Overdenture challenges - a case series report from a developing country

Abstract

Background: Overdentures generally provide superior treatment outcomes compared to conventional dentures. However, the satisfactory outcomes are associated with various challenges encountered by both the clinician during treatment as well as the patient during the use of the prosthesis. Objective: This paper discusses the challenges encountered by dental practitioners in a developing country – Kenya, while managing eleven different patients and how these challenges were successfully mitigated. Materials and Methods: Eleven patients had treatment done to restore function and aesthetics, utilizing acrylic and cast-metal overdenture prostheses, as was deemed appropriate, to mitigate various challenges. Design: This is a case series. Herein, the clinical management of eleven edentulous cases, utilizing overdentures is illustrated. Results: Limited vertical dimension of occlusion encountered in two patients with Amelogenesis Imperfecta, was mitigated by performing mock jaw registrations before the definitive prosthetic work. Limited maxillary ridge resorption encountered in three patients was mitigated by having the maxillary labial flanges in their narrowest dimensions, or placing the periphery of the denture below the height of contour. Denture bases were strengthened in four patients’ prostheses by utilizing cobalt chromium frameworks on the mandibular overdentures. Telescopic crowns on overdenture prostheses fabricated over vital abutment teeth were utilized in three cases. Despite the prohibitive cost of treatment in developing countries, one patient had an implant-retained mandibular overdenture fabricated. Conclusion: When a clinician is well-versed with the challenges to anticipate and how to overcome them, the use of overdentures yields satisfactory results for the patients