Can both implants and teeth be used as abutments in a single partial?

I have a patient who I have treatment planned for a maxillary removable partial denture.  He currently has teeth #7-11 [maxillary right lateral and central incisors and maxillary left central and lateral incisors and maxillary left canine; 12 – 23]. I would like to install an implant in #6 site [maxillary right canine; 13] and use it for an abutment for the maxillary removabe partial denture.  I would also like to use #11 natural tooth on the contralateral side.  Can I do this?  Would you recommend a Locator attachment or PFM on #6 implant as the abutment?

9 thoughts on “Can both implants and teeth be used as abutments in a single partial?

  1. CRS says:

    I think a better option would be two three unit posterior implant bridges. (Don’t have an X-ray ) The single unilateral fixed implant may act as a fulcrum and damage the natural teeth. Not sure about stress relief in the partial. Or at least another implant on the other side to balance. Did you check out Dr Misch’s prosthetic treatment planning book? Perhaps the locator option would be better. Sorry not to be much help but I wanted to get the discussion started Partials tend to slowly extract teeth,age of patient?

    • Dr. Dan says:

      You can, but you have to inform the patient that this solution is not a permanent solution and that at some point more implants may be needed to make a more definitive overdenture.

      • Gerald Rudick says:

        Implants are a terrific way of helping retain a removable partial denture when some natural teeth are still present…..there will be no unsightly clasp, and there are many variety of prosthetic options to help retain the partial.
        The patient should be informed that more is better than less…… and therefore it would be advisable to place at least two implants, preferably splinted with a metal frame that will support a Hader Bar, or a couple of ball attachments or Locator attachments if height is a concern.
        The initial implants can work in unison with future implants should at a future time the patient decides to have fixed implant supported bridges, instead of an overdenture situation.

        Dr. Gerald Rudick Montreal, Canada

  2. Pankaj Narkhede, DDS; MDS;FAAID (hon) says:

    Yes! you can do it. Check zest attachments. The only problem would be lifting of the palate. This being a temporary solution. Patient be advised denture adhesive at present and implant on #3, 14 in future with attachments.
    OR
    Place implant on # 12 instead of making # 11 as attachement. Therefore you have 7-11 teeth, implant # 6, 12 — n future #3, 14 –

  3. Dr. Trevor says:

    I have done it many times with good success. Pankaj and I agree that #12 may be a better location. I primarily use Locator abutments and consider them to have superior retention to a clasp on a natural tooth.

    As you work with this patient in the future, remember that additional implants will improve the function of the prosthetic. The case will be improved with posterior implants (sites #3 and #14). An additional implant in site #5 would improve retention and allow you to eliminate the unsightly clasp on #6. As long as you are using removable abutments, you can use those same implants to retain future fixed bridges. I used that strategy to transition a budget minded patient with insurance benefits into fixed bridges over a few years. It is a very comfortable plan for the right patient because each implant improves the function of the partial, they are never without teeth and at any point they can determine that their treatment is complete.

  4. michaeljohnsonddsms says:

    contrary to other opinions, this is an excellent solution. do not use an overdenture abutment, the partial will rock around this and many times, in the partially edentulous situation, there isn’t enought interarch space for the abutment, attachment and a bulk of framework and acrylic for strength without overbulking the RPD. Instead, make a conventional implant retained crown with either a distal semiprecision attachment or simply a cingulum rest and mesiobuccal undercut for a conventional gold wire clasp. It takes a very difficult RPD situation (clasping to a lateral) and makes it simple. Unfortunately, not many practitioners understand removable partial denture design and forget that well made partials can be a great restoration. I agree that implant bridges are ideal but fixed restorations are significantly!!! more expensive. Nice design!

  5. CRS says:

    An implant is not a tooth it is fixed without a PDL. An unbalanced single implant will be a fulcrum to help the extraction process. I like the #12 position and the #6 positions for cross arch stabilization see other excellent posts. I think the key is balance. The possible lack of inter arch distance is remedied by an alveoplasty in that area. This is hard to judge without an X-ray. It is a smart play to plan for eventual implants in the second premolars and canine areas for locators. Placing a single implant will only speed the extraction process think balance! Great post!

  6. Sharon Goodwin says:

    This is a really great post!!! I like the ideal of #6 and #12 implant for cross arch stabilisation.When I was in the prostho residency we were always advised that implants in the maxilla should be splinted with a bar and free standing implants in the maxilla with attachments are more likely to fail.
    If you wanted to plan for a bar retained overdenture in the future in case teeth #’s 7-11 are going to fail,is it acceptable to do enough alveoplasty at site #6 and #12 for the individual Locator attachments without compromising the attcahment/osseous levels on #7 and #11? I know you need much more space like 4mms more, for a bar retained overdenture vs individual Locator attachments.
    For CRS….would you do a full palatal coverage in CoCr for the overdenture with the Locators on #6 and #14?
    Thank you!!!

    • CRS says:

      I would place two implants in the bilateral molar areas before removing the palate. It’s really theorectical since we don’t have an xray! I was advised by my prostodontist to place the locators in the canine/first molar areas. I find that if you plan for the eventual failure of 7-11 it would be safe, The alveoplasty is not a problem. Great post thanks!

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