Clinical Outcome of Double Crown-Retained Mandibular Removable Dentures Supported by a Combination of Residual Teeth and Strategic Implants.

Abstract

There is a lack of data regarding the clinical outcome of removable partial dentures (RPDs) supported by a combination of residual natural teeth and implants placed in strategic positions. The aim of the present case series was to conduct a retrospective investigation of the clinical outcome of mandibular tooth-implant-retained partial dentures (TIRPD) rigidly retained via telescopic double crowns. Between 1999 and 2010, 18 patients with reduced residual dentition (1 to 3 natural abutment teeth) and in need of an RPD received 1 to 3 implants in strategic positions for support of the removable prostheses. All TIRPDs were rigidly retained by telescopic crowns according to the Marburg Double Crown (MDC) technique; all prostheses were placed in a private practice. Tooth/implant survival and success rates, prosthetic maintenance requirements, and peri-implant parameters were analyzed retrospectively using patient records and clinical examinations during the final recall appointments. Only patients attending at least annual supportive post-implant hygiene therapy visits (SIT) were included. After a mean functional period of 5.84 ± 3 years (range: 3.01-12.21), 14 patients with 14 dentures supported by 24 implants and 27 teeth (mean number of abutments: 3.6) were available for assessment. Four teeth (survival rate: 85.19%) and no implants (survival rate: 100%) were lost. Peri-implantitis was observed around one implant (4.17%). All 14 dentures were functional (survival rate: 100%) and required only limited maintenance (i.e., screw loosening, acrylic resin fracture repairs, relining) amounting to 0.086 treatments per patient per year (T/P/Y). Within the limitations of this case series, it can be concluded that TIRPDs retained via MDCs might represent a viable treatment option in mandibles with few remaining abutment teeth. Further long-term clinical evaluations with a greater sample size are needed for a more detailed evaluation of this treatment concept.