Producing a Telescopic Denture
STEP 1 – First surgery visit
- Take upper and lower full arch silicon impressions.
- Send impressions to the lab.
STEP 2 – In lab
- Cast models.
- Make upper primer (inner crowns) for telescopic denture.
- Make upper wax bite block.
- Make upper special tray with holes.
STEP 3 – Second surgery visit
- Try primer crowns in the patient mouth (inner crowns).
- DO NOT CEMENT ANYTHING AT THIS STAGE.
- Record the bite using wax bite enclosed.
- Take silicon pick up impression of the inner crowns using the special tray enclosed.
- Send the impression for the attention of lab manger to ensure impression is casted in the correct manner.
STEP 4 – In Lab
- Cast model.
- Make secondary crowns on top of the primers enclosed.
- Make upper metal frame with acrylic teeth set up in wax.
- Weld the secondary crowns to the frame. Build up the secondary crowns in composite.
STEP 5 – Third surgery visit
- Without cementing anything at this stage, try the fit of the frame with the inner crowns in the patient’s mouth.
- Ensure to check the fit and shade.
- If you need any adjustment (to the frame design) let the lab know at this stage.
- If you are pleased with the aesthetics send the work back to the lab to be finished.
- It is very important not to lose any components and not to cement anything at this stage.
STEP 6 – Final in lab
- Finish the upper frame in veined acrylic.
- Send everything back to the surgery.
STEP 7 – Final surgery visit
Ensure all crowns/primers are attached to the frame and place everything in the mouth at the same time. Cement only one or two primers at a time, repeat this process until all primers are cemented.
Indications for a telescopic denture
- Few remaining or unfavourably distributed abutment teeth.
- Extensive caries or poor contour on abutment teeth that therefore need to be covered by crowns.
- Advanced periodontitis.
- Abutment teeth that are not parallel, making path of insertion difficult to find.
- Oral cancer.
- Undergone occlusal reconstruction.
- Poor manual dexterity.
Good Retention and Stabilization
The great retentive force is a result of the accurate contact and tight fit between the inner and outer crown surfaces.
Occlusal forces transferred through the long axis of abutments is achieved because the crowns surround the abutments.
Common Path of Insertion
This can be easily created as the inner crowns surround the abutment.
Easy to Keep Clean
As the denture can be removed, this allows an effective home oral hygiene regime. The excellent fit of the inner crown of the abutment may protect the tooth from caries.
The double crown technique is more aesthetic than a conventional denture as there are no visible clasps.
Ease of Repair and Adjustment
Telescopic dentures can be easily repaired, even when an abutment has been lost.
Length of Completion
The fabrication contains complicated clinical and laboratory procedures, which can result in the treatment period being long and increased costs.
The retention of the denture can only be evaluated after cementation of the crowns. The repeated removal and insertion of the denture will eventually decrease the retentive mechanical force as the metal wears.
If the crowns do not accurately cover the whole of the abutment and the patient has poor oral hygiene, cervical caries may occur.
Extensive Follow up Required.
Technical failures may occur such as loss of cementation, loss of facings, fracture of artificial teeth, and fracture of framework or denture base. Therefore, regular appointments for assessment and maintenance is necessary to prevent failures.