Favorite size implant for overdenture?
I would like to know what everyone’s go-to implant is for an overdenture. I know it depends on bone, but what is the minimum diameter/length you would use? I am planning on doing a three implant lower overdenture.
9 Comments on Favorite size implant for overdenture?
New comments are currently closed for this post.
Dok
8/13/2019
Because overdentures are meant to support "tissue born" denture prosthetics, the need for large implants is lessened. The overdenture should only act to "hold down" the denture. Lateral forces should be spread and supported by the denture sitting on the soft tissue. The largest size that fits comfortably in the available boney space is usually OK. No need for big/wide/long.
Bill McFatter
8/13/2019
It concerns me you are thinking of 3 implants for an overdenture. Would love to hear your reasoning. Misch has no designation for 3 independent implants for an overdenture. Your occlusion is distal to the terminal implants so just by adding the anterior implant you have introduced a fulcrum when in function-compression on the posterior implants and tension of the anterior one. Your axis of rotation is impossible to balance. You may get away with that if you use ball abutments but you will do just as well with 2 at the B and D positions. If you must do 3 then do 4 and use a bar.
Roadkingdoc
8/13/2019
The trouble I have occasionally have with a 2 implant retained lower denture is rotation. I like all my occlusion on the posterior teeth. The third implant placed medialy would not have an attachment. Only serve as anti rotational support.
Bill McFatter
8/14/2019
If you place the implants at the B/D position you wont get the rotationunless it is a severe V shaped arch which I rarely see. I find the midline and then start osteotomy 7-8mm on either side of that. If you place at cuspid then you will get rotation Also, if you place at the cuspid you can limit upgrade to 5 implants due to the proximity to the mental nerve. I use to place at the cuspid then I realized the patient could in many cases not upgrade to hybrid or all on 4. Then I read Misch and he talked about staging the implants for future upgrades using the B/D positions. You have to be very skilled to do this flapless if you plan on taking a postop conebeam to confirm placement. Most of these cases will require bone reduction to get to the proper emergence profile of the implants since the trajectory of the mandible changes as you move towards the basal bone . The bone is often thin above this bone and can direct you osteotomy in the wrong direction
Dr Dale Gerke, BDS, BScDe
8/13/2019
The brand and size is not critical, although tried and proven brands would be prudent.
The implant will need to have a locator or ball abutment (or similar), so the implant brand needs to have an appropriate abutment readily available (off the shelf or specially milled).
Generally when we are talking about an implant retained denture, there has been considerable bone loss in a patient of more advanced years (of course not always). As such, often the implant size of choice will be one that fits the existing bone volume. As well, not always but often, because of the age of the patient, minimal trauma would usually be wise and so flapless, non grafted surgery would be best.
Vipul Shukla
8/13/2019
For overdentures, I prefer MIS C1 bone-level standard platforms at the canine locations, usually two, rarely four, in which case, the molar spots are preferred. I prefer LOCATOR brand of overdenture anchors with replaceable vinyl liners that come in different strengths (different colors). The LOCATOR abutment should be about 2-4 mm above crest of gingiva for best prosthetic solution. A 10mm implant placed properly is just as effective as a 13mm length, as long as meticulous home care and at least once a year visit is followed.
Good Luck!
mark simpson
8/14/2019
for nearly 25 years I have place 4 implants [Xive tg Dentsply] in the anterior mandible and immediately loaded them with a laser welded bar and clip assembly so the implants are splinted. This is the final prosthesis as we have an inhouse lab so the denture is processed.They have worked great with very little maintenance. We do the same in the maxilla with 6 implants
Bill McFatter
8/15/2019
Can you post a picture and description of your technique. It sounds like you are very successful with it. It is a RP-4 or an RP-5?
mark simpson
8/14/2019
As far as size ,the bone determines that but better to have more bone around the implant than having more implant. In the old days we used to try to get the largest implant we could . That is not smart, error toward a little narrower implant and get all the length you comfortable can
