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A survey of dentitions and removable partial dentures constructed for patients in North America.

The prevalence of removable partial dentures in North America is not known. This study was designed to collect information about (1) the indications for, (2) the teeth to be replaced with, and (3) the type of major connectors used in removable partial dentures. Five commercial dental laboratories situated in different regions of North America were selected to give as wide as possible a view of the production of removable partial dentures. Each laboratory was asked to provide details of 300 consecutive removable partial dentures. Photographs (35 mm) of master casts and processed partial dentures were obtained for more than 1300 patients. The color slides were analyzed and the remaining teeth and types of dentures were recorded. The dentures were classified as follows: cast frame denture, acrylic resin denture with or without some wrought metal, and acrylic resin denture with some cast units. The major connectors were classified as one of seven alternatives in the maxillae, and as one of six alternatives in the mandible.

Canada↗

Clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses.

STATEMENT OF PROBLEM: It is important to evaluate the long-term clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses. PURPOSE: A prospective, long-term clinical study was conducted to evaluate the success of resin-bonded fixed partial dentures since 1985 and of resin-bonded extracoronal attachments from 1987. METHODS: Until 1993, a total of 130 resin-bonded fixed partial dentures had been seated in 101 patients, as well as 12 removable partial dentures (RPDs) with 24 extracoronal retainers in 10 patients. The clinical treatment protocol and the laboratory procedures were standardized. By the end of 1993, it was possible to reexamine 98 patients with a total of 127 resin-bonded fixed partial dentures and all 10 patients with removable partial dentures. The average time in function for the resin-bonded fixed partial dentures at the time of examination was 3.4 years and 2.3 years for the removable restorations. RESULTS: During the period of observation, one retainer failed on six of the resin-bonded fixed partial dentures, which represents a failure rate of 4.7%. Debonding of extracoronal attachments was recorded for 8.3% of the total number of retainers. CONCLUSION: The resin-bonded fixed partial denture technique can be considered to be a clinically reliable method of treatment, and permits the expansion of indications beyond a classical three-unit resin-bonded fixed partial denture. Long-term clinical success of removable partial dentures with resin-bonded extracoronal retainers warrants additional clinical studies.

Adolescent↗

The maxillary complete denture opposing the mandibular bilateral distal-extension partial denture: treatment considerations.

The dentist should approach the treatment of the complete maxillary denture opposing the mandibular bilateral distal extension partial denture cautiously, and the institution of correct treatment initiatives is essential. Every patient must be aware from the outset that the longest possible life of any prosthesis with the least possible harm to the remaining tissues can only be ensured by regular recall and maintenance care.

Bone Resorption↗

Periodontal status of regular dental attenders with and without removable partial dentures.

The periodontal status of 14 regular dental attenders who had been wearing removable partial dentures was compared with a matched group of non-denture wearers. Most partial dentures were mucosally supported. Reported plaque control practices, levels of plaque, subgingival calculus and gingival bleeding, mean pocket depth and mean loss of periodontal attachment were similar in both groups. Severe destructive periodontal disease was present in five (36%) of the denture wearers compared with seven (50%) of the non-denture wearers. We conclude that regular dental attenders with partial dentures were no more likely to have poorer periodontal health than comparable non-denture wearers.

Adult↗

Influence of clasp design of distal extension removable partial dentures on the periodontium of the abutment teeth.

Three removable partial denture designs were investigated to determine the effect of minor connector configuration on the periodontal health of abutment teeth. Twenty-five patients wore three different removable partial dentures for 19 weeks each. The first removable partial denture placed a tilting force on the abutment teeth; the second was stress-releasing; and the third collected the least amount of plaque. Plaque accumulation, the condition of the periodontium, migration of the abutment teeth, deformation of the clasp arms, retention of the prosthesis, and patient preferences were assessed. The results demonstrated that the partial denture retentive design did not affect plaque formation. The prosthesis designed to place a tilting force on the abutment teeth appeared to cause the least mobility and migration of the abutments and had the greatest acceptance by the patients.

Dental Abutments↗

Clinical outcome of glass-fiber-reinforced crowns and fixed partial dentures: a three-year retrospective study.

OBJECTIVE: Glass-fiber-reinforced resin composites for the fabrication of esthetic single crowns and fixed partial dentures have been developed recently. However, little data on the clinical outcome of such restorations have been published. The purpose of this retrospective study was to evaluate the clinical outcome of crowns and fixed partial dentures made from the glass-fiber-reinforced resin composite material Targis/Vectris. METHOD AND MATERIALS: Between 1995 and 1997, 39 patients were treated with 67 single crowns and 83 fixed partial dentures. Twenty-five crowns and 28 fixed partial dentures were cemented with temporary cement, while 42 crowns and 55 fixed partial dentures were cemented with either zinc-phosphate cement or glass-ionomer cement. RESULTS: In September 2001, 57 restorations in 17 patients were still in function. The three-year survival rate calculated according to the Kaplan-Meier method was 58.8% for all restorations. However, after this time, it was 37.5% for crowns and 59.9% for fixed partial dentures cemented with temporary cement, and 55.1% for crowns and 67.9% for fixed partial dentures cemented with zinc phosphate or glass ionomer. The differences between the restoration groups were not statistically significant. CONCLUSION: Glass-fiber-reinforced crowns and fixed partial dentures made with the glass-fiber-reinforced resin composite material Targis/Vectris showed a lower survival rate than that published for metal-ceramic crowns and fixed partial dentures. Therefore, the use of this material for the fabrication of single crowns or fixed partial dentures as permanent restorations cannot be recommended.

Adult↗

A two-stage resin-bonded fixed partial denture seated in conjunction with postextraction healing of the alveolar socket: a clinical report.

A patient treatment modality that involved a two-stage resin-bonded FPD was presented in this clinical report. During recovery of the alveolar socket, a direct bonded acrylic pontic was seated with an adhesive resin (Super-Bond C&B Clear). This primary prosthesis provided service for 6 months without trouble and was effective for maintaining the open space and recovery of oral functions. The secondarily seated resin-bonded FPD, which was made of silver-palladium-copper-gold alloy and bonded with a primer for noble alloys (V-Primer) and an adhesive resin (Super-Bond Opaque), has been functioning satisfactorily for more than 5 years. This two-stage procedure is useful in situations that require conservative or periodontal treatment before seating final prostheses.

Acrylic Resins↗

Intraoral repair of fiber-reinforced composite fixed partial dentures.

STATEMENT OF THE PROBLEM: Fractured composite facings may result in replacement of a fixed partial denture unless a reliable intraoral repair method can be provided. PURPOSE: This in vitro study tested the quality of an intraoral repair method for fractured facings of fixed partial dentures made of a fiber-reinforced composite system. MATERIAL AND METHODS: Shear bond strengths of a light-curing composite to a fiber-reinforced composite material were determined after different mechanical surface treatments. Aluminum oxide air abrading provided the most reliable bond strength values and therefore was used as a pretreatment for the facing repair of three-unit posterior fixed partial dentures. Facing repair was performed with the tested light-curing hybrid composite. Facing fracture strengths of repaired and original fixed partial dentures were determined after thermocycling and mechanical loading. RESULTS: Median facing fracture strength of the original fixed partial dentures was 1450 N after a simulated clinical service of 5 years. Facing fracture strengths of the repaired fixed partial dentures were significantly lower compared with the control group after an additional simulated 2-year interval. However, the median fracture force was still 1000 N. CONCLUSIONS: The facing repair of a fiber-reinforced fixed partial denture with a hybrid composite in combination with aluminum oxide air-abrading pretreatment and silanization provided sufficient fracture strength. Therefore the replacement of the complete restoration may be avoided.

Acrylates↗

The implant-supported, heat-processed provisional fixed partial denture.

When fabricating an implant-supported fixed partial denture a provisional prosthesis is commonly required for function and esthetics. A laboratory-fabricated, heat-polymerized provisional restoration will provide excellent fit, function, esthetics, and durability while saving chair time. This article describes the clinical and laboratory procedures for the fabrication of the implant-supported, heat-processed provisional fixed partial denture.

Dental Implants↗

Indications for removable partial dentures: a literature review.

PURPOSE: The purpose of this report was to evaluate indications for the use of removable partial dentures based on a comprehensive literature review. MATERIALS AND METHODS: Using a model similar to a Delphi process, the literature relating to the indications and contraindications for the prescription of removable partial dentures was discussed by seven experienced educators in a 2.5-day workshop. RESULTS: Evidence for indications and contraindications for the prescription of removable partial dentures is not clearly stated in the literature; however, some basic principles are defined. There appears to be a trend in favor of the use of the shortened dental arch concept or implant-supported restorations instead of conventional removable partial dentures, given the evidence that the long-term use of removable dentures is associated with increased risks of caries and periodontitis and low patient acceptance. The presence of sound abutment teeth appears to encourage the use of removable partial dentures, as the fixed partial denture alternative requires sacrifice of healthy hard tissues. When economic factors influence the decision-making process, removable partial dentures are often chosen. CONCLUSION: While evidence-based indications and contraindications for prescribing removable partial dentures are still lacking, major underlying principles for clinical decision making are identified.

Contraindications↗

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↗

Periodontal disease in partial denture wearers--a biological index.

Studies on the adverse effects of partial dentures on the remaining tissues require both a yardstick of measurement to record the level of oral disease, and the use of controls, preferably within the same patient. A method was devised for pooling the individual values related to the level of periodontal disease on abutment and control teeth in partial dentitions. The difference in these combined values was expressed as the Biological Price. This value provided a useful means of evaluating partial denture designs and patient features, in attempting to assess the major contributing factors responsible for the Biological Price levied by the denture. Whilst wearing an acrylic partial denture at night adds to the price paid by the remaining tissues, the mechanical features of the partial denture, and the overall features of the patient and his remaining dentition appear to be insignificant in determining the Biological Price.

Adolescent↗

Comparison of titanium and cobalt-chromium removable partial denture clasps.

STATEMENT OF PROBLEM: The use of titanium alloys for removable partial dentures is an increasingly popular application. While the flexibility of titanium would allow for cast clasps to be placed in deeper undercuts than advisable with cobalt-chromium, it is possible that the retentive forces of the titanium clasp might not maintain sufficient retention after repeated flexing of the clasp arm during insertion and removal of the partial denture. PURPOSE: This study assessed the characteristics of cast clasps made of titanium and titanium alloys to determine whether these materials are suitable alternatives for removable partial denture applications. MATERIAL AND METHODS: Removable partial denture clasps at two undercut depths were fabricated from commercially pure titanium, titanium alloy (Ti-6A1-4V), and cobalt-chromium. Loss of retention force was measured as the clasps underwent 3 years of simulated clinical use. The data were subjected to ANOVA and Scheffé's tests to determine differences. Evidence of casting defects and porosity was evaluated by radiographic examination and nonparametric statistics. SEM microscopy was used to observe surface characteristics that were described qualitatively. RESULTS: For the 0.75 mm undercut specimens, there was less loss of retention for clasps made from pure titanium and titanium alloy than for cobalt-chromium clasps. Porosity was more apparent in the pure titanium and titanium alloy clasps than in those made from cobalt-chromium, but the amount of porosity did not correspond to evidence of fractures or permanent deformation. CONCLUSIONS: The long-term retentive resiliency of the pure titanium and titanium alloy clasps suggests that these materials are suitable for removable partial dentures.

Alloys↗