Clinical outcomes of rigid and non-rigid telescopic double-crown-retained removable dental prostheses: An analytical review

PURPOSE: The objective of this literature review was to analyze the cumulative survival rates (CSRs) of rigid and non-rigid double-crown-retained removable dental prostheses.MATERIALS AND METHODS: Screening of the literature published from January 1995 to December 2019 was performed by using electronic data base (Pubmed) and manual search. The CSRs of rigid and non-rigid double crown removable dental prostheses were investigated.RESULTS: A total of 403 articles were reviewed and 56 relevant articles of them were selected. Subsequently, 25 articles were included for data extraction. These articles were classified according to rigid and non-rigid type double crowns and further subdivided into teeth, implants, and teeth-implant combination types. The CSRs of rigid type double crown ranged from 68.9% to 95.1% of 5 to 10 years in tooth abutments, 94.02% to 100% over a 3-year mean observation periods in implant abutments, and 81.8% to 97.6% in tooth-implant combination. Non-rigid type double crowns had various CSR ranges from 34% to 94% maximum during 10 years observation in teeth abutment. The CSRs of non-rigid type had over 98% in implant abutments, and ranged from 85% to 100% in tooth-implant combination.CONCLUSION: The CSRs of double crowns varies according to types. With accurate evaluation of the remaining teeth and plan of the strategic implant placement, it could be successful treatment alternatives for partially or completely edentulous patients.

Prosthetic treatment for Down's syndrome patient with dental cross bite problem using maxillary double crown denture / 대한치과보철학회지

Patients with Down's syndrome have several dental complications such as small teeth caused by underdevelopment of dentin and enamel, periodontitis, agenesis of teeth, prolonged retention of primary teeth and malocclusion due to narrow palate. Removable denture with maxillary double crowns would be a good treatment option to solve the problems of the patient with Down's syndrome. Double crowns compensate the insufficient support and retention of denture and easily solve the cross bite problem. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 26-year-old female patient with Down's syndrome and dental phobia had small number of teeth with enamel hypoplasia, prolonged retention of primary teeth and dental cross bite. Prosthetic treatment was done using removable denture with double crowns in the maxilla. In the mandible, teeth preparation was done on enamel margin without anesthesia. Anterior laminate and posterior complete zirconia crown restorations were performed. As a result, the cross bite was effectively corrected by denture with double crowns. Pronunciation and appearance were also improved without extraction of teeth and dental anesthesia.

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture / 대한치과보철학회지

Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.

Clinical Report by using hybrid telescopic double crown Removable Partial Denture on a few remaining teeth with severe periodontal disease / 대한치과보철학회지

The successful results of the treatment using a double crown denture have been reported in several papers for some of the few remaining teeth in patient. In particular, double crown dentures may be an alternative to treatment in cases where the periodontal status is poor and clasp type removable partial dentures are inappropriate (crown/root ratio > 1). In this case, the patient visited clinic with a chief complaint of difficulty in mastication due to loss of posterior teeth and overall teeth mobility. After teeth with severe periodontitis were extracted, treatment plan of mandible is Kennedy class I removable partial denture (RPD) and treatment plan of maxilla is hybrid telescopic double crown RPD with a friction pin. Patient is well adapted after the prosthetic treatment and we report due to achieving satisfactory results in pronunciation, mastication, retention and aesthetics.

Prosthetic rehabilitation for patient with hemi-maxillectomy: Obturator combined with a hybrid telescopic double crown using friction pin

When oral cancer develops in the maxilla, oro-nasal communication occurs after surgical treatment including removal of the primary site. Restoration through an obturator is necessary to prevent food from storing due to non-oral opening, and to ensure proper pronunciation and aesthetic restoration. In this case, the patient was treated with right hemi-maxillectomy due to oral cancer and has residual abutment and poor periodontal support due to the effect of head and neck radiotherapy. The obturator was treated with a hybrid telescopic double crown denture. Reporting a successful prognosis in 18 months of follow-up.

Causes of failed implant attachments and application of double crown implant overdenture in one patient / 대한치과보철학회지

In this case, the patient was restored with gold Hader bar mandibular implant overdenture using two implants about 10 years ago, and the retentive force was lost due to severe wear of the bar due to 3.5 years use. The overdenture was repaired using a Locator attachment, but the male part was completely worn after 6.5 years use. Finally, we used a hybrid telescopic double crown with a friction pin to fabricate a new implant overdenture, which was observed for 2 years and showed excellent prognosis. So, we describe the cause of failure of each attachment (Gold Hader bar, Locator) in two implant overdentures and report on the advantages and disadvantages of double crown implant overdenture and the conditions for success.

Causes of failures of long-term used double crown denture and new rehabilitation with dental implant and tooth combined denture using remaining teeth and implants / 대한치과보철학회지

Hybrid telescopic double crown have ever been good treatment option for patient with periodontally unfavorable few remaining teeth for successful prognosis. Tooth and implant combined telescopic double crown can be used for improving retention and support for denture with strategically placed implants on edentulous ridge. In this case, an 55-year-old female patient had chronic periodontitis with few remaining teeth on maxilla and fixed partial prosthodontics on mandible. Treatment of hybrid telescopic double crown with friction pin lasted 9.5 years only with natural teeth. After 9.5 years, additional implants was installed due to fracture of cast-posted abutment teeth. After implantation, tooth and implant combined double crown had fabricated. Through re-treatment, no complications of new denture has been found during 2 years follow up. This case presents fair prognosis of tooth and implant combined double crown denture in periodontally unfavorable condition.

Comparison of retention forces with various fabrication methods and materials in double crowns

PURPOSE: The purpose of this study was to analyze the retention force changes and wear behaviours of double-crown systems over long-term use. MATERIALS AND METHODS: Ten groups, each consisting of six samples, were evaluated. Specifically, casting gold alloy primary crown - casting gold alloy secondary crown (AA), laser sintering primary crown - laser sintering secondary crown (LL), casting Cr alloy primary crown - casting Cr alloy secondary crown, (CC) zirconia primary crown - electroformed secondary crown (ZA), and CAD/CAM titanium alloy primary crown - CAD/CAM titanium alloy secondary crown (TT) groups were evaluated at cone angles of 4° and 6°. The samples were subjected to 5,000 insertion-separation cycles in artificial saliva, and the retention forces were measured every 500 cycles. The wear levels were analyzed via SEM at the beginning and end of the 5,000 cycles. RESULTS: In all samples, the retention forces increased when the conus angle decreased. The highest initial and final retention force values were found in the LL-4° group (32.89 N-32.65 N), and the lowest retention force values were found in the ZA6° group (5.41 N-6.27 N). The ZA groups' samples showed the least change in the retention force, and no wear was observed. In the other groups, wear was observed mostly in the primary crowns. CONCLUSION: More predictable, clinically relevant, and less excursive retention forces can be observed in the ZA groups. The retention force values of the LL groups were statically similar to those of the other groups, except the ZA groups.

A clinical case of hybrid telescopic double crown using friction pin with an isolated few remaining teeth

A few authors have reported good clinical results using double crown removable partial denture (RPD) with a few remaining teeth. Hybrid telescopic double crown is a good indication for a patient with poor periodontal condition and/or few remaining teeth after extraction, especially located in cross-arch position. In this case, there was a poor periodontal condition with teeth mobility. Several teeth with poor prognosis were extracted. Remaining anterior teeth was restored with fixed prostheses and edentulism was restored with Kennedy class I removable partial denture in maxilla. In mandible, it was hard to restore with clasp removable partial prostheses because of bilaterally isolated remaining teeth so that hybrid double crown removable partial denture with friction pin was suitable for this case. The objective of this report is to discuss the characteristics and the utility of hybrid double crown prostheses using a few remaining teeth in mandible.

Prosthetic restoration of a partially edentulous patient using double crowns: a clinical report / 대한치과보철학회지

In removable dental prostheses, it is important to minimize impairment of residual tissue caused by wearing dentures. There are two factors that harm residual tissue. The first is functional load bearing of remaining teeth and alveolar ridges and the second is the effect of poor oral hygiene. Double crown retained removable dental prostheses provide rigid support, and it may reduce impairment caused by load bearing of alveolar ridges. Also, dental plaque and oral deposits, which are attached to outer crowns and dentures, can be easily managed extra-orally. In addition, it is beneficial to the health of the marginal gingiva because inner crowns have easy access for oral hygiene. In this case, double crown retained removable dental prostheses were used for the partially edentulous patient with severe residual alveolar bone resorption and poor oral hygiene, and the result was clinically satisfactory in terms of functional, esthetical, and oral hygiene aspects.

Hybrid telescopic double crown denture on maxillary few remaining teeth and 2 mandibular implants in case of failed implant overdenture / 대한치과보철학회지

Double crown prostheses can be used in patients who have a few remaining teeth and poor periodontal condition because of secondary splinting of abutments, vertical loading, decrease of the length of lever arm due to fulcrum line located on margin of inner and outer crown. Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth and implant overdenture using a small number of implants have been reported. In this case, there were a few remaining teeth with a very poor periodontal condition in maxilla, and there were a failed implant with severe alveolar bone resorption and shrinkage in the mandible. The main objective of this report is to introduce our case because a double crown partial denture showed satisfactory results in functional and esthetical aspects during more than one-year follow-up period.

Prosthetic treatment for patient with upper lip cancer and severe periodontitis: Maxillary complete denture with denture adhesive and mandibular double crown-retained removable partial denture / 대한치과보철학회지

When oral cancer is occured, one may experience problems such as lip defect, necrosis of periodontal tissue and cervical caries caused by radiotherapy. According to ADI (Association of dental implantology), recent radiotherapy on jaw bone could be a relative contraindication of implant treatment. Due to this controversy, in most cases, treatment is done with removable dentures rather than implants. Especially, lip defect caused by an oral cancer operation have a serious repercussion on the retention of the denture. In this case report, patient with upper lip cancer had undergone resection primarily and secondary radiotherapy was done periodically. As a result, upper teeth of patient were extracted gradually and lower teeth showed very poor periodontal status. Therefore, Polident(R) denture adhesive cream (GlaxoSmithKline, London, England) was applied on maxillary complete denture to overcome reduced retention due to the lip defect and double crown RPD with friction pin was applied on the mandible successfully for two years.

Periodontal prosthesis on medically compromised patient with few remaining teeth: hybrid telescopic double crown with friction pin method / 대한치과보철학회지

Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth have been reported in several journals. A double crown removable partial denture can be an alternative treatment for the patients with a poor periodontal condition of remaining teeth. Since a double crown removable partial denture can be applied without the risk of surgical operation to the medically compromised patients with a poor periodontal condition which is inadequate for dental implants, it has psychological and economical advantages. In this case, there were sufficient remaining teeth to be restored with fixed prostheses in maxilla, while there were a few remaining teeth with a very poor periodontal condition so that it was almost impossible to restore with a clasp removable partial denture using these remaining teeth in mandible. In addition, the patient had the medical history of surgical operation due to osteomyelitis in the mandibular anterior areas a year ago, thus difficult to conduct an implant placement. The main objective of this report is to introduce our case because a double crown partial denture using a few mandibular remaining teeth showed satisfactory results in functional and esthetical aspects during more than two years follow-up period in this unfavorable condition.

Double crown retained removable partial denture -4 years in retrospect / 대한치과보철학회지

STATMENT OF PROBLEM: Little in known about the importance of selection of various double crowns as retainer in determining the outcome of treatment with double crown retained removable partial denture. Purpose : To obtain information about the effects and the results of this treatment modality. MATERIAL AND METHODS: This study describes 61 double crown retained removable partial dentures worn by 51 patients from Samsung Medical Center, Seoul a time ranging between 6 and 48 months and evaluate occlusal contacts on the denture teeth, denture movement, incidence of denture relining, denture retention, fracture of dentures and abutments, hygiene, residual ridge inflammatory changes, number of lost abutments, interruption of denture use. RESULTS: One tenth of all the restorations were relined. Restorations in 21 arches fractured repeatedly for various reasons. There was no apparent interrelationship between fractures and the five groups. CONCLUSION: Good prognoses of removable partial dentures were shown in all groups(Kennedy Classes I, II, III, combination and few remaining abutment).