Telescopic Crowns Attachments for Implant Supported Restorations

Abstract

The use of dental implants to support mandibular or maxillary overdentures is a widely used treatment modality. Advantages are an increase in retention, an increase in chewing ability, and easy access for oral hygiene procedures. While telescopic and conical crowns have been used for decades to connect natural teeth to overdentures, not many cases have been reported in the literature of telescopic crowns placed on implants to support overdentures. This article describes 7 patients with overdentures supported by telescopic crowns who received 65 implants (ITI Straumann). The cases presented in this report have been in function for up to 4.5 years. During that time no adverse events were reported. The use of telescopic crowns as attachments for implant-supported overdentures may be a viable treatment option.

Introduction

The use of telescopic crowns on natural teeth (ie, a double crown system in which an interior crown with a cylindrical shape is placed on the tooth to support a removable crown), is a treatment concept that has been widely and successfully used to support dentures since telescopic crowns were introduced in the 1970s.1–18 They allow for easy access for oral hygiene around the abutment teeth as well as easy handling of the overdenture.4 The comparatively high retention obtained leads to good mastication and phonetics. Therefore, they often offer more advantages than other types of attachments.

Telescopic crowns also allow for an overdenture design that includes teeth with questionable long-term prognosis, leaving room for later tooth removal if necessary, while still guaranteeing sufficient support of the denture.

The use of implant-supported overdentures is a treatment approach with a very high long-term success rate.19–22 The use of implants to support overdentures increases patient comfort by improving retention and chewing ability.

Compared to the use of fixed-implant–supported dentures, this treatment modality often leads to an esthetically more pleasant result, the best access for oral hygiene, and allows for the use of a lower number of implants. Furthermore, the use of overdentures, tooth- or implant-supported, is often beneficial for phonetic reasons.10

Bar, ball, and magnetic attachments have been suggested to connect the overdenture to the implants.23–25 Contrary to their use on natural teeth, there are not many reports in the literature on the use of telescopic crowns for the connection between implants and overdentures.