Journal of Oral Implantology April 2013 - (Page 182)

CLINICAL A Technique for Improving the Retention of Dentures Retained by Ramus Frame Implants Yung-tsung Hsu, DDS, MS1* Jon Olafur Sigurjonsson, DDS2 Carlos A. Polo Montes, DDS, MS3 Retention for a denture on a ramus frame implant is usually less satisfactory. The friction between the frame and denture is not reliable. Locking-type attachments require manual dexterity, which could be a problem for many patients. This article presents a technique of cementing the stud-type attachments to the ramus frame to convert the retention mechanism from one that uses the friction between the acrylic resin and ramus frame to a conventional resilient precision attachment. The retention can also be adjusted by changing the nylon inserts. Key Words: attachment, ramus frame, retention, resorbed mandible INTRODUCTION T he long-term success rate of a ramus frame implant may not be as good as that for a root form implant;1 however, in situations such as severely resorbed ridge or when a patient refuses to have a ridge augmentation procedure, the ramus frame implant will still be an option for patients. Many patients have acceptable results with dentures retained by ramus frames implants, but a common complaint is their loose fit. The denture is mainly retained by the friction between the vertical wall of the ramus frame and the acrylic resin.2–4 Frequent removals and insertions of the denture cause wear on the acrylic resin and result in a loose denture. To regain the retention, the denture needs to be relined frequently, which frustrates both the clinician and the patient.5 Locking-type attachments, such as the Lew passive attachment (Attachments International, San Mateo, Calif), have been used,3 and there have been many reports of success, but it requires a degree of manual dexterity to open or lock the attachments, and these procedures could 1 Department of General Dental Sciences, School of Dentistry, University of Alabama, Birmingham. 2 School of Dentistry, University of Iceland, Reykjavik, Iceland. 3 Private Practice, Winter Haven, Fla. * Corresponding author, e-mail: ythsu@uab.edu DOI: 10.1563/AAID-JOI-D-11-00005 182 Vol. XXXIX /No. Two / 2013 be difficult for certain patients, such as those with arthritis. Metal clips have been suggested as attachments on the metal frame; however, the parallel walls of the frame are not retentive for the clips.6 To improve retention, cementing the denture to the ramus frame implant has been proposed,7 but this will compromise the hygiene. This article presents a technique of making stud-type attachments on the ramus frame and converting the retention from metal-acrylic resin friction to metal-nylon dental attachments. Metal-nylon attachments last longer and are more durable; when wear happens, the attachment can be replaced easily without relining the denture.8 PROCEDURE 1. Block out the undercuts around the ramus frame and make a final impression with the polyvinyl siloxane (PVS) impression material. Pour the impression with a type IV stone (SilkyRock, WhipMix, Louisville, Ky). 2. Apply a layer of baseplate wax on the ramus frame of the definite cast as a spacer and make a record base. 3. Follow conventional complete denture procedures until the teeth are arranged and verify the arrangement intraorally.

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2013

Evidence-Based Practice or Practice-Based Evidence?
Evaluation of Optimal Taper of Immediately Loaded Wide-Diameter Implants: A Finite Element Analysis
A Prospective, Randomized Controlled Preclinical Trial to Evaluate Different Formulations of Biphasic Calcium Phosphate in Combination With a Hydroxyapatite Collagen Membrane to Reconstruct Deficient Alveolar Ridges
Retention of Implant-Supported Overdenture With Bar/Clip and Stud Attachment Designs
The Clinical and Histologic Outcome of Dental Implant in Large Ridge Defect Regenerated With Alloplast: A Randomized Controlled Preclinical Trial
Fluoride-Treated Bio-Resorbable Synthetic Hydroxyapatite Promotes Proliferation and Differentiation of Human Osteoblastic MG-63 Cells
Resonance Frequency Analysis of 208 Straumann Dental Implants During the Healing Period
A Simplified Technique for Solving the Transfer Problem of Implant-Supported Fixed Partial Dentures for Patients With Microstomia
Esthetic Evaluation of Single-Tooth Morse Taper Connection Implants Placed in Fresh Extraction Sockets or Healed Sites
A Technique for Improving the Retention of Dentures Retained by Ramus Frame Implants
Treatment of Congenitally Missing Maxillary Lateral Incisors: An Interdisciplinary Approach
Use of Titanium Mesh in Lieu of a Fixation Screw to Stabilize an Autogenous Block Graft: A Case Report
A Novel Approach to Preserve the Buccal Wall in Immediate Implant Cases: A Clinical Report
Implant Failure Associated With Actinomycosis in a Medically Compromised Patient
Replacement of Mandibular Posterior Teeth With Implants in a Postmandibular Resection Case: A Case Report
Zygomatic Implants/Fixture: A Systematic Review
An Overview of Immediate Root Analogue Zirconia Implants
Letter to the Editor
Reviews of Current Literature

Journal of Oral Implantology April 2013