Different Prosthetic Approaches for Implant - Essay Example

? Edentulous Dentistry: DIFFERENT PROSTHETIC APPROACHES FOR IMPLANT-RETAINED OVERDENTURE (IRO) IN EDENTULOUS PATIENT of Department] [Name of Institution] [Contact] [Word Count] Mandible treatments for two implants among edentulous have become one of the effective ways to help edentulous patients. A number of approaches have been found by the usage of different systems such as ball-attachment, bar attachment etc. With the increased number of approaches, there have been certain situations which were observed as influential to the decision of dental surgeons. Customer satisfaction was also noted to be prominent in the researches which were conducted to understand the advantages and disadvantages of the approaches. Taking the case of an edentulous patient in consideration, this paper aims to evaluate different options of prosthetic approaches for the two implants mandible. The paper discusses the employment of free-standing attachment, ball attachment, bar attachment, self-aligning attachment, TG-O Ring attachment etc. A number of researches have been reviewed in order to understand the advantages and disadvantages of the options that will influence the decision-making process in order to provide a prosthetic option treatment to the edentulous patient. The two implant retained attachments are much effective than the conventional mandibular overdenture because the research (1) has proven that the oral health is noted to be better in case of conventional mandibular. This is in ratio of 33% as per the cost-effective analysis. The employment of any prosthetic option of an implant-retained overdenture (IRO) needs careful selection of the dental surgeon. It is because that the consequences and determinants of the options can play significant role in the well-being of an edentulous patient (2). It should be noted that the edentulous patients need the prosthetic option with careful research of such factors and determinants. The satisfaction level, speech factor and the cost of maintenance are some of the influential factors that would need avid consideration by the surgeons. There are a number of prosthetic options that can be applied for the purpose of implant-retained denture. These options include free-standing attachment, ball attachment, bar attachment, self-aligning attachment etc (3). These attachments of prosthetic options have been well-researched by the researchers in terms of cost, satisfaction and maintenance factor. The following explanation of the prosthetic options includes advantages and disadvantages as researched by the investigators. These aspects are more likely to affect the decision of dental surgeons while undertaking treatment for implant-retained overdenture (IRO). Free-standing attachment: Among different traditional and conventional prosthetic options for mandible transplant among edentulous patients, free-standing attachment is one of the most effective treatments. As per the report by Glidewell Laboratories (4), the need of selection of this prosthetic option is because it has many advantages over other options for edentulous patients in terms of speech, chewing etc. Most precisely, the researches conducted in order to find out the effectiveness of the option, free-standing attachment provides better enhancement of phonetics among patients (5). This option is used after the careful fabrication of principles which may include border adaption as the field of focus, occlusion etc (6). Free-standing attachment is conducted with the help of palate and vestibules. The steps of impression can be conducted within the level of implant. This can also be done when the healing abutments because this will allow the tray to be used in the impression technique. Ball Attachment Option: As per the research of numerous authors (7), implant-retained overdenture (IRO) is supposedly the best way to provide treatment to an edentulous patient. The usage f the ball attachment option is quiet common among the edentulous patients. This is mainly because of the advantages. A number of researches have been conducted over the years to understand the intensity of strain over implant undertaken by the ball attachment. It has also been noted in the past researches that the strain has an uncertain intensity over the implants even on the employment of options other than ball attachment. The mathematical research (7) also confirms that the usage of option ball attachment among edentulous patients is very significant and effective because strain can be divided equally on both the sides. The ball attachment option is very effective because the strain gets divided in a very firm and equal manner because the distance between both the implants becomes equal which makes the ball attachments clipped more smoothly (8). In some cases, the ball socket attachment has been noted to work effectively even after ten years. Numerous writers (9) have noted that in case comparison is undertaken, it can be said that the total number of years after the implant can prove better stability. In that case, in comparison of bar attachment, ball attachment or ball socket attachment can be regarded as more effective. It is mainly because of the system which allows better grip for the mandibular. Another factor that has been noted in this review is the satisfaction of the patients (10). It was because the patients observed mucosal condition which has been noted to scare patients the most. Another research (11) was conducted to understand the necessity of quick mandibular implants with the help of ball-attachment option. This needs a careful understanding of fixation. This means that the fixing of the first implant needs to be accurate and stable. This will help in achieving overall success with the two immediate implants (12). This notifies that the ball system needs to be divided with consideration of pressure, strain and space divided in exact manner. Another research which researched the factors such as patient’s satisfaction and maintenance of the ball attachment over the three years trials (13) stated that it was rather noted that the need of second or new dentures as per the maintenance purpose was much needed. The ball attachment at the baseline is considered to be less satisfactory and needs second implant as soon as possible. The authors (13) also notified that the need of the applying prosthetic option, be it ball attachment or the bar attachment, needs avid consultation of the subjects (patients) satisfaction level. According to the research (13), it can be said that the usage of ball attachment prosthetic option needs maintained and repairing in a greater volume. Another drawback as noted in the research (14), the ball attachment has a lowered rate of retention which is much needed in terms of maintenance. It should be noted that in comparison with other prosthetic options, the usage of ball spring attachment option can proved to be very expensive. More maintenance is also needed in this option. Self-aligning attachment: The statement as passed in the research concerning the quality-of-life (15), states that the options for two implants in mandible for edentulous patients is an open choice. This is a consensus by McGill which can be considered as an invitation to further research on the effects of the transplants with the aid of different prosthetic options. It should be noted that the consensus of the McGill has been supported and researched by different researches (16) which makes it evident that the dental surgeons must take two implants into account for the proper treatment. Conventional attachment treatments have not been able to make use of authentic attachment systems that created difficulties for the patients in terms of speech and chewing. It will not be incorrect to state that the self-aligning approach to the treatment of edentulous patients can be very useful in terms of quality of life. This can be compared with the ball attachment. The research (15) has proven that the quality of life is satisfying with the approach of self-aligning approach. It is mainly because the researchers have found out that the space distance is maintained in such a manner that there is neither expectation of halt in the meal intake nor the lack of healthy diet (17). Another advantage as per the research with a controlled and intervention group evaluation (14), self-aligning approach has a higher rate of retention in terms of system maintenance. Along with some of the advantages of the self-aligning prosthetic option is the disadvantage that cannot be overlooked. It has been noted that self-aligning prosthetic option is not applicable or satisfying in the subjects with a wider gingival height. It should be noted that the advantages of the self-aligning prosthetic approach is because it is compared with other approaches for the two implants in the mandible (18). Alone, the approach cannot be stood as entirely suitable approach to help edentulous patients. According to the research involving the comparison of traditional approaches to the two implant-retained dentures (14), there is still an avid need of research regarding self-aligning attachments among the edentulous patients. The research made use of a sample of controlled group as well as intervention group (19). TG-O Ring: It is considered as a classical approach to the two implant-retained dentures. It has been used over the years among edentulous patients (20). A number of researches made the instance of uncertainty when it was found out that the system of rubber ring as used in this prosthetic approach are lost when the loss of retention of the system was lost. As per the survey with controlled and intervention groups (14), it was noted that the TG-O Ring was the weakest prosthetic option in terms of maintenance. Bar Attachment: The mathematical research including different options of treatment for the edentulous patients (7), states that the bar attachment is also used in most of the patients. Fouad and Hegazy (21) noted that the bar attachment can be used in case there is a need to save the marginal alveolar bone. This means that the dental surgeons who are willing to make use of bar attachment in case of implant-retained overdenture. The bar attachment likewise other options have some of the disadvantages which might influence the decision of the dental surgeons for the two implants in the mandible (22). The common drawback of the attachment is that it is likely to affect the bone because the distance of the ridged and bars is unequal which makes it unsatisfying for the patient to have correct speech (23). In order to achieve maximum retention with the help of bar attachment, magnet clips are used to provide better grip and retention (24). The need of using magnet clips is because the bar attachment will serve better eating exercise to the patient. But in some cases (25), the subjects (patients) have expressed ball sockets and bar clips instead of magnet clips in terms of rate of retention. In other words, it can be said that the magnet systems are not preferred much in for satisfaction purpose of the subjects (patients). The critical viewpoint of dental surgeons with the magnetic attachments or clips has started for more than thirty years because it was noted that the application of magnetic clips and systems as attachment readily resulted in corroded material. This means that the magnetic material is more likely to cause deterioration in the mouth (26). The biggest reason behind the deterioration was the contact between the magnetic attachments and saliva. It is because of this reason that there is still uncomfortable air about the usage of the magnetic attachment. However, it has been noted that there were a number of techniques which were used to remove corrosion. There were numerous questions which were being asked earlier regarding the usage of magnetic attachment and the leakage of flux. As per the evaluation (27), it was also noted that the magnetic field was leaking flux as well. But notably, this flux was not dangerous and thus World Health Organization (WHO) also provided assurance regarding the non severity of the flux being leaked by the magnetic attachment. Despite the increasing number of techniques to make use of magnetic attachment, most of the dentist tries to avoid the approach of using magnetic clips to provide grip to the mandible (28). A critical account (27)has been noted in the case of bar attachment overdenture. It has been noted that that the surgeons who are using bar attachment in the mandibles of the edentulous patients have observed limited vertical movement. Also, the rotation has been notes as limited among the patients because of bar attachment among elderly patients. This may attachment also needs varied degree of retention for the stability. Only-Attachment Overdenture: Many cases (29) have been noted where the bar attachment can be noted as expensive. It is for this reason that more recently only attachment overdenture have become common among dentists as a preference. It is mainly because this method is capable to reduce an exceeding cost of the laboratories. The focus of the dentists in the current dentistry field is to provide cost effective methods for their well-being. It is for this reason that the only-attachment overdenture has become quiet common (30). However, most of the dentists claim that the bar attachment is the most successful yet effective prosthetic option. But considering the cost of the operations and the maintenance, it is suggested that the patients are given the options of only-attachment overdenture. This option is also noted as a conversion method from bar retained overdenture to attachment-retained overdenture (31). As per the case of a sixty years old woman (29), it was noted that the need of the only-attachment overdenture may work in the case of elderly edentulous patients. The usage of prosthetic options also depends upon the cases of vulnerability and the space of the mandible. Milled Bar Implant Support Overdenture: It has been proven by the case (32) of a 65 years old woman who has been suffering through the bone loss and high morbidity of mandibular teeth. It should be noted that the mandibular teeth were the remaining ones. It was decided by the dental surgeon that the height and width of the patient’s bones were decreased which made it quiet complicated for the direct implant thus the milled bar implant was used along with the support of a locator (33). It can be said that the case presents some of the most easy to understand points about the milled bar implant. It was noted that the design of the milled bar implant made was removable which was seemingly convenient for the patient to take off whenever needed (34). It can also be said that the milled bar implant can help the surgeons to fulfill the need of patients to have less pressure on the mucosa. The system of the miller bar and the support of locator can be considered as an option for edentulous mandible (35). Critical Appreciation to the Prosthetic Options: The usage of the prosthetic options for the edentulous patients can prove to be very effective one for better chewing. Some of the critics have claimed that with implant of different system, the patient s more likely to get affected in terms of chewing and eating functions. But as per the clinical controlled trial (36), it was noted that the patients with increased implants and maintenance with two implants were able to have better oral health. The chewing problems were relatively lesser in the patients with the overdenture implants. It should be noted that the only critical aspect of the overdenture implant is the cost and the stability that is needed to be achieved thoroughly. The ball sockets and bar attachments have proven to work effectively among the patients (37). However, newer and more cost effective techniques have come to light. It is for this reason that the uncertainty of the stability of the mandible fixing has decreased by large. It has become compulsory for the edentulous patients to undergo two implants for achieving the cost effective ways to function like normal people and have better speech with increased clarity of phonetics (38). Also, with the increased number of researches that have been undertaken, it has become easier for the dentist to come up with effective systems. Other aspects that can be noted influential aspects of the prosthetic options would be age, sex and self-esteem (31). As per the statistical study, it was noted that the self-esteem, sex and age play a major role in satisfying the patients regarding their prosthetic options. The newer prosthetic options have played a major role in terms of better oral health (39). Patients who have used newer systems of prosthesis have showed higher rate of satisfaction with the implant-retained overdenture. It should also be noted that patients of older age had shown limited satisfaction with the implants because the moods and other psychological situations have influential degree (40). Conclusion: Through the above analysis of the different prosthetic approaches for mandible among edentulous patients, it can be said that there are various effective mechanisms available for the dentistry field for providing patients with better and effective treatments. However, there are some of the weaknesses as noted in the research. A great deal of researchers has given special consideration to their chosen systems for researching the weaknesses and benefits of the approach. As per my evaluation, I consider the ball socket attachment as the most effective approach among different prosthetic approaches available. The reason behind my selection is the rate of retention and the effective stability. Also, the equal division of the strain is a very interesting effect of the ball attachment. It should be noted that the mechanism for treatment of edentulous patients varies person to person. The variation is due to the influential factors such as cost effectiveness of the implant, sex of the patient, self-esteem, age, height and width of the mandible, bones condition, retention, maintenance, pressure on mandible etc. The variations must be put under consideration by the dental surgeons before making use of the implant approach. With a wide range of attachments and implant strategies available to the dentist, it has become easier for the dental surgeons to deal with any critical case of edentulous patient. The mandible size and the cost effectiveness along with the rate of retention can be considered as an interesting subject of further research for most of the researchers. It has been claimed by most of the dentists that the avid need of cost effective models will remain present in dentistry. In a nutshell it can be said that the prosthetic approaches are needed to be utilized after careful understanding of the case. References List x 1. Heydecke G, Penrod J, Takanashi P, Lund J, Feine J, Thomson J. Cost-effectiveness of Mandibular Two-implant Overdentures and Conventional Dentures in the Edentulous Elderly. Journal of Dental Research. 2005 September; 84(9). 2. Arthur R. Vernino JGEH. The Periodontic Syllabus California: Lippincott Williams & Wilkins; 2007. 3. Halim A. 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