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Patient use of removable partial dentures: two- and four-year telephone interviews.

Two telephone surveys requested patients to report on their use of removable partial dentures that were constructed by undergraduate dental students. In the first survey, of the 431 patients called, 290 were contacted and interviewed 24 to 33 months after their removable partial denture(s) had been inserted. Of these, 258 patients reported using their prostheses and 238 had no apparent problems. In the second survey, the 238 trouble-free removable partial denture wearers from the first survey were called and 169 were contacted and interviewed 48 to 57 months after the removable partial dentures had been inserted. Of these, 156 reported still using their prosthesis and 152 had no apparent problems. These data are provided, along with some interpretive caveats, for dentists to use in discussing treatment options with patients.

Consumer Behavior↗

Immediate replacement removable partial dentures with cobalt-chromium frameworks: rationale, technology and a case report.

The advantages of removable partial dentures with cobalt-chromium frameworks over those made entirely of acrylic resin, in oral health and hygiene, are well documented. However, in cases where teeth are to be extracted for fitting the removable partial denture, a difficulty arises because of the need to test the fit of the removable partial denture framework. The advent of two modern technologies-- laser welding and metal bonding agents -- make it possible to test the fit of the major part of the framework prior to adding additional metal components to support artificial teeth. A case is described in which the four lower incisors were extracted. The main part of the framework was constructed and its fit tested. A second casting was laser-welded to the lingual plate of the first casting to support the artificial incisor teeth. This technique avoids the need to make an acrylic resin temporary denture but incurs the cost of the additional technical work and so the advantages may be considered to be economically neutral.

Adult↗

Laser welding of a cobalt-chromium removable partial denture alloy.

STATEMENT OF PROBLEM: The electric alloy brazed joints of removable partial denture alloys have failed frequently after routine usage. PURPOSE: A technique providing higher joint strengths was investigated. This investigation compared the tensile strengths of electric-brazed and laser-welded joints for a cobalt-chromium removable partial denture alloy. MATERIAL AND METHODS: Twenty-four cobalt-chromium standard tensile testing rods were prepared and divided into three groups of eight. All specimens in the control group (group 1) were left in the as-cast condition. Groups 2 and 3 were the test specimens, which were sectioned at the center of the rod. Eight specimens were joined by using electric brazing, and the remaining specimens were joined by using laser welding. After joining, each joint was ground to a uniform diameter, then tested to tensile failure on an Instron universal testing machine. Failure loads were recorded and fracture stress calculated. Statistical analysis was applied. RESULTS: The student-Newman-Keuls test showed a highly significant difference between the joint strengths of the as-cast control specimens, the electric-brazed and laser-welded joints. CONCLUSIONS: The tensile strengths of the as-cast joints were higher than those for the laser-welded joints, and both were higher than the electric-brazed joint strengths.

Analysis of Variance↗

Frictional resistance of removable partial dentures with retrofitted resin composite guide planes.

Frictional resistance to the dislodging forces of a removable partial denture with and without resin composite retrofitted guide planes was compared in vitro. Six master models of four natural teeth, each simulating a Kennedy Class III modification 1 arch, were used. Guide planes were prepared, and 18 cobalt-chromium removable partial denture frameworks without clasps were fabricated. Three resin composite materials were applied to the guide planes as retrofitting materials. Following this, the resistance to dislodgment of the removable partial denture framework was evaluated under cyclic dislodgment, and the resistance to dislodgment before and after resin composite retrofitted guide planes was compared. The dislodgment force was recorded every 500 cycles. Testing was concluded when the dislodging force value reached 50% of the initial value. There was a significant difference between the dislodging forces with and without retrofitted guide planes. Higher dislodging forces were recorded when resin composite retrofitted guide planes were used. Z100 was the most effective retrofitting material under cyclic dislodgment, and Heliomolar and Herculite XR performed similarly.

Acrylic Resins↗

Factors affecting displacement of free-end saddle removable partial dentures.

Tissueward movement of the free-end saddle of a removable partial denture during function takes place around the most distal fulcrum created by the most mesial rests. Displacement because of sticky foods takes place around the fulcrum created by the most distal rests. These and other factors affecting displacement of the free-end saddle removable partial dentures are discussed, and designs intended to increase retention are presented. The forces applied to the most anterior and posterior axes of rotation can be calculated mathematically to reveal the hazards of a too-short lever arm in combination with a strong retentive clasp system.

Dental Stress Analysis↗

[Quantitative changes of microflora on stress-bearing areas relating to bases of removable partial dentures].

OBJECTIVE: This study was designed to find out the changes in microflora on the stress-bearing areas after insertion of removable partial dentures, and in turn to explore the difference between such changes caused by metal bases and acrylic resin bases respectively. METHODS: Sixteen patients who were ready to accept removable partial dentures were selected and divided into two groups. Eight patients used metal bases while the other eight patients used acrylic resin bases. Then at the following three points: before dentures were inserted, one month after wearing and three months after wearing, the total cultivable flora were counted and the proportions of bacteria detected on the stress-bearing areas were calculated. RESULTS: No matter what type of bases was selected, the wearing of removable partial denture enhanced the accumulation of microflora on stress-bearing areas. The percentages of Candida albicans and Lactobacilli detected on stress-bearing areas also increased significantly (P < 0.05). When such changes were compared, the authors found that the increment of Candida albicans caused by acrylic resin bases was higher than that caused by metal bases (P < 0.05). CONCLUSION: The wearing of removable partial dentures forms new retention areas between the bases and the stress-bearing areas, as a result enhances the deposit of microbe and facilitate the growth of Candida albicans and Lactobacilli. Compared with increment of Candida albicans caused by metal bases, the increment relating to acrylic resin bases is more evident.

Aged↗

Influence of loading positions of mandibular unilateral distal extension removable partial dentures on movements of abutment tooth and denture base.

PURPOSE: The aim of our study was to explore the effects of different loading positions on the movements of the abutment tooth and denture base of removable partial denture with unilaterally designed framework (RPD-U). MATERIALS AND METHODS: The experiment was carried out with a simulation model of a mandible without left molars. The movements of abutment tooth and denture base of the unilateral and bilateral designs were due to 30N vertical load on 12 loading positions determined with a strain gauge circuitry. The effects of loading positions on the movements of the abutment tooth and denture base were compared between two designs. RESULTS: During the loading on buccal, lingual positions, and the most disto-central position the movements of the abutment tooth and denture base of the unilateral design were significantly greater than those of the bilateral design (P < 0.01). During the loading on the three mesio-central positions the movements of the abutment tooth and denture base were equal between designs, and were significantly lower than during the loading on the other positions (P < 0.01). CONCLUSION: Ending the denture teeth at the mesial cusp of second molar and positioning the occlusal contacts over the ridge crest adequately stabilize the abutment tooth and denture base of RPD-U.

Acrylic Resins↗

Maxillary and mandibular overlay removable partial dentures for the treatment of posterior open-occlusal relationship: a clinical report.

This clinical report describes the use of maxillary and mandibular overlay removable partial dentures to treat a patient with class III skeletal malocclusion and a posterior open-occlusal relationship. Overlay removable partial denture therapy was used as an alternative to other options such as orthodontics and combined orthodontic/oral surgery procedures; it satisfied the esthetic and functional requirements of the patient and provided a stable occlusion. Overlay removable partial dentures are a reversible and relatively inexpensive treatment for patients with congenital or acquired anomalies, but the potential disadvantages of these prostheses include compromised esthetics when the dentures are removed; caries and periodontal disease as a result of poor oral hygiene; and veneer material fracture, debonding, discoloration, and wear.

Chromium Alloys↗

A loading impression technique for semiprecision and precision removable partial dentures.

The rationale of designing a seimprecision or precision distal-extension removable partial denture and the justification of ridge loading in distal-extension ridge impression techniques have been presented. The effectiveness of existing impression techniques in securing firm seats for abutment castings, accurate border extension of the denture base, and loading of the ridge mucosa has been evaluated. A technique has been described that overcomes the limitations of existing impression techniques for semiprecision and precision distal-extension removable partial dentures.

Acrylic Resins↗

Custom-made denture teeth and denture base material for removable partial dentures.

A method that uses Isosit material to fabricate custom-made denture teeth and denture base has been described. The advantages of this technique are the denture teeth can be made to function in harmony with dynamics of the stomatognathic system; any type of occlusal scheme can be used; the material is esthetically pleasing; it can be characterized; it can be used as a denture base material, which can also be characterized; it can be repaired, relined, or rebased with little difficulty; and laboratory procedures can be accomplished in the dental office or laboratory.

Acrylic Resins↗

A provisional and new crown to fit into a clasp of an existing removable partial denture.

A technique that forms an abutment crown to fit into an existing clasp of a removable partial denture by relining an acrylic resin pattern is described. The outer contour of the pattern is made within an irreversible hydrocolloid impression by use of Duralay autopolymerizing acrylic resin applied with precision dispensers. The pattern is formed before tooth preparation and is made approximately 0.4 mm thick. After tooth preparation, the shell pattern is relined with the same autopolymerizing resin and the existing removable partial denture is fitted over it. The gross pattern is trimmed and the margins refined on a die made from an elastomer impression. The refined pattern is cast and finished, avoiding reduction of the contours established. A second crown is similarly formed in tooth-colored autopolymerizing acrylic resin. It serves as a provisional restoration that allows the patient to wear the removable partial denture while the laboratory procedures are performed.

Crowns↗

Treatment outcomes with mandibular removable partial dentures: a population-based study of patient satisfaction.

STATEMENT OF PROBLEM: Little is known about the outcomes of treatment with mandibular removable partial dentures provided by dentists in private dental practice. PURPOSE: This study examined 15 aspects of patient satisfaction and explored the factors found to be associated with dissatisfaction. MATERIAL AND METHODS: A questionnaire was mailed to people whose dental insurance claims included CPT Code 5214 within the last 5 years. A composite measure of treatment outcome was created by combining the responses to the 15 satisfaction items, and 10 factors were then tested statistically to determine their relationship to dissatisfaction. RESULTS: A majority of the respondents were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was greater when there was no previous wearing experience or when there was an opposing maxillary removable partial denture. Respondents under the age of 60 expressed more dissatisfaction than did those over the age of 60, and subjects with lower levels of general health also reported less satisfaction. One third of the respondents believed their prosthesis required adjustment or replacement, and one fourth said the removable partial denture had caused a problem with the natural teeth. CONCLUSION: A majority of survey respondents treated with a mandibular removable partial denture in private dental practice were satisfied with the prosthesis, but a substantial amount of dissatisfaction existed. Dissatisfaction was related to age, health, prior experience with a prosthesis, and the type of opposing dentition.

Denture, Partial, Removable↗

Longitudinal study on torque transmitted from a denture base to abutment tooth of a distal extension removable partial denture with circumferential clasps.

Not only forces but also torque exerted on abutment teeth are important factors for planning the construction of distal extension removable partial dentures. The purpose of this study was to make longitudinal analysis of torque transmitted from denture base to a direct abutment tooth of these dentures with circumferential clasps. The results are summarized as follows: (i) Vertical Max. MT (maximal mean value of torque) was decreased and became constant after one or one and half months of the insertion of new dentures. (ii) Lateral Max. MT in one subject was changed from the lingual direction to the buccal direction while in another subject it was constant. (iii) In the vertical direction, there were no remarkable differences of Max. MT and Ave. T (average value of torque) between subjects. Max. MT was 5-10 x 10(-3) kgm-1 in the downward. Ave. T was 2-3 x 10(-3) kgm ss-1 in the downward and 0.3 x 10(-3) kgm ss-1 in the upward. (iv) In the lateral direction, there were considerable differences of Max. MT and Ave. T between subjects. Max. MT was less than 20 x 10(-3) kgm. Ave. MT was 2-8 x 10(-3) kgm ss-1.

Aged↗

Longitudinal study on forces transmitted from denture base to retainers of lower distal-extension removable partial dentures with conus crown telescopic system.

The purpose of this study was to perform longitudinal measurement of forces transmitted from the denture base to retainers of lower distal-extension removable partial dentures with a conus crown telescopic system. The experimental denture was embedded with a force-detecting unit which could detect a change in lateral and vertical forces transmitted from denture base to retainers at the same time. Forces were measured during chewing of food on several separate occasions from the insertion of new dentures to about 3 months after. Max.ver (maximal mean value of vertical force) and Max.lat (maximal mean value of lateral force) were calculated from the peak level of all strokes of chewing of food at the minimum of the interocclusal distance. The results are summarized as follows: (i) There were no significant changes of Max.ver and Max.lat; (ii) There were no significant differences of Max.ver between subjects the value of which was about 20 N; (iii) There were significant differences of Max.lat between subjects the value of which was less than 15 N.

Bite Force↗

Sectional impressions for mandibular distal extension removable partial dentures.

STATEMENT OF PROBLEM: Corrected impression procedures provide the best possible support to be gained from an edentulous ridge for a removable partial denture, but they are time-consuming and technique-sensitive. PURPOSE: An experimental mandibular distal extension removable partial denture was used to measure the vertical movement of denture bases during biting. MATERIAL AND METHODS: Five patients participated for whom vertical movement of denture bases was measured by comparing the thickness of plaster interocclusal records made with the denture at rest and under biting pressure. Denture bases were processed on master casts formed from final impressions made in full arch custom trays. Secondly, bases were readapted using sectional relining impressions with the same regular body polysulfide impression material. RESULTS: Statistical analysis of the vertical movement of denture bases during biting at 4 points on the right and left denture bases showed a significant decrease in vertical movement with sectional impression. The reduction was less than a 0.1 mm, a result that questions the routine use of sectional impression for every distal-extension mandibular removable partial denture. CONCLUSION: Supportive form of distal-extension edentulous ridges can be recorded successfully by full arch impressions in custom trays.

Adult↗

The measurement of forces transmitted to abutment teeth of removable partial dentures.

Despite the limited number of patients in the study, the following conclusions may be made regarding the magnitude and direction of forces transmitted to abutment teeth of extension-base removable partial dentures. 1. A technique was presented for using strain gauges to determine the magnitude and direction of forces transmitted to abutment teeth of removable partial dentures. 2. There are variations in force magnitude with a patient and between patients from chewing cycle to chewing cycle. 3. The transmitted forces vary when different removable partial denture designs are used. 4. Improving adaptation of the extension bases to the residual ridge is an excellent means for providing maximum support, increasing patient comfort, and decreasing forces to abutment teeth. 5. Extension bases apply mesially directed forces to abutment teeth during mastication. 6. Further research is needed to elucidate the effects of the various philosophies of removable partial denture design.

Alveolar Process↗