Strategic Use of Telescopic Retainers and Semi-rigid Precision Attachments in a Geriatric Patient: A Case Report

Abstract

The rehabilitation of medically compromised elderly patients with long span partially edentulous arches has been a tremendous challenge for dentists. Proper dental management requires a commitment to provide the best treatment despite the compromised oral conditions. The aim of this paper is to describe the prosthetic rehabilitation of an elderly patient who presented with chief complaints of gagging sensation while using upper denture, loose upper and lower dentures and difficulty in eating food. Patient was rehabilitated using removable partial denture with semi-rigid attachments in the maxillary arch and telescopic prosthesis in the mandibular arch. Use of semi precision attachments helped in increasing the retentive ability of the maxillary prosthesis, even in the presence of only few abutments. Fabrication of a telescopic denture is a technique sensitive procedure but it offers advantages like bilateral splinting effect in long span partially edentulous arches, reduced effective crown-root ratio, maintenance of proprioception and transfer of forces along the long axis of the abutments. Although the management was complex but it improved patient's esthetics, oral function and social confidence.

Keywords: Fixed removable prosthesis; Multiple missing teeth; Semi-precision attachment; Telescopic prosthesis.

Fig. 1

a Pre-treatment extra oral view. b Pre-treatment panorex view. c Diagnostic casts

Fig. 2

Cemented metal copings

Fig. 3

a Wax pattern on refractory cast. b Metal framework try- in

Fig. 4

a Try-in (Right lateral view). b Try-in (Left lateral view)

Fig. 5

a Final maxillary prosthesis (occlusal view). b Final mandibular prosthesis (occlusal view). c Final prosthesis