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Finite element stress analysis of tooth-to-implant fixed partial denture designs.

PURPOSE: The purpose of this study was to conduct a three-dimensional finite element stress analysis to compare models representing a natural tooth and an integrated implant connected with rigid and nonrigid prostheses. MATERIALS AND METHODS: The mathematical models described an integrated implant connected to a second premolar tooth with a three-unit metal-ceramic fixed partial denture. In one model, the tooth and implant were rigidly connected, and in the other, a nonrigid connection was assumed. From a simulated vertical load the computer generated resultant stress contours and values (compressive and tensile) in horizontal and vertical dimensions. RESULTS: A comparison of the magnitude and pattern of stresses generated in the models shows minimal differences. Although the maximum stress values were slightly higher in some areas of the rigid prosthesis model, the differences were negligible. CONCLUSIONS: Based on the similarities in both the patterns of stress contours and the stress values generated in the two models, advocating a nonrigid connection because of a biomechanical advantage may be erroneous.

Alveolar Process↗

An investigation of aspects of design of partial dentures.

PURPOSE: The purpose of the study was to establish the incidence of the prescription of partial denture design by dentists and also to establish the nature of clasp design, if prescribed. BASIC PROCEDURES: Data relating to cobalt chromium partial dentures were collected from filed slips from a dental laboratory that provided fabricated cobalt-chromium partial dentures for hospital and general dental-practitioners. The data collected related to whether or not there was a design for the prosthesis and, also, to the design of clasp (gingivally or occlusally approaching). MAIN FINDINGS: Only 39% of slips had evidence of a partial denture design and of those, 41.5% involved the prescription of an inappropriate design of clasp. PRINCIPAL CONCLUSIONS: The incidence of partial denture design by a group of dentists using a commercial dental laboratory is unacceptably low. Despite evidence advocating the use of gingivally-approaching clasps on teeth anterior to (and including) premolars, there is still an unacceptably high level of the use of occlusally-approaching designs.

Chromium Alloys↗

Designing successful removable partial dentures.

In today's busy dental offices, removable partial denture design is often abdicated by dentists, both as a result of a lack of experience and consensus of design and because of educational failure on the part of dental schools. The result is delegation of the clinical design process to the lab technician. The lack of clinical data provided to the dental technician jeopardizes the quality of care. This article will focus on a logical and simple approach to this problem, making removable partial denture design simple and predictably achievable. The clinical evidence related to removable partial denture design will be described, along with a checklist to simplify the process and make it practical and applicable to everyday clinical practice.

Dental Abutments↗

On the clinical deformation of maxillary complete dentures. Influence of denture-base design and shape of denture-bearing tissue.

This paper aimed to study the influence of denture base design and the shape of the denture-supporting area on the functional deformation of maxillary complete dentures. Six strain-gauged duplicate maxillary dentures were made for the study of two test subjects with different shapes of the palatal vault. Each subject was supplied with two polymethyl methacrylate dentures, one with a 1-mm-thick palatal base and the other 2 mm thick. A third denture was constructed with a cobalt-chromium base. The functional loading tests included maximum biting and the chewing of the food test samples. An analysis based on chewing time and total number of chewing cycles per test piece was also made. The results showed that surface straining is highly complex at the anterior part of the maxillary dentures constructed from polymethyl methacrylate and that increasing the denture thickness per se might not be accompanied by a reduction of strain. The results also suggest that high thrust to the supporting tissue is produced with high palatal vault dentures made in polymethyl methacrylate. The study proposes that cobalt-chromium bases may be used in maxillary dentures to reduce functional deformation and thrust to the supporting tissues at the anterior part of the maxilla.

Aged↗

Designing removable partial dentures.

Various designs have been suggested for the more frequently- occurring situations of the partially edentulous state. Obviously, a discussion of all the probabilities of design is not possible. The important factor is that basic principles are not violated. Retainer choice, rest placement, major and minor connector design, and support of the distal extension base are all critical factors. However, the fact remains that adequate time must be spent in properly diagnosing the particular case and devising a workable treatment plan. A thorough oral and radiographic examination, accurate articulated diagnostic casts, and a profile of the patient in terms of prosthetic needs and expectations must all be made. Once this picture is in order, the rather mechanical task of laying out the "nuts and bolts" of removable partial denture design can be carried out to ensure that our patients receive the full benefits of our knowledge and skills.

Denture Bases↗