The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

A case changed from fixed superstructure to removable superstructure
for elderly patients
M.Iwamoto1.2,J.Ashizawa2,W.Atsuta2,T.Kanno2,T.Mizuguchi2,J.Tanaka2
12

MI General Dental Clinic,Shizuoka Japan
Clinical Implant Society of Japan

Introduction
In defect prosthetics, the usefulness of implant treatment is widely recognized and is becoming acommon treatment. As a result, the superstructure may fracture or design changes may be necessary.
In this study, we experienced a case in which an elderly patient was changed from a fixed
superstructure to a removable superstructure in consideration of the possibility of becoming along-term care patient in the future.

Case report
1.Patient Information
The patient was a 77-year-old woman, and the main complaint was that the teeth were wobbly andpainful when chewing, and the gums were swollen. I had experience with implant treatment at otherdental clinics for more than 10 years, and I had a fixed prosthetic device for implant abutments in 13,
23, 24, 26, 27, 28, 35, 36, 37, 44, 46, and 47.
2.Treatment Procedure
In December 2017, a tooth with poor prognosis in the upper jaw was extracted under inpatientmanagement, in February 2018, the superstructure of the upper jaw was removed, and in March
2018, the remaining tooth that was judged to have a poor prognosis was extracted under inpatientmanagement. As of October 2023 (5 years later), no abnormal findings were found in the oral cavity,and no abnormal findings such as pronounced bone resorption or peri-implantitis were observed on
X-rays.

[Web Presentation] PS1-1-1

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

Fig.1 Panoramic radiograph at the first examination

Fig.2 Intraoral photograph after tooth extraction on the upper right mortar

Fig.3 Intraoral photograph After superstructure
removal and after fitting a temporary tooth.

Fig.5 Denture completed

Fig.4 Fabrication of a denture after extractionof a tooth with a poor prognosis.
(bite registration, denture trial fitting,bite-Seating impression, trial fitting of themetal base).

Fig.6 Magnetic attachments were fitted to the denture.

[Web Presentation] PS1-1-2

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

Fig.7 Intraoral photo after fitting the keeperof a magnetic attachment.

Fig.9 Panoramic radiograph in July 2018

Fig.8 Intraoral photo after wearing denture.

Fig.10 Panoramic radiograph in October 2023

Results
We obtained excellent results.

Discussions/Conclusions
This time, we changed the design of the superstructure of a patient who had undergone implant
treatment at another clinic in the past. Due to the deterioration of systemic diseases, surgicalprocedures and additional implant placement were not possible, and in anticipation of the need forlong-term care, cleanability was emphasized, and the treatment policy was decided after sufficient
discussion with the patient and family. Areas that are difficult to remove were polished to avoid
lacerations due to exposed abutments, and implant overdentures were created. This time, I realizedthat it is very important to determine the treatment plan and provide oral cleaning guidance not onlyto patients but also to their families. Therefore, it is necessary to develop further guidelines andexplain future design changes to patients in advance.

References
1)

2)

J Tanaka,Evaluation of the level of need for design changes to implant overdentures
Dental Outlook 2015;8:242-250
J Tanaka: Fundamentals and clinical applications of implant over dentures new edition-Focused on applying magnetic attachments, Ishiyaku Publishers Inc, Tokyo, 2020,
148-155.

[Web Presentation] PS1-1-3