Table 72 Check List on Insertion of Overdentures

1 Check degree of clasp activation prior to insertion.

2 Ensure clasps or magnets accurately locate on the attachments on insertion.

3 Assess "fit" of the prosthesis over the denture bearing area, in particular denture extension and presence of pressure spots. (Adjust accordingly.)

4 Ensure that occlusion is well balanced and that the occlusal table is at the correct occlusal vertical dimension. Measure freeway space.

5 Seek the patient's assessment of aesthetics (Fig 7-15}.

6 Check phonetics.

Fig 7-16 Ball clips are cross cut and can be reactivated or deactivated with special instruments, that crimp or splay the flanges.

Fig 7-17 Magnets have a definitive retentive power, that can not be altered If a patient complains of loss of magnetism, the offending magnets should be shelled out and new ones cured into place.

Fig 7-18 The bar clips can be reactivated or deactivated by simply crimping or splaying the flanges with a flat plastic or similar instrument.

Fig 7-19 When a patient reports a total improvement in quality of life, it is hard to imagine thai there is such a thing as an adequate conventional denture ed and adjusted in the usual manner. The one month recall should concentrate on the attachment system (Figs 7-16, 7-17 and 7-18) ensuring that the level of activation has not altered, and that there is no differential activation between free standing implants. This might precipitate adverse loading of the more highly activated implant. Observe closely as the patient removes the prosthesis to ensure that the patient is removing the denture with even pressure.

An assessment of the implant retained components is also essential to ensure that bridge screws, baits and magnet keepers show no signs of loosening and to record plaque and bleeding associated with the peri-implant tissues. Appropriate prophylaxis and oral hygiene instruction should be instigated where indicated. Most patients will have been long standing sufferers of ill-fitting, uncomfortable and embarrassing dentures. It is not unusual that, having experienced the joys of eating, speaking and laughing without concern, they express the strong influence the overdentures have had on their quality of life (Fig 7 -1 9). This has been well documented with other implant retained prostheses.28'30 It is the sense of this dramatic life improvement that begs the question: Is a conventional denture ever adequate?

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