Mandibular IOD using riegel telescope with magnetic
attachment
IMAIZUMI N1,2）, MARUO R1,2）, MUTO R2） SUZUKI Y1,2）, NAKATA T1,2）,
SHIMPO H1,2） , KURIHARA D1,2） , OHKUBO C1,2）
１）

2）

Dept. of Removable Prosthodontics, Tsurumi University School of Dental Medicine
Center of Maxillofacial Implantology, Tsurumi University Dental Hospital

Abstract【Objective】
Retention and stability of mandibular complete denture for fully edentulous patients can be
improved by implant placement. In this case, three implants were placed in the mandibular jaw, andriegel telescope denture with magnetic attachments was delivered to obtain well function.
【Method】
Three implants (Branemark MK II RP 10 mm, Nobel Biocare) were placed between the foramen
mentale in the edentulous mandibular jaw. Riegel telescope system was selected as a retainer ofmandibular implant overdenture (IOD), the milling bar and outer crown were fabricated with optimal
fitting. Three implants were connected by a milling bar with two holes which two rods could beinserted. The keeper and magnetic attachment (Hyper slim 5213, Neomax) were attached to the rods
and outer crown of the denture, respectively. The riegel telescope, metal backing, and T-shapestructured framework were cast with Au-Pt alloy and then accurately constructed.
【Results, Discussion】
Approximately 18 years were passed after delivery, there were little bone resorption around
implants and patient’s satisfaction could be kept by well denture stability. Magnetic attachment must
be useful device for not only direct retainer on the root and implant but also fixing of the rods in theriegel telescope.

Introduction
The use of implant support and retention to rehabilitate a mandibular edentulous jaw has becomea well-established and contemporary clinical method. There are lots of evidences that an
mandibular implant overdenture (IOD) significantly reduces certain problems compared toconventional mandibular complete denture.
Outline of the Case
The patient was a 55 years partially edentulous woman with 3 remaining teeth (#11, #13, and #14)
in the maxillary jaw and fully edentulous mandibular jaw. Her chief complaint was an unstable
existing mandibular denture. (Fig.1).
The patient received an explanation of treatment plan and was informed of the possibility for using
the conventional removable denture, implant-fixed prosthesis or an implant-retained overdenture.
After informed consent was obtained, the patient selected conventional overdenture for maxillary
jaw and implant-retained overdenture for mandibular jaw for economical and anatomical reasons.

Fig.1 Intraoral view before treatment:
Clinical ProcedureThree implants (Branemark MK II RP 10 mm, Nobel Biocare) were placed between the foramen
mentale in the edentulous mandibular jaw (Fig.2). Riegel telescope system was selected as a retainerof mandibular implant overdenture (IOD), the milling bar and outer crown were fabricated with
optimal fitting. Three implants were connected by a milling bar with two holes which two rods canbe inserted. The keeper and magnetic attachment (Hyper slim 5213, Neomax) were attached to therods and outer crown of the denture, respectively (Fig.3,4). The riegel telescope, metal backing, andT-shape structured framework were cast with Au-Pt alloy and then accurately constructed.
.

Fig.2 Three implants were placed following the surgical template:
A. Intraoral photography
B. Panoramic X-ray photography

Fig.3 Schematic drawing of riegel telescope system: A. Without locking, B. With locking

Fig.4 Riegel Telescope system
A. milling bar on the three implants
B. Inner and labial surface of denture base without locking
C. Inner and labial surface of denture base with locking
After the auto-polymerizing PMMA resin was polymerized, the implant-stabilized overdenture wasdelivered. For the maxillary arch, the middle coping was placed the right canine and second
premolar and a conventional overdenture was fabricated (Fig.5).
Results
The denture maintenances have been continued at once every six months. Approximately 18 years
were passed after delivery, there was little bone resorption around implants and patient’s satisfaction
could be kept by well denture stability (Fig.6). Although the lateral incisor was extracted byperiodontal disease, the maxillary denture could be continued to use by performing the direct reline
and repairs.

Fig.5 Placement of the dentures: A. maxillary view, B. Front view, C. Mandibular viewFig.6 Panoramic X-ray: A. 10 years after wearing dentures, B. 17 years after wearing dentures
Discussion
Sufficient retention and stability could be provided by the combination of riegel telescope system
and magnetic attachments, and satisfactory aesthetic and function could be achieved using themandibular IOD. Magnetic attachment must be useful device for not only direct retainer on the root
and implant but also fixing of the rods in the riegel telescope.