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S J Sadowsky
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ABSTRACT: The implant-retained overdenture for the mandible has been shown to be a highly successful prosthetic treatment similar to the fixed implant denture. However, controversy persists as to its design and indications. Few literature reviews have been published on the topic. This article critically analyzes the existing mandibular implant overdenture literature relative to bone preservation, effect on antagonist jaw, number of implants required, anchorage systems, maintenance, and patient satisfaction. A MEDLINE search was completed (from 1987 to 2001), along with a manual search, to locate relevant English-language articles on mandibular implant overdentures. Twelve treatment concepts are elucidated from a distillation of the literature review.
Journal of Prosthetic Dentistry 12/2001; 86(5):468-73. · 1.32 Impact Factor
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ABSTRACT: Controversy exists regarding the effect of anchorage systems and extension base contact on stress transfer to multiple implants by mandibular overdentures.
This simulation study measured photoelastically the biologic behavior of 4 implants retaining a mandibular overdenture. The purpose of the investigation was to compare the load transfer characteristics of different mandibular-retained overdenture designs, with and without edentulous ridge contact.
A photoelastic model of a human edentulous mandible was fabricated having 4 screw-type implants (3.75 x 10 mm) embedded in the parasymphyseal area. Substructure designs utilizing a cantilevered bar, spark erosion framework, noncantilevered bar, and solitary anchors were fabricated. A vertical load of 30 lb was applied to the first molar unilaterally on each of the 4 standardized overdenture prostheses, with and without a silicone tissue spacer, for a total of 8 tested conditions. Stresses that developed in the supporting structure were monitored photoelastically and recorded photographically.
Without the simulated tissue contact on the posterior edentulous ridge, the cantilevered bar framework caused the highest stresses to the terminal implant, followed by spark erosion framework, non-cantilevered bar, and solitary anchor design. With simulated tissue contact under the extension base, stress transfer to the distal implant was uniformly reduced to a low level.
Without intimate extension base contact with the posterior edentulous ridge, the cantilevered anchorage systems generated the highest stresses, under load, to the ipsilateral terminal implant and the solitary anchor design transferred the least. With simulated intimate extension base contact, all anchorage systems transferred low stress to the distal implant region. For all conditions and designs, low stress was transferred to the contralateral side of the arch.
Journal of Prosthetic Dentistry 10/2000; 84(3):327-34. · 1.32 Impact Factor
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S J Sadowsky
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ABSTRACT: STATEMENT OF PROBLEM: Edentulous patients who require implant-supported prostheses have diverse jaw anatomy and functional, esthetic, and economic concerns. Four main prosthetic designs have been used to meet these needs. PURPOSE: In this article, the fixed ceramometal, fixed detachable, overdenture, and fixed removable prostheses are discussed with emphasis on indications and limitations. An in-depth diagnosis and informed treatment planning will maximize implant success and patient satisfaction.
Journal of Prosthetic Dentistry 08/1997; 78(1):28-33. · 1.32 Impact Factor
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S J Sadowsky
Journal of the California Dental Association 02/1992; 20(1):59-62.
