Problems of attachment retention in daily clinical practice

Abstract

Introduction: Attachments are precise interlocking devices. They consist of one component which is fixed to the abutment, and the other is integrated into a removable part of the complex denture. The main roles of attachment are in retention and stabilization of denture and to guide the denture into its proper position. Adequate retention of attachments is one of the main demonstrations of successfully made prosthetic device. The aim of this paper is to explain the mechanisms which reduce the retention force of removable partial dentures with attachments. Material and methods: The search strategy applied was a combination of Medical Subject Headings (MeSH) terms and free text words, including the following keywords 'wear', 'retention' and 'attachment'. The selected studies were analyzed with regard to wear parameters, type of attachment and used material. A total of fourteen studies were included. The selected articles were published in the past ten years. Results: These articles have provided evidence that the majority of attachment systems demonstrate a reduction in their retentive force. Wear has been unquestionably implicated as the etiologic factor for the loss of retention. Findings from the literature have also implicated several factors that influence the retentive force of the attachment system and its wear features and accelerate the retention loss. Conclusion: Proper indication, suitable materials, accuracy in casting and other laboratory procedures and motivation of patients make attachment retention reduction as little as possible.

Atečmeni su precizni vezni elementi koji povezuju fiksni i mobilni deo parcijalne skeletirane proteze u jedinstvenu celinu i imaju ulogu u retenciji, stabilizaciji i vođenju proteze u osnovni položaj. Adekvatna retencija atečmena u izradi parcijalne skeletirane proteze jedna je od mera uspešnosti protetskog rada. Cilj rada je bio da objasni koji mehanizmi smanjuju retenciju parcijalne proteze s atečmenima. Dosadašnja istraživanja pokazuju da su gubitku retencije podložni svi najčešće korišćeni sistemi atečmena. Kako bi taj gubitak bio što manji, neophodna je pravilna indikacija, odabir najpogodnijeg materijala za njihovu izradu, preciznost u izradi laboratorijskih faza i motivacija pacijenta da pravilno rukuje protezom.