Division of Oral and Maxillofacial Implantology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
J Prosthodont Res. 2013 Apr;57(2):140-4. doi: 10.1016/j.jpor.2012.11.002. Epub 2013 Mar 13.
The patient was a 62-year-old partially edentulous woman with missing bilateral premolars and molars in the mandibular jaw. The patient selected implant supported-removable partial denture rehabilitation. Implants were placed bilaterally at the distal extension of the denture base in order to minimize denture displacement. The stress-breaking ball (SBB) attachment consists of a flat-top ball head male and O-ring rubber female. The female was covered by a silicone housing with three amounts of space to allow three kinds of settlement (0.3 mm, 0.5 mm, and 0.7 mm); they were selected by thickness or pressure displacement of the mucosa and occlusal force. After the healing period, the SBB attachments (0.3 mm) were placed on the implants, and the implant-supported removable partial denture was then conventionally fabricated. The delivered denture had sufficient retention and appropriate stress breaking.
The advantages of SBB attachments over conventional attachments are as follows: (1) they prevent the implant from excessive occlusal force, (2) they are ready-made, (3) they show appropriate retention, and (4) they can be easily mounted on the denture base. The disadvantages of these attachments are as follows: (1) they are approximately 1mm higher than conventional ball attachments and (2) the retentive force cannot be adjusted.
The use of a stress-breaking attachment for implant overdenture rehabilitation should be considered so that the occlusal force is equally distributed between the alveolar ridge and the implants.
患者为 62 岁部分无牙颌女性,下颌双侧缺失前磨牙和磨牙。患者选择采用种植体支持可摘局部义齿修复。为了尽量减少义齿移位,在义齿基托的远端延伸部位双侧植入种植体。应力中断球(SBB)附着体由平头球头阳性和 O 型环橡胶阴性组成。阴性部分被硅树脂外壳覆盖,有三个空间量可供选择,以允许三种沉降(0.3mm、0.5mm 和 0.7mm);它们通过黏膜的厚度或压力位移和咬合力来选择。愈合期后,将 SBB 附着体(0.3mm)放置在种植体上,然后常规制作种植体支持的可摘局部义齿。交付的义齿具有足够的固位力和适当的应力中断。
SBB 附着体相对于传统附着体的优势如下:(1)它们防止种植体受到过大的咬合力量,(2)它们是成品,(3)它们显示出适当的固位力,(4)它们可以很容易地安装在义齿基托上。这些附着体的缺点如下:(1)它们比传统的球附着体高约 1mm,(2)固位力无法调整。
在进行种植体覆盖义齿修复时,应考虑使用应力中断附着体,以使咬合力均匀分布在牙槽嵴和种植体之间。