Double crown rescue concept: clinical and dental technical workflow

For decades, double crowns in different variations have proven to be reliable attachments in removable prosthetics. Supported by teeth and implants, they provide proper retention, a considerable degree of chewing comfort, and satisfying esthetics. A wide range of applications, optimal oral hygiene capabilities, and almost unlimited expandability are just some of the advantages of double crown anchored dentures. Among other things, abutment tooth loss is a frequent complication. If an abutment tooth is lost, the secondary crown is usually filled with resin and the denture can continue to be used. However, since the loss of one or more abutment teeth changes biomechanical load ratios, a decline in stability and comfort is likely to occur as well as overloading of the remaining abutment teeth. The concept presented in this article provides for the application of computer-assisted technologies that enable the preservation of the denture according to its original design. For this purpose, a lost or hopelessly decayed tooth is replaced with an implant using digital preplanning and guided implant surgery. The original primary crown is then reattached in its exact former position applying a CAD/CAM-fabricated meso-abutment. In effect, the number of abutment teeth can be preserved, the functionality of the denture maintained with reasonable effort, and further damage prevented. Keywords: CAD/CAM, double crowns, guided surgery, implant dentistry, implant prosthetics, removable denture, telescopic crowns