A Case Report of a Removable Denture Using Magnetic Attachments for
Mandibular Molar Missing with a decreased occlusal vertical dimension
R. Negoro, M. Sone, F. Okutsu, T. Kusano, T. Matsukawa, Y. Toyota, S. Yorichika, K. Okamoto and S.
OhkawaDivision 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
vertical dimension (OVD). This case report describes our establishment of an appropriate OVD for apatient (Eichner B3: mandibular molar missing) with a decreased OVD to restore the aesthetics andfunction by the use of magnetic attachments.

Clinical History
The patient, a 59-year-old female, complained of aesthetic dissatisfaction and masticatory dysfunction.
The patient had a partially edentulous maxilla (Eichner B3: mandibular molar missing). All fixed
prostheses were failed restorations with a marginal discrepancy and damaged by caries. The patientrefused to wear a mandibular removable partial denture because of dissatisfaction with a visible metalclasp on the anterior teeth. She was diagnosed with intraocclusion by analysis of OVD (Fig.1). Finally,
we suggested that a mandibular removable overlay denture with coping-type of magnetic attachments
and a maxillary removable partial denture with extracoronal-type of magnetic attachments and porcelain
fused to metal crowns were fabricated, which the patient found acceptable.

Fig.1 Intraoral view at the initial examination

Treatment Procedure
At first, the prostheses with the marginal discrepancy were removed (Fig.2), and temporary restorations
were placed. The #3 and #12 teeth were extracted because of severe caries. After the preprosthetic
treatment, the OVD was increased by the use of the treatment denture, and the patient obtained anadequate occlusal relationship (Fig.3).

Fig.2 Intraoral views of removing theprosthesis with the marginal discrepancy

Fig.3 Intraoral views of inserting
temporary restorations and treatment
dentureAs a definitive prostheses, a maxillary removable overlay denture with coping-type of magnetic
attachments and a horseshoe plate as the major connector was fabricated (Fig.4), and a mandibular
removable partial denture with an extracoronal-type of magnetic attachment was also fabricated (Fig.5).
The magnetic attachments in this case report were used by GIGAUSS C400® (GC, Japan). The keepersof the magnetic attachment and magnetic assemblies were fixed with adhesive resin cement (Multilink®
Automix, Ivoclar Vivadent, Liechtenstein) (Figs.6 and 7). Fig. 8 is an intraoral view of the definitive
prostheses.

Fig.4 Maxillary removable overlay denture

Fig.5 Mandibular removable denture

Fig.6 Keeper of a magnetic attachments

Fig.7 Extracoronal type of magnetic
attachments

Fig.8 Intraoral view with definitive prostheses

Conclusions
A magnetic attachment could be provided as a means for alleviating patient concerns regarding
aesthetics and functions. It is difficult to maintain an ideal combination of aesthetics and functionality
because the design of a final prosthesis is complex. Therefore, continuous follow-up is necessary withocclusal adjustment and relining of the denture base to prevent any reduction of the OVD. In addition,
periodontal management and force control of the remaining dentition should be evaluated during themaintenance program.