A case report of maxillary IARPD using magnetic attachments andanterior milling teeth
A. Tokue1, H. Shimpo1, D. Kurihara1, Y. Suzuki1, N. Harada2, and C. Ohkubo1
1
Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
2
Dental Technician Training Institute, Tsurumi University School of Dental Medicine

Abstract
The patient was a 51-years old female with partially edentulous maxillary jaw (six anterior teeth
remained, Kennedy classification I, Eichner classification B4). Her chief complaints were difficultiesof mastication using existing denture and bad esthetic by metal clasps on the anterior teeth.
Prosthetic rehabilitation was planned using an implant assisted removable partial denture (IARPD)
with magnetic attachments and milling crowns on the anterior remaining teeth.
Two implants (GENESiO Plus, GC, Japan) were placed in the regions of # 14 and # 24 and magnetic
attachments (GIGAUSS D400, GC) were set on the custom abutments using adhesive cement (SuperBond, Sun Medical, Japan). The porcelain fused to metal crowns with milling on their lingual sides
were placed on the six anterior remaining teeth. IARPD with Co-Cr framework were delivered after
vertical dimension was heightened.
Sufficient retention and stability could be provided by the combination of milling crowns andmagnetic attachments, and satisfactory aesthetic and function could be achieved using the IARPD.

Introduction
From an aesthetic reason, patients are distinguished by metal clasps on the anterior teeth. In this case,an implant assisted removable partial denture (IARPD)1,2) with magnetic attachments3) and millingcrowns on the anterior remaining teeth was fabricated for aesthetic appearance.

Patient’s characteristics
The patient was a 51-years old female with partially edentulous maxillary jaw including dental root
fractures #16, #15, and #24 (Fig. 1, 2). Maxillary acrylic partial denture was worn for five years. Her
chief complaints were difficulties of mastication using existing denture and bad esthetic by metal
clasps on the anterior teeth (six anterior teeth remained, Kennedy classification I, Eichnerclassification B4). There was no significant medical history.

Fig. 1 Intraoral photograph at the first visit

Fig. 2 Panorama radiograph at the first visitTreatment progresses
2014/ June
September
2015/ February
MayNovember
2016/ July
2017/ January
February,First visits
Extraction of #16, #15, and #24.
Two implants (GENESiO Plus, GC, Japan) were placed in the regions of # 14
and # 24 with socket rifting.
Second-stage surgery for the implants
Vertical dimension was increased using a treatment denture.
Functional Bite Impression (FBI)4) was madePorcelain fused to metal crowns with milling on their lingual sides were placedon the six anterior remaining teeth. IARPD with Co-Cr framework weredelivered.
Magnetic attachments (GIGAUSS D400, GC) were set on the custom abutments
using adhesive cement (Super Bond, Sun Medical, Japan).

Fig. 3 Magnetic attachments (GIGAUSS D400, GC) were set on the customabutments using adhesive cement (Super Bond, Sun Medical, Japan).

Functional Bite Impression (FBI)

A

B

E

F

C

D

Fig. 4 FBI tray (Fig. A) was fabricated and tried in the oral cavity (Fig. B). Using theauto-polymerized resin (Pattern resin, GC) on the occlusal surface, the functional generated path
was recorded (Fig. C). The definitive impression (Exafine, GC) was made under the occlusalpressure after the border molding, and the anatomical morphologies of the opposite teeth wererecorded with white silicone impression material (fit checker, GC).

Delivered the prosthetic appliancesabdc

Fig. 5 View of mucosal surface of metal base denture (Fig. a). Fabricated porcelain fused tometal crowns with milling on their lingual sides and IARPD with Co-Cr framework (Fig. b),
Intraoral photograph when wearing prosthesis (Fig c, d).

Fig. 6 Panorama
postoperative visit

radiographattheDiscussions
Sufficient retention and stability could be provided by the combination of milling crowns andmagnetic attachments, and satisfactory aesthetic and function could be achieved using the IARPD.

References
Ohkubo C, Effect of implant support on distal extension removable partial dentures: in vitro
assessment, J Oral Rehabili 34(1):52-56, 2007.
2. Ohkubo C, Effect of implant support on distal-extension removable partial dentures: in vivo
assessment, Int J Oral Maxillofac Implants 23(6):1095-1101, 2008.
3. Suzuki Y, Kono K, Shimpo H, et al, Clinical Evaluation of Implant-Supported Removable
Partial Dentures With a Stress-Breaking Attachment, Implant Dent 26(4):516-523, 2017.
4. Shimizu S, Sato Y, Shirai M, et al, Occlusion accuracy of restorations and removable partial
dentures fabricated using the impression under Occlusal force with FGP, J Oral Sci, in Press.
1.