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

Case report of the efficacy of magnetic attachments with upper complete
denture using implants for different skeletal types.
Wataru Atsuta1,2, Yuka Atsuta1, Maya Iwamoto2, Jin Ashizawa2, Takeshi Kanno2, Kazumasa Hoshino2,Toshiyuki Mizuguchi2, Jyoji Tanaka2
12

Blossom Dental Office, Tokyo, Japan
Clinical Implant Society of Japan

Abstract: The aim of this presentation is to consider the utility of implants and magnetic attachmentsin the case of complete overdentures with different skeletal types. Those upper complete overdenturesin the maxilla of two patients diagnosed class II and class III skeletal types were not enough getting
stability due to unique problems of remaining teeth position and skeletal types.
Case 1 First visit: October 2012, 62-year-old female.
This patient exhibited skeletal class Ⅱ type. The upper prosthesis transitioned from a fixed bridge to acomplete denture. Dental implants were placed in 6┴6, and a magnetic attachment was attached.
Case 2: First visit: January 2013, A 58-year-old male.
This patient exhibited skeletal class Ⅲ type. The upper prosthesis was transitioned from using clasps
denture to a maxillary complete denture with the remaining 2┴235 teeth and placed 76┘dental implants
and attached the magnetic attachments.
Those problems were solved by using dental implants and magnetic attachments for modified fulcrum
lines of the residual roots and retentive force. It has been suggested that the use of dental implants andmagnetic attachments were very useful in cases with such complex problems.

I. Introduction
There are some factors that inhibit of stability of maxillary complete dentures. Skeletal type is one of them.
Complete overdentures case in the maxilla of two patients diagnosed class II and class III skeletal types were
not enough getting stability due to unique problems of remaining teeth position and skeletal types. In suchcases, it was difficult to solve the problem with complete denture treatment techniques only. We reported
experienced that the problem could be solved by using dental implants and magnetic attachments.

II. Objective
The aim of this presentation is to consider the utility of implants and magnetic attachments in the case ofcomplete overdentures with different skeletal types.

III. Materials and Methods
1 Patients’ data Case1
Case 1 First visit: October 2012, 62-year-old female.
This patient exhibited skeletal class Ⅱ type. The upper prosthesis was transitioned from a fixed bridge to acomplete denture du e to removing teeth for periodontitis. Dental implants were placed in 6┴6, and amagnetic attachment was attached (Fig.1~3).
Fig.1 Pre-treatment intra-oral view

[Web Presentation] PS2-3-1

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

Fig.2 Comparison of pre and post initial periodontal therapy for Panoramic X-ray.

Fig3 Analysis of ANB for CBCT and problem list
ANB ：6.25°（Japanese female 3.05 S.D. 1.23）
Diagnosis: Skeletal maxillary protrusion
Skeletal Class Ⅱ
Periodontitis classification Stage Ⅳ Grade B
Problem list: Lip incompetence
Weak gagging reflex
2 Patients’ data Case2
Case 2: First visit: January 2013, A 58-year-old male.
This patient exhibited skeletal class Ⅲ type. The upper prosthesis was transitioned from using clasps
denture to a maxillary complete denture with the remaining 2┴235 teeth and placed 76┘dental implants andattached the magnetic attachments.
Fig.3 Pre-treatment intra-oral viewFig.4 Comparison of pre and post initial periodontal therapy for Panoramic X-ray.

[Web Presentation] PS2-3-2

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

Fig.5 Analysis of ANB for CBCT and problem list
ANB ：-0.57°（Japanese male 2.34 S.D. 1.30）
Diagnosis: Skeletal reversed occlusion
Skeletal Class ⅢPeriodontitis classification Stage Ⅳ Grade C
Problem list: Occlusal form in which the denture
is pushed up by the lower anterior teeth.
Desiring a short posterior denture border.

IV. Results
1 Case1: 6┸6 dental implants placement and magnetic attachments for Skeletal Class Ⅱ
By preserving the maxillary anterior teeth, the alveolar ridge was maintained, resulting in a further tendency
for maxillary protrusion. In order to improve the lip incompetence, it was necessary to shorten (thin) thelabial denture flange and further shorten the short posterior denture border, so dental implants were placed at6┸6 and magnetic attachments were attached to maintain the denture. As a result, the lip incompetence wasimproved, and the dentures were able to suction well (Fig.6).
Fig.6 Post-treatment intra-oral view (After 3years of wearing denture) and X-ray[Web Presentation] PS2-3-3

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

2 Case2: 76┸ dental implants placement and magnetic attachments for Skeletal Class Ⅱ
When improving the anterior occlusal relationship in a reversed occlusion, pushing up of the mandibular
anterior teeth can cause the denture to fall out, so to preserve the remaining teeth in the anterior region. And
it was placed dental implants at 76 ┸ sites because of further increasing the denture support area.
Furthermore, a magnetic attachment was added to provide suction. The patient wanted the posterior denture
border to be shortened, and this was achieved by magnetic attachment's function (Fig.7).
Fig.7 Post-treatment intra-oral view (After 1.6 years of wearing denture) and X-ray (After 7 years)

V. Discussions
Maxillary complete dentures are generally maintained by suction, but denture stability may not be achieved
due to various inhibiting factors, and skeletal class Ⅱ and Ⅲ are considered to be one of the inhibiting
factors. In case of skeletal class Ⅱ, in addition to the over angle of convexity of the labial side, the denture
flange suffers from insufficiency of entrance lip closure, resulting in constant lip pressure, and the undercut
becomes strong, resulting in a shortening of denture flange. Furthermore, in class Ⅲ, the denture falls out
due to pushing up of the mandibular anterior teeth. To solve these problems, if there is a residual root, thestability of the denture can be improved by widening the support area surrounded by the fulcrum line andaiming for bilateral symmetry, but it is difficult to maintain the denture due to poor suction. In such cases,
the use of implants and magnetic attachments has made it possible to increase the support area of the dentureand obtain suction. It was also suggested that the use of magnetic attachments could satisfy the gag reflex[Web Presentation] PS2-3-4

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

and the desire of a certain number of patients to shorten the trailing edge of their dentures (Fig.8).
Fig.8 Simulation of dental implant placement position and denture support area
8-1 Case1: 6┸6 dental implants placement
By using implants, it is possible to expand the support area symmetrically.

8-2 Case2: 76┸ dental implants placement
This case was diagnosed as having severe reverse occlusion, and it was diagnosed that it would be difficult
to place it on the anterior teeth. The implant was placed in a position where it could be placed on the alveolar
crest of the denture, with the aim of widening the support area.

VI. Conclusions
Those problems were solved by using dental implants and magnetic attachments for modified fulcrum
lines of the residual roots and retentive force. It has been suggested that the use of dental implants andmagnetic attachments were very useful in cases with such complex problems.

References1)
Jyoji T, Fundamentals and clinical applications of implant overdentures,12-29, Ishiyaku
Publishers,Inc. Tokyo, 2020.

[Web Presentation] PS2-3-5