The implant-supported milled bar overdenture: A literature review

Abstract

Purpose: This bibliographical review aims to determine the present situation of the implant-supported milled bar overdenture as a therapeutic option in implantology, as well as to set and compare the techniques and materials currently used for making them. Materials and methods: By searching the main electronic bibliographical data in indexed Medline articles, we obtained a total number of 20 articles that fulfilled the requirements of this bibliographical review. Results: The implant-supported milled bar overdenture offers excellent long-term successful results, although complication rates are higher in emergency cases of patients initially planned for a fixed prosthesis. Krenmair and collaborators found cumulative survival rates of implants on milled bars after 5 years, of 99% in mandible cases, and of 97.8% in maxilla cases. No detailed protocols specifying the necessary number of implants or their characteristics have been found, though they are never made with less than 4 implants in mandible or 4-6 in the maxilla. Milled bars are screwed, generally cast in a precious metal alloy, with a metal or acrylic suprastructure and include attachments that regulate the tightness. The suprastructure adjusts precisely and rigidly to the milled bar, and presents similar biomechanical movements to those of fixed prostheses. The overdenture is removable and its prophylaxis is simple. Conclusions: The implant supported milled bar overdenture is a very interesting option in the treatment of patients with moderate to severe reabsorbed maxilla problems. It offers both the advantages of removable prostheses as well as the stability and retention of a fixed prosthesis.

Use of intraoral digital scanning for a CAD/CAM-fabricated milled bar and superstructure framework for an implant-supported, removable complete dental prosthesis

“…4 This design has demonstrated a lower prosthetic complication rate and has reduced maintenance requirements compared to implant mucosasupported, removable complete dental prosthesis. 5,6 Its higher initial cost may be compensated by less maintenance. 1 With the increasing cost of material and the complexity of laboratory procedures, computer-aided design/ computer-aided manufacturing (CAD/CAM) technology has been used to fabricate different types of dental restorations.…”

Rehabilitation with implant-supported overdentures in total edentulous patients: a review

“…As well, Krennmair et al (22), in a 5 year follow-up study among 51 patients wearing same mandibular ISOs, arrived at the same conclusions. According to Bueno-Samper et al (23), milled bars constitute a predictable treatment alternative due to their retention and stability as a fixed denture and have the advantages of a removable denture.…”

Strain characteristics of Marburg double crown-retained implant overdentures compared with bar and ball-retained implant overdentures, with and without a rigid major connector

“…10,14 Various retentive mechanisms are available for attaching an overdenture to implants. [3][4][5][15][16][17][18] Unfavorable load transfer from the attachment to the implant and thereby to the alveolar bone surrounding the implants can be detrimental to osseointegrated implants. 6,19,20 The choice of retention mechanism in planning the IOVD might be critical in providing equitable load transfer within the maxilla.…”