Attachement's selection criteria for mandibular implant overdentures

The use of attachments for the retention of implant overdentures has been adapted from their long-lasting use in conventional, root-retained overdentures.

The recent McGill University consensus statement on implant overdentures (May 2002) has highlighted the advantageous contribution of this type of therapy in increasing the stability and retention of mandibular complete dentures. Despite the present popularity of this therapeutic approach, the choice of the attachments used has largely remained anecdotal, based on dentists’ preference or the laboratory’s ease of use.

Guidelines regarding the advantages and disadvantages as well as the indications and contra-indications for the use of each type of attachment are scarce, making an evidence based decision not always feasible. The purpose of the present literature review is, therefore to examine the effect of the different attachments on various biological and technical aspects of implant overdenture therapy and assist the clinician in making an informed decision when called upon to use them. Several clinical parameters including the interaction between attachments and crestal bone loss, peri-implant soft tissue and implant loading, together with the attachments’ respective retention and need for maintenance will be examined.

Last but not least, overall patients’ satisfaction with each type of attachment will be looked into as well, in an effort to assist the clinician with evidence-based decision making.

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