Implant-Supported Maxillary Overdentures: Anterior vs. Posterior?
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Subscribe to this PostThis week our featured implant abstract is: Implant-supported maxillary overdentures retained with milled bars: maxillary anterior versus maxillary posterior concept–a retrospective study.
PURPOSE: The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior or posterior maxillary implant placement.
MATERIAL AND METHODS: Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region or 6 to 8 implants placed in augmented maxillary posterior regions with sinus augmentation and anchored
either on a single anterior bar or on 2-bilaterally placed milled bars in the posterior regions.
RESULTS: The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups.
CONCLUSIONS: In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance.
Source: Int J Oral Maxillofac Implants. 2008 Mar-Apr;23(2):343-52. Krennmair G, Krainhöfner M, Piehslinger E.
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I would be a little concerned with rigid fixation in the maxilla since we usually do not get the greatest quality bone up there. I would like to mention two studies that have shown much more favorable force distribution using resilient attachments.
Dr. Federic and Caputo’s UCLA study comparing bars (which in all practicality are rigid) to free standing resilient abutments. Dr. Vicki Petropoulos at the University of Pennsylvania conducted a similar study which also showed a much better distribution of forces to the implants when using free standing reslilient abutments for anchorage.