Attachments a lost art?

  Over the past 20 years with the growth in popularity of Implants, Precision Attachments have become less popular. Although attachments are still  used in conjunction with implants, mainly for overdentures, conventional combination cases have decreased significantly.
There are still many situations where Precision Attachments / combination prosthesis should be the restoration of choice but due to ignorance or a simple lack understanding by Technicians and Dentists alike the decline is growing.
  We at S.B.O have many years experience with such restorations, whether its a simple fixed- free bridge or a more complex combination case with bridgework using extra coronial attachments and dentures.
  In the stages below you will find a step by step protocol outlining the clinical and laboratory stages that are required for combination cases to obtain predictable results.

Combination Cases 

Technical stages / Clinical Stages
  •  Discuss patients needs and objectives.
  •  Full upper and lower impressions.
  •  Construct occlusal rim and special tray.
  •  Take bite and definitive impressions.
  •  Choose teeth and set up. Assess for attachments.
  •  Try-in with usual checks.
  •  Construct crown & Bridgework .Align attachments. Adjust special tray to accommodate bridgework.
  •  Try-in bridgework, if o.k. take pick up impression (rubber) with adjusted special tray.Ensure full sulcas depth suitable  for denture work.
  •  Cast pattern resin model. Fabricate chrome(if required). Incorporate attachments. Set denture teeth.
  •  Try-in. Check bite, aesthetics, fit, check that attachments male and female engage.
  •  Process denture and finish
  •  Fit case