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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2025 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided 

the original author and source are credited  

 

 

Management of Severe Mandibular Posterior Ridge Atrophy Using Tooth-
Supported Telescopic Complete Denture: A Clinical Report 

Mefina Kuntjoro * , Utari Kresnoadi , Karina Mundiratri , Abil Kurdi , Bambang Agustono , Merina 

Dwi Pangastuti  

Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia 

Article Info: 
_____________________________________________ 
Article History: 

Received   13 March 2025     
Reviewed  22 April 2025 
Accepted   19 May 2025 
Published 15 June 2025 

_____________________________________________ 
Cite this article as:  

Kuntjoro M, Kresnoadi U, Mundiratri K, Kurdi 
A, Agustono B, Pangastuti MD, Management 
of Severe Mandibular Posterior Ridge 
Atrophy Using Tooth-Supported Telescopic 
Complete Denture: A Clinical Report, Asian 
Journal of Dental and Health Sciences. 2025; 
5(2):20-24                                                                   DOI: 
http://dx.doi.org/10.22270/ajdhs.v5i2.132              

Abstract 
_________________________________________________________________________________________________________________ 

Severe residual ridge resorption poses a significant challenge in prosthodontic rehabilitation, 
especially in partially edentulous patients with compromised anatomical support. Conventional 
removable dentures often fail to provide sufficient retention and stability in such cases. Telescopic 
dentures offer a conservative and effective solution, particularly for the elderly, to avoid surgery. 
Double crowns, which consist of primary copings cemented to abutment teeth and secondary 
crowns incorporated into the denture, will create passive friction for mechanical retention to 
enhance load distribution, stabilize abutment teeth, and preserve natural dentition. Telescopic 
dentures are adaptable over time and provide improved comfort, esthetics, and patient confidence. 
This clinical report presents a 70-year-old male patient with severe ridge resorption in the bilateral 
posterior mandible, characterized by extremely shallow retromylohyoid areas. Successful 
rehabilitation was achieved using a mandibular telescopic complete denture, demonstrating the 
value of conservative prosthodontic planning. 

Keywords: overdenture, telescopic, double crown, ridge atrophy. 

*Address for Correspondence:   

Mefina Kuntjoro, Universitas Airlangga, Faculty of Dental Medicine, Department of Prosthodontic, 60132, Surabaya, Indonesia 

 

Introduction 

Severe residual ridge resorption remains a major 
challenge in prosthodontic rehabilitation, particularly in 
partially edentulous patients where the anatomical 
foundation for conventional removable prostheses is 
compromised.1 In such clinical situations, achieving 
adequate retention, stability, and support becomes 
increasingly difficult, often resulting in patient 
dissatisfaction and functional impairment.2 Addressing 
these challenges requires a treatment modality that is 
both functionally effective and biologically conservative, 
particularly in older individuals who prefer simpler 
procedures with fewer surgical risks. 

One such option is the telescopic denture system, a 
prosthetic modality that has proven valuable in the 
management of complex cases involving few remaining 
teeth with moderate-to-good periodontal support.3 This 
system is characterized by the use of double crown 
mechanisms, where primary copings, are permanently 
cemented to the abutment teeth, and secondary crowns 
are integrated within the removable prosthesis to fit 
precisely over the primaries.4 The passive friction 
generated between these components provides 
mechanical retention, eliminating the need for visible 

clasps or auxiliary attachments.5 Moreover, this design 
helps stabilize abutment teeth and distributes occlusal 
forces more evenly onto abutment teeth and underlying 
tissues.6 

Telescopic dentures are in harmony with conservative 
dental treatment concepts, as they prioritize the 
maintenance of the patient’s natural dentition and 
reduce reliance on invasive surgical techniques.7 This 
form of prosthetic care is especially advantageous for 
older individuals or those with systemic limitations 
where implant placement may not be advisable. Its 
capacity to be modified over time makes it a flexible long-
term solution. Notably, patients often express greater 
comfort and assurance in public situations, attributed to 
the reliable retention and esthetically pleasing design of 
the restoration.8 

This clinical report highlights the use of a telescopic 
complete denture in a patient with severe alveolar ridge 
resorption. It demonstrates how thoughtful 
prosthodontic planning and conservative use of 
remaining dentition can restore esthetics, function, and 
patient confidence without the need for surgical 
intervention. 

                     Open Access                                                                                                                                                                                                                Case Report                                                                           

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http://dx.doi.org/10.22270/ajdhs.v5i2.132
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Kuntjoro et al.                                                                                                                             Asian Journal of Dental and Health Sciences. 2025; 5(2):20-24 

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Case Report 

A 70-year-old male patient visited the Prosthodontic 
Department Universitas Airlangga Dental Hospital with 
with a chief complaint complain of difficulty in 
mastication due to multiple missing teeth. He expressed 
the desire to have a comfortable and easy-to-use denture, 
emphasizing his need for enhance his overall quality of 
life, without undergoing any surgical procedures. 

Medical history was unremarkable, with no systemic 
conditions contraindicating dental treatment. Intraoral 
examination revealed partially edentulous maxillary and 
mandibular arches, along with significant residual ridge 
resorption, particularly in the posterior mandible. Tooth 
18 was present as a retained root, while teeth 34 and 44 
were fully erupted, periodontally stable, and deemed 
suitable for use as abutments were periodontally stable, 
exhibiting adequate bone support and crown height, 
rendering them viable abutments for a fixed-removable 
prosthesis. Panoramic radiographic assessment 

confirmed the presence of root fragment 18, generalized 
ridge resorption on the posterior mandible, and healthy 
bone support around teeth 34 and 44. Periapical 
radiograph of tooth 44 exhibited a normal periapical 
appearance and adequate bone support and tooth 34 
demonstrated a radiolucency extending into the root 
canal system, accompanied by a mild periapical 
radiolucency.  

Tooth 18 was scheduled for extraction. Tooth 34 
underwent root canal treatment followed by the 
placement of a fiber post to restore its structural integrity 
and enable it to serve as a functional abutment. The 
definitive treatment plan involved the fabrication of a 
maxillary complete denture and a mandibular telescopic 
complete denture supported by the strategically 
preserved teeth 34 and 44. This prosthetic solution was 
chosen for its conservative nature, allowing improved 
retention and stability without the need for surgical 
intervention.

 

 

Figure 1: Objective Examination. (A-C) Intraoral Examination (D) Radiographic Examination 

Initially, treatment was commenced with the fabrication 
of a maxillary complete denture and a mandibular 
transitional removable partial denture. This interim 
prosthesis served to restore function and esthetics 
during the planning phase, while also allowing for 
occlusal assessment and adaptation by the patient. 
Maxillary and mandibular primary impressions were 
taken using irreversible hydrocolloid material, followed 
by custom tray fabrication. Border molding and final 
impressions were made with polyvinyl siloxane (PVS) to 
capture accurate soft tissue details. 

Maxillomandibular relationship records were then 
established by determining a new occlusal vertical 
dimension (OVD), to ensure proper function and 
esthetics. Teeth arrangement was performed in 
accordance with the newly established vertical 
dimension and patient-specific esthetic requirements. 
Following the try-in and verification of esthetics, 
phonetics, and occlusion, the maxillary complete denture 
and transitional mandibular denture were inserted. The 
transitional mandibular denture was designed to be 

tissue-supported, providing short-term function while 
preserving abutment teeth 34 and 44. These interim 
prostheses restored function and esthetics during the 
treatment phase, allowing the patient to adapt while 
definitive rehabilitation was being planned.  

Following the successful adaptation to the maxillary 
complete denture and mandibular transitional 
prosthesis, definitive treatment was initiated. Tooth 34 
had previously undergone root canal treatment and was 
restored with a fiber post to ensure adequate retention 
and stability for the planned telescopic system. Tooth 44, 
with a healthy periapical status and sufficient crown 
structure, was also selected as an abutment. Both 
abutment teeth were prepared with a parallel milling 
technique to accommodate primary metal copings with a 
path of insertion aligned to enhance retention. The first 
definitive impressions were made using polyvinyl 
siloxane (PVS) impression material using stock tray. The 
primary copings were fabricated in cobalt-chromium 
alloy, checked intraorally for fit and parallelism. 



Kuntjoro et al.                                                                                                                             Asian Journal of Dental and Health Sciences. 2025; 5(2):20-24 

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Figure 2: Fabrication of Maxillary Complete Denture and 
Mandibular Transitional Denture. (A) Measurement of 
OVD; (B) Alignment of the maxillary complete denture; 
(C) Try-in of artificial teeth; (D) Insertion of the denture 

Once the primary copings were confirmed for fit, a 
secondary impression was taken using the pick-up 

impression technique. The primary copings were 
temporarily placed onto the abutment teeth, and a new 
impression was made to capture the copings in place 
using individual tray. This step ensured that the final 
framework would fit precisely over the primary copings, 
providing a stable and passive retention mechanism. 

After the pick-up impression was obtained, a secondary 
framework incorporating the outer crowns was designed 
to friction-fit over the primary copings and integrated 
into the mandibular removable prosthesis. 
Maxillomandibular relationship records were taken 
based on the transitional denture. A try-in was 
performed to verify esthetics, occlusion, and phonetics 
before final processing. 

At the time of prosthesis delivery, occlusion was carefully 
adjusted, and the patient was provided with instructions 
on the proper insertion, removal, and maintenance of the 
prosthesis. The patient was followed up at 24 hours, 
three days, and one week, with no significant complaints. 
At the end follow-up, the patient reported significant 
improvement in masticatory function, prosthesis 
stability, and overall comfort, with enhanced satisfaction.

  

 

Figure 3: Fabrication of Tooth-Supported Telescopic Complete Denture. (A) Abutment tooth preparation; (B) Evaluation 
of preparation using transitional denture; (C) Try-in of primary coping; (D) Pick-up impression; (E) Try-in of secondary 

coping with metal framework; (F) Jaw relation record; (G) Try-in of artificial teeth; (H) Final denture insertion 

 

Figure 4: Facial Appearance. (A) Before treatment; (B) With transitional denture; (C) After treatment without wearing 
denture; (D) With definitive denture 



Kuntjoro et al.                                                                                                                             Asian Journal of Dental and Health Sciences. 2025; 5(2):20-24 

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Discussion 

In the prosthodontic management of partially edentulous 
patients, especially those with advanced alveolar ridge 
resorption, treatment planning must be individualized by 
balancing functional demands, anatomical limitations, 
systemic health, and patient preferences. While implant-
supported prostheses often provide superior retention 
and stability, they are not always feasible.9 In this case, 
implant placement was not pursued due to the patient’s 
reluctance to undergo any surgical procedures, a decision 
influenced by age-related concerns and the desire for a 
minimally invasive solution.  

Instead, a tooth-supported telescopic complete denture 
was selected as a strategic alternative. This approach 
leverages the remaining dentition as abutments to 
enhance prosthesis stability and retention without 
relying on surgical intervention. Unlike conventional 
removable partial dentures (RPDs) that utilize visible 
clasps for retention, telescopic systems employ a double 
crown mechanism.10 Primary copings are cemented onto 
prepared abutment teeth, while secondary crowns, 
integrated into the denture base, fit precisely over the 
primaries using frictional retention. This configuration 
eliminates the esthetic and biomechanical drawbacks 
associated with clasp-retained dentures.11 

One of the key advantages of the telescopic dentures lies 
in its ability to distribute occlusal forces more uniformly 
across the supporting structures.12 The splinting effect of 
the double crown system reduces stress concentration on 
individual abutments and improves the longevity of 
remaining teeth.13 Additionally, telescopic copings 
maintain axial loading and enhance proprioception, 
which is often diminished in conventional RPDs.14 This 
controlled force transmission is particularly important in 
patients with compromised ridges, where uneven stress 
may exacerbate residual ridge resorption. 

Moreover, telescopic dentures offer superior esthetics 
due to the absence of clasps, which can be particularly 
beneficial for anterior abutments.10 The design also 
facilitates easier hygiene access, as the prosthesis can be 
removed, and the abutments can be cleaned thoroughly. 
This design is essential feature for elderly patients with 
declining manual dexterity. The precision fit between the 
primary and secondary components also results in 
improved retention and resistance to dislodging during 
mastication and speech.8 Moreover, research indicates 
that individuals rehabilitated with telescopic dentures 
demonstrate considerably higher satisfaction regarding 
retention, comfort, and social confidence when compared 
to those with conventional clasp-retained dentures.15 

In the present case, the use of telescopic complete 
dentures successfully restored the patient’s masticatory 
function, improved retention and esthetics, and 
eliminated the need for invasive procedures. By utilizing 
the available abutment teeth conservatively and 
integrating a biomechanically sound design, this 
treatment not only respected the patient's preferences 
and clinical limitations but also ensured long-term 
adaptability and comfort. The transitional denture phase 
allowed gradual functional adaptation and occlusal 

planning, further contributing to the clinical success of 
the definitive prosthesis. 

Overall, this case underscores the value of telescopic 
complete dentures as a viable prosthetic option in 
medically compromised or surgically averse patients. 
They serve as a bridge between conventional dentures 
and implant-supported restorations, offering a blend of 
mechanical performance, biological preservation, and 
esthetic enhancement that is particularly suited for 
complex partial edentulism. 

Conclusion 

Tooth supported telescopic complete dentures offer a 
conservative and effective solution for patients with 
severe ridge resorption and limited abutment teeth, 
especially when implant placement is not feasible. 
Compared to conventional clasp dentures, they provide 
better retention, stability, and esthetics through a 
friction-fit double crown system. In the present case, the 
use of strategically preserved mandibular abutment, 
combined with careful endodontic and prosthodontic 
planning, resulted in a successful rehabilitation with 
improved mastication, phonetics, and patient 
satisfaction. The non-surgical nature of the approach, 
coupled with high functional outcomes, further supports 
the role of telescopic dentures as a conservative yet 
durable treatment modality in modern prosthodontics.  

Acknowledgement: The authors declare that there are 
no acknowledgments 

Conflict of Interest: The authors declare no conflict of 
interest. 

Author Contributions: All authors have equal 

contribution in the preparation of manuscript and 

compilation. 

Source of Support: Nil 

Funding: The authors declared that this study has 

received no financial support. 

Informed Consent Statement: Informed consent was 

obtained from all subjects involved in the study.  

Data Availability Statement: The data presented in 

this study are available on request from the 

corresponding author.   

Ethical approval: Not applicable. 

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