Biological and technical complications in root cap-retained overdentures after 3-15 years in situ: a retrospective clinical study

Clin Oral Investig. 2021 Apr;25(4):2325-2333. doi: 10.1007/s00784-020-03555-3. Epub 2020 Sep 7.


Objectives: This retrospective clinical study investigates the frequency of biological and technical complications in patients rehabilitated by natural root-retained overdentures (RODs) with cast post-and-cores (root caps) wearing precision attachments and analyses factors influencing complication rates (e.g. oral hygiene routines).

Materials and methods: Patients formerly treated with RODs were invited for a cost-free clinical visit to evaluate their intraoral status. Furthermore, they were interviewed and patient records were screened for complications occurring since denture delivery. Statistical models include descriptive analyses, Fisher's exact test, odds ratios, and a multivariate regression model.

Results: A total of 114 patients wearing 128 RODs with a total of 280 abutment teeth were evaluated (mean service time: 7.9 years). Technical complications occurred in 68.8% of the RODs, with matrix loosening being the most frequent complication (50.1%). Biological complications occurred in 53.9% of all RODs, with the presence of denture stomatitis being the most common biological complication (38.3%). The presence of denture stomatitis was significantly higher in the maxilla relative to the mandible (p = 0.0029), in subjects cleaning their dentures less than twice a day (p < 0.001), in subjects regularly using CHX-containing products (p = 0.036) and in subjects with a plaque index > 40% (p < 0.001).

Conclusions: Root cap-retained overdentures with precision attachments are a viable treatment option in partially dentate subjects, even over long-term periods. However, high complication rates should be expected.

Clinical relevance: Establishing good oral hygiene is a decisive factor in preventing complications in RODs. Furthermore, CHX-containing products may not be recommended for routine domestic use.

Keywords: Intraoral microbiome; Overdentures; Post-and-cores; Root-caps.

MeSH terms

  • Dental Prosthesis, Implant-Supported
  • Denture Retention*
  • Denture, Overlay*
  • Humans
  • Mandible
  • Retrospective Studies