Minimally invasive implant-assisted removable partial dentures with surveyed crowns for atrophic edentulous arches: a retrospective case series with up to a 67-month follow-up.

BACKGROUND: The rehabilitation of completely edentulous arches with fixed implant-supported prostheses is often precluded by systemic, anatomic, or financial constraints that necessitate invasive posterior bone grafting. While conventional implant overdentures offer a surgical compromise, they frequently present mechanical complications such as loss of attachment retention and gradual collapse of the vertical dimension of occlusion over the long term. To address these limitations, this clinical report introduces a versatile paradigm utilizing implant-supported surveyed crowns (ISSCs) to retain an implant-assisted removable partial denture (IARPD).

CASE PRESENTATION: This report details the rehabilitation of four completely edentulous patients utilizing this protocol for two distinct purposes. First, it served as a primary rehabilitation strategy to circumvent invasive posterior bone grafting in medically compromised patients. Second, it acted as a prosthodontic revision strategy that repurposed existing, well-integrated fixtures from failing conventional overdentures, resolving severe biological and mechanical complications caused by problematic attachments. By strategically utilizing anterior implants to support splinted ISSCs and a distal extension IARPD, this approach provided stable vertical occlusal support and mitigated destructive cantilever effects. Over a follow-up period of up to 67 months, clinical and radiographic evaluations demonstrated favorable peri-implant tissue health with minimal marginal bone resorption (mean 0.44 ± 0.24mm). Furthermore, mechanical complications were minor and readily manageable, and patients reported a high level of masticatory and esthetic satisfaction.

CONCLUSIONS: The ISSC-retained IARPD is a predictable and minimally invasive treatment option for completely edentulous patients. By successfully bridging the biomechanical gap between fixed prostheses and conventional overdentures, it serves as both a primary and revision treatment. The favorable clinical outcomes of this protocol requires strategic implant distribution, precise prosthodontic design, and regular monitoring to prevent biomechanical overload.