A case report of a free end saddle telescopic denture using a magnetic
attachment for maxilla molars.
M. Sato, M. Hideshima*, J. Wada, T. Ando, J. Wadachi, M. Tsurumi, Y. Tsubota, Y. Odaka and Y.
IgarashiRemovable Partial Denture Prosthodontic, Graduate School,
Clinic for Conservation of Oral and Maxillofacial Function, University Hospital*,
Tokyo Medical and Dental University

Introduction
It is known that partially edentulous patients were not in favor of wearing removable partialdentures(RPDs) at the point of comfortable wearing, aesthetic aspect and the function. It is common
for the treatment of the unilateral distal extension defect with more than three molars(Kennedy ClassII) to choose bilateral design of RPDs in consideration of the long-term preservation of abutment
teeth and the residual ridge and of the movement of RPDs. However, considering patient discomfort
certain problems remain in bilateral design. We report the case that patient satisfaction was improvedat the point of comfortable wearing, aesthetic aspect and the function, using unilateral RPD design
by applying a Konus telescopic crown and magnetic attachment.

Case Report
The patient was a 45-year-old male. The chief complaint was malfunction of the maxillary left
molar bridge. This bridge was fabricated in a few years ago, and he began to feel uncomfortablefrom a few months ago. The bridge was moving subsequently, and he was no longer able tomasticate on left side.

Fig.1 Frontal view of remaining dentition at the initial visit

Fig.2 Panoramic radiograph at the initial visit
As shown in the Fig.1, the veneering crown of the maxillary left lateral incisor(#22) has been
fractured. Panoramic radiograph showed root fracture of maxilla left second premolar(#25) andsecond molar(#27) ,cervical caries of first premolar(#24) and a poor canal treatment of canine(#23).
Remaining teeth had been suffering from mild periodontal disease as a whole.

Treatment Planning and Procedures
After removing the bridge of the left maxillary molars, immediate resin plate denture(#24~#27)
was inserted at the same time as the extraction of #25 and #27(Fig.3 & 4). The denture was arranged
to bilateral design by setting wire clasps on #13, #16 and #23.

Fig.3 Occlusal view immediately after #25 and #27 extraction.

Fig.4 Occlusal view with immediate denture
A final denture was fabricated after root canal treatment of #23 and #24.
Considering comfortable wearing and aesthetic aspect, Konus telescopic denture was selected as
final denture(Fig. 5~7). The design was as follows;#23, #24 and #25 were selected as the abutment teeth. Konus telescopic crown was applied to #23
and #24.
Magnetic attachment was applied to #25 because the poor condition of it.
In this case due to less inter-maxillary space at the palate side of #24, the telescopic denture wasreinforced by applying the metal teeth(Fig. 7).
After obtaining retentive force of telescopic crown following the delivery of the denture, themagnetic assembly was embedded in the denture with auto polymerizing resin. The patient was
satisfied with comfortable wearing, aesthetic aspect and function.

Fig.5 Occlusal view without final denture.

Fig.6 Occlusal view with final denture

Fig.7 Final Konus telescopic denture with magnetic attachment

Conclusions
The final denture was arranged to unilateral design by using a magnetic attachment with a Konus
telescopic denture and was got sufficient satisfaction of the patient with comfortable wearing,aesthetic aspect and the funciton. In addition, somewhat suggestion was provided for the indicationof the unilateral denture by the combination of Konus telescope and magnetic attachment.

References
1. Nokubi T., Igarashi Y.: Contemporary removable partial denture, 102-109, Quintessence,Tokyo, 2000. (in Japanese)
2. Mizutani H.: Characteristics and clinical indication of magnetic attachment. J Jpn Prosthodont
Soc, 48: 10-19, 2004. (in Japanese)
3. Mizutani H.: Selection of retainer for removable partial denture –Conic telescope or magneticattachment?-. J Jpn Prosthodont Soc, 48: 138-141, 2004. (in Japanese)4.