Palmeri Publishing Inc. will be closed from December 21, 2018 to January 02, 2019. We won't be able to ship or process any order as of December 21, 2018 and we will resume processing orders and shipments as of January 02, 2019. Sorry for any inconvenience.
Bredent’s VKS – OC universal attachment has been on the market for close to 20 years. Many manufacturers have tried to duplicate it to no avail, because the “duro-plast” retention cap is made with thermoplastic which
provides a very resilient snap when inserted.
Because of this innovation this radicular or ball attachment is still the most popular amongst dental health professionals and vindicates the success of this simple and reliable root cap “snap” attachment.
The technique of cross-pinning using a transverse screw to fasten a prosthesis to a custom prefabricated abutment allows retrievability in all situations including misalignment. The most important reason to consider this technique is the complex pathologies and interactions between the peri-implantitis and chronic periodontal diseases. Understanding the clinical complications most certainly challenges the judgment in permanently cementing an implant supported restoration and the frequency of technical and clinical difficulties that encompass dental implants can be expected.
In the ever-changing world of dental technology, the one segment that seems to be a mainstay in growth consistency is removables. Whether it is full dentures, partials, implant overdentures, or attachment overdentures, the potential for continued laboratory business growth in these areas is substantial. While growth opportunity is a major factor, the success factor for removable cases included in the areas mentioned includes many variables.
Over the last thirty years there has been a gradual evolution according to McNamara, regarding the way in which functional jaw orthopedics is used in a contemporary orthodontic practice, especially concerning appliance selection, the time of intervention and the need for “pre-orthopedic” orthodontic treatment.8 Therefore functional appliance therapy has become an increasingly popular method in correcting Class II malocclusion with mandibular skeletal retrusion, with appliances such as the Bionater, the FR-2 of Fränkel, Sander II and the Twin Block appliance. All of these functional jaw orthopedic appliances have one aspect in common - they include a forward mandibular posturing as a part of the treatment effect. Presumably Fränkel mentioned that this alteration in the postural activitiy of the muscles of the craniofacial complex ultimately leads to changes in both skeletal and dental relationships.
It is the aim of all these therapeutic regimes to correct existing problems in Class II and Class III malocclusions in the hard and soft tissues and to attain dental, skeletal and neuromuscular relationships that remain stable after the functional appliances have been removed.
The treatment planning of attachments is an area that causes much confusion among dentists today. With the fast pace of the dental school curriculum, this topic simply gets glanced over at best. It is a fortunate occurrence for a dental student to do a case that includes attachments. Many of the lectures I give to dentist’s bears this out. Dentists simply do not know enough about how attachments work, let alone how to treatment plan then into their case planning to insure success. Attachments have been used in dentistry for over one hundred years and have provided dentists with a means for achieving successful restorative alternatives, superior esthetics and retention, and overwhelming patient satisfaction.
Attachments are simply rigid or resilient connectors that redirect the forces of occlusion. By simply redirecting these forces, we can decide on whether hard tissue (teeth) or soft tissue (ridges) should bear more or less of the occlusal load.
In order to determine this, we need all the necessary diagnostic tools available such as a full mouth series of x-rays, mounted study models, periodontal probing depths and mobility patterns, intra oral photographs, and a clear idea as to what teeth we will use as abutments after phase one periodontal therapy is initiated and completed. We also need to have good reference manuals on attachments to familiarize us with the various types that are available. We then need to understand that some attachments are more rigid than others. Some require more vertical height while others provide more or less stability. They all provide various levels of retention. Ideal places to get information are from the attachments companies themselves. I suggest purchasing the company’s reference manuals and obtain their product brochures. Sterngold, Zest Anchors, Attachments International, Rhine 83, Preat, EDS, and Bredent are a few companies that you can find on the internet. They will provide you with a wealth of information. I have listed the contact information for them at the end of this article.
When it comes to selecting the best attachment for a given case, a few things need to be taken into consideration. First and foremost is the overall design/size of an attachment and how well it can combine practical, long lasting function with maximum aesthetics. Among other equally important characteristics are levels of retention, cost effectiveness, ease of use by the lab and retrievability/serviceability by the dentist and or laboratory when the attachment wears out. Research has shown that no matter which attachment system is used, eventually all of them reach the end of their line due to the myriad of factors that they are exposed to on daily basis.
Bredent introduces the newest components to the popular VKS Exchangeable Stud line of attachments. The VKS-SG/OC Exchangeable Stud with a titanium bond-in threaded sleeve offers the dental technician the possibility of processing crown and bridge work independent of the attachment. In essence, crowns are waxed, cast, finished and porcelainized as usual; then, the titanium stud-head screw is screwed into the thread sleeve. The titanium threaded sleeve is bonded into a pre-established hole (created by the auxiliary modeling element) in the crown using high quality anaerobic cement.
The ball screw is now checked for proper functioning (screws and unscrews) and then the case can be further processed. This eliminates all variables inherent to the casting process and is more cost effective than the platinum-iridium components. All parts are available in 2.2mm and 1.7mm sizes, and below is a step by step picture sequence of their use.
The VKS-SG/OC Bond-in Exchangeable Stud system provides a variety of benefits tailored to increase the lifespan of attachment retained removable prosthetics. Featuring a titanium ball screw which is less susceptible to wear compared to those cast out of alloys commonly used in the dental laboratory. However, in the rare cases where a titanium ball screw should wear out and cause loss of retention; then the dentist can easily unscrew the worn ball and replace it with a new one. In the worst case scenario… if damage to the threaded sleeve should occur, the dentist can carefully grind it out and bond in a new threaded sleeve to restore the attachment assembly. In conclusion, the VKS-SG/OC Bond-in Exchangeable Stud creates a completely retrievable and serviceable, precision removable prosthesis. Technicians will avoid unnecessary aggravations using a high quality, simple and cost-effective attachment system. Dentists can confidently deliver to their patients an attachment case with superior, long term maintenance capabilities that will save them both time and money.
Whether they are called “Ball Abutment”, “Ball Attachment”, “Dal-Ro”, “Dalla Bona Spherical”, “Ball”, “Bona” or “Dalbo”; if you are referring to an attachment with a spherical part of a diameter of 2.25 millimetres, there is a strong possibility that you are in the presence of a product whose origin is the result of an invention by Hans Dalla Bona!
In the same lineage as other renowned fellow countrymen such as Prof. Gerber and Prof. Dolder, Dr. Hans Dalla Bona gave his name to a system that has become essential in the biomechanical therapy of removable dentures.
The principle of the ball anchor made of precious metal alloys is among the first achievements in the field of anchors. It is one of the pioneer attachments when it comes to dental retainers. Today, that is to say half a century later, it is one of the key solutions for the retention of partial or hybrid dentures. The benefit of these 50 years of clinical traditional dentistry and its application on natural teeth constitutes an important element in implant prosthetics (Figure 1).
Portrait of the inventor, Hans Dalla Bona (1926-2002)
His first professional choice was dental technique. Following his apprenticeship in Lucerne, Switzerland he acquired his first years of practical experience in Frauenfeld and Zurich. Because patient contact was a priority for him, he attended complementary training in dentistry in Vienna.
Hans Dalla Bona opened his cabinet in Biel-Bienne in 1955. Combining his knowledge in dental technique and his clinical experience, he started developing a series of ideas related to prosthesis retaining elements such as the Dalbo Vertical Stress-Breaker, the Dalbo Ball Anchor and the Dalbo Cylindrical Anchor, that were eventually entrusted to Cendres & Métaux SA in Biel-Bienne for their development, manufacturing and distribution.
The rapid success of the retaining elements is a testimony to the practical nature of his inventions and a demonstration of his visionary spirit.