Removable Partial Overdenture Research Articles

Stress analysis of mandibular Kennedy class I partial overdenture submitted to different implant length and clasp designs - An in vitro study.

To analyze the distribution of stresses for mandibular Kennedy class I removable partial overdentures submitted to different implant lengths and clasp designs. Twenty-seven heat-cured acrylic resin casts with a uniform soft acrylic layer were constructed from models representing the mandibular Kennedy class I removable partial denture with the first premolars terminal abutment on both sides. The casts were grouped into a control group, group I, and group II with three casts of each for designing a different clasp on the last abutment with Rest, Proximal plate, Aker circumferential (RPA), Rest, Proximal plate, I-bar (RPI), and wrought wire (WW). All casts were submitted to vertical load for stress analysis after preparing channels at the buccal/distal surface of abutments, the crest of the ridge, and the buccal/lingual of the implant for placement of uniaxial strain gauges that can convert the electro-signals to micro-strain by using the software. Kolmogorov-Smirnov normality test, independent t-test, and one-way anlysis of Variance (ANOVA) test followed by Tukey`s Post Hoc for multiple comparisons test were used for statistical analysis. The control group results revealed more significant stresses on the ridge with RPA and RPI clasps but on the abutment with WW clasp as P < 0.05. In group I, the ridge was significantly stressed more than the implant followed by the abutment when the RPA clasp was used while there was insignificance on the implant with RPA and RPI as p > 0.05. In group II, the stresses were more on the abutment with RPA, RPI, and WW clasps followed by lower on the implant and lowest on the ridge. Proper implant and clasp type selection are critical for stress distribution on the ridge, abutment, and implant when using removable partial overdenture. The stresses on longer implants are tolerated and more widely distributed than shorter ones.

Tooth-Supported Overdenture – Preventive Prosthodontics to Redeem Ridge Resorption

Abstract This case series elaborates on tooth-supported overdenture for prosthetic rehabilitation as a treatment modality in partially edentulous patients. Loss of teeth causes continuous ridge resorption and poor denture foundation affecting the success of prosthesis. Retained natural teeth act as abutments for prosthetic rehabilitation of partial edentulous arches. Tooth-supported overdenture is the mainstay of preventive prosthodontics which preserves natural teeth and/or roots. The cases describe the use of tooth-supported complete overdenture and removable partial overdenture with metal denture base to rehabilitate partially edentulous arches. The natural teeth maintain proprioception and provide additional support, stability, retention, and psychological benefit to the patient than the conventional complete denture with completely edentulous ridges.

Closed sinus lift and fixed prostheses versus implant-assisted overdentures in management of atrophied distal extension maxillary ridges: A one-year randomized clinical trial

Rehabilitation of elderly or medically compromised patients with an atrophied unilateral posterior maxillary ridge by an implant-supported prosthesis may be complicated by maxillary sinus pneumatization with insufficient bone for implant placement. This short-term clinical trial assessed clinical results of closed sinus lift and fixed prosthesis versus implant-assisted overdentures in the management of participants with atrophied distal extension maxillary ridges. Forty participants with unilateral atrophying distal extension maxillary ridges were randomly assigned into 2 groups. The CSL group (n=20) participants received fixed prostheses supported by 3 implants following a closed sinus lift. The IOD group (n=20) participants received removable partial overdentures assisted by a single implant that was positioned mesially to the maxillary sinus. The modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and vertical bone loss (VBL) were measured at prosthesis delivery (T0), and 6 (T6) and 12 months (T12) after delivery. The oral health impact profile (OHIP-14) questionnaire was used to assess oral health-related quality of life (OHRQoL) at T12. Significant differences between observation times were performed using Friedman and Wilcoxon signed-rank tests for MPI and MGI and using repeated measures ANOVA with Bonferroni correction of P values for PD, IS, VBL, and OHIP. Between-group comparison of MPI and MGI the Mann-Whitney test was used, while for PD, IS, VBL, and OHIP comparison was made using independent samples t test (α=.05 for all tests). The implant survival rates were 100% for both groups. MPI and PD significantly increased with time for both groups. MGI significantly increased with time for the CSL group only (P=.049). The IS significantly decreased with time for the IOD group. VBL increased significantly from T6 to T12 for the CSL (P=.042) and the IOD (P=.002) groups. The CSL group recorded higher MPI, MGI, PD, and IS values than the IOD group (P<.05). The IOD group recorded higher VBL than the CSL group (P<.001). The CSL group scored significantly lower OHIP-14 values (better OHRQoL) than the IOD group for all values (P<.05). In comparison with implant-assisted partial overdentures, closed sinus lift with fixed prostheses had higher implant stability, reduced bone loss, and higher participant OHRQoL. However, peri-implant soft tissue health was found to be better with implant overdentures.

Comparison Between Flexible And Skeletal Implant Supported Mandibular Removable Partial Overdenture In Kennedy Class I Situation

Comparison Between Flexible And Skeletal Implant Supported Mandibular Removable Partial Overdenture In Kennedy Class I Situation

Photoelastic Stress Analysis for Cobalt Chromium and Nylon Denture ‎Base on Mandibular Kennedy Class I Implant Supported Removable ‎Partial Overdenture

Photoelastic Stress Analysis for Cobalt Chromium and Nylon Denture ‎Base on Mandibular Kennedy Class I Implant Supported Removable ‎Partial Overdenture

Clinical outcomes of small-diameter implant-retained overdentures: a retrospective analysis

Aims To analyze the survival rate of small-diameter implant (SDI) retained overdenture and evaluate the implant and attachment complications, as well as prosthetic maintenances, over a follow-up period of ≤4.5 years. Materials and methods Implant placement procedures were performed by dentists at the Advanced General Dentistry Clinic, Faculty of Dentistry, Mahidol University (Thailand) for all patients treated since 2016. Panoramic and periapical radiographs were taken before and after implant placement, to assess bone height around the implant. SDIs of 3 mm diameter and 10 mm length (PW plus®, PWSE, Nakhon Pathom, Thailand) were placed. After implantation for at least 2 months, corresponding housings were incorporated into overdentures using a conventional loading protocol. Assessment of implant survival rate, implant complications, and prosthetic maintenances were conducted as part of a regular implant checkup during the recall period from 2019–2020. Subsequently, patient characteristics, implant survival rate and complications, attachment complications, and prosthetic maintenance procedures were analyzed using descriptive statistics. Results Patients included in the study (n = 27) had a mean age of 68 years, and received 119 SDIs (41 in maxilla, 78 in mandible) and 38 overdentures (15 complete overdentures, 23 removable partial overdentures). The implant survival rate was 98.3% at mean survival time of 19.4 months (range, 6–55 months). After overdenture delivery, complications related to implant, attachments, and prosthetic maintenances were recorded. One implant complication (peri-implantitis) was recorded among 119 SDIs (0.8%). Attachment (Equator®) complications included: deformation of attachment matrices (34.4%), loss of attachment screw preload (14.0%), wear of metal housing (1.6%), wear of attachment head (0.8%), and dislodgement of attachment screw (0.8%). Prosthetic maintenance procedures comprised occlusal adjustment (72.7%), tissue surface adjustment (6.8%), denture base repair (6.8%), addition of artificial teeth (2.3%), and repair of artificial teeth (2.3%). Conclusion Our findings suggest that SDI retained overdenture is a successful treatment modality with a high implant survival rate (98.3%) over a 4.5 year follow-up period. Nevertheless, SDI retained overdenture maintenance is crucial.

An alternative technique for fabrication of a tooth-supported removable partial overdenture: A case report

Overdenture is one of the recommended treatment methods for elderly patients with few remaining teeth and deeply resorbed ridges. Root retained under the denture base maintains more alveolar ridge resorption, which provides sensory feedback and improves the stability of the dentures. In addition, after endodontic therapy, the use of copings (short/long) and braces on the remaining teeth improves denture protection. This case report aimed to describe prosthodontic rehabilitation of a tooth-supported removable partial denture using a Locator attachment.A 48-year-old woman presented to the Faculty of Dentistry, University of Malaya, complaining looseness and repeated fracture of her denture, which led to difficulty in eating and chewing. She presented with Kennedy Classification II modification 1 on the maxilla with 23 and 24. The treatment plan was to provide her with maxillary cobalt–chromium overdenture using the Locator attachment system. The abutment teeth were designed, prefabricated using Locator, and were attached to the root of 23. Esthetics was achieved, and the patient reported satisfactory outcome.The present case report signifies that few remaining teeth are effectively preserved to support tooth-retained overdenture. This treatment approach was chosen considering the patient’s favorable inter ridge distance and economic status rather than full extractions accompanied by a complete denture or implant-supported overdenture. This technique using a Locator attachment on a natural tooth can be an alternative method in prosthodontic rehabilitation of a partially edentulous adult patient with a distinct approach to meet the needs, esthetics, and psychological well-being of the patient.

Full mouth rehabilitation in anterior crossbite and posterior bite collapse patient – A case report

Background : Esthetically and functionally successful full mouth rehabilitation requires careful attention and me-ticulous treatment planning. Successful restoration in a patient with anterior crossbite and a partially edentulous situation can be challenging especially when bilateral posterior segment teeth is missing. Combination restora-tion using attachment retained removable partial denture (RPD) and removable partial overdenture (RPO) is such kind of treatment modality in prosthodontics. Purpose : This study was to provide an overview of a case about full mouth rehabilitation in anterior crossbite and posterior bite collapse patient. Case : A 64-year-old female pa-tient came to Prosthodontic Department of RSGMP Universitas Airlangga to have dentures replacing her missing teeth with aesthetic issue on her anterior teeth in order to eat well and be more confident. The patient wants to change her smile into new smile with acceptable aesthetic and function. Management : Diagnostic wax-up was made to capture the right occlusal vertical dimension (OVD) in centric relation (CR) that will be used in the first stage of full mouth rehabilitation, followed by management of the remaining teeth by endodontic and periodontal intervention by crown lengthening. Then, definitive restorations were made by maxillary attachment retained RPD with splint four anterior crowns and mandibular RPO with two single crowns on the lower teeth to correct anterior crossbite and posterior bite collapse. Conclusion : Patient had a satisfactoryly aesthetic and functional results with new occlusion using maxillary attachment retained RPD and mandibular RPO.

EFFECT OF HYPERBARIC OXYGEN THERAPY ON THE OSSEOINTEGRATION AROUND IMPLANTS AFTER MANDIBULAR RECONSTRUCTION BY DESTRACTION OSTEOGENESIS

Increases in mandibular width by distraction osteogenesis have recently been shown to be an acceptable and stable treatment option for deficiencies, and also, in the oral rehabilitation, where one of the major problems is the alveolar bone loss, and adjacent soft tissues.Aim: The aim of this study is to evaluate the influence of hyperbaric oxygen therapy (HBOT), on the osseointegration of implants retained partial mandibular overdenture after reconstruction of mandibular deficiency by distraction osteogenesis. Methods: This study was conducted on eight male patients with a lack of the anterior mandibular jaw bone due to anterior marginal mandibulectomy, and partially edentulous maxillary arch (different classes), selected from the maxillofacial outpatient clinic, Faculty of Dentistry, Misr University for Science and Technology, (mean age 43 years, minimum 35 years and maximum 51 years). For all patient, distraction the insufficient alveolar ridge by using an Extraosseous Track Alveolar Distractor (KLS Martin, Germany), after consolidation period, patients received maxillary and mandibular conventional acrylic partial dentures prior to implant insertion. Then, each patient received two endoosseous implants in the mandibular interforaminal region, (following two stage surgical protocols), to retain partial mandibular overdentures. Patients were randomly divided by closed envelops, into two equal groups. Group I; Patients were received hyperbaric oxygen therapy (HBOT), on a protocol of five sequential sessions (study group), while Group II; Patients were received no hyperbaric oxygen therapy (HBOT), as a control group. Ball attachments were screwed to the implants, after four months of surgery. All patients received new mandibular removable partial overdentures were retained by two implants, and designed as Kennedy class IV partial overdentures, to fitted partial mandibular overdentures. Marginal bone height changes and bone density were assessed using cone beam computed tomography(CBCT); at time of prosthetic loading, then after six, and twelve months.Results: Decrease in marginal bone height and increase in bone density through a follow-up period (one year) were observed in both groups , however; group I; that received HBOT revealed less marginal bone resorption and more increase in bone density than group II. Conclusion: After mandibular reconstruction by distraction osteogenesis, hyperbaric oxygen therapy effective treatment, and improve osseointegration around implants retained partial ovedentures, as it associated with increased bone density and reduced marginal bone loss after one year follow up.

Effect of Two Implant-supported Partial Overdenture Attachment Design on the Periodontal Health

This study aimed to evaluate and compare the effect of locator attachment and ball and socket (BS) attachment on the peri-implant and periabutment supporting structures on clinical pocket depth and gingival index in cases of limited interarch spaces in mandibular Kennedy class I implant-supported removable partial overdentures. A comparative clinical trial was conducted among twenty partially edentulous patients aged 30-60 years. The study participants were randomly divided into two study groups based on the attachment system used: group I - locator attachment, and group II - BS attachment. Two implants were positioned in the 1st or 2nd molar area following the two-stage surgical protocol. Evaluation of the peri-implant and periabutment supporting structures was done at the time of overdenture insertion and after 6, 12, and 18 months by measuring the pocket depth and gingival index. Inter- and intragroup comparisons were done using independent-samples t test and paired-sample t test respectively. p < 0.05 was considered statistically significant. It was observed that there was a statistically significant increase in the pocket depth around the implant as well as the abutment in both groups at 6, 12, and 18 months when compared to baseline. Intergroup comparison for pocket depth and gingival index revealed nonsignificant results. However, the values were higher in the BS group. The locator attachment group had lower, though statistically not significant, pocket depth and gingival index scores around both the dental implant and the natural abutment as compared with the BS attachment. Gingival health surrounding dental implant attachments is very crucial for the long-term success of dental implant, this could help the clinician to select the proper design for implant attachment underneath the over denture prosthesis.

The Effect of using different locator attachments with a different retention value on the bone height changes in Implant Supported class I removable Mandibular partial Overdenture, A Radiographic Evaluation

Purpose: The aim of this study was to evaluate the effect of using different locator attachments with a different retention value and ball and socket attachment on the bone height changes in Implant Supported class I removable Mandibular partial Overdenture.Introduction: The use of osseointegrate dental implants is one of the most successful treatment options to solve the problem of distal extension cases. A critical factor affecting the success of an implant is the manner in which mechanical stresses are transferred from the implant to the bone. One of the factors which affect the amount of force transmitted to the implant is the choice of the attachment. The Locator attachment system is a self-aligning and has dual retention, supplied in different colors; with a different retention value (white, orange and blue). The white housing has light retention, the orange housing has standard retention, and the blue has high retention while the ball and socket attachments consist of a titanium male unit and an easily replaceable rubber ring female unit that is retained in a metal retainer ring. The question is which of the various Locator attachment system used to retain mandibular partial overdenture affect the magnitude of stresses transmitted to the implants thus affecting the bone height changes around the implants.Material and methods: Twelve class I mandibular partially edentulous patients with opposing full dentate maxillary arch were selected from the from the Outpatient clinic, Prosthodontic Department, Faculty of Dentistry, Ain shams University. For all the patients extra and intraoral examinations were done associated with the proper laboratory investigations. Acrylic temporary partial denture was made for all the patients, the partial denture was duplicated into clear acrylic resin model then the model was scanned using CBCT machine and the DICOM data was processed to obtain STL file for the model. The digital image was performed and the virtual implant was placed in the most optimal position at the first molar area according to the surgical and prosthetic design. Conventional implant fixture were surgically inserted so that the top level of fixture needs to be located 0.5mm below the marginal crestal bone level, After three month from implant insertion, each patient was recalled For the insertion of super structure. The selected cases were randomly divided into three equal groups; Group I received an implant Supported class I removable Mandibular partial Overdenture with white locator attachment Group II received a Implant Supported class I removable Mandibular partial Overdenture with an orange locator attachment and Group III received an implant Supported class I removable Mandibular partial Overdenture with a ball and socket attachment.CBCT was used to evaluate the bone height changes around each implant at time of partial over denture insertion, 6months and 12 months from partial over denture insertion.Results: The results show that in all groups the bone loss appeared to be within acceptable limits in the groups during follow up period(less than1 mm during first year) but with significant differences in the bone height changes around the implant between both locator attachments and ball and socket attachment while the results show no significant difference between white and orange locator but the orange locator show higher bone resorption than the white locator.Conclusion: The current study concluded that locator attachments with different retention value provides better preservation of crestal bone than ball and socket stud attachment , where the white locator attachment show transmits less stress to the abutment resulting in reducing the amount of bone loss around the implants than orange locator when used in implant supported class I mandibular partial over denture

Metal additive manufacturing technologies: literature review of current status and prosthodontic applications.

To review the current metal-based additive manufacturing (AM) technologies, namely powder bed fusion (PBF) technologies, and their current prosthodontic applications. The PBF technologies reviewed are selective laser sintering (SLS), selective laser melting (SLM), and electron beam melting (EBM). The literature on metal AM technologies was considered, and the AM procedures and their current applications in prosthodontics were collated and described. Published articles about AM metal in dental care were searched (MEDLINE, EMBASE, EBSCO, and Web of Science). All studies related to the description, analysis, and evaluation of prosthodontic applications using metal AM technologies. AM technologies are reliable for many applications in dentistry, including metal frameworks for removable partial dentures (RPDs), overdentures, tooth- and implant-supported fixed dental prostheses (FDPs), and metal frameworks for splinting implant impression abutments. However, further studies are needed in future to evaluate the accuracy, reproducibility, and clinical outcome throughout function of AM technologies.

Evaluation of bilateral mandibular distal extension implant supported overdenture retained by two clasp assemblies

Purpose Clinically evaluate the effect of clasp design on tissue health around abutment teeth and implants assisting mandibular bilateral distal extension removable partial overdenture. M&M: 12 partially edentulous patients with mandibular bilateral free end saddle opposed by almost dentulous intact maxilla with the first premolars. Two dental implants were inserted at the first molar areas to support a bilateral distal extension partial overdenture with lingual bar as major connector. According to clasp design patients are divided in two groups. Group I: six patients for whom removable partial overdentures were retained with O-ring attachment to the implants and RPI clasp to the first premolar abutment teeth. Group II: six patients for whom removable partial overdentures were retained with O-ring attachment to the implants and conventional Aker clasp to the abutment teeth. Clinical evaluation Gingival index, probing depth and teeth mobility together with radiographic evaluation for alveolar bone loss around both implants and abutments using Digora for Windows were carried out immediately at insertion, 3, 6, and 9 months after insertion. Results After the first 3 months gingival index and probing depth increased significantly in both groups within the physiological limit while at the end of ninth month after insertion, no statistically significant difference between two groups. Differences between two groups regarding mobility and alveolar bone loss around abutment teeth through all the study periods, there is no statistically significance difference between the two groups. Regarding mobility and alveolar bone loss around implants through all the study periods, there is no statistically significant difference between results. Conclusion Presence of bilateral posterior implants reduce most problems of mandibular Kennedy class I such as preservation of abutment teeth, reduction of alveolar bone loss around the abutments and reduction the problems of rigid (Aker) clasp.

COMPARISON OF PERI-IMPLANT CLINICAL INFLAMMATORY PARAMETERS AMONG SCREW RETAINED CAD/CAM METAL BAR AND ZIRCONIA BAR FOR PATIENTS WITH RECONSTRUCTED MANDIBLES

Background: Segmental resection of the mandible results in severe disturbance of chewing function. Advances in microvascular surgeries and CAD/CAM technology helped with the prosthetic rehabilitation of reconstructed mandibles.Purpose: The aim of this study was to assess metal bar versus zirconia bar in patients with reconstructed mandibles that were rehabilitated with implant retained mandibular removable partial overdenture concerning the peri implant gingival index and probing depth.Materials and methods: fourteen patients were selected according to the inclusion criteria, the participants were stratified equally into two groups, patients were assigned to receive either metal bar or zirconium bar. Preparation of implant sites started with pilot drill followed by sequential drilling under copious refrigerated irrigation. Monthly follow up appointments were scheduled for each patient. After second stage surgery, abutments were secured to implant fixtures. Open top impression technique was used for bar fabrication using CAD/CAM technology. The bar was screwed in the patient’s mouth and checked for passive fit. Construction of the implant assisted removable partial overdenture took place in the conventional way. Female part were picked up directly in the patient’s mouth. Patients were recalled one week, 3,9 and 12 months after delivery for assessment of gingival index and probing depth. Results: Mann-Whitney U test was used to analyze the gingival index score between the two groups metal bar and zirconium bar. The metal bar group mean and standard deviation was 0.40±0.48 after 1 week and 0.36±0.32 after 3 months, 0.30±0.42 after 9 months, 0.20±0.42 after 12 months. While for zirconium group 0.30 ± 0.70, 0.28± 0.42 ,0.25±0.32, 0.10±0.32 respectively after 1 week,3 months ,9 months and 12 months. There was a statistical significance between the groups in 9 and 12 months, where P value was Conclusion: Within the limitation of this study, zirconia metal bar is considered more biocompatible than the metal bar.

Maxillary removable partial overdenture within Locator Root Attachment in a retained root: a case report

Maxillary removable partial overdenture within Locator Root Attachment in a retained root: a case report

The effect of two different solitary attachments used to retain implant assisted mandibular distal extension Removable Partial Overdenture on abutment alveolar bone height changes

The main objective of this clinical comparison study was to compare between different designs of solitary attachments used to retain implant assisted mandibular distal extension RPD regarding alveolar bone height changes around abutment teeth. Methods: Twelve patients with mandibular Kennedy Class I were selected for this study. The remaining natural teeth were extended from the first premolar on one side to first premolar on the other side. One implant was placed in each first molar region bilaterally. The removable partial dentures were retained anteriorly by RPA clasp design and posteriorly either by ball attachment (group I) or by OT-equator attachment (group II). Alveolar bone height changes around the primary tooth abutments were radiographically evaluated using cone beam volumetric CT. Results: Regarding bone loss around the primary abutment teeth, ball attachment group (0.72±0.15) significantly (p value=0.008) showed less crestal bone resorption when compared to OT-equator attachment group (1.01±0.25). Conclusion: Within the limitation of this study and regarding the preservation of abutment teeth, the use of ball attachment may be the suitable choice for anchoring distally extended removable partial denture to dental implants with improved longevity of the natural tooth abutments.

Root Resection: An Alternative Treatment Option to Extraction

An 80 year old male patient was referred to restorative postgraduate waiting list for replacement of missing maxillary posterior teeth affecting masticatory function. On further examination right maxillary second molar was diagnosed with vertical root fracture. The mesiobuccal root was resected and subsequently following healing a milled metal crown was cemented. The missing teeth were replaced with a removable partial overdenture.

Clinical and radiographic evaluation of implant-supported removable partial overdenture in the lower Kennedy class IV cases

Introduction The objective of the present study was to evaluate the effect of implant-supported partial overdenture design in restoring mandibular long class IV Kennedy's classification on the supporting structure, both clinically and radiographically. Materials and methods Ten partially edentulous patients with lower six anterior teeth missing were selected. Their ages ranged from 40 to 50 years. Each patient received two dental implants placed in the lower edentulous span at the canine area bilaterally. Ball-and-socket attachment (polycarbonate housing with rubber O-ring) was used between the implant and the overlay removable partial denture for retention. Periodic evaluation was carried out for every patient before denture insertion and then after 3, 6, and 9 months. As regards the clinical evaluation, the probing depth, gingival level, and attachment level around the implants were recorded. The radiographic evaluation included the use of specially developed software for measuring the alveolar bone density in gray scales and the bone height in pixels for the implants and the residual alveolar ridges. Results All implants were highly successfully osseointegrated at the end of this study. There was a statistically nonsignificant increase in the clinical parameters (probing depth, gingival level, and attachment level) around the dental implants throughout the 9-month follow-up period after denture insertion. Radiographically, there was a nonsignificant increase in bone loss, but a significant increase in bone density around the dental implants and the alveolar ridge throughout the follow-up period. Conclusion From the previous results, it was found that the concept of immediate loaded dental implant was efficient to be used successfully in the mandibular long Kennedy class IV to retain the partial overdenture.

Interdisciplinary treatment of an adult with bilateral cleft lip and palate with missing premaxilla: The prosthodontic perspective

Conventional orthognathic surgery and orthodontic techniques occasionally fail to completely correct the occlusal relationship and esthetic deficits of patients with cleft lip and palate and severe midface deficiency. Prosthodontic rehabilitation is often required to establish adequate occlusion and provide a more proportional facial appearance. This clinical report describes the interdisciplinary management of an adult with complete bilateral cleft lip and palate who was treated with distraction osteogenesis using a rigid external distraction device for maxillary advancement and his prosthodontic rehabilitation with a dual path removable partial overdenture to develop definitive facial and dental esthetic form.

Efficacy of Posterior Implant Supported Distal Extension Removable Partial Overdenture for Management of Patients with Intra articular Temporomandibular Disorders

Efficacy of Posterior Implant Supported Distal Extension Removable Partial Overdenture for Management of Patients with Intra articular Temporomandibular Disorders