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.

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.

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.

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.