Stress analysis of mandibular implant-retained overdenture with independent attachment system: effect of restoration space and attachment height

Self-Instruction Exercise No. 363
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Exercise No. 363
Subject Code: 674
Fixed Removable Hybrid Prosthesis

The 15 questions for this exercise are based on the article, Stress analysis of mandibular implant-retained overdenture with independent attachment system: effect of restoration space and attachment height, on pages 61-67. This exercise was developed by Robert A. Busto, DMD, MBA, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing the exercise will enable you to understand the:

  • theoretical force distribution on implants and surrounding bone;
  • differences between ball and Locator attachments; and
  • unfavorable biomechanical scenarios for implant overdenture treatment.

Answers for this exercise must be received by December 31, 2015.
  1. All of the following are factors for selecting the optimal mandibular overdenture attachment except one. Which is the exception?

    A. required retention
    B. patient finances
    C. patient compliance
    D. jaw morphology

  2. The ball attachment places_______ stress on implants and produces ______ bending movement than the bar-clip attachment.

    A. less; less
    B. more; less
    C. less; more
    D. more; more

  3. What is the minimum vertical restorative space (mm) required for using Locator attachments on an implant-supported overdenture?

    A. 12.5
    B. 10.5
    C. 8.5
    D. 6.5

  4. The crown height space is the distance from the ______ to the ______ in implant-supported prostheses.

    A. mandibular crest of alveolar bone; maxillary crest of alveolar bone
    B. most superior point of the implant attachment; plane of occlusion
    C. crest of the alveolar bone; most superior point of the implant attachment
    D. crest of the alveolar bone; plane of occlusion

  5. Increasing the crown height space by 1 mm results in a _____% increase in the cervical load on a fixed implant prosthesis.

    A. 10
    B. 15
    C. 20
    D. 25

  6. If the vertical restorative space is 12 mm, which implant-supported overdenture attachment(s) is/are acceptable?

    A. Locators only
    B. Locators and balls
    C. Locators and bar clips
    D. Locators, balls, and bar clips

  7. How were the implants in this study placed in relation to the occlusal plane?

    A. Angled 30 degrees
    B. Angled 45 degrees
    C. Angled 75 degrees
    D. Angled 90 degrees

  8. The implants in this study were placed with an interimplant distance of ___ mm.

    A. 14
    B. 16
    C. 18
    D. 20

  9. Which combination of implant collar height and occlusal plane height (mm) resulted in maximum stress?

    A. 1; 9
    B. 1; 15
    C. 2; 9
    D. 2; 15

  10. Cakarer et al reported that the Locator attachments receive greater stress than ball attachments. Celik & Uludag reported that Locator attachments have a higher implant failure rate.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  11. The Locator implant is ______ retentive and  ______ resilient than the ball attachment.

    A. equally; less
    B. more; equally
    C. more; less
    D. less; more

  12. The level of stress correlated to bone resorption has not been clearly defined in the literature. Finite element analysis studies can produce clinical conclusions to determine how much stress an implant can take before bone resorption.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  13. In a restricted vertical space, this study recommends using a _____ attachment system with minimum collars to address stress concerns.

    A. Locator
    B. ball
    C. Dalbo
    D. bar clip

  14. Increasing the crown height space in removable implant overdentures decreases the stress generated in the bone. Increasing the crown height space in fixed implant prostheses increases the stress in the bone.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  15. In unsplinted implants, decreasing the distance from the crest of the bone to the __________ will decrease the stresses generated in the bone.

    A. abutment
    B. plane of occlusion
    C. apex of the implant
    D. facial midline

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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