Physical and metallurgical considerations of failures of soldered bars in bar attachment systems for implant overdentures: A review of the literature

The purpose of this literature review was to identify the etiological factors of failure of soldered bars in bar attachment systems for removable implant overdentures. A search of MEDLINE using the key words "bar attachment systems" was performed of English language peer-reviewed journals published between 1975 and 2005. Clinical studies of implant overdentures with prosthodontic maintenance complications of bar attachment systems were identified to establish the perceived etiology of failure. A further search of MEDLINE using the key words "solder joint" was also performed of the fixed prosthodontic literature to identify specific factors affecting the strength, fatigue resistance, and quality of gold solder joints used for bar attachment systems. The first search on bar attachment systems produced evidence of low failure rates of interabutment bars, but higher failure rates of bars where distal cantilever extensions were used. There were no explanations or descriptions of the nature of those failures in the clinical studies reviewed. The second search on fixed prosthodontic literature identified multiple factors that could potentially relate to the failed solder joints with bar attachments. Two potential sites of failure in bar attachments with distal cantilevers were identified, and a simple estimate of the tensile stresses at the solder joints was performed. The values found are comparable to the fatigue failure stresses reported in the searched literature.