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How To Design and Incorporate Ball Attachments into an Overdenture Framework?

posted in Implant Supported Overdentures, advice

« Attached Gingiva: How Much is Necessary for Maintaining Periodontal Health after Implants? | Establish Harmonious Plane of Occlusion with Implant Replacement: Correct Procedure? »

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Dr. E. asks:
I would like to use a ball type of attachment to retain a mandibular overdenture. All I can find are guidelines for Locators and ERA attachments. But, I have heard some lecturers say that this is a better attachment design because it allows for universal movement around the ball which is something that other attachments are not capable of doing. This increased envelope of movement should transfer less force to the implants. Is this accurate? And how do I learn how to do this? Can anyone recommend a good article or text book that describes how to design and incorporate ball attachments into an overdenture framework?

5 Responses to “ How To Design and Incorporate Ball Attachments into an Overdenture Framework? ”

• Mark May 26th, 2009

  
  

  I strongly suggest that you take the Misch prosthetics course.

• Gregori M. Kurtzman DDS May 26th, 2009

  
  

  There are some problems with “O” ring (ball) attachments which include: a need for greater interarch space to accommodate the attachments height, due to the increased height any divergence between attachments is magnified which can lead to lateral stresses on the fixtures when the prosthesis is inserted. The fallacy i that the Ball attachment allows rotation in all directions under load. This would be true if you had an edentulous arch and only 1 fixture with attachment was present but as soon as you have two or more attachments the rotational motion is limited. Attachments that have lower heights to the gingiva allow less stress on the fixtures then taller attachments when the denture is inserted and also require less interarch height allowing more denture acrylic to be placed over them and allowing longer life to the denture without the need to repair it.

• Dr. T May 27th, 2009

  
  

  The “O” ring attachments seem to do better with patient has a severe bone or ridge resorption.

• Mark Huels, CDT, MICOI June 3rd, 2009

  
  

  Don’t believe everything you hear. Implants, properly integrated–especially in the mandible–are much stronger than the forces from a Locator attachment. This attachment is very popular because it works great! The only torque problem could come from improper processing. The side walls of the abutment–if it is at all above tissue height–must be blocked out. Your lab should know this. I have been doing removable lab work for 32 years and now do almost exclusively implant restorations. The greatest success I’ve seen with free standing implants is the Locator abutments.

  Also, as Dr. Kurtzman wrote in the previos comment, the vertical height of the ball attachment can cause problems in some cases.

  I have no ties to any implant or attachment manufacturer.

• Dr. A June 4th, 2009

  
  

  I agree with the above posts. Locators are the way to go. I personally like to deliver them one by one chairside.

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