Seven Years Maintenance Cost of Implant-Retained Overdentures on Ball Versus Locator ® Abutments.

Abstract

Denture wearers often complain about jeopardized function and reduced quality of life due to lack of prosthesis’ retention. Implant retained mandibular overdentures, on 2 non-connected implants (2IOD) are well-proven solutions to overcome these issues. We prospectively assessed 69 patients and scrutinized clinical records until at least 7 years of function. Thirty-six were retained on Locator ® Abutments (LA) and thirty-tree on Ball Abutments (BA). Both systems were compared regarding the type, amount and total cost of required maintenance. One implants was lost, yielding 98.7% survival after 7 years. In total 438 technical issues occurred: 121 (27.35%) in BA and 317 (72.4%) in LA. Out of these, 343 events (78%) were solved chairside: 191 (43.6%) were replacements of retention caps, 113 (25.8%) were minor acrylic repairs, in 26 (5.9%) pressure ulcers had to be relieved and 13 (3%) related to abutments. LA required 179 insert replacements compared to 12 in the BA group. The overall initial treatment cost was 3850 euro. The average total maintenance cost in relation to the initial cost for the LA and BA groups was 19.11% (range 0% - 82.24%) and 18.91% (range 0% - 113.26%) respectively (P=0.540). Conclusions: The 7-years maintenance costs for a 2IOD is acceptable when the patient is regularly checked and professionally maintained. Most events are easily solvable chairside, but a few patients required more expensive interventions, regardless of the type of attachment used.

Design and Numerical-Method-Aided Optimization of a Novel Attachment System for Implant-Retained Dental Prostheses Using NiTi Shape Memory Alloys

“…The form of the NiTi element The use of prefabricated attachment systems such as locators (Zest Dental Solutions, Carlsbad, CA, USA), instead of utilizing individually fabricated attachments such as telescopic crowns or bars, drastically reduces the initial treatment costs in the edentulous mandible [13,14]. Several studies have shown that maintenance frequency [15] and associated costs [16] in such restorations are quite high, equaling or even exceeding initial treatment fees [14,17]. In particular, loss of retention and fractures of the prostheses in the area of the attachment constitute the two main technical complications [18,19].…”