J Korean Acad Prosthodont.  2018 Oct;56(4):368-374. 10.4047/jkap.2018.56.4.368.

Causes of failed implant attachments and application of double crown implant overdenture in one patient

• Kwon JU
• Cho JH

• KMID: 2424039
• DOI: http://doi.org/10.4047/jkap.2018.56.4.368

Abstract

In this case, the patient was restored with gold Hader bar mandibular implant overdenture using two implants about 10 years ago, and the retentive force was lost due to severe wear of the bar due to 3.5 years use. The overdenture was repaired using a Locator attachment, but the male part was completely worn after 6.5 years use. Finally, we used a hybrid telescopic double crown with a friction pin to fabricate a new implant overdenture, which was observed for 2 years and showed excellent prognosis. So, we describe the cause of failure of each attachment (Gold Hader bar, Locator) in two implant overdentures and report on the advantages and disadvantages of double crown implant overdenture and the conditions for success.

Keyword

Implant; Attachment; Overdenture; Double crown; Telescopic crown

MeSH Terms

Crowns*
Denture, Overlay*
Friction
Humans
Male
Prognosis

Figure

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  Fig. 1. Panoramic radiograph after implant placement.

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  Fig. 2. Maxillary metal ceramic crowns and denture teeth set-up on edentulous area (A) Maxillary occlusal view; surveyed metal ceramic crown, (B) Frontal view, (C) Mandibular occlusal view; denture teeth set-up for determining attachment.

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  Fig. 3. Mandibular implant overdenture using gold Hader bar attachment. (A) Gold Hader bar attachment at initial placement, (B) Fabricated mandibular implant overdenture, (C) Frontal view; decreased vertical dimension by worn denture teeth after 3.5 years.

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  Fig. 4. Tissue surface of mandibular overdenture (A) At delivery (B) 3.5 years later; shortened denture border. As the distance of the two implants are same in both pictures, it is shown that the denture border in (B) is significantly shorter than the denture in (A).

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  Fig 5. Locator attachment wear and result. (A) Worn male part of Locator attachment after 4 years, (B) After 7.5 years Locator use, (C) Frontal view after 7.5 years Locator use.

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  Fig. 6. Mandibular provisional overdenture. (A) Healing abutment on implants, (B) Partially adapted tissue conditioner for retention, (C) Frontal view.

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  Fig. 7. Mandibular implant overdenture using double crown attachment. (A) Inner crown on implant, (B) Tissue surface of implant overdenture, (C) Frontal view of implant overdenture.

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  Fig. 8. Final panoramic radiograph.

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