Telescopic overdenture is a prosthesis consisting of a primary or inner crown, which is attached to a supporting tooth in the oral cavity, and a secondary or outer crown, that is attached to the denture, which must fit the primary denture. The aim of this case report is to restore function and aesthetics as well as improve the patient’s psychological status by constructing a fixed removable prosthesis using an existing abutment as a telescopic overdenture.
A 36 year old woman came to Prosthodontic Clinic of Airlangga Dental Hospital (RSGM) UNAIR on her own accord to make front dentures for the upper and lower jaws after a traffic accident one and a half years ago. The patient arch was installed two months after the accident, then removed after two months. The patient wants new dentures to improve her eating ability and appearance.
The initial treatment is; planning on scaling of the maxillary and mandibular roots; crown lengthening of teeth 15; extraction for tooth 16, 41, 42, and 43; and alveolectomy in the anterior mandibular region. Before definitive treatment to improve the aesthetic appearance can be done, the first step is to construct transitional dentures in the upper and lower jaws. It will be used while waiting for healing, following the preservation of the socket in the mandibular area. Then, for definitive restoration, we used telescopic overdenture for the maxilla and removable partial denture for the mandible.
Telescopic dentures are prostheses consisting of a primary crown cemented into the abutment in the patient’s mouth, and a secondary crown attached to the prosthesis, suitable with primary crown. This increases retention and enlarges the prosthesis. According to prosthodontics, a telescopic denture is also referred to as an excess tooth, which is defined as a removable dental prosthesis that is connected and resting on one or more growing teeth, on a natural tooth, and / or on an implanted tooth. These are also referred to as denture lining, prosthetic lining, and superimposed prosthesis. Double crown systems are usually distinguished from each other by different retention mechanisms. There are four types of double crown systems: cylindrical crowns, conical crowns, resilient designs and modified designs. Cylindrical crown, or telescopic crown, achieves retention by means of friction between the inner and outer crown. Conical crowns, or tapered telescope crowns, showing friction only when they are actually seated using the “wedge effect”.
The amount of wedging effect mainly determined by the convergence angle of the inner crown: the smaller the convergence angle, the greater the retention force. The resilient design is one that is not rigid, as it allows freedom in vertical and rotational movement between the inner and outer crown. It can be achieved with some modifications to the inner crown, outer crown, or both. This modification results in a reduction in intimate contact and the creation of a distance between the inner and outer crown. The modified design was developed with many modifications in the double crown concept. They depend largely on combining the atelescic system with other types of attachments. In this case, we used the conical crown design as a guideline for the manufacture of the double crown system. One of the advantages of using overdenture is telescopic aesthetics, using a double crown as a holding element allows better aesthetics than clasps. Good aesthetics can be provided by using ceramides on the labial surface and selecting the appropriate color. Telescopic overdenture also has good retention and stabilization properties due to the double crown system, secondary splinting action, transfer of occlusal forces through the long axes of abutments, creation of the common insertion path, and improved hygienic properties.
Telescopic overdenture is recommended for patients who need good esthetics for anterior tooth loss. Telescopic overdenture uses a double crown as a supporting element, which provides better aesthetic results compared to the clasps, thereby enhancing the patient’s psychological status. Furthermore, they have better retention and stabilization compared to conventional complete dentures.
Author: Utari Kresnoadi Detail of this paper can be viewed on: DOI: 10.20473 / j.djmkg.v53.i3.p133–139
Author: Utari Kresnoadi Detail of this paper can be viewed on: DOI: 10.20473 / j.djmkg.v53.i3.p133–139 Dental Journal, 2020, September, 53 (3): 133-139. Telescopic overdenture as an alternative rehabilitation for the loss of several anterior teeth due to traffic accidents, by: Birgitta Dwitya Swastyayana Subiakto and Utari Kresnoadi, Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga (UNAIR).
