Mandibular overdenture supported by two canines: A two-year clinical follow-up case report

Introduction: Mandibular complete dentures often present insufficient retention and stability due to anatomical limitations in edentulous patients. Although implant therapy is commonly used to address these issues, it may not be feasible in patients with systemic conditions that contraindicate surgical interventions. In such cases, preserving and utilizing remaining natural teeth as abutments can enhance prosthetic success while minimizing invasiveness and improving patient comfort. Tooth-supported overdentures are a valuable alternative, particularly when strategic teeth such as canines are available. Case Description: A 60-year-old male patient with a history of diabetes mellitus presented with complaints of instability in his mandibular complete denture. The patient exhibited a fully edentulous maxilla and retained only two mandibular canines. Implant therapy was contraindicated due to his systemic condition. As an alternative, a tooth supported mandibular overdenture was planned. Clinical and radiographic evaluations confirmed that both canines were periodontally and structurally suitable for overdenture support. Endodontic treatment was performed, and the clinical crowns were reduced to allow sufficient space for prosthetic components. Cast copings with ball attachments were fabricated and cemented. A mandibular overdenture incorporating matching female housings was constructed and delivered. A conventional complete denture was also fabricated for the maxilla. The patient was recalled every six months for clinical evaluation and maintenance. Over a two-year follow-up period, no complications such as attachment loosening, mucosal irritation, or abutment failure were observed. The patient reported high satisfaction in terms of masticatory function, prosthesis stability. Discussion: This case demonstrates that, in patients for whom implant therapy is contraindicated, mandibular overdentures supported by two natural canines with ball attachments can offer a stable, functional, and long-term treatment solution. Tooth-supported overdentures provide biomechanical advantages and improve patient satisfaction through a minimally invasive approach. The strategic use of retained natural teeth, particularly canines, remains a clinically effective alternative for managing mandibular edentulism.