Tooth-Supported O-Ball Retained Maxillary Overdenture in a Patient Contraindicated for Dental Implants Due to Bisphosphonate Therapy

Tooth-supported overdentures offer an effective and conservative option for patients with partial edentulism and systemic contraindications to implant therapy. Retaining natural roots under the denture base helps preserve alveolar bone, enhances proprioception, and improves prosthesis stability. This case report describes the rehabilitation of a 76-year-old man with osteoporosis on long-term bisphosphonate therapy, type 2 diabetes, and hypertension. Due to the high risk of medication-related osteonecrosis of the jaw (MRONJ), implant placement was contraindicated. A maxillary overdenture retained by custom O-ball attachments on multiple remaining roots was chosen as a minimally invasive and cost-effective treatment. The prosthesis provided excellent retention, stability, and patient satisfaction, successfully resolving issues experienced with previous conventional dentures. This case highlights the value of utilizing existing teeth with custom attachments to achieve functional and predictable overdenture outcomes in medically compromised patients.