If magnets are slightly misaligned
following placement then
orthodontic movement of root
through forces of magnetic
attraction will result in correct
contact being reached.
l The flat surfaces of magnet and root
keeper can slide and rotate during
function, allowing slight movement
of the denture. This reduces
transmission of detrimental stresses
to teeth/implants and surrounding
bone.
l Magnetic attachments also enable
the automatic reseating of the
denture through the forces of
magnetic attraction should it
become dislodged during chewing.
Occasionally this process causes a
clicking sound and rocking of the
denture, which some patients find
troublesome.
CORROSION
The main problem associated with the
use of magnets as retentive devices is
corrosion.6 Both Sm-Co and Nd-Fe-B
magnets are extremely brittle and
susceptible to corrosion, especially in
chloride-containing environments such
as saliva. The corrosion products from
432
rare earth magnets have also been
shown to have cytotoxic effects.10
Therefore, the magnetic materials must
be securely separated from the oral
fluids before use in dental applications.
Current magnet assemblies are
encapsulated in stainless steel or
titanium, but some of these devices are
failing after only approximately 18
months in clinical use (Figure 6), due to
corrosion and loss in retention.11 Various
methods have been used to try to
eliminate the problem of corrosion with
varying degrees of success.
Corrosion of magnetic attachments
can occur by two different
mechanisms:11
1. Corrosion of the magnet due to the
breakdown of the encapsulating
material.
2. Corrosion of the magnet due to
diffusion of moisture and ions
through the epoxy seal.
Nd-Fe-B and Sm-Co magnets do
corrode in saliva and the presence of
bacteria increases the corrosion of Nd-
Fe-B magnets:12 it is therefore necessary
to encapsulate or coat the magnets for
use in dental applications. However,
continual wear of the encapsulating
material leads to exposure of the
magnet,11 as shown clinically.9 Wear
takes the form of deep scratches and
gouges on the surface caused by wear
debris and other particles that become
trapped between the two surfaces. The
excessive wear of the magnet may be
due to the abrasive nature of the
titanium nitride-coated soft magnetic
root keeper that is used with some
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implant systems.
Pitting corrosion of the stainless steel
is due to the corrosive oral environment,
and similar corrosion has been observed
in different systems.12 It would appear
that to overcome the problems associated
with the use of dental magnets, a
different encapsulating material or
surface coating is required. In industry
other coatings have been used to prevent
wear but these require further
investigation before use in the mouth.
An additional problem associated with
attachments sealed by polymeric
materials is the diffusion of moisture and
ions through the seal, which then attack
the magnetic component (this mechanism
applies only to magnets sealed by this
technique, and the time to failure is
dependent on the rate of diffusion and
length of the seal11). In order to achieve a
highly reliable system other non-
permeable sealing techniques, such as
laser welding, may be used, and merit
further investigation.
If the keeper fractures at the edge of
the sample where it is joined to the
titanium dome, then corrosion products
will leak out. As bulk magnet material is
lost from within the stainless steel can, it
is no longer supported and plastically
deforms inwards. Clinically this is
observed as grooves around the contact
face of the magnet face 11 (Figure 6).
TECHNOLOGICAL
ADVANCEMENTS
In the past the use of dental magnets
has received bad press in the dental
literature. Their use is very successful
initially and there is often good patient
acceptance; however, with time the seal
that protects the magnet from the oral
environment is lost and corrosion sets
in.
l The technology and engineering of
magnets has advanced greatly over
the last 5 years and it is now
possible to produce much smaller
magnets, which offer better seating
to the keeper.
l Improved engineering techniques
now make it possible to offer
different keeper and magnet shapes.
Dental Update – November 2002

l Laser welding techniques are now
better understood and there is no
need to seal in magnets with epoxy
resin materials, which was one of
the main reasons for failure of the
magnets.
All of these improvements still require
long-term clinical trials to assess the
durability of the new generation of
magnets under clinical function.
However, there is no doubt that, if
magnets are selected for a particular
clinical case, then they serve as a good
introduction to the use of attachments
and in many cases can prove highly
successful.
Welcome to Professor Robin Davies
The Editorial Director and Editorial
Board have great pleasure in welcoming
Professor Robin Davies to the Editorial
Board of Dental Update.
Professor Davies is the Director of
Clinical Dental Research in Europe for
the Colgate-Palmolive Company and is
also Director of the Dental Health Unit
in Manchester. The unit tests products
for their effectiveness in preventing
caries and periodontal disease and also
conducts epidemiological studies.
Professor Davies graduated in
Manchester, before taking a Diploma in
ABSTRACT
A PLACE FOR EVERYTHING, AND
EVERYTHING IN ITS PLACE!
Accidental Injection of Sodium
Hypochlorite Beyond the Root Apex.
H. Balto and Al-Nazhan. Saudi
Dental Journal 2002; 14: 36–38.
Cautions such as these appear in
the dental literature from time to time,
and it is worthwhile taking a moment
to consider the implications for one’s
own practice. The authors describe a
situation during endodontic treatment
Dental Update – November 2002
T E C H N O L O G Y
R EFERENCES
1. Riley MA, Walmsley AD, Speight JD, Harris IR.
Magnets in medicine. Mater Sci Technol 2002; 18:
1–12.
2. Sandler PJ, Meghji S, Crow V. Magnets and
orthodontics. Br J Orthod 1989; 16: 243–249.
3. Vrijhoef MMA, Mezger PR, Van Der Zell JM,
Greener EH. Corrosion of ferromagnetic alloys
used for magnetic retention of overdentures.
J Dent Res 1987; 66: 1456–1459.
4. Riley MA, Walmsley AD, Harris IR. Magnets in
prosthetic dentistry. J Prosthet Dent 2001; 86:
137–142.
5. Akaltan F, Can G. Retentive characteristics of
different dental magnetic systems. J Prosthet
Dent 1995; 74: 422–427.
6. Gillings BRD. Magnetic retention for complete
and partial overdentures. Part 1. J Prosthet Dent
1981; 45: 484–491.
7. Gillings BRD. Magnetic denture retention
Bacteriology and PhD in Manchester.
His previous positions include Senior
Lecturer/Consultant in Periodontology
at the University of Bristol Dental
School and Head of Dental Research at
ICI, Alderley Edge, Cheshire. He has
published over 100 papers in national
and international peer-reviewed
journals.
Professor Davies’ experience in the
field of clinical research and his broad
knowledge of dentistry make him a
valuable addition to the Editorial
Board.
of an upper incisor, when the
irrigation needle became lodged in
the root canal. One per cent sodium
hypochlorite was then inadvertently
expressed under pressure through the
apical foramen. The patient rapidly
experienced severe pain and swelling
extending from the upper lip to the
infra-orbital region. Drainage of the
exudates was achieved through the
root canal and extra-oral cold
compresses were applied to the area,
and repeated for six hours. The
patient was prescribed anti-
inflammatory analgesics and
prophylactic antibiotics. After 24
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Use for licensed purposes only. No other uses without permission. All rights reserved.
T R A N S F E R
systems: inexpensive and efficient. Int Dent J
1984; 34: 184–197.
8. Wang N-H, von der Lehr WN. The direct and
indirect techniques of making magnetically
retained overdentures. J Prosthet Dent 1991; 65:
112–117.
9. Walmsley AD, Frame JW. Implant supported
overdentures – the Birmingham experience.
J Dent 1997; 25: S43–S47.
10. Donohue VE, McDonald F, Evans R. In vitro
cytotoxicity testing of neodymium iron boron
magnets. J Appl Biomater 1995; 6: 69–74.
11. Riley MA, Williams AJ, Speight JD, Walmsley AD,
Harris IR. Investigations into the failure of
dental magnets. Int J Prosthodont 1999; 12: 249–
254.
12. Wilson M, Patel H, Kpendema H, Noar JH, Hunt
NP, Mordan NJ. Corrosion of intra oral
magnets by multispecies biofilms in the
presence and absence of sucrose. Biomaterials
1997; 18: 53–57.
hours, the pain had resolved but the
swelling was more profound, taking
several days to resolve completely.
During that time warm mouth rinses
were prescribed to improve
circulation in the area.
The authors caution all
practitioners to make certain the
irrigating needle is never wedged in
the root canal, to ensure that irrigant
is expressed freely and slowly, and to
make use of a coronal reservoir of
irrigant. And, of course, to be aware
of appropriate emergency treatment.
Peter Carrotte
Glasgow Dental School
433