Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
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CiteScore (2021) – 2.0
JCI (2021) – 0.5
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
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Dental and Medical Problems

2016, vol. 53, nr 4, October-December, p. 559–565

doi: 10.17219/dmp/64976

Publication type: review article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Precision Attachments: A Review to Guide Clinicians

Precyzyjne elementy retencyjne – przegląd piśmiennictwa

Marco Roy1,A,B,C,D, Małgorzata Idzior-Haufa1,B, Wiesław Hędzelek1,A,E,F

1 Department of Prosthodontics, Poznan University of Medical Sciences, Poznań, Poland


The present paper is intended to compare the results gathered by multiple authors on the different precision attachments available to help clinicians in their daily practice to make the right decision while planning an overdenture. The literature has been gathered through PubMed and from data gathered and published from the Department of Prosthodontics, Poznan University of Medical Sciences. Patients with overdentures are generally satisfied no matter what type of system is used. The clinician, therefore, is usually guided by the patient’s anatomy. Correct planning of the position of the implants is imperative for successful treatment. Moreover, the clinician should also take into account the opposing arch for a correct restoration. The paper aims to clarify the differences between various precision attachment systems for overdentures. Clinicians, therefore, will have a better understanding and confidence in making the right decision while rehabilitating a patient with an overdenture, improving patients’ quality of life and satisfaction.

Key words

overdenture, precision attachments, locators, ball-attachments

Słowa kluczowe

proteza nakładowa, elementy precyzyjne, lokator, zatrzaski kulkowe

References (41)

  1. D’Souza K.M., Aras M.: Association between socio-demographic variables and partial edentulism in the Goan population: An epidemiological study in India. Indian J. Dent. Res. 2014, 25, 434–438.
  2. Teofilo L.T., Leles C.R.: Patients’ self-perceived impacts and prosthodontic needs at the time and after tooth loss. Braz. Dent. J. 2007, 18, 91–96.
  3. Shimazaki Y., Soh I., Saito T., Yamashita Y., Koga T., Miyazaki H., Takehara T.: Influence of dentition status on physical disability, mental impairment, and mortality in institutionalized elderly people. J. Dent. Res. 2001, 80, 340–345.
  4. Johnson N.W., Glick M., Mbuguye T.N.: Oral health and general health. Adv. Dent. Res. 2006, 19, 118–121.
  5. Boven G.C., Raghoebar G.M., Vissink A., Meijer H.J.: Improving masticatory performance, bite force, nutritional state and patient’s satisfaction with implant overdentures: A systematic review of the literature. J. Oral. Rehabil. 2014, 42, 220–232.
  6. Sun X., Zhai J.J., Liao J., Teng M.G., Tian A., Liang X.: Masticatory efficiency and oral health-related quality of life with implant-retained mandibular overdentures. Saudi Med. J. 2014, 35, 1195–1202.
  7. Rentsch-Kollar A., Huber S., Mericske-Stern R.: Mandibular implant overdentures followed for over 10 years: Patient compliance and prosthetic maintenance. Int. J. Prosthodont. 2010, 23, 91–98.
  8. Watson G.K., Payne AG., Purton D.G., Thomson W.M.: Mandibular overdentures: Comparative evaluation of prosthodontic maintenance of three different implant systems during the first year of service. Int. J. Prosthodont. 2002, 15, 259–266.
  9. Behrman S.J.: The implantation of magnets in the jaw to aid denture retention. J. Prosthet. Dent. 1960, 10, 807–841.
  10. Riley M.A., Williams A.J., Speight J.D., Walmsley A.D., Harris I.R.: Investigations into the failure of dental magnets. Int. J. Prosthodont. 1999, 12, 249–254.
  11. Vrijhoef M.M., Mezger P.R., Van der Zel J.M., Greener E.H.: Corrosion of ferromagnetic alloys used for magnetic retention of overdentures. J. Dent. Res. 1987, 66, 1456–1459.
  12. Ceruti S.R.B., Lee J-H., MacEntee M.I.: Magnet-retained implant supported overdentures: Review and 1 year clinical report. J. Can. Dent. Assoc. 2010, 76, 6–14.
  13. Bilhan H., Geckili O., Sulun T., Bilgin T.: A Quality-of-life comparison between self-aligning and ball attachment systems for 2-implant-retained mandibular overdentures. J. Oral Implantol. 2011, 37, 167–173.
  14. Thomason J.M., Feine J., Exley C., Moynihan P., Muller F., Naert I., Ellis J.S., Barclay C., Butterworth C., Scott B., Lynch C., Stewardson D., Smith P., Welfare R., Hyde P., McAndrew R., Fenlon M., Barclay S., Barker D.: Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients – the York consensus statement. Br. Dent. J. 2009, 207, 185–186.
  15. Feine J.S., Carlsson G.E., Awad M.A., Chehade A., Duncan W.I., Gizani S., Head T., Heydecke G., Lund J.P., MacEntee M., Mericske-Stern R., Mojon P., Morais J.A., Naert I., Payne A.G., Penrod J., Stoker G.T., Tawse-Smith A., Taylor T.D., Thomason J.M., Thomson W.M., Wismeijer D.: The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Gerodontol. 2002, 19, 3–4.
  16. Walton J.N., Glick N., Macentee M.I.: A randomized clinical trial comparing patient satisfaction and prosthetic outcomes with mandibular overdentures retained by one or two implants. Int. J. Prosthodont. 2009, 22, 331–339.
  17. Kronstrom M., Davis B., Loney R., Gerrow J., Hollender L.: A prospective randomized study on the immediate loading of mandibular overdentures supported by one or two implants; A 3 year follow-up report. Clin. Implant Dent. Relat. Res. 2014, 16, 323–329.
  18. MacEntee M.: Mandibular overdentures retained by a bar on two implants need less aftercare and costs less than overdentures retained by two bars on three implants or by ball attachments on two implants. J. Evid. Based Dent. Pract. 2008, 8, 2, 76–77.
  19. Ruchala-Tyszler A., Loster B.W.: Application of dental implant supported overdentures in edentulous patients – academic literature review. Implantoprotet. 2007, 8, 4, 38–42 [in Polish].
  20. Banton B., Henry M.D.: Overdenture retention and stabilization with ball-and-socket attachments: Principles and technique. J. Dent. Technol. 1997, 14, 7, 14–20.
  21. Turk P.E., Geckili O., Turk Y., Gunay V., Bilgin T.: In vitro comparison of the retentive properties of ball and locator attachments for implant overdentures. Int. J. Oral Maxillofac. Implants 2014, 29, 1106–1113.
  22. Kleis W.K., Kammerer P.W., Hartmann S., Al-Nawas B., Wagner W.: A comparison of three different attachment systems for mandibular two-implant overdentures: One-year report. Clin. Implant. Dent. Relat. Res. 2010, 12, 209–218.
  23. Evtimovska E., Masri R., Driscoll C.F., Romberg E.: The change in retentive values of locator attachments and hader clips over time. J. Prosthodont. 2009, 18, 479–483.
  24. Krennmair G., Seemann R., Fazekas A., Ewers R., Piehslinger E.: Patient preference and satisfaction with implantsupported mandibular overdentures retained with ball or locator attachments: A crossover clinical trial. Int. J. Oral Maxillofac. Implants, 2012, 27, 1560–1568.
  25. Kim H.Y., Lee J.Y., Shin S.W., Bryant S.R.: Attachment systems for mandibular implant overdentures: A systematic review. J. Adv. Prosthodont. 2012, 4, 197–203.
  26. Schneider A.L., Kurtzman G.M.: Restoration of divergent free-standing implants in the maxilla. J. Oral Implantol. 2002, 28, 113–116.
  27. Sadig W.: A comparative in vitro study on the retention and stability of implant-supported overdentures. Quintess. Int. 2009, 40, 313–319.
  28. Chiapasco M., Gatti C., Rossi E., Haefliger W., Markwalder T.H.: Implant-retained mandibular overdentures with immediate loading. A retrospective multicenter study on 226 consecutive cases. Clin. Oral Implants Res. 1997, 8, 48–57.
  29. Khadivi V.: Correcting a nonparallel implant abutment for a mandibular overdenture retained by two implants: A clinical report. J. Prosthet. Dent. 2004, 92, 216–219.
  30. Asvanund C., Morgano S.M.: Restoration of unfavorably positioned implants for a partially endentulous patient by using an overdenture retained with a milled bar and attachments: A clinical report. J. Prosthet. Dent. 2004, 91, 6–10.
  31. Mericske-Stern R.D., Taylor T.D., Belser U.: Management of the edentulous patient. Clin. Oral Implants Res. 2000, 11, Suppl 1, 108–125.
  32. Elsyad M.A., Al-Mahdy Y.F., Salloum M.G., Elsaih E.A.: The effect of cantilevered bar length on strain around two implants supporting a mandibular overdenture. Int. J. Oral Maxillofac. Implants 2013, 28, e143–150.
  33. Kono K., Kurihara D., Suzuki Y., Ohkubo C.: In vitro assessment of mandibular single/two implant-retained overdentures using stress-breaking attachments. Implant Dent. 2014, 23, 456–462.
  34. Gotfredsen K., Holm B.: Implant-supported mandibular overdentures retained with ball or bar attachments: A randomized prospective 5-year study. Int. J. Prosthodont. 2000, 13, 125–130.
  35. MacEntee M.I., Walton J.N., Glick N.: A clinical trial of patient satisfaction and prosthodontic needs with ball and bar attachments for implant-retained complete overdentures: Three-year results. J. Prosthet. Dent. 2005, 93, 28–37.
  36. Massad J.J., Ahuja S., Cagna D.: Implant overdentures: Selections for attachment systems. Dent. Today, 2013, 32, 128–132.
  37. English C.E.: Critical A-P spread. Implant Soc. 1990, 1, 1, 2–3.
  38. Davis D.M., Packer M.E.: Mandibular overdentures stabilized by Astra Tech implants with either ball attachments or magnets: 5-year results. Int. J. Prosthodont. 1999, 12, 222–229.
  39. Ahuja S., Cagna D.R.: Classification and management of restorative space in edentulous implant overdenture patients. J. Prosthet. Dent. 2011, 105, 332–327.
  40. Lee C.K., Agar J.R.: Surgical and prosthetic planning for a two-implant-retained mandibular overdenture: A clinical report. J. Prosthet. Dent. 2006, 95, 102–105.
  41. Sadowsky S.J.: Treatment considerations for maxillary implant overdentures: A systematic review. J. Prosthet. Dent. 2007, 97, 340–348.