Purpose: This bibliographical review aims to determine the present situation of the implant-supported milled bar overdenture as a therapeutic option in implantology, as well as to set and compare the techniques and materials currently used for making them. Materials and methods: By searching the main electronic bibliographical data in indexed Medline articles, we obtained a total number of 20 articles that fulfilled the requirements of this bibliographical review. Results: The implant-supported milled bar overdenture offers excellent long-term successful results, although complication rates are higher in emergency cases of patients initially planned for a fixed prosthe sis. Krenmair and collaborators found cumulative survival rates of implants on milled bars after 5 years, of 99% in mandible cases, and of 97.8% in maxilla cases. No detailed protocols specifying the necessary number of implants or their characteristics have been found, though they are never made with less than 4 implants in mandible or 4-6 in the maxilla. Milled bars are screwed, generally cast in a precious metal alloy, with a metal or acrylic suprastructure and include attachments that regulate the tightness. The suprastructure adjusts precisely and rigidly to the milled bar, and presents similar biomechanical movements to those of fixed prostheses. The overdenture is removable and its prophylaxis is simple. Conclusions: The implant supported milled bar overdenture is a very interesting option in the treatment of patients with moderate to severe reabsorbed maxilla problems. It offers both the advantages of removable prostheses as well as the stability and retention of a fixed prosthesis.

/pdf/the-implant-supported-milled-bar-overdenture-a-literature-v8ggp3hmo6.pdf

The implant-supported milled bar overdenture: a literature review.

Placement of dental implants to enhance complete denture stability and retention is a well-accepted treatment modality. Most implant overdenture abutments and related components require parallelism within approximately 10 degrees to function properly. Non-parallel implant placement as a result of flared maxillary bone may preclude the use of conventional implant overdenture abutments, requiring the use of costly custom abutments or bar prostheses. A case report is presented that illustrates the use of a new, 2-piece, angled overdenture abutment to accommodate non-parallel implant placement.

A maxillary implant overdenture that utilizes angle-correcting abutments

Purpose : This study evaluated the bending strengths of five types of framework structures for implant-stabilized overdentures.Materials and Methods : Five types of framework structures for implant-stabilized removable prostheses were cast using a Co-Cr alloy : conventional housing (Type A), housing with short skeleton (Type B), long skeleton only (Type C), housing with long skeleton (Type D), and Type D plus a metal backing connected by columns (Type E ; hereinafter referred to as the “double structure”). All castings were embedded in a heat-cured denture base resin. As controls, the same size resin blocks without frameworks were prepared. A bending test was used to test each specimen as it acted as a fulcrum on the implant. Breaking load, maximum stiffness, and strain were measured.Results : The breaking load and maximum stiffness of the double structure were significantly greater (p<0.05), i.e., 1.5-4.5 times and 2-6 times greater, respectively, than for the conventional frameworks.Conclusion : When the double structure framework was used for implant-stabilized prostheses, the bending strengths were greater than for the conventional housing design.

Bending Strengths of Metal Framework Structures for Implant-stabilized Overdentures

To replace the missing anterior teeth has always been a challenge for the prosthodontist. Replacing missing teeth along with the defect is a technique sensitive process which requires proper treatment planning. This article presents a case report of missing upper anterior with a sebeart’s class 3 defect which was replaced by Andrew’s bridge. It is a combination of fixed partial denture and removable partial denture which is described in the following article.

Management of anterior ridge defect with fixed-removable partial denture – Andrew’s bridge

/pdf/andrew-s-bridge-achieving-esthetics-with-a-prosthetic-2eth50v9q0.pdf

Andrew's Bridge: Achieving Esthetics with a Prosthetic Alternative-Managing Severe Anterior Ridge Defects in Operated Case of Cleft Lip and Palate

The selection of appropriate implant treatment modalities for the edentulous maxillary arch is complex. Although many patients are candidates for an implant-supported removable prosthesis, two major considerations affecting choice of treatment type are the amount of residual alveolar bone and soft tissue, and cost. A technique is described that employs a cast milled primary bar and a secondary casting constructed using a vacuum-formed 0.040-in plastic matrix. The secondary casting is intimately adapted to the primary bar and incorporates the retentive elements within it. The resulting prosthesis is less expensive than comparable designs, and retentive elements are easily replaceable. The technique is adaptable to most implant systems. The matrix-assisted secondary casting technique provides a design that is esthetic and hygienic. The prosthesis may also be easier to insert and remove than implant-supported removable prostheses that use plunger- or latch-type retention.

Restoring the Edentulous Maxilla Using an Implant‐Supported, Matrix‐Assisted Secondary Casting

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Restoring the Edentulous Maxilla Using an Implant‐Supported, Matrix‐Assisted Secondary Casting