A Case Report of Occlusal Reconstruction with Overdenture Using Magnetic
Attachments
Y. Kawakami, M. Sone, F. Okutsu, T. Matsukawa, Y. Toyota, R. Negoro, S. Shimokawara, M. Seki, K.
Okamoto, and S. Ohkawa
Division of Removable Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai
University School of Dentistry

Introduction
To maintain a harmonious craniofacial system, it is essential to establish an appropriate occlusal verticaldimension (OVD). This case report describes the establishment of an appropriate OVD and occlusal
reconstruction with an overdenture using magnetic attachments.

Clinical History
The patient, a 65-year-old male, had a partially edentulous mandible (Eichner B1: missing mandibular second
premolar and first molar teeth) with the chief complaint of masticatory dysfunction. All maxillary prostheses
had failed, with a marginal discrepancy and caries damage. In addition, OVD analysis led to a diagnosis ofintraocclusion (Fig.1).

Fig.1 Intraoral view at the initial examination
In addition, upon periodontal examination, mobile teeth and poor periodontal tissue health were evident(Fig.2). Radiographic examination showed alveolar bone resorption (Fig.3). Finally, we made the treatment
decision to fabricate a maxillary overlay complete denture with magnetic attachments, which the patient foundacceptable.

Fig.2 Periodontal chart at the initial visit

Fig.3 Dental radiographs at the initial visit

Treatment Procedure
At first, the prostheses with the marginal discrepancies were removed, and the #6, 7, and 8 teeth wereextracted due to severe caries and periodontitis. Then, an immediate denture in the maxilla was set on a portionof the edentulous area (Fig.4).

Fig.4 Intraoral view with an immediate denture
However, the patient was dissatisfied with the dynamic stability and retention of the immediate denture.
Therefore, the magnetic attachments that act as the retention elements were applied to the remaining radicularteeth (#3, 10, and 11 teeth). The magnetic attachments used in this case report were GIGAUSS D400® (#10 and#11 teeth) and GIGAUSS D1000® (#3 tooth) (GC, Japan). Keepers of the magnetic attachment were fixed withadhesive resin cement on the abutment teeth (Multilink® Automix, Ivoclar Vivadent, Liechtenstein) (Fig.5). As
a result, the patient’s complaints of functional dissatisfaction were resolved.

Fig.5 Seating of keepers on the abutment teeth
After the initial preparation (Periodontal treatment and extraction of the #14 tooth), the OVD was increased
both by use of the treatment denture and by the built-up restoration using composite resin materials on the teeth,and the patient obtained an optimal occlusal relationship (Fig.6a,b).

a: Intraoral view withtreatment dentureb: Composite resin restoration

Fig.6 Bite raisingAs a definitive denture, a maxillary complete overlay denture was fabricated with a metal framework made oftitanium alloy with magnetic attachments (Fig.7). Fig. 8 is an intraoral view of the definitive denture.

Fig.7 Maxillary overlay complete denture

Fig.8 Intraoral view withdefinitive denture

Conclusions
The results suggest that the magnetic attachment in the immediate denture could provide the patient with
comfortable retention earlier. Therefore, continuous follow-up is necessary with occlusal adjustment andrelining of the denture base to prevent any reduction of the OVD. In addition, periodontal management andforce control of the remaining dentition should be evaluated during the maintenance program.