Prosthodontic Rehabilitation of Missing Dentition Using Multi Unit Precision Attachment Hybrid Overdentures–Clinical Report of Two Patients

Prosthodontic rehabilitation of a patient with terminal dentition is very challenging. Any conservative treatment that can delay or eliminate future prosthodontic problems should be considered. Complete and partially edentulous patients are generally unsatisfied due to the inherent instability of dentures during functional and parafunctional movements which results due to the lack of adequate supporting hard and soft tissues. Inspite of rapid development and good success rate in the field of implantology, preservation of remaining natural teeth or roots is more desirable which supports Devan’s dictum. Overdenture is a complete or partial denture prosthesis supported partly by soft tissues and partly by retained natural teeth or its roots or implants. Overdenture increases the retention, stability and support, improves the masticatory efficiency, preserves the alveolar bone and muscular patterns and preserves sensory receptors within the periodontal ligament which increases manipulative skills in handling the denture. Retention and stability of overdentures can be improved by attachments or magnets. Fixed partial denture is not an option when there is no distal abutment. The solution of such a critical situation is to give combined or hybrid prosthesis. A combined prosthesis carries the advantage of fixed removable prostheses without surgical intervention, where an acrylic prosthesis is retained with an extra coronal attachment to tooth. This paper presents a twin patient report of rehabilitation of a mandibular and maxillary terminal dentition with a combined prostheses of acrylic retained by extra coronal precision attachment system (Rhein 83, Italy).