Rehabilitation of a Failed Implant-Supported Mandibular Complete Denture Using Cast Copings: A Case Report Implant Rehabilitation with Cast Coping

Abstract

Background: Managing a completely edentulous patient is a major challenge to both the patient and the clinician, as most patients experience difficulty in using the new prosthesis fabricated. The conventional course of treatment for these individuals has been removable complete maxillary and mandibular dentures. Nonetheless, they have been associated with problems such as discomfort, instability, retention and functional impairment.

An Implant-supported overdenture restores dental and alveolar tissues and provides improved facial support, better comfort, long-term patient acceptance and satisfaction.  The design of implant-supported overdentures varies based on the attachment method and the desired level of implant and ridge mucosa support. These attachment designs include bar and ball attachment systems, studs, magnetic attachments and telescopic copings. Failure of attachments, wear, and fracture of the prosthesis or abutment screws results in mechanical complications.

Clinical Case: A Case of an 84-year-old female who presented to the Prosthetics clinic, University of Benin Teaching Hospital, Nigeria for rehabilitation of a failed implant-supported mandibular complete denture using bar cast coping. She had an all-on-four implant-retained mandibular overdenture with a resilient liner done outside the country. The prosthesis was replaced with a new acrylic mandibular overdenture retained with cast copings and a bar over the implant. She had one and four weeks of post-insertion review.

Conclusion: Fabricating a new prosthesis using a cast coping and bar attachment enhanced the patient's denture success criteria after the implant-supported overdenture failed. This illustrates the prosthetic options in difficult prosthodontic situations.