A telescopic retainer prosthesis in full mouth rehabilitation.

The use of questionable abutments has been made possible by modifying the design of the prosthesis. Telescopic retainers help to retain a prosthesis on a tilted and malaligned abutments.

A telescopic removable or fixed retainer prosthesis is a coping that fits over an abutment to support and retain a crown and bridge.[1] It may be an abutment for removable, fixed or over-denture. Telescopic crown or bridge is “an artificial crown constructed to fit over a coping, the coping can be another bar or any other suitable rigid support for the prosthesis.”[2]

Case Report

A 70-year-old patient reported with a complaint of missing teeth and difficulty in chewing. On extraoral examination, patient's profile was normal without loss of vertical dimension. Intraoral examination reveals completely edentulous upper arch and partially edentulous lower arch. Patient was unwilling for implant treatment. Fixed partial denture could not be done due lack of adequate abutments. Hence, support from the remaining teeth was obtained to fabricate a removable prosthesis [Figures 1–6].

Figure 1

Coping over prepared tooth

Figure 6

Telescopic retainer prosthesis

Coping with bar

Jaw relation procedure

Prosthesis to be attached over the bar

Restored final prosthesis

Discussion

The objective of replacing the missing teeth was to improve the esthetics and function of the patient. When only a few teeth are remaining, fixed partial denture would exert undue forces on the remaining teeth. In such clinical situations, it is mandatory to obtain support from the remaining few teeth and soft tissues.[34] Replacing missing teeth in the above case appears to be simple yet technically demanding procedure.[5] Yalisove and Dietz[67] described the versatility of telescopic retainer in restorative dentistry. Telescopic retainer has the following advantages, simple home care by removing the prosthesis, reducing lateral stress, retaining weak or compromised abutment, bilateral splinting, preventing teeth, and reducing alveolar bone loss.[8] Pezzoli et al. discussed local transmission in distal extension partial denture and found telescopic retainer to produce less stress in the edentulous region and transmitted loads more equally to the abutments. Yalisove and Dietz,[7] showed that in telescopic crown sleeve is coping restoration, the effective crown to root ratio is reduced at the point that the telescopic over crown rotates.