Overdenture Case Reports

Overdentures have been an excellent solution for the management of the completely edentulous patient.1–4 By using a minimum of two to three implant fixtures, stabilization attachments can be utilized for improved retention of the complete denture. Individual ball type, ERA, spark erosion, clip bar, and modified Dalbo attachments may be used as the retentive element(s). When sufficient implants are in place, overdentures can have retention that nearly replicates the stability of fixed prosthetics in function, while allowing superior cleansability and oral hygiene. Multiple maxillary dental implants5–7 can allow the elimination of palatal coverage, which is poorly tolerated by many patients, and provide patients with better taste sensation and phonetics.

The following are cases that represent maxillary and mandibular overdenture treatment.

Case 1

Completely edentulous mandible reconstructed with 3-screw type dental implants and fabrication of a bar with three ball attachments and an overdenture (Figures 21B.1–21B.5). (Dental implant surgery: Alex M. Greenberg, DDS, Oral and Maxillofacial Surgeon, New York, NY. Implant prosthodontics: Ava Thaw, DDS, Prosthodontist, Private Practice, New York, NY.)

21B. Overdenture Case Reports

FIGURE 21B.2 Frontal view of edentulous mandible with overdenture bar. Note the unfavorable floor of mouth and tongue position relative to the edentulous ridge.

FIGURE 21B.3 Occlusal view of edentulous mandible with overdenture bar.

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FIGURE 21B.4 View of overdenture base and three o-rings.

FIGURE 21B.5 Mandibular overdenture in occlusion with maxillary fixed bridge.

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FIGURE 21B.7 Frontal view of maxillary overdenture bar and occlusal clearance.

FIGURE 21B.8 Occlusal view of maxillary overdenture bar.

A.M. Greenberg

FIGURE 21B.10 Close-up view of overdenture base with Lew attachment pushed into position.

FIGURE 21B.11 Close-up buccal view of Lew attachment push–pull button.

FIGURE 21B.9 View of overdenture base and 5 Hayder nylon clips. Note the absence of palatal coverage.

FIGURE 21B.12 Maxillary overdenture in opposing mandibular fixed bridge.

21B. Overdenture Case Reports

Case 2

Completely edentulous maxilla reconstructed with 10 dental implants, fabrication of continuous bar with posterior bilateral skirts for Lew attachments, 5 Hayder clips, and overdenture (Figures 21B.6–21B.12). (Dental implant surgery: Alex M. Greenberg, DDS, Oral and Maxillofacial Surgeon, New York, NY. Implant Prosthodontics, Joel Hirsch, DDS, Prosthodontist, Private Practice, New York, NY.)

References

1.Branemark P-I, Zarb GA, Albrektsson T. Tissue Integrated Prostheses. Quintessence: Chicago, 1987:283–287.

2.Worthington P, Branemark P-I. Advanced Osseointegration

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Surgery: Applications in the Maxillofacial Region. Chicago:

Quintessence, 1992:233–247.

3.Misch CE. Contemporary Implant Dentistry. St. Louis: MosbyYearbook, 1993:223–240.

4.Jemt T, Chai J, Harnett J, Heath MR, et al. A 5-year prospective multicenter follow-up report on overdentures supported by osseointegrated implants. Int J Oral Maxillofac Implants. 1996; 11:291–298.

5.Misch LS, Misch CE. Denture satisfaction: a patient’s perspective. Int J Oral Implant. 1991;7:43–48.

6.Floystrand F, Karlsenk, Saxegaard E, Orstavik JS. Effects on retention of reducing the palatal coverage of complete maxillary dentures. Acta Odontol Scand. 1986;44(2):77–83.

7.Lundqvist S. Speech and other oral functions. Clinical and experimental studies with special reference to maxillary rehabilitation on osseointegrated implants. Swed Dent J. (suppl) 1993;91:1–39.