Co-Cr Material Telescope Crowns Precision Attachment Stabilizing Properties

Introduction                                                                                                                            

Telescopic copings have been used for several years in oral rehabilitation of patients with advanced periodontal disease.

Patients with periodontal disease undergoing prosthetic reconstruction often present with teeth with minimal supportive tissue and increased tooth mobility.

Therefore, it is extremely important for the prosthesis not to cause periodontal destruction or worsen an existing periodontal condition.

Three different types of double crown systems are used to retain RPDs. They are distinguished from each other by their retention mechanisms:

Advantage                                                                                                                            

• Creation of a common path of insertion

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• Easy to perform routine oral hygiene

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• Rigid splinting action

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• Distribution of stresses to the abutment teeth

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• Provision of suitable abutments for RPDs even when the remaining teeth are periodontally compromised

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• Much easier insertion and removal for the patient

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• Accommodates future changes in the treatment plan

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• Psychologically well-tolerated by patients.

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Disadvantage                                                                                                                         

• Increased cost

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• Complex laboratory procedures

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• Extensive tooth reduction required

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• Increased number of dental appointments

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• Difficulty in achieving esthetics

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• Retention diminishes after repeated insertion/separation cycles

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• Readjustment of retentive forces is difficult.

Although fixed restoration provides favorable conditions for preservation of oral function, telescopic overdenture may be considered as another option, combining good retentive and stabilizing properties with a splinting action. The telescopic system may therefore be seen as providing suitable abutments for overdenture even when the remaining teeth are compromised. For other prostheses, excellent oral hygiene maintenance is essential for an optimal prognosis. With telescopic construction, apart from the splinting of the abutment teeth with the telescopic system, the gingival tissues are easily accessible around the entire marginal circumference of the abutment, thus permitting easy home care and oral hygiene. However, correctly implemented plaque control is fundamental in the prevention of recurrence of gingivitis.