H. STARK*, H. SCHRENKER (Department of Prosthetic Dentistry, University of Würzburg)
As part of a prospective clinical long-term study 68 patients were provided with telescope prostheses and followed up regularly over a period of six years. The telescope prostheses proved reliable, since only one total failure was registered in the observation period with the complete loss of abutment teeth. Only ten of 258 abutment teeth have got lost at seven patients. Approximately 35 % of the cases had to be rebased or repaired at the superstructure. 34 solved primary crowns had to be cemented again or replaced by other attachments. Slight, but progressive pathological changes, such as strengthened inflammations of the gingiva, increasing pocket probing depths and alveolar bone loss, were ascertained at the periodontium of the abutment teeth. On the contrary the strength of the telescope abutment teeth did not change. Plaque of different extent was found both on the primary crowns as well as on the superstructure at all patients. As a consequence of plaque-deposition on the dentures the clinical indication of inflammations of the denture bearing area increased significantly during the last years of observation. The denture-stability decreased approximately in a third of the cases. In all the patients rated their dentures positively. Factors for the value of the telescope prostheses were sex, type of denture base, localization, number of abutments, quality of the crown margin and patient-orientated judgement of the dentures. Men wearing telescopic cover dentures in the lower jaw, which are anchored with up to three abutments, need more intensive after-care.
Altogether half-yearly follow-ups seemed to be sufficient maintaining structure and function of the masticatory system being provided with a telescope prosthesis. Because of increasing pathological findings a periodic motivation and instruction of the patients concerning the cleansing of their teeth and dentures is still necessary.