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.

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.

Treatment of the cleft lip and palate patient with few remaining posterior teeth using hybrid telescopic crown denture

For individuals with cleft lip and palate, the removable partial dentures (RPDs) have been an important treatment option. Some modifications from conventional prosthetic treatment may be necessary to achieve satisfactory functional and esthetic results in cleft patients. In case of cleft palate patient with periodontally compromised and only posterior few remaining teeth, removable partial prosthesis connected to telescopic crown can be the alternative treatment option. When connected to the RPD, telescopic crowns increase the prosthetic stability and retention, optimize favorable force transmission to the long dental axis, and improve esthetics. And the cross arch stabilization of double crown denture helps to stabilize both divided maxillary ridges in CLP patient. This case present one adult CLP patient using an RPD connected with hybrid telescopic crowns with friction pins to improve not only retention and stability but also aesthetics.

Clinical outcome of double crown-retained implant overdentures with zirconia primary crowns

PURPOSE: This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS: In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS: One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: 5.9 +/- 2.2 years), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION: Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required.

A FEM study on stress distribution of tooth-supported and implant-supported overdentures retained by telescopic crowns / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the stress distribution in mandibular implant-supported overdentures and tooth-supported overdentures with telescopic crowns. MATERIALS AND METHODS: The assumption of this study was that there were 2, 3, 4 natural teeth and implants which are located in the second premolar and canine regions in various distributed conditions. The mandible, teeth (or implants and abutments), and connectors are modeled, and analyzed with the commercial software, ANSYS Version 10.1. Stress distribution was evaluated under 150 N vertical load bilaterally on 3 experimental conditions - between canine areas, canine and 2nd premolars, 10 mm posterior to 2nd premolars. RESULTS: Overall, the case of the implant group showed more stress than the case of the teeth group in stress distribution to bone. In stress distribution to superstructures of tooth and implants, there was no significant difference between TH group and IM group and the highest stress appeared in TH-IV and IM-IV. The stress caused from bar was much higher than those of implant and tooth. TH group showed less stress than IM group in stress distribution to abutment teeth and implant. CONCLUSION: The results shows that it is crucial to make sure that distance between impact loading point and abutment tooth does not get too far apart, and if it does, it is at best to set abutment tooth on premolar tooth region. It will be necessary to conduct more experiments on effects on implants, natural teeth and bone, in order to apply these results to a clinical treatment.

Model establishment and stress analysis of telescopic crown-retained removable partial dentures / 上海交通大学学报（医学版）

Objective To redevelop the finite element model libraries and to analyse the stress distribution of telescopic crown dentures. Methods The finite element model libraries were redeveloped based on the model libraries of normal dentition, fixed partial denture and removable partial denture. With the help of softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, the telescopic denture models on the bilateral free-ended case were imported and edited, then the finite element stress analysis was performed. Results The models were easily established. The maximum value of stress and its distribution on abutment root, periodontal membrane, alveolar mucosa, alveolar bone and dental prostheses were observed and studied by the finite element stress analysis. Conclusion The way to establish models of telescopic crown dentures by model libraries is feasible and reliable.

A STUDY ON THE STRESS DISTRIBUTION OF ABUTMENT TEETH AND RESIDUAL RIDGE AREA BETWEEN TELESCOPIC AND CLASP TYPE RPD BY FEM METHOD / 대한치과보철학회지

The purpose of this study was to compare and evaluate the stress distribution and displacement developed in the abutment teeth and residual ridge area by madibular unilateral distal extension removable partial denture with 2 different retainer designs. The retainers on right and left canine and right 2nd molar were Akers clasp in one model and telescopic crown in the other model. The stress distribution of abutment teeth and residual ridge area on two model were compared and analyzed with 3-dimensional finite element method. 150N and 400N forces were applied vertically, 30 degree and horizontally on the central fossa area of left 1st molar of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows 1. As the magnitude and angulation of applied force were increased, the magnitude of stress on the right and central residual ridge area and the right canine of the telescopic type increased and comparing to those of the Akers clasp type. 2. As the magnitude and angulation of applied force were increased, the mesial direction of displacement on the right residual ridge area and the right tooth of the telescopic type increased and the distal direction of displacement on left residual ridge area and the left canine increased comparing to those of Akers clasp type. 3. As the vertical force was applied, the distal direction of the displacement of the right tooth were greater and that of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. 4. As the 30 degree force was applied, the mesial direction of the displacement of the right tooth were greater and the distal direction of the displacement of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. In the horizontal force the results were same in right area tooth but the distal direction of displacement was greater in left canine. 5. In both removable partial dentures, as the magnitude and degree of force were increased, the stress and displacement were increased. The compressive force was dominative than the tensile force. 6. In both removable partial dentures, the magnitude of stress was greater on mucosal tissue area than that of the alveolar bone area on distal extension residual ridge area but the result was reversed on anterior residual ridge area. The displacement was always greater on mucosal tissue area than that of alveolar bone area.