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Implant Patient with Parkinsons Disease: What is the Best Attachment to Use?

posted in Surgical Placement of Dental Implants, Implant Supported Overdentures, en

« Dental Implants for Organ Transplant Patients? | Particulate Graft: Place Implant and then Pack? »

Dr. I. asks:
I have got a new patient 78 year old male with Parkinsons Disease and I have treatment planned him for 2 lower implants in a edentulous mandible and a mandibular overdenture . He is wearing a maxillary complete denture. He is losing weight due to his inability to chew. What would be the attachment that would require the least dexterity to get the denture to insert and remove while still providing a high level of stability? Finances are not a consideration. I have excellent laboratory support.

8 Responses to “ Implant Patient with Parkinsons Disease: What is the Best Attachment to Use? ”

• DR. B August 4th, 2009

  
  

  LOCATOR is a good choice

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID August 4th, 2009

  
  

  “O” Rings or Locator’s are a good choice.

• Gregory J. Gosch D.D.S. August 4th, 2009

  
  

  The only drawback to utilizing the suggestions of the good doctors above is the tendency for food and debris to pack into the female attachments in the denture which negates the retentive aspects.

  A bar with two ERAs on the end would allow more retentive options for the denture and accomodate the patient’s dexterity issues if they arise. Also, if the lower ridge is atrophic, many times two locaters just are not enough retention to satisfy a patient’s desires.

• Henry August 4th, 2009

  
  

  My brother has end-stage P Dz at 55 y/o and has never had a pill rolling tremor, just freezes up until next dose kicks in. My suggestion is use what’s easiest for patient - Locator. If he’s loosing a lot of weight and has a companion, a feeding gastrostomy is a terrific option to suggest to him until he proves he can eat again. He may be in the end stages too.

• Caesar Wong August 4th, 2009

  
  

  The simple ball abutment and silastic ball caps offer the easiest solution considering the physical handicaps of Parkinson patients. The overdenture can easily be snapped in and out. Since this website does not allow outside links, sorry I cannot help you further to source for this kind of overdenture attachment system.

• Nicole August 5th, 2009

  
  

  I think free-standing abutments are the way to go here. Someone with limited manual dexterity would have a much easier time with this. I prefer to use the ERA’s for something like this.

• Nailesh Gandhi August 10th, 2009

  
  

  I fully agree with Caesar Wong.Still believe that a proper demo can be shown by making vsuals acceptable.

• John Willardsen, DDS August 15th, 2009

  
  

  Milled bar with bredent attachments on distal and one at midline of bar. This has one path of insertion and is very stable. Locators or ball attachments are difficult to maintain and especially if they are not seated all the way, I would imagine that the patient might get them seated half of the time, and the rest of the time they will be frustrated. It does cost more but worth it for the patient and the doctor to minimize the frequent visits to replace attachments that collapse on themselves, due to not seating or food impaction, with his condition I am sure it is difficult to brush and maintain the implants and the antaglio surface of the denture and housings.

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