Dual-Arch Rehabilitation with a Maxillary Tooth-Supported Overdenture Opposing a Mandibular Two-Implant Supported Overdenture in a Severely Resorbed Ridge: A Case Report

Abstract

Aim: Rehabilitation of resorbed ridges is challenging because conventional complete dentures often exhibit compromised retention, stability, and support. Preservation of strategic natural teeth, combined with implant supported overdenture therapy, can improve proprioception, load distribution, and patient satisfaction. This clinical report describes the rehabilitation of a patient using a maxillary tooth-supported overdenture opposing a mandibular two-implant-supported overdenture. Presentation of Case: A 73-year-old female patient presented with missing maxillary posterior teeth and dissatisfaction with an existing mandibular denture. Clinical examination revealed a Kennedy Class I maxillary arch with modification 1 and a severely resorbed mandibular ridge corresponding to Atwood Order VI. Radiographic evaluation demonstrated a poor prognosis for multiple maxillary teeth and inadequate posterior mandibular bone support. All maxillary teeth, except the canines, were extracted, and a maxillary tooth-supported overdenture was planned. Two implants were placed in the mandibular interforaminal region at the B and D positions and restored with stud attachments using O-ring retention. Prostheses were fabricated following conventional complete denture procedures. Discussion: The patient reported improved retention, stability, comfort, and masticatory efficiency following rehabilitation. Preservation of the maxillary canines enhanced proprioception and support, while the mandibular implant overdenture improved denture retention and functional performance. Stud attachments provided a cost-effective and hygienic treatment option with satisfactory patient acceptance. Conclusions: A tooth-supported overdenture opposing an implant-supported overdenture can serve as an effective and economical treatment modality for rehabilitation of severely resorbed edentulous ridges.  Strategic preservation of natural teeth and appropriate attachment selection contribute significantly to improved prosthesis function, comfort, and overall treatment success.