Dr. Sanders asks,
What is the current protocol for maxillary support and retention of an overdenture, assuming four fixtures are to be used?
Are Locator abutments adequate or do the dental implant fixtures need to be
connected with a bar? I have concerns that the longevity of the
dental implants may be compromised if they are not connected. Have there been
any studies regarding these issues?
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Dr. Sanders,
I am not aware of a good study to clarify this issue, but in clinical practice I have seem failure with advanced bone loss when maxillary implants are not splinted. The prosthodontists I work with and respect don’t treatment plan maxillary overdentures over unsplinted implants. Misch doesn’t recommend it in his books. Hope this helps.
When you place implants in the maxilla, those implants are in the frontal area from canine to canine. If you have 4 implants with such a distribution try to conect them with a bar. In my experience non splinted implants in the maxilla have sooner or later bone loss.
Locator needs to have a paralellpath of insertion that you cannot obtain in the maxilla.
Try to splint them with a bar.
Above statements are generally right on but remember their are few absolutes. If the maxillary bone is denser than typical where the implants are going then you might be able to get away with four with attachments but not usually.
I agree with Ray with the added comment that Locator attachments do not need to be parallel. They can be up to 40 degrees non-parallel and with their modified female attachments the overdenture will still seat.
I would like to know some dentist in the Chattanooga Tenn area who does the over denture
implants.
Karen
If you will send me contact info I will be happy to give you the names of 6-10 dentist in Chattanooga who do a excellent job of placing dental implants.
Joe