EZ-Change Overdenture Attachment

Allan S. Deutsch, D.M.D., F.A.C.D.
The New EZ-Change Overdenture Attachment:
Maximum Retention with Minimum Stress

Allan Deutsch

nlike most articles that appear in Endo-Mail, this article does not have anything to do with endodontics directly. However, when we developed the Flexi-Post, we also made an overdenture attachment to go along with it. That overdenture attachment is affixed to an endodontically treated tooth. Voila! That’s the connection between this article and endodontics.
This simple ball-and-nylon-socket attachment has been successfully used around the world for the past fifteen years. Many articles about the attachment and the technique have been published in international dental journals. The EZ-Change Overdenture Attachment has been found to have the highest retention among all overdenture attachments being sold. Yet installing it is a very simple and direct technique to do. So why am I talking about it here? Recently, we have improved it and now offer it as an implant attachment.

Advantages of the EZ-Change Overdenture Attachment
Unfortunately, not every root canal is a success, and many patients come to us with only a few teeth left in the arch. In addition, there are implant cases that start out with many implants placed and end up with only a few that have integrated.
Also, many patients would like the convenience and esthetics of fixed restorations, but can only afford removable restorations for their implants. The restoration of implants with fixed cases is a time-consuming procedure that is difficult for the dentist to master. The operatory and laboratory aspects of these cases are quite complicated, and the majority of dentists in the United States don’t perform restorations of implant cases yet.
The placement of the EZ-Change Implant Overdenture Abutment Attachment (from Essential Dental Systems) truly is “easy.” It’s a simple technique even if you have not restored implant cases before. It gives your patient a restoration that looks great and works even better.

FIGURE 1: A healing screw allows the gingiva to heal in the desired shape.

The Placement Technique
O.K., so what do you need to perform this technique? Well, you don’t need teeth. If your patient has an existing denture, even better. If not, hold on to the bridgework that the patient currently has as a temporary restoration until the implants have integrated and are ready to be loaded (usually approximately six to nine months). Talk to your oral surgeon or periodontist to determine which implant type they are most comfortable in placing. Generally, they will be placing either a; Branemark , 3i, SteriOss, Calcitek, IMZ, or Paragon implant.
    We have overdenture attachments that are compatible with these implants.
    Once the implant has integrated, whoever placed it will now surgically uncover it. A healing screw can now be placed to allow the gingiva around the implant to heal in the desired shape. The shape that we want is just a parallel cylinder from the top of the implant to the top of the gingiva (see Figure 1). Once the gingiva has healed, you will need to know the height (thickness) of this gingiva to determine the gingival cuff height of the implant overdenture attachment (labeled H in Figure 2). When you know the implant type (Branemark, 3i, Paragon etc.), and the gingival cuff height of the attachment , you will be able to pick out the exact implant OVD attachment from the catalog for your case.
    Before placing the attachment, the denture is constructed. You can let the patient wear it for several weeks until all the soft tissue is compressed and any wear spots are relieved. You can now remove the healing screw from the implant and, using the appropriate wrench, screw in the E-Z Implant Overdenture Attachment into the implant (Figures 3 and 4). Then the rubber band is placed over the ball attachment to block out the height of contour of the ball and prevent the acrylic from locking under the ball. Once the rubber band is in place the EZ-Change nylon cap and keeper are placed onto the ball (Figures 5 and 6).

FIGURE 2: H indicates the gingival cuff height.

FIGURE 3: Removing the healing screw from the implant.

FIGURE 4: Screwing the E-Z Implant Overdenture Attachment into the implant.

FIGURE 5: The EZ-Change nylon cap and keeper.

FIGURE 6: The cap and keeper in place on the ball.

    Some marking paste or Occlude marking spray is placed on top of the keeper. The denture is seated and then removed. The marking paste indicates the area in the denture that must be relieved to make room for the female nylon cap and keeper part of the attachment. The denture is then relieved. The denture is placed over the attachments and checked to make sure that it seats passively in place (Figure 7). Pink cold-cure acrylic is mixed and poured into the relieved areas in the denture.
    The denture is seated while the cold-cure acrylic sets. After eight to ten minutes, the denture is removed. The metal keeper that holds the nylon cap is now incorporated into the denture permanently. The excess flash is removed, and the denture smoothed and polished. You can now remove the rubber band that is still under the ball and dismiss the patient.
    The nylon caps last about eighteen months to two years before they wear out and lose their retention. At that time, a special wrench is used to unscrew the nylon cap from the keeper and a new nylon cap can be threaded in its place. This takes about thirty seconds to do and is a really simple and easy technique to start you off with implants. The attachments have a fifteen-year clinical history of happy patients and, consequently, happy dentists.

11/02/1999

FIGURE 7: The denture is placed over the attachments and checked to make sure that it seats passively in place.

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