What is a telescopic restoration? A telescopic restoration consists of an abutment made at zero degrees on a tooth or implant abutment and a prosthetic part that fits intimately on the top. It relies on excellent fit and friction grip to stay in place and can be removed by the patient for cleaning. A telescopic restoration looks and feels like fixed crown & bridge or implant work.
These type of restorations have been used successfully for many decades globally and especially in Germany. There is a misconception because of the time involved in telescopic work that it is more expensive than conventional crown & bridge and implant work and this may be one of the reasons this work has not developed in New Zealand. However in the hands of experienced and skilled technicians such as Team Niho’s master craftsmen this is not the case.
Where would you use a telescopic restoration? In conventional crown & bridge work where in the future further adjustments to a restoration may be required, for example, abutment failure or tooth loss. Normally this would mean starting again but with a telescopic restoration the abutment can be reused and sometimes the prosthetic part merely modified. However in some circumstances it may mean a total remake of the prosthesis. Also where there is soft tissue loss be it an implant case or crown & bridge case an aesthetic soft tissue component/flange can be added with out compromising hygiene because the prosthetic part can be removed.
In combination with teeth or implant abutments a telescopic partial denture can be made with excellent retention and the absence of clasps resulting in a better aesthetic result for the patient. A partial denture made this way is as dainty if not more so than a conventional partial denture and in some maxillary dentures palatal coverage is not required giving the patient a more comfortable prosthesis.
Implant placement is not always perfect in terms of the aesthetics of a definitive restoration. However with a telescopic restoration there is no need for a screw access hole through the prosthesis and no requirement for cross-pinning or angulated abutments, hence the ideal aesthetic prosthesis can be delivered to the patient.Even though no larger than fixed implant work telescopic restorations are stronger as they are not subject to the stresses around the screw access holes especially in the cantilever region. Even with ideal implant placement we believe that the telescopic option is less prone to failure and hence a better choice.
All large implant cases will need maintenance at some time. Telescopic restorations are easier to manage both clinically and technically and in some instances the patient may be without his prosthesis for only a matter of a few hours rather than days.
The telescopic prosthesis can be made of any material such as porcelain fused to metal, metal and plastic, all-ceramics and combinations of all of these, for example, a PFM or an all-ceramic restoration with a plastic soft tissue. The galaxy’s the limit.
Well that’s it folks see you in the Spring (Koanga) for Issue 2. We hope that this first newsletter has been of interest and if you have any comments or suggestions please feel free to contact us.