Salvaging a Telescopic-Crown-Retained Partial Denture Using a Novel Flexible Attachment System-A Case Report.

Abstract

Background and Clinical Significance: Removable partial dentures still present a relevant treatment option in an aging population. With the exception of clasps, the vast majority of attachment systems available for anchoring these restorations on natural abutments requires invasive tooth preparations causing secondary problems such as caries and abutment tooth fractures. In cases where an abutment tooth cannot be salvaged, placing an implant and connecting the existing prosthesis to this implant presents a viable solution. While a common path of insertion has been established during initial fabrication, it is almost impossible to match this with a newly placed retentive element. In the case presented, a novel ball anchor that allows for compensatory movements was used as a retentive implant abutment for salvaging a removable partial prosthesis. Case Presentation: An 83-year-old, medically compromised male patient, restored with a removable partial denture, stabilized by one abutment tooth and two clasps in the mandible, suffered from a non-restorable fracture of the abutment tooth. After tooth extraction, immediate implant placement (MT implant, AlfaGate, Bonn, Germany), closed healing of the implant for three month, then second-stage implant surgery and soft tissue healing for another four weeks, the implant was connected to a novel flexible attachment system, the REFLEX abutment (Hader Solutions, Dublin, Ireland). Shaped as a retentive ball, the REFLEX abutment allows lateral movements of the male attachment part while maintaining vertical dimensions like rigid locator-type attachments. Conclusions: The retrofitting of the novel flexible attachment under an originally telescopic-crown-retained partial denture allowed for a successful conversion of the prosthesis while preserving prosthetic fit and retention for the patient.