Using an Implant to Retain or Support a Removable Partial Denture?

Dr. K asks:
Is there any way that we can use an implant to retain or support a removable partial denture? I see so many cases where there are too few teeth to provide adequate retention and support for a removable partial denture. I would like to place implants and either survey crowns or attachments. My first preference would be for survey crowns. Unlike Locators or ERA’s these do not need to be replaced. I am also more accustomed to using survey crowns for removable partial dentures. I have not seen anything about this. I welcome advice.

8 thoughts on “Using an Implant to Retain or Support a Removable Partial Denture?

  1. I have being holding partials in for 15 years using O ring abutments or the new Toadstool abutments from Simpler Implants. These work very well and are soft tissue supported. It eliminates those dangerous clasps as well.

  2. Dear doc K you didn’t explained how many teeth, what kind of teeth or minimum what class of Kennedy does he/she have? Anyway, it’s would be more difficult to open case, but I’m going to explain what is the most common placing implants to support RPD.
    -Yes you can place implants to support RPD same as a natural teeth if your cases are in class I or class IV Kennedy.You have to place long implant if your implants would be on DIRECT RETAINER for RPD.You never use direct retainer on implant and natural teeth.It’s better to place implants parallel and bilateraly(e.g in class I Kennedy if you place an implant on area tooth 21 or 22,so you have to place implant on area 28 or 29 too.It’s would be much favorable if you use an implant in RPD as a INDIRECT retainer.You mention you like to use an attachment with implant it’s okay in class I(free end)only, but you have to place two implants each side and better you splint them .However,use an attachment need strong dental LAB knowledge. I did on more than 80th cases with 10 years post follow up(I used intercoronal attachment and all dental lab job I did by myself). Hopefully, this information help you with your case,farther more,you remember
    -Never connect frame of the RPD unilaterally or bilateraly to natural teeth and implants.
    -Never use implants as direct and indirect retainer.It’s better use one of them.
    -Never use unilateral attachment on natural teeth and implants.You did good job usin SURVEY. Without surving on RPD same as grinding a tooth with blank eyes.
    Good luck to you.
    Dr.Vaziri- Tehran,Iran

  3. Dr. K,
    Yes, you can place an implant to get additional retention for your removable partial in cases where there are too few teeth for adequuare retention.
    If you look at those cases closely, you will see that many of them get support from the soft tissue. In those cases, you are better off planning the implant for additional retention and not for support.
    Consider a low profile attachment instead of a surveyed crown for two good reasons:
    1- It will look better since the shape of a surveyed crown with an attachment or a clasp is always less esthetic than the tooth included in the partial, and
    2-You bring the fulcrum of the forces to a low level (close to the gingiva) where there is less chance for the forces acting on the implant to cause any deleterious effects.
    I have cases like this that have been in the mouth for over a decade now without any problems other than an occassional o-ring change which takes me 5 minutes.
    Good question, and good luck!

  4. We have being using implants for patial dentures since about 10 years and actually for us is much better using MDI or similar implants also it is not so expensive for our patients with a very good results for a long term studies. Just try and will be so surpeised for the good results. All teh sugesttion of Dr.K and DR.Vaziri are important to take a note about.

  5. Using dental implants to add retention to unstable partial dentures is a terrific idea. Even a single implant with an attachment can make a very significant difference to the confidence and well being of patients. When there is unilateral edentulism one or two implants in the bicuspid/first molar regions can make a day and night difference. These areas are usually the most favorable sites for stabilization because of their strategic location in the arch and because it is difficult to place implants with attachments in the anterior segment (even at the cuspid site) because of the diminished vertical height in these regions. Where there is adequate room, ball/caps work very well or where vertical height is a problem “locators” are the connector of choice. I am not a big fan of “O” rings due to the high maintenance they seem to require. Combinations of clasps and implant overdenture segments work for years with minimal problems and the implants survive very well because they are minimally torqued.

  6. i have been using implant retained partials for over 5 yrs and have been very successful. the implants allow for more esthetics and greater retention than conventional rpds. i use locator type attachments. have many cases in use and no loss of any implants up to date. locators allow little torque on implants and you get soft tissue support as well. pick them up chairside with whatever product you prefer. good luck

  7. The easy answer is that implants can be used to retain a partial denture. However, in the situation you describe with few remaining teeth for retention, several issues come to the fore. First, with few remaining teeth, a complete diagnostic set-up is mandatory so that if you chose to do surveyed crowns, the surgical guide gets the implants placed directly under teeth and not inbetween teeth. Secondly,with few teeth remaining, the probability of diminished bone for ideal implant placement might become an issue. Locator attachments should only be used when the emergence angles of implants relative to one another are less than 20*. Surgeons often place implants in the only availaable bone and this can causes huge problems from less than ideal angulations

  8. Custom Abutments designed for an overdenture can be made for you with Atlantis Abutments. It is just important that you are clear in the Rx as to the intent to have an over denture and indicate the shape prefered for the abutments. Atlantis can give a high or low taper for retention and parrallel any number of abutments flawlessly. Telescope sleeves from your laboratory could be a consideration.
    Jon

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