Prosthodontic Rehabilitation with Telescopic Overdenture: An Alternative for Severely Compromised Teeth

International Journal of Dental Science and Innovative Research (IJDSIR) IJDSIR : Dental Publication Service Available Online at:www.ijdsir.com Volume – 8, Issue – 5, September – 2025, Page No. : 05 - 09 Corresponding Author: Dr. Pallavi Thalakola, ijdsir, Volume – 8 Issue - 5, Page No. : 05 - 09 Page5 ISSN: 2581-5989 PubMed - National Library of Medicine - ID: 101738774 Prosthodontic Rehabilitation with Telescopic Overdenture: An Alternative for Severely Compromised Teeth 1Dr. Pallavi Thalakola, BDS, Masters in Health Information Technology from University of South Carolina, USA 2Dr. Rachel R. Changrani, MDS, Department of Oral and Maxillofacial Surgery, Private Practitioner 3Dr. Kawalpreet Kaur Kalra, BDS, Preet Medical and Dental Care, Patiala, Punjab 4Dr. Ritu Mohindra, Reader, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow 5Dr. Mohd Anwar, Reader, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow 6Dr. Deeksha Chaudhary, MDS, Prosthodontics 3rd Year, Babu Banarasi Das Dental College Corresponding Author: Dr. Pallavi Thalakola, BDS, Masters in Health Information Technology from University of South Carolina, USA Citation of this Article: Dr. Pallavi Thalakola, Dr. Rachel R. Changrani, Dr. Kawalpreet Kaur Kalra, Dr. Ritu Mohindra, Dr. Mohd Anwar, Dr. Deeksha Chaudhary, “Prosthodontic Rehabilitation with Telescopic Overdenture: An Alternative for Severely Compromised Teeth”, IJDSIRSeptember – 2025, Volume – 8, Issue – 5, P. No. 05 – 09. Copyright: © 2025, Dr. Pallavi Thalakola, et al. This is an open access journal and article distributed under the terms of the creative common’s attribution non-commercial License. Which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given, and the new creations are licensed under the identical terms. Type of Publication: Original Research Article Conflicts of Interest: Nil Abstract Background: Loss of teeth continues to be a significant challenge in geriatric and compromised dental patients. While complete dentures have long been used to restore function and esthetics in edentulous patients, their limitations in stability and bone preservation are well documented. In cases where teeth remain but are severely compromised, extractions followed by complete dentures or implant-supported prostheses are often considered. However, complete dentures accelerate alveolar resorption, while implants may be limited by systemic health, economic constraints, or inadequate bone volume. Telescopic overdentures, utilizing a system of primary and secondary copings, provide an alternative strategy that maximizes the utility of remaining teeth and improves prosthesis stability. Objective: This article reviews the role of telescopic overdentures in prosthodontic rehabilitation for patients with severely compromised teeth, examining their biomechanical principles, clinical indications, advantages, limitations, and future prospects. Methods: A narrative literature review was conducted using databases such as PubMed, Scopus, and Google Scholar, focusing on telescopic overdentures, compromised dentition, and prosthodontic rehabilitation strategies. Articles published between 1990 and 2024 were considered. Results and Discussion: Telescopic overdentures distribute occlusal loads axially, preserve residual Dr. Pallavi Thalakola, et al. International Journal of Dental Science and Innovative Research (IJDSIR) ©2025 IJDSIR, All Rights Reserved Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 Page6 dentition, and enhance retention compared to conventional dentures. They improve patient satisfaction by maintaining proprioception, esthetics, and stability. However, they are technique-sensitive, time-consuming, and require meticulous hygiene maintenance. Their success largely depends on accurate fabrication and patient compliance. Conclusion: Telescopic overdentures represent a valuable alternative for patients with severely compromised teeth when implants are not feasible. Advances in digital dentistry and biomaterials are expected to further enhance their clinical applicability and long-term outcomes. Keywords: Telescopic overdenture, Double crown system, Severely compromised dentition, Prosthodontic rehabilitation, Retentive prosthesis, Alternative to implants Introduction The preservation and restoration of oral function in patients with compromised dentition has long been a cornerstone of prosthodontics. With advancing age, periodontal disease, and caries, many patients present with severely reduced numbers of teeth, often with compromised periodontal support. Traditionally, such cases were managed with complete dentures following extraction of the remaining teeth. However, complete dentures are associated with significant drawbacks including poor retention, impaired masticatory efficiency, reduced patient confidence, and progressive alveolar bone resorption. 1,2, Implant-supported prostheses have emerged as a gold standard in modern prosthodontics due to their superior function, esthetics, and patient satisfaction. Nonetheless, systemic conditions such as diabetes, osteoporosis, or cardiovascular disease, along with financial limitations and inadequate bone availability, may restrict their use.3 In such situations, telescopic overdentures offer a middle ground between complete dentures and implantsupported prostheses. By retaining and utilizing remaining compromised teeth through primary and secondary coping systems, telescopic overdentures ensure retention, distribute masticatory loads axially, and preserve alveolar bone, all while providing patients with a removable, hygienic solution. Discussion 1. Biomechanical Basis of Telescopic Overdentures4 The telescopic overdenture is based on a double crown system comprising:  Primary coping (inner crown): Cemented permanently to the prepared abutment tooth.  Secondary coping (outer crown): Integrated into the removable denture and fitting over the primary coping. This arrangement creates frictional retention and ensures parallel path of insertion. The advantages of this biomechanical design include: 5,6  Axial load transmission: Functional forces are directed along the long axis of abutments, reducing tipping and lateral forces.  Splinting effect: Multiple abutments connected through the overdenture increase stability and reduce tooth mobility.  Stress distribution: Forces are shared between the teeth and edentulous ridge, preventing overloading of a single structure.  Retention and stability: Friction and precision fit provide greater resistance to dislodgement compared to conventional dentures. 2. Clinical Indications 7,8 Telescopic overdentures are particularly useful in the following scenarios: Dr. Pallavi Thalakola, et al. International Journal of Dental Science and Innovative Research (IJDSIR) ©2025 IJDSIR, All Rights Reserved Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7 Page7  Patients with few remaining teeth (often 2–6), compromised but strategically distributed across arches.  Periodontally weakened teeth that can be splinted and preserved rather than extracted.  Contraindications to implants such as systemic disease, anticoagulant therapy, or patient reluctance for surgery.  Elderly patients requiring minimally invasive and cost-effective solutions.  Cases with esthetic requirements where conventional dentures would compromise appearance. 3. Advantages 9,10  Preservation of natural teeth: Retaining even compromised teeth helps preserve alveolar bone and proprioception.  Improved retention and stability: Telescopic copings enhance denture stability compared to conventional dentures.  Esthetics: Metal copings can be hidden under denture material, providing good cosmetic outcomes.  Ease of hygiene: Removable design allows thorough cleaning of both abutments and prosthesis.  Longevity and adaptability: Can be modified if additional teeth are lost over time.  Psychological benefit: Patients retain their natural teeth, avoiding the psychological trauma of complete edentulism. 4. Limitations 11-13 Despite its advantages, telescopic overdenture therapy has challenges:  Technique sensitivity: Requires precise preparation, parallelism, and laboratory procedures.  Increased treatment time: Multiple steps including coping fabrication, adjustment, and verification.  Higher cost: More expensive than conventional dentures due to additional lab work and materials.  Maintenance issues: Caries, periodontal problems, or coping wear can compromise long-term success.  Dependence on patient compliance: Requires rigorous hygiene practices and regular follow-up. 5. Comparison with Alternatives14-17 Aspect Conventional Denture Implant Prosthesis Telescopic Overdenture Retention Low to moderate Excellent High (via copings) Stability Moderate Excellent Good–Excellent Bone preservation Minimal Strong Moderate (retained teeth) Cost Low High Moderate Surgical need None Yes None Hygiene Easy Moderate Easy (removable) This table highlights that telescopic overdentures provide a balanced compromise between affordability, function, and tissue preservation. Conclusion Telescopic overdentures provide a unique prosthodontic alternative for patients with severely compromised dentition. They preserve natural abutments, enhance retention and stability, improve function and esthetics, Dr. Pallavi Thalakola, et al. International Journal of Dental Science and Innovative Research (IJDSIR) ©2025 IJDSIR, All Rights Reserved Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 Page8 and minimize bone loss compared to conventional dentures. While more complex and costly than traditional removable dentures, they remain invaluable in situations where implants are contraindicated or declined. Future Directions 1. Integration of Digital Dentistry: CAD/CAM technology and intraoral scanning will enhance precision in coping design, reduce errors, and shorten treatment time. 2. Advanced Materials: The use of zirconia, titanium alloys, and high-performance ceramics for primary copings may improve wear resistance and esthetics. 3. Hybrid Designs: Combination of telescopic overdentures with strategically placed implants may improve long-term retention in patients with severely reduced dentition. 4. Patient-Centered Protocols: Simplification of clinical steps and cost reduction strategies will make telescopic overdentures more accessible in general practice. 5. Long-Term Clinical Research: Well-designed clinical trials with long-term follow-up are needed to establish evidence-based survival rates, patient satisfaction indices, and cost-effectiveness compared to implants. References 1. Aesthetic and occlusal rehabilitation using a telescopic denture. Yee A, Chui Ling G. Cureus. 2020;12:0. doi: 10.7759/cureus.7402. [DOI] [PMC free article] [PubMed] [Google Scholar] 2. Periodontal considerations for removable prosthesis. Abrams L, Feder M. Alpha Omegan. 1962;55:123– 136. [Google Scholar] 3. Telescopic overdenture and implant supported fixed partial denture: a pragmatic treatment approach. Dede DÖ, Cenk Durmuşlar M, Şahın O, Köroğlu A, İşısağ Ö. Case Rep Dent. 2015;2015:392397. doi: 10.1155/2015/392397. [DOI] [PMC free article] [PubMed] [Google Scholar] 4. Singer F, Schön F. 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