Prosthodontic Rehabilitation with Telescopic Overdenture: An Alternative for Severely Compromised Teeth

Abstract Background: Loss of teeth continues to be a significant challenge in geriatric and compromised dental patients. While complete dentures have long been used to restore function and esthetics in edentulous patients, their limitations in stability and bone preservation are well documented. In cases where teeth remain but are severely compromised, extractions followed by complete dentures or implant-supported prostheses are often considered. However, complete dentures accelerate alveolar resorption, while implants may be limited by systemic health, economic constraints, or inadequate bone volume. Telescopic overdentures, utilizing a system of primary and secondary copings, provide an alternative strategy that maximizes the utility of remaining teeth and improves prosthesis stability. Objective: This article reviews the role of telescopic overdentures in prosthodontic rehabilitation for patients with severely compromised teeth, examining their biomechanical principles, clinical indications, advantages, limitations, and future prospects. Methods: A narrative literature review was conducted using databases such as PubMed, Scopus, and Google Scholar, focusing on telescopic overdentures, compromised dentition, and prosthodontic rehabilitation strategies. Articles published between 1990 and 2024 were considered. Results and Discussion: Telescopic overdentures distribute occlusal loads axially, preserve residual dentition, and enhance retention compared to conventional dentures. They improve patient satisfaction by maintaining proprioception, esthetics, and stability. However, they are technique-sensitive, time-consuming, and require meticulous hygiene maintenance. Their success largely depends on accurate fabrication and patient compliance. Conclusion: Telescopic overdentures represent a valuable alternative for patients with severely compromised teeth when implants are not feasible. Advances in digital dentistry and biomaterials are expected to further enhance their clinical applicability and long-term outcomes.