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Improved retention of acid-etched fixed partial dentures: a longitudinal study.

Debonding of acid-etched fixed partial dentures has been a problem since their introduction. A study was conducted to determine whether this problem could be resolved by modifying the mechanical retention of tooth preparations. Retentive grooves were prepared at the line angles to create mechanical locks for the resin bonded fixed partial denture. The 4-year retention of posterior resin-bonded fixed partial dentures improved from 60% to 95% by the placement of the proximal grooves. This study was conducted in a dental school clinic during a period of 10 to 52 months. The results demonstrated that design modifications were necessary to improve clinical longevity so that the restoration could be considered "permanent" in the traditional sense. The less-experienced dentist may be more confident of the treatment with the recommended modifications and projected longevity.

Acid Etching, Dental↗

Removable partial denture design in Alberta dental practices.

Studies published in the dental literature have found, all too frequently, that dentists do not pay adequate attention to the design of cast removable partial denture frameworks. This study investigated removable partial denture design in Alberta dental practices. The authors considered various issues related to surveying, partial denture design, and provider education, as well as the possible collaboration of clinical dentistry with denturism in removable partial denture treatment. Although the study found that a significant proportion of Alberta's dentists get involved in designing the cast framework, relatively few undertake surveying. Instead, surveying tends to be deferred to dental technicians. As was the case in other studies, no clear reason for this trend emerged, and it appeared to be unrelated to remuneration or time utilization issues. Responding dentists perceived that their undergraduate education was adequate for providing removable partial denture care. The study also identified a need for small, hands-on continuing education courses. About half of the respondents indicated that it is appropriate for dentists to collaborate with denturists on complete denture care. However, very few respondents considered it appropriate to refer to, or collaborate with, denturists in removable partial denture care.

Alberta↗

The influence of spruing technique on the development of tension in a cast partial denture framework.

Distortions of cast removable partial denture frameworks result more from the method of sprue connection than from other variables in the investment and mold preparation. A standard test pattern and optical measuring equipment were used to evaluate residual casting stresses. Based on the data obtained from the initial study, modified removable partial framework patterns were made and cast under varying conditions. The use of a dorsal spruing technique and a box-type casting flask resulted in less distortion than use of the conventional vertical sprue attachment and investing in a ring flask. Dorsal spruing and use of a box-type casting flask reduced the deformation of a cast partial denture framework in the area of the palatal bar and retentive elements up to 0.3 mm. Such a tension-free casting method means a better fit of the partial framework on the master cast and intraorally.

Dental Casting Investment↗

Gingival autografts as an adjunct to removable partial dentures.

The lingual bar of a mandibular removable partial denture, especially a free-end saddle type, may exert a great deal of pressure on the underlying periodontal tissues. It is best that the lingual bar be placed as far away from the marginal tissues as possible but still on dense, collagenous attached gingiva. If an inadequate amount of attached gingiva is present on the lingual surfaces of the mandibular anterior teeth, this tissue may be augmented by a free, palatal gingival autograft. The patient with a partial denture must be constantly monitored to determine whether any changes have occurred in the edentulous saddle areas. Resorption of these ridges may allow the partial denture to settle, thereby compromising the periodontal health of the supporting teeth.

Adult↗

A clinical survey of removable partial dentures. --Analysis of follow-up examinations over a sixteen-year period--.

In order to carry out the proper prosthetic treatment, it is necessary to select the method of treatment on the basis of accurate information concerning the prognosis of the prosthetic appliance. The oral structures are particularly proved to change when partial dentures are being used because the structures of the partial dentures are quite complex and they are easily broken. Therefore, in an attempt to analyze the changes that occur in the oral structures and partial dentures after insertion of the partial dentures, we conducted 3 series of follow-up examinations. The author sent out questionnaires and also conducted follow-up examinations of the patients. A summary of the major findings is as follows: 1) The percentage of those patients who came for their follow-up examinations, using metal based dentures, rose sharply over time. There were only 11.99% of the patients using the metal based dentures at the time the first study was conducted, but this rose to 58.13% at the time of the second study and 73.73% at the time of the third study. 2) The proportion of the patients who had anterior partial dentures declined over time from 9.36% at the time of the first study to 8.74% at the time of the second study and finally to 5.61% at the time of the third study. 3) The proportion of the partial dentures that had fractured was 23.15% at the time of the first study and 16.37% at the time of the second study and 16.67% at the time of the third study. 4) There was a striking difference in the fracture frequency of the acrylic resin based partial dentures and that of the metal based partial dentures. The denture bases of the acrylic resin-based partial dentures fractured about four times as often as those of the metal based partial dentures. 5) In all three studies it was found that about 60% of the caries occuring on the abutment tooth occurred on the edentulous proximal side. 6) Changes in the mucous membrane, such as inflammation or development of ulcers, had occurred in 48.86% of the cases at the time of the first study. This proportion declined to approximately 47% at the time of the second and finally to 43% at the time of the third study. 7) In examining the changes in the mobility of the abutment teeth, it was found that in all three studies approximately 20 to 30% of the abutment teeth demonstrated increased mobility, and about 10 to 20% showed decreased mobility while 55 to 65% showed no change.

Acrylic Resins↗

Patients' experiences with partial dentures: a qualitative study.

OBJECTIVE: The aim of the study was to gain insight into people's experiences of being given and using partial dentures. METHODS: In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. RESULTS: The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. CONCLUSIONS: Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers.

Adaptation, Psychological↗

Finite element stress analysis on the effect of splinting in fixed partial dentures.

STATEMENT OF PROBLEM: Long-span fixed partial dentures usually require splinting of multiple abutments to overcome mechanical problems associated with the long edentulous span. Most information and indications for the use of multiple splinted abutments have been empirically derived. PURPOSE: This study analyzed the stress levels in the teeth and supporting structures of a fixed prosthesis and ascertained how the addition of multiple abutments in a fixed prosthesis modifies the stresses and their deflection. MATERIAL AND METHODS: The finite element method was used to analyze mechanical behaviors of a prosthesis and its supporting structures when a fixed prosthesis with several designs replaced a mandibular second premolar and a first molar. Variations of the standard finite element model were made by changing the number of splinted teeth and the level of bone support. RESULTS: A reduction of stress and deflection was observed in the supporting structures when a fixed partial denture was fabricated and teeth were splinted together. Increasing the number of splinted abutments did not reveal a proportional reduction of stress in the periodontium. Stress concentrations were seen in the connectors of prosthesis and in the cervical dentin area near the edentulous ridge. CONCLUSION: Increasing the number of the splinted abutment did not compensate for the mechanical problems of a long-span fixed partial denture sufficiently.

Alveolar Bone Loss↗

A technique for fabrication of a provisional fixed partial denture for nonparallel abutments.

A satisfactory provisional fixed partial denture (FPD) should provide positional stability, maintain the occlusion, and place an additional load on the abutments so that if sensitivity develops, it will subside before the insertion of the definitive FPD. This article presents a technique using an indirect-direct procedure for the fabrication of a 2-part provisional FPD, utilizing a commercially available stainless steel wrought-wire clasp with an occlusal rest, which fulfills all the requirements of a provisional FPD.

Crowns↗

Crown preparations for semiprecision attachment removable partial dentures.

The utilization of intracoronal or extracoronal removable partial denture attachments in conjunction with a fixed retainer applies additional stresses to the structural durability of the fixed retainer and its integrity with the underlying abutment. Therefore, the utilization of this attachment with a fixed retainer requires understanding and diligent application of the basic principles of fixed prosthodontics.The primary objective of prosthodontics must be the preservation and health of the remaining existing tissues and structures: teeth, periodontal tissues, temporomandibular joint, and oral facial muscles. This must be of primary importance as we achieve our goals of (1) eliminating existing pathology, (2) restoring morphology and function, and (3) improving esthetics and thereby heightening self-esteem and the psychological well-being of the individual. These objectives make us sensitive to the considerations we have discussed in preparation design and the tissue management required in the fabrication of fixed retainers.

Crowns↗

[Fiber-reinforced adhesive partial dentures].

Dental applications of fiber-reinforced polymers include adhesive partial dentures. Dental resin composite materials can be reinforced by several types of fibres. Fiber orientation, proper wetting of the fibers by the resin and fiber volume are important. An application of fiber reinforced composites is the composite inlay bridge. This paper deals with some aspects of this type of adhesive partial denture. Advantages include the satisfactory esthetics and the minimally invasive character. Not clear yet is the long-term survival. The adhesive properties of fiber-reinforced adhesive partial dentures require an adaptation of the current dental philosophy, in which direct and indirect restorative techniques can be combined. An increase in knowledge and experience is needed to determine the dental applications.

Composite Resins↗

[Statistical analysis of fabrication of fixed and removable partial dentures].

A statistical survey based on laboratory records was performed on the number of fixed and removable partial dentures fabricated at the dental hospital of Tokyo Medical and Dental University from April 1 to September 30, 1997. A comparison was also performed with a previous survey, which had been carried out in 1986, in order to detect any change and possible alterations in the near future. From the findings of this statistical survey, the conclusions were as follows: 1. A total of 2,478 fixed and removable partial dentures were fabricated during the six month period in 1997. 2. The 3-unit fixed partial denture (bridge) was most common (63.1%) and the number of bridges decreased as the number of units increased. 3. For the single missing tooth, a fixed bridge was more popular (81.0%) than a removable partial denture. 4. For two missing teeth, there was no difference between the number of fixed bridges and removable partial dentures. 5. The percentage of fixed and removable partial dentures, which were not covered by health insurance, decreased to a large extent in comparison with the survey in 1986.

Denture, Partial, Fixed↗

The oral status of elderly removable partial denture wearers.

A random sample of 1019 elderly home dwelling persons participated in this study. There were 809 dentate respondents, 28.6% of whom wore removable partial dentures. They were examined for coronal and root caries, gingival recession, pocket depth and loss of gingival attachment. The removable partial dentures were also evaluated. Abutment teeth were found to be more likely to have caries and periodontal disease than all other teeth. Using a MANOVA statistical procedure, the analysis indicated that the partial denture itself, irrespective of any professionally determined problems with the denture, appears to affect coronal and root caries on the teeth of partial denture wearers. Partial dentures judged to need repair or adjustment were related to periodontal status. The data on adverse effects of partial dentures suggest a need for patient education by the dentist and through public health measures, and good oral self care and regular professional recall for people who wear removable partial dentures.

Black or African American↗

Detection of improvement in the masticatory function from old to new removable partial dentures using mixing ability test.

The aim of this study was to determine the sensitivity of the Mixing Ability Test to detect improvement of masticatory function in subjects on transition from old to new removable partial dentures. Thirty-two subjects (seven males, 25 females, mean age 65.0 years) with distal extension partially edentulous area in mandible and/or maxilla participated in the study. The following reasons were presented for replacing the old removable partial dentures with new ones: fracture and/or poor fitness of retainers, extraction of abutment teeth, poor fitness of denture base, severe wear of artificial teeth and request for metal base dentures. Masticatory function with old and new removable partial dentures after an adaptation period (mean 27.4 weeks) was evaluated by the Mixing Ability Test. Subjects were asked to masticate five two-coloured wax cubes with each removable partial denture. Mixing Ability Index was obtained from the colour mixture and shape of the masticated cubes. Wilcoxon signed-rank test was used to test the difference of Mixing Ability Indexes between old and new removable partial dentures. The mixing ability indexes with new removable partial dentures (mean+/- s.d.: 0.70+/- 0.68) was significantly higher (P<0.001) than those with old removable partial dentures (-0.11+/-1.13). The results suggest that the Mixing Ability Test was capable of detecting improvement in masticatory function with new removable partial dentures.

Aged↗

Replacing an anterior metal-ceramic restoration with an all-ceramic resin-bonded fixed partial denture: a case report.

Since the first resin-bonded fixed partial denture was described, this adhesive technique for splinting mobile teeth has developed into a conservative method for replacing missing teeth. Heat-pressed all-ceramic materials have been introduced for the fabrication of 3-unit fixed partial dentures in the anterior and premolar region. This clinical report describes the replacement of a conventional partial coverage metal-ceramic resin-bonded fixed partial denture with an all-ceramic resin-bonded fixed partial denture in the anterior maxillary area.

Adult↗

Precision metal occlusal surfaces for removable partial dentures.

The prosthodontist is often limited in developing the desired occlusal pattern when integrating removable partial dentures with natural dentitions or fixed partial dentures. A technique that allows the development of an esthetic, accurate metal occlusal surface for a removable partial denture is described. The occlusion developed allows an occlusal harmony with the removable partial denture that is not possible with stock denture teeth or metal occlusal surfaces developed with stock denture teeth.

Dental Occlusion↗

Analysis of stress on a fixed partial denture with a blade-vent implant abutment.

Using a two-dimensional finite element method, a study was made that compared the behavior of a model mandibular posterior fixed partial denture constructed on the second premolar abutment and a blade-vent implant imbedded at the site of the second molar with the behavior of a fixed partial denture constructed on the second premolar and second molar abutments. The following were the results: 1. Deflections of the implant fixed partial denture were less than those of the natural tooth fixed partial denture in vertical and inclined loads. 2. Stress concentration was markedly found in the pontic and the mesial and distal parts of the premolar retainer in both restorations and the implant neck in the implant fixed partial denture. 3. In the implant fixed partial denture, stresses induced in the surrounding bone became higher around the posterior abutment and became lower around the premolar retainer than the stresses produced with the natural tooth fixed partial denture. 4. Therefore it was suggested that, to relieve stress to the surrounding bone around the implant abutment, occlusal forces loaded to the implant fixed partial denture have to be more concentrated on the premolar abutment than do forces loaded to the natural tooth fixed partial denture.

Alveolar Process↗