Escolar Documentos
Profissional Documentos
Cultura Documentos
Attachments:
Vertical Movement
Hinge Movement
Rotation Movement
Translation
Combination between any type of
movement.
TYPES OF ATTACHMENTS BASED ON
RESILIENCY
Rigid Non-Resilient Attachments (the implant
receives 100 percent of the chewing forces)
This type of attachment needs sufficient number of
implants.
Ex: A screw-retained hybrid overdenture.
RestrictedVertical Resilient Attachments:
This type of attachment provides 5–10
percent load relief to the supporting
implants, and the
prosthesis can move up and down with no
lateral movement.
Ex: telescopic attachment with vertical
relief.(Syncone abutment)
Hinge Resilient Attachments: Hinge resilient
attachments provide almost 30–35 percent load
relief to the supporting implant.
vertical
components of the masticatory forces
are shared between the attachments and the
posterior portions of the residual ridge—the
buccal shelf and retro molar pad.
Ex: A Hader bar or any other kind of round
bar can provide hinge resiliency
Combination Resilient
Attachments: allow unrestricted
vertical and hinge movements.
This type of attachment offers
45–55 percent load relief to the
supporting implants. Ex:The
Dolder bar joint (egg shaped) is a
combination resilient
attachment.
Rotary Resilient Attachments: This type of attachment
provides vertical hinge and rotation movements. Rotary resilient
attachments transfer both the vertical and horizontal components of
masticatory forces to the residual ridge. this type of attachment
provides 75–85 percent load relief to the supporting implants. Ex. The
stud attachment.
UniversalResilient
Attachments: These
attachments provide vertical,
hinge, translation, and
rotation movements.
Thistype of attachment
offers 95 percent load relief
to the supporting implants.
Ex: Magnetic attachments are
the best example of the
universal resilient attachments.
FACTORS INFLUENCING THE DESIGN AND RESILIENCY
LEVEL OF THE ATTACHMENT ASSEMBLY
Angled narrow
diameter implant
allow the
placement of the
implant in the
anterior maxilla.
Sphero Flex
Additional implant
at C position is
required For bar
connection
The center of the implants
should be 24–26mm apart if
standard diameter 4mm
implants are being used.
The length of the bar will be
20–22mm to accommodate two
clips/riders to have proper
retention.
Ifthe two implants are too
close, the short bar cannot
provide enough retention
and stability for the
overdenture
If the implants are placed too
far distally, a straight-line bar
will interfere with the tongue
space and create problems in
fabricating the prosthesis, also
it will be at risk of bending.
Asa general rule the bar should
be perpendicular to the line that
bisects the angle formed by the
two posterior mandibular arch
segments.
Retention required
In general, poor bone quality and bone volume, short implant length, and
poor initial stability are factors associated with the lower success rate for
implants in the maxilla compared with the mandible.
because of the poor bone quality, splinting of implants in the maxilla using a
rigid bar connector has been suggested to reduce unfavorable loading.
Different retention systems for implant-supported overdentures have been
presented in the literature. Whereas unsplinted systems, such as various
types of ball attachments, have been frequently used in the mandible,
prefabricated bar systems in combination with clips for denture retention
seem to be the most preferred concept in the maxilla.