Long-term follow-up case reports on the use of magnetic
attachment as intracoronal/extracoronal attachments
T. Goto1, Y. Ishida1, K. Nagao1 and T. Ichikawa1
1

Department of Oral & Maxillofacial Prosthodontics, Institute of Health Biosciences, The Universityof Tokushima Graduate School

Introduction
In recent years, the magnetic attachment has been applied to the removable prostheses, such as bar
attachment, intracoronal and extracoronal attachment. In this clinical report, three long-term
follow-up cases of removable dentures using magnetic attachment are presented.

Case 1The patient, 79 years old woman, was referred to the clinic with complaints of masticatory
dysfunction and poor esthetics caused by the missing teeth. The missing teeth were 11-13, 15, 16,21-23, 26 and 35-36. In this case, the removable bridge with intracoronal magnetic attachment at 17,
14, 24, 25 and 27 for upper side and removable dentures for lower side were applied. The patient
was satisfied with these dentures. About three years later, 27 was extracted due to the periodontal
reasons, then the removable bridge was repaired with the denture base at 26 and 27 (Fig.1-a).
Twelve years later, patient addressed the complaining of the pain at 14 and the denture base atpalatal region (Fig.1-b) was then placed to the removable bridge for increasing the supporting zone(Fig.2).

ba

Fig.1 The removable bridge for upper side
(a: Denture base at 26 and 27, b: Denture base at palatal region)

Fig.2 The views of intra oral and removable bridge (left: Intra oral view without bridge, center: The
removable bridge after repaired, right: Intra oral view with bridge)
The patient has been recalled for fourteen years with scaling and checking the fit of denture base. In
this case with the magnetic attachment, when the abutment teeth were lost, the concept of increasing
the supporting zone for the occlusal force was confirmed.

Case 2This patient, 81 years old woman, complained with poor esthetic of lower denture and instabilityof the upper denture. The missing teeth were 11-16, 21-27, 35-37 42 and 45-47. In this case, theremovable partial denture with extracoronal magnetic attachment at 34 and 44 for lower side andremovable dentures for upper side were applied. Regarding the mechanical stress in extracoronalmagnetic attachment, the remaining teeth of 31-34, 41, 43 and 44 was connected with fixed bridge
before the removable partial denture was set (Fig.3). The reasonable space was allocated between theextracoronal magnetic attachment and residual ridge mucosa for easy to clean by patient. The patientregained masticatory function and esthetic with these dentures (Fig.4).

Fig.3 The fixed bridge at anterior region and the partial denture for lower side

Fig.4 The oral view with removable dentures(left: Frontal view with dentures, right: Intra oral view with dentures)

After about fifteen years, the removable denture for upper side was refabricated with titanium castplate denture. Clinical maintenance with scaling and occlusal adjustment for this patient has
executed over fifteen years (Fig.5). In such a case with extracoronal magnetic attachment, themechanical problems with cantilever effect of extracoronal attachment and the hygiene under theattachment should be considered. In this case, the fixed bridge at the anterior region and appropriate
morphology of extracoronal attachment were addressed to these problems.

Fig.5 The oral view with removable dentures after about fifteen years(left: Frontal view with dentures, right: Intra oral view with dentures)

Case 3This patient, 50 years old man, came with complaint of masticatory dysfunction caused by the
missing teeth. The missing teeth were 46 and 47. The removable bridge with extracoronal magnetic
attachment at 45 and intracoronal magnetic attachment at 48 were applied to this patient. The
reasonable space was allocated under the extracoronal magnetic attachment for easy to clean up as
well as the “case 2”. The extracoronal magnetic attachment was applied to reasons of poor esthetic
in clasps by patients and vital tooth of 45 (Fig.6). This patient has been scheduled for occlusal
adjustment and checking fit of removable prostheses for nine years (Fig.7). The comfortable
mastication and good periodontal condition could be observed.

Fig.6 The view of removable bridge and the keepers in working cast at 45 and 48(left: Bottom view of removable bridge, center: Keepers in abutment teeth, right: Oral view withremovable dentures)

Fig.7 The oral view with removable dentures after nine years

Conclusions
To conclude, the treatment with magnetic attachment applied for the intracoronal and extracoronalattachment was reliable plans, however careful periodic examination and occlusal adjustment isessential for long-term better prognosis.