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

A Case of recovery from Occlusal dysfunction by Crestal approach andMagnetic attachment to Implant Super-Structure for Aggressive
PeriodontitisAuthor(s):○ JIN ASHIZAWA＊1,2 MAYA IWAMOTO＊2 TAKESHI KANNO＊２
WATARU ATSUTA＊2 TOSHIYUKI MIZUGUCHI＊2 JYOJI TANAKA＊2
Affiliation/Organization: KINSHICHO SMILE DENTAL CLINIC ＊1
CLINICAL IMPLANT SOCIETY OF JAPAN ＊2

AbstractImplant overdentures (hereinafter referred to as IOD) are extremely useful in today's super-aging
society, as they provide high therapeutic effects with a small number of implants, are easy tomaintenance, and keep treatment costs low. This is a great treatment method. When selecting an IOD,
we believe that the selection of attachments is very important.The main attachments are Bar, Ball,Rocator, and Magnetic.Among these, Magnetic has a smaller retention force than others, but It is easy
to maintenance and easy to remove, which is advantageous for elderly people.We believe that theadvantage is that it can be applied even if the implant has poor orientation, and the retention force does
not deteriorate with use, so it does not require periodic replacement like the Rocator.

Introduction
This time, we performed a fixed implant Bridge using the Sinus -Lift method for thedefective free end of the maxilla, and an IOD using a magnetic attachment for the freeend defect of the mandible. As a result, the occlusal function was improved. We attempted
to restore the patient's appearance, and we would like to report hat the patient's progress
was good.

Case Report.

Fig 1:

Patient Information
First visit : 3 , Oct ,2009,Sex : Female , Age : 51 y
Medication : None , Medical history : N.P.
Chief compliant: Maxillary Anteior tooth was natural omissionand overall tooth mobility[Web Presentation] PS1-2-1

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
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Treatment procedure.

Fig 2:First Visit
Intra-oral Findings
Oct ,. 2009

Eichner Class B2

Bio-type: Thin-Scallop

Pigmentation: (-)

Alveolar ridge deformity: (-)

Metal tatoo: (-)

Gingival colar : Pink

Tooth wear: (-）

Mandibular torus: (-)

Keratinized tissue: (+-)

Fig 3: First Examination Periodontal Chart. 3, Oct, 2009

Problem List
1.Diffuseness aggressive periodontal
2.Hopeless tooth
3.Mobility tooth
4. Posterior Bite Collaps[Web Presentation] PS1-2-2

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

Treatment Goal
1. Providing appropriate forward guidance and establishing vertical stops
2, Acquisition of cleanability and long-term stable periodontal tissue
3 , Correction of the tooth axis
4 , Retention of jaw position after final modification
Fig 4: Hopeless Tooth Extraction after at December , 2010
Pre Operation Implant Placement First Visit past 2 months laterFig 5: Initial Treatment post & First Provisional Restration at January , 2010

[Web Presentation] PS1-2-3

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

Fig 6: Upper Left side Implant Placement at SinusLift(Crestal approach byOsteotome technique) at February , 2010

Fig 7: X-ray

Pantography

Guidelines for the selection of various attachments in implant abutment overdenturesBar Attachments

Stud Attachments

Magnet Attachments

Chewing function is restored◎○×

Maintain long-term stability△△◎Arch form recovery○◎◎

Restrictions on planting positions

areareless

Restrictions on planting directionsarehere arefew

Tolerance of abutment parallelism

Less

Less

Large

Use with natural teeth

×

○

Yes

Dealing with V-shaped jaws

×

○

○

Clearance Large

◎

○

○

Clearance Small△○○

Maintenance

△

○

○

Mechanic operation iseasy

difficulteasy

Economy△○○Jaw absorption mild△◎○Moderate◎◎◎Altitude○△◎[Web Presentation] PS1-2-4

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

Fig8:Second-Stage
Surgery&SecondTemporary
FullDenture
September , 2010

Fig9:Final Restoration
at January . 2011

[Web Presentation] PS1-2-5

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

Fig 10: Comparsion between InitialExamination and Final Restoration
PreAfter

Fig11:Final Restoration
past 12years 11months
later at Dec , 2023

Benefit of Implant Over Denture
1, Minimally invasive surgery
2, Design frexibillity
3, Low cost
4, Short term
5, Easy maintenance[Web Presentation] PS1-2-6

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

Reflection
Ideally, I think it's best to bury it on both sides of the Ap spread3,7.From the point ofview of bone mass problems and anatomy, natural teeth could be preserved in #14.#21
and #24, but in which part was it correct to place it? (The placement position
considered from the superstructure is also important in IOD,It is essential to set up ahighly rigid reinforcement structure <top reinforcement, three-dimensional structure>.

Conclusion
There are Bridge, Denture, and Implant as a way to deal with missing dentition, butwhen considering a missing prosthesisVarious factors must be carefullyconsidered.A large number of implants cannot be applied due to physical burden or
financial reasons. In the case as well, the benefits of implants can be achieved byusing Over Denture.I think I was able to make the most of it.By utilizing theattachment< the functional recovery > and the < abutment and jaw maintenance >We
believe that it is possible to create a harmonious and highly predictable state.
We will continue to monitor it closely in the future.

References
1, Ceruti P, Bryant SR, Lee JH, MacEntee MI.
Magnet-retained implant supported overdentures:review
and 1-year clinical report.J Can Dent Assoc 2010; 76: a52
2, Cristache CM, Muntianu LA, Burlibasa M, Didilescu AC.
Five-year clinical trial using three attachment systems.
for implant overdentures.Clin Oral Implants Res 2014;25(2):e171-178.
3, Yang TC, Maeda Y, Gonda T, Kotecha S
Attachment systems for im-plant overdenture: influence of implant
Inclination on retentive and lateral forces.
Clin Oral Implants Res 2011;22(11):1315-1319.

[Web Presentation] PS1-2-7