IMPLANT

SUPPORTED
OVERDENTURES
GUIDE: DR.B.MUTHUKUMAR MDS
PROFESSOR & HOD
CO-GUIDE: DR.BRINTHA JEI MDS
READER
PRESENTED BY:AKSHAYAA B
III YR PG
WHAT ARE OVERDENTURES???

• Any removable dental prosthesis that covers and rests on one or

more remaining natural teeth, the roots of natural teeth, and/or
dental implants;
• A dental prosthesis that covers and is partially supported by
natural teeth, natural tooth roots, and/or dental implants
CONSEQUENCES OF COMPLETE
EDENTULISM

• Continued bone loss

• Soft tissue effects
• Negative facial esthetics
• Decreased mastication
• Psychological impact
 Conventional
complete
denture

Completely
edentulous

Fixed implant Implant

dentures overdentures
INCLUSION CRITERIA
Patient desire for implant
treatment
Systemic health status, which
permits a minor surgical
procedure
Sufficient bone quantity to
accommodate prescribed
implant dimensions
Patient willingness and ability to
maintain oral health status
Residual ridge dimensions do not
accommodate preferred implant
dimensions
Compromised cognitive skills
General health conditions preclude
EXCLUSION CRITERIA
a minor surgical intervention
Local anesthesia with a
vasoconstrictor is contraindicated
Immunosuppressive therapy,
prolonged intake of antibiotics or
corticosteroids, or brittle metabolic
disease history
ADVANTAGES DISADVANTAGES

Maintain bone Psychological

Restore and maintain Greater crown height space
occlusal vertical dimension required
Maintain facial esthetics More long-term
(muscle tone) maintenance required
Improve esthetics Attachments

Improve phonetics Relines

New prosthesis every 7
Improve occlusion
years
Improve or regain oral Continued posterior bone
proprioception loss
Increase prosthesis success Food impaction
Improve masticatory
Movement
performance
PROSTHESIS MOVEMENT

• PM 0 : No movement of prosthesis, requires implant support

similar to fixed prosthesis
• PM 2: Prosthesis with hinge motion
• PM 3: Prosthesis with hinge and apical motion
• PM 4: Allows movement in four directions
• PM 6: All ranges of prosthesis movement
OVERDENTURE ATTACHMENTS
• An overdenture attachment permits movement during function and
removal from the mouth.
• The attachment should offer the possibility of controlling the degree of
retention.
• A loose attachment used at initial delivery ensures prosthesis movement
and decreases screw loosening during the first few months.
• A gradual increase in retentive capability may be achieved later by
replacing the component within the encapsulator by a more retentive one
O-RING ATTACHMENT SYSTEM

• O-rings are doughnut-

shaped, synthetic
polymer gaskets that
possess the ability to
bend with resistance
and then return to
their approximate
original shape .
HADER BAR AND CLIP
MAGNETIC ATTACHMENTS

• Basically, they consist of one magnet attached to the denture and another to
the implant.

• They constitute a simple and comfortable system for the patient as magnet
attraction guides the denture insertion.

• On the other hand, they have a weaker lateral stability and retention in
comparison with mechanic attachments as ball or bar devices.
SELECTING THE RETENTION SYSTEM
1. Depending on upper and lower
jaw
• In the mandible it will be easier to place
parallel implants, thus, ball or Locator
attachments would be indicated
• In the maxillary, implants divergent
emergency, worse bone quality and the
use of short implants due to sinus
proximity, will mandate the use of bar
attachment
2. Depending on the arch form
• bar attachments will be indicated in wide
arches.
• On the other hand, in narrow arches using
ball or Locator attachments would be
indicated.
3. Depending on bone
reabsorption rate and implants’
length
• If implant is at least 10 mm long, it can be
used as unsplinted , but if it less than 10
mm long , it will be indicated that the
implant be splinted with bar attachments.
CANTILEVERS IN ISO

• A cantilever should be shorter than the distance

between implants to avoid overloads.
• In addition, it is advisable to avoid the
placement of clips on the cantilever as this will
increase tensions of the adjacent implant.
• A cantilever in the mandible shorter than 12 mm
does not involve a great bone reabsorption,
whilst, on the other hand, maxillary treatments
are more susceptible to fail.
OVERDENTURE TREATMENT OPTIONS

MANDIBULAR TREAMENT OPTIONS:

OVERDENTURE TREATMENT OPTION 1
(OD-1)
PATIENT SELECTION CRITERIA:
• Opposing a maxillary full denture
• Anatomical conditions are good to excellent (division A or B anterior
and posterior bone)
• Posterior ridge form is an inverted U shape
• Patient’s needs and desires are minimal, primarily related to lack of
prosthesis retention
• Edentulous ridge not square with a tapered dentate archform
• Additional implants will be inserted within 3 years
OVERDENTURE TREATMENT OPTION-2
(OD-2)
PATIENT SELECTION CRITERIA
• Opposing arch is a maxillary denture.
• Anatomical conditions are good to excellent Posterior ridge forms
an inverted U shape.
• Patient’s need and desires are minimal
• Patient can afford a new prosthesis and connecting bar.
• Additional implants will not be inserted for more than 3years.
• Low patient force factors (e.g., parafunction)
• The mandibular residual ridge form is square to ovoid, and the
dentate arch form is square to ovoid.
OVERDENTURE TREATMENT OPTION-3
(OD-3)
PATIENT SELECTION CRITERIA
• Opposing arch is a maxillary denture.
• Anatomical conditions are moderate to excellent.
• Posterior ridge forms an inverted U shape.
• The patient’s needs and desires require improved retention, support,
and stability.
• The patient may have moderate force factors (e.g., parafunction).
OVERDENTURE TREATMENT OPTION-4
(OD-4)
PATIENT SELECTION CRITERIA
• Moderate to severe problems with traditional dentures
• Need to decrease bulk of prosthesis
• Desire to abate posterior bone loss
• Unfavorable anatomy for complete dentures
• Problems with function and stability
• Posterior sore spots
• Opposing natural teeth
• C–h bone volume
• Unfavorable force factors
OVERDENTURE TREATMENT OPTION-5 (OD-5)
PATIENT SELECTION CRITERIA
• Moderate to severe problems with traditional dentures
• Unfavorable anatomy for complete dentures
• Problems with function and stability
• Posterior sore spots
• Moderate to poor posterior anatomy
• Lack of retention and stability
• Soft tissue abrasion
• Speech difficulties
• Maxillary teeth or fixed implant prostheses
• Angle’s class II division I mandible restored to class I
MAXILLARY TREATMENT OPTIONS
OVERDENTURE TREATMENT OPTION-1
OVERDENTURE TREATMENT OPTION-2