Upgrading removable denture design by using strategic implants: A case report

Inserting a dental implant in a strategic position under a removable partial denture (RPD) can upgrade the RPD design by changing a mainly tissue-supported RPD to an implant-tissue-supported RPD or an implant-tooth-tissue-supported RPD with better retention, support, and stability. Case presentation: The patient (female, 77-year-old) was unsatisfied with her maxillary and mandibular clasp-retained removable dentures (RDs). Medical, social, and systemic health evaluations revealed that the patient was healthy. Dental history, intraoral and extraoral examinations, functional screening, and esthetic analyses revealed that the patient had a reduced vertical dimension, resulting in pseudo-class III malocclusion and angular cheilitis. Strategic implants were used to improve the retention, support, and stability of the new RDs. The maxillary canine 23 (World Dental Federation notation) and maxillary premolar 24 were used to retain the maxillary conical crown attachments. Three strategic mini-implants were inserted in the positions of teeth 12, 13, and 14 to support and retain the maxillary RPD. Two locators above the standard implants (33 and 43) were used to support and retain the mandibular overdenture. An improvement in the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular RDs was observed immediately after using the new RDs. This improvement did not diminish after a year. Conclusion: Herein, using strategic implants to support the maxillary RPD and two standard implants under the mandibular overdenture improved the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular prostheses in terms of the retention, stability, support, eating ability, speaking ability, appearance, and cleanability.