Ancient implants with ball abutments: how best to manage this case?
I have a patient who I have treatment planned for a mandibular overdenture. He has 2 implants with ball attachments placed in France many years ago. Upon observation I noticed that the implants are both different and the ball abutments have been ground, to reduce diameter perhaps, in order to be compatible with some attachments system. The original dentist sent me these 2 images. Does anyone know what ball attachment system these are? Can I still use these ball attachments for retention of the overdenture and if so, how should I manage that. Any recommendations?
![]Donzilia-1](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2013/07/Donzilia-1-e1374422740893.jpg)
![]Donzilia](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2013/07/Donzilia-e1374422768952.jpg)
22 Comments on Ancient implants with ball abutments: how best to manage this case?
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incisor
7/23/2013
First step would be discovering what implants were used, but I can't find anything similar... any suggestions?
Gregori Kurtzman, DDS, MA
7/23/2013
Can you snap a pic of the inside of the denture showing the other portion of the attachment?
incisor
7/25/2013
No Gregori, I can't because they came loose from denture... it's the main reason for my doubts. It would be easy to find similar female attachments from a supplier.
Colin Logan
7/23/2013
If you can measure the diameter of the "ball" you can match up with an existing system, or you can cast a cap to cement for each linked by a bar and fit a traditional bar between the 2 implants for a bar retained overdenture. What is in the existing denture? CAn you remove and reuse it?
There are a large number of old, weird or modified components out there, but a bit of lateral thinking can usually solve the problem. A good lab can often help.
incisor
7/25/2013
Hi Colin Logan, thank you for your reply.
As I mentioned, someone before me tried to reduce the diameter of the males, but obviously they were not successful, and now the balls are irregular and unusable...
I have a plan "B", in case I can't remove the ball abutments, to replace with a known system: I will use the CEKA-PRECILINE RTI system (usually used on roots) with the appropriate CEKA BOND and position new male balls on the existing implants...
Regards
Rui
Dr Ron
7/23/2013
the ball is a old screw vent, now Zimmer ball abutment, but the first xray is a two piece system that was used for awhile. The second looks like the standard single piece abutment. You can still get replacements from Zimmer. Implant looks like a standard 3.75 mm internally hexed (2.5mm) implant, although the first implant looks like a microvent series, the internal connection is the same. First xray, the abutment cannot be unscrewed by grasping the body, only the ball portion. Second one can be unscrewed using the body.
Dr Ron
incisor
7/25/2013
Thank you Dr. Ron for your input, it was most helpfull. I have orderd replacements from Zimmer supplier and am waiting to receive. I hope it's all compatable and works 1st time, in the mean time I have a plan "B", just in case.
Regards
Moki Sousa
7/23/2013
Easiest way: Remove existing attachments and check to see the threads are compatible with attachments you usually use. If so change the attachments to ones with which you are familiar. If threads are not compatible then use the best previous suggestion.
incisor
7/25/2013
No doubt, best and most logical solution.
Thank you for your input.
Regards
Rui
Devin Savage
7/23/2013
Easiest, measure them, they are probably 1.8 or 2.3 mm. O company can probably get you the attachments.
Dr. Will Johnson
7/23/2013
Bredent out of Miami Florida, makes a ball attchment modification kit that you can
use to update any such implant. I forget the main guy there, but he's a top shelf
laboratory technical advisor. The patrices is attached at the implant and they
have a preconstructed matrices to install in the prosthesis. Simple design and
mechanics, challenging to actually do.
Dr, Don
7/23/2013
"Corevent" by Gerry Niznick ---now "Implant Direct"-- and Nobel by Branemark were the two big guns of the original implant companies -----try the Implant Direct site. You will find them extremely helpful. A lot of things have changed in the design of implants but I am sure that you will find the internal threading of the implant to be "standard" and you should be able to fit the manufacturers male portion of a ball attachment, from any manufacturer of implants onto the implant.
Better still---ask the original dentist what he used?
While on the subject--there were two or three companies manufacturing implants before 1980 --now we have an explosion of this lucrative field with each company having it's own designs --can you imagine the confusion that is coming when we reach the time when thousands of "older" implants may need servicing???? Good luck--contact Gerry.
incisor
7/24/2013
Thank you Gerry, cross my fingers and hope its standard...
I think in the future we will not have the same problem because, in the mean time due to this problem, there have been databases made with xrays for matching (like "what implant is that"). Also, with standards and certification measures, characteristics must be documented and are available. I think only these Predatabase implants will be problematic.
Thank you for your information I'm going to check up shortly.
Rui
Gerve ,msc
7/23/2013
I now the system.hi-tec ltd from israel.
Implants are TRX and Internal hex 3,75.
The ball atachmen for internal hex is competibal with biohorizons,Zimmer .
Anyway ,please ask the staff of Hi-tec
cory c
7/24/2013
yikes!! was it that long ago that ALL dental implants were newfangled? anyway, its a good arguement for standardization.internal connections aren't THAT old... or is it me.
incisor
7/25/2013
Time goes by... Just yesterday we had to take impressions and soon it's going to be oral scanners everywhere. The good thing, besides the obvious, is that we can now manufacture custom abutments in house and don't have to pay exaggerated amounts to dental supply companies. Thank you for your comment Cory, Regards.
DR Ron
7/25/2013
Just be carefull removing the two piece abutment, I have had the ball snap off because most likely the hex in it is worn and stripped, I had to once take a #701 bur and cut a slot in the top, and use an old "flat head screw driver" wrench to remove it. Over the years the high molecular nylon snap in the metal keeper has been a very reliable attachment with the ball
incisor
7/26/2013
Thank you for your help, I will book patient next week and let you know how it went. Personally I prefer metal attachments due to less wear and substitution of teflons... have you tried the CEKA springs? M2 + M3. very versitile, far better than locators etc.
Gregori Kurtzman
7/26/2013
problem with metal to metal attachments is with time we always see wear and it makes it difficult to manage when the portion on the implant wears, with a plastic insert in the denture its easy to replace and doesnt wear the portion on the implant
DR Ron
7/26/2013
Agree metal on metal long term (3-5 years) wears out to quickly, was using Ceka in the late 70's , the high molecular weight nylon has outlasted them all, and that includes, locator, ERA's, "O"-rings and every vinyl and low molecular weight snap available.
Alex
7/27/2013
I bet you can unscrew the balls and find the internal structure is compatible with one of the US systems. try it, then you can convert it to a loator case.
Oleg amayev
8/24/2013
Use o-ring the have two sizes micro and regular try both and see which one will fit better. It's very simple
