Precision attachments in partial removable prosthodontics: an update for the practitioner part 2

Precision attachments potentially offer many advantages over conventional removable dentures. When these are used appropriately they can lead to increased patient satisfaction. There is also a vast number of different attachments available for use. This means that appropriateness has to be carefully assessed, not only by correct case selection, but also by clinical and technical experience, and patient compliance and dexterity.

Careful treatment planning is essential. Errors at this early stage may result in failure of the case. A clinical examination to assess for caries, periodontal disease, peri-apical disease, tooth surface loss, or infections of the oral mucosa should be completed. This should inform the clinician of the suitability of the mouth to receive complex restorations. In conjunction with this, it is fundamental that the patient is assessed as a whole as previous dental history and manual dexterity may impact on the decision process.

A patient's medical history can also influence the decision-making process. The construction of a precision attachment-retained denture is more time consuming than a conventional denture. Any component of the medical history that would preclude long appointment times may make this form of treatment an inappropriate choice. Owing to the very nature of their precise fit, patients would require sufficient manual dexterity to enable placement and removal of the prosthesis. For example, patients with severe arthritis affecting the hands, or neurological disorders such as Parkinson's disease, may find the placement and removal too difficult, without assistance. These problems can be overcome with the use of magnet-retained overdentures, as they may prove easier to remove.