FREDS FACTS

Connecting Your Office to Ours

The Implant
Supported
Overdenture
f you follow the trends in

By Dr. Frederick
Gustave, D.D.S.

implant dentistry at all, it is

pretty evident that the
current thinking is to try to
use the
latest
IN SIDE THIS ISS UE
techniques
1 The Implant Supported
and
Overdenture
technology
2 Grows Study Club
available.
My
3 Literature Review:
personal
Overdentures
experience
with the
dentists in
the
Southern IL
Dental
Society is
that an

Oct.-Nov. 2016
Newsletter

tons of advertising for the All

on Four or Teeth in a Day
and a lot of similar marketing
pitches.
These treatment approaches
can be costly and there is
definitely a place for this
approach in our patient base,
but not all patients can afford
this type of treatment.
Not every patient needs bone
grafts, full arch implant
placement followed with the
porcelain bridgework or an all
on four screw retained
prosthesis. For many folks a
stable denture they can wear
comfortably is all they need to
satisfy their wants and desires.
Enter the implant retained or
implant supported
overdenture.
A very popular attachment for
implant supported
overdentures is the locator
attachment. You can find them
online by googling zest
anchors.

overwhelming number of you

want the best for your pateints
and are always looking for new
treatment ideas to help give
the best affordable treatment.
The operative word in that
sentence is affordable. If you
pay attention to the internet
and print media, you will see
1

Zest anchors are versatile

devices that have several

FREDS FACTS

Connecting Your Office to Ours

advantages over the ball
attachment. First of all, the
anchor has an
extremely low
profile which
allows them to
be used in sites
with limited
interarch
space. The
recommendation is that the
top of the attachment be
about 2mm above the
surrounding mucosa. Even
with the low profile
attachment, remember that
your denture still needs a lot of
acrylic bulk and should be
reinforced during the lab
processing.
The zest anchor has always
been marketed as having the
ability to deal with implant
misalignment up to 20 degrees
and now the latest version can
accept even greater angle
differences up to 60 degrees
between implants.
Keep in mind that just because
this device can accommodate
a large degree of
misalignment doesnt mean
that we should be careless
about the placement of the
implants. The literature shows
that one of the big factors
contributing to the failure of
the implant or the prosthesis
supported by the implant is
dental implant misalignment.
2

Oct.-Nov. 2016
Newsletter

The overdenture has been

around for decades but has
fallen out of favor with the
introduction of the all on four
and promotion of fixed
bridgework to replace the
denture.
What we see now are folks
revisiting the overdenture but
without the bar and framework
that was promoted early on in
the beginning days of implant
dentistry. And now with the
new generation implant and
retention device designs, new
implant designs and
predictability of implant
success makes it possible to
depend on the unsupported
dental implant for long term
success.
Some of the denture retention
devices are commonly used
and are quite successful for
the long term. These devices
hold up greatl if they are well
maintained. Keep in mind that
any human made device will
likely wear out over time and
require maintenance or
replacement.

Upper jaw option

An older retention device

which
has
around for
a
Please
seebeen
Overdenture
on page
2, 3

Overdenture

FREDS FACTS

Connecting Your Office to Ours

long time is the ball and Oring. The O-ring is favored by
many because it has a lot
more stress breaking features
that are kinder to the implant
and take advantage of the
tissue support given to the
overdenture.

Oct.-Nov. 2016
Newsletter

FREDS FACTS

Connecting Your Office to Ours

Overdenture
continued
The rubber O-ring tends to wear
out. However. I have seen really
well designed O-ring cases fail
because of the lack of
maintenance. The patient
continued to wear the overdenture
even though the O-ring had worn
out. As a result, the O-ring housing
actually rubbed against the ball
and wore it nearly flat on one side
completely destroying the
retentive capacity of the ball even
if a new rubber O-ring were
placed.
To further complicate matters, the
ball attachment was welded to the
bar and could not be replaced and
the whole device had to be
scrapped to make use of the
implants.
The information on the next couple
of pages is an excellent review of
literature about the current
thinking on overdentures.
Significant is its final comment.
Let me leave with this final
thought. When it comes to implant
supported mandibular
overdentures, Two is good,
three is better, but four is
best!
This is a topic for one of our future
newsletters. We will discuss
overdenture design and what the
literature says about maxillary
overdentures. Also, look for some
comments from an interview I did
with a colleague from the AAID
who has been involved with dental
implants from the near beginning.
4

Oct.-Nov. 2016
Newsletter

STAY
CONNECT
ED

The literature indicates that

implant overdenture prosthesis
provides predictable results enhanced stability, function
and a high-degree of
satisfaction compared to
conventional removable
dentures.

TWO IS GOOD

Another article makes the

following interesting comment:

THREE IS
BETTER

Our blogwww.drgustave.wordpress.co
Conversely a surgeons
mability
to place parallel implants
may
Twitterhttps://twitter.com/drfredgust
affect not
only the implant
survival rate, butave
also
us on Facebookprosthetic Add
maintenence
and
www.facebook.com/drgust
av
complications
and patient
e

satisfaction. In one study,

Walton et al. found that a high
complication rate with a ball
attachment matrix could be
due to the misalignment of
implants.
(Kim, Lee, Shin & Bryant, 2012)

FOUR IS BEST!