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The seating of one-piece and soldered fixed partial dentures.

This laboratory study compared the seating of one-piece castings with that of soldered fixed partial dentures. Two investments were investigated, five American Dental Association type III and five metal ceramic alloy fixed partial dentures were made by using the conventional indirect technique. The investing and casting protocol was designed to produce an ideal fit of the individual complete crown abutments, not the fixed partial denture. Independent seating of each retainer provided a baseline measurement for complete seating and was compared with fixed partial denture seating. Fixed partial dentures were then sectioned and reassembled by soldering twice, using a low- and high-expansion investment. Statistical evaluation identified significant differences between the metals and the techniques. Marginal discrepancies with one-piece casting and lower (0.6%) thermal-expansion soldering were clinically unacceptable. A clinically acceptable fit was obtained with the higher (1%) thermal-expansion soldering investment.

Dental Abutments↗

Diastema preservation in resin-bonded fixed partial dentures.

The etched-metal, resin-bonded fixed partial denture has evolved rapidly from its origination as an extracoronal splint. Technologic advancements in both resin chemistry and retentive surface etching techniques have markedly improved the quality of the prosthesis. Today, resin-bonded fixed partial dentures are an effective, conservative means of replacing missing teeth when specific contra-indications--long spans, insufficient sound enamel, malocclusion, pathologic occlusal habits--are identified and avoided. A universally-accepted standard preparation does not exist for resin-bonded fixed partial dentures; rather, common principles of tooth reduction are agreed upon by most authors. This case report details necessary modifications in typical preparation and framework design that must be included to maintain a midline diastema when such spacing is required or preferred by the patient.

Adolescent↗

Esthetic considerations in the construction of a removable partial denture.

In the construction of a removable partial denture, the patient's interest frequently lies in the improvement of his or her esthetic appearance. This desire can be underestimated by the scientifically trained dentist, resulting in a disappointed patient. The perimeters of potential esthetic improvement might be influenced by the limitations of each individual case. However, appropriate care in the selection, arrangement, and position of teeth can overcome some of the limitations. This article describes the benefits of a well-planned, systematic approach to selection of the framework design, porcelain shade, and tooth mold as well as the base finish, and it illustrates, with specific examples, how to achieve the maximum esthetics in removable partial denture prosthodontics.

Acrylic Resins↗

Functional preprosthetic orthodontics and prosthetic reconstruction with resin-bonded fixed partial dentures.

When a resin-bonded fixed partial denture is planned in the maxillary anterior region, special attention must be paid to occlusal diagnosis. Specific instrumental diagnosis is necessary to define the functionally important factors: the anterior teeth, the occlusal plane, the temporomandibular joint, and their three-dimensional relation. The optimal treatment in an anterior-guided occlusion is a complete integration of the retainers in the given tooth form without altering the original inclination of the palatal guiding surfaces of the anterior teeth. In many cases, preprosthetic orthodontics is indicated because of functional and esthetic reasons. The objective is to achieve an anterior tooth position that allows the retainers of a resin-bonded fixed partial denture to be incorporated with the designed inclination of the guiding surfaces, using noninvasive preparation techniques. Preprosthetic orthodontic treatment planning, possible problems, and limiting factors as well as the subsequent prosthetic reconstruction have been described in detail. The interdisciplinary treatment has to be planned individually for each patient, depending on the functional diagnosis and the clinical and anatomic situation.

Adult↗

The significance of major connectors and denture base mucosal contacts on the functional strain patterns of maxillary removable partial dentures.

The purpose of this study was to investigate the biomechanical significance of major connectors and base mucosal contacts on the mechanical behaviour of maxillary removable partial dentures in vivo. Six subjects wearing maxillary dentures retained by conical crowns were selected for the study. Reflective photoelasticity and strain gauges were used to monitor the development of strain/stress during functional loading. Loading tests were performed initially with a denture design including a palatal major connector and denture bases and then repeated after removal of the major connectors and denture base alveolar muccosa contacts. The palatal major connector and the denture bases mucosal contacts contribute significantly to the rigidity and stability of removable partial dentures retained by conical crowns.

Aged↗

The cantilever fixed partial denture--a literature review.

The cantilever fixed partial denture (FPD) is a restoration with one or more abutments at one end and unsupported at the other end. Forces transmitted through the cantilevered pontics can cause tilting and rotational movements of the abutments. In a cross-arch unilateral cantilever FPD, the distal cantilevered unit is subjected to comparatively less force than the contralateral posterior abutment. The unilateral lack of terminal abutments causes lateral bending forces activate peripheral inhibitory feedback reactions from the periodontal and/or temporomandibular mechanoreceptors. The greatest strain in distal cantilevered FPDs is recorded mesial to the most distal retainer because most fractures occur in this location. To improve the prognosis of the FPD cantilever, the number of abutments should be increased and the number of pontics decreased. The abutment teeth need long roots and acceptable alveolar support. Prepared abutments require adequate length and parallel axial walls. An equilibrated and harmonious occlusion is necessary, as well as exemplary oral hygiene. A cantilevered FPD with adequate periodontal support can replace any tooth in the dental arch, but is especially useful as an alternative to a removable partial denture. The cantilevered FPD requires at least two abutment teeth. The only documented exception permitting a single abutment is the replacement of a maxillary lateral incisor with the canine as an abutment. An alternative to the cantilevered FPD is the osseointegrated implant. As osseointegrated implants become more popular, the need for the tooth-supported cantilevered FPD may decline, but it will remain an alternative treatment modality.

Biomechanical Phenomena↗

Precision attachment retained removable partial dentures: 1. Technical long-term study.

Patients provided with 53 distal extension-base removable partial dentures retained using rigid intracoronal slide attachments were followed up to 25 years. The initial treatment consisted of fixed partial dentures involving all remaining teeth in the treated arches and removable partial dentures having a cast cobalt-chromium framework. The removable dentures showed few complications and little need for relining. The failures primarily involved the fixed partial dentures. Seven arches required complete dentures as a result of technical complications in five patients. Cement failures, root fractures, and fractures of the fixed prostheses were most problematic. The survival rate was about 65% up to 15 years, and a survival time of 50% was extrapolated to 20 years.

Adult↗

Treatment planning for fixed and removable partial dentures: a periodontal view.

1. Chronic occlusal trauma of partial denture abutments may be observed in radiographs before other clinical symptoms are noticed. 2. Evaluation methods can determine when teeth are unsuitable to serve as abutments, but these methods may not be reliable to predict the capacity for some essentially normal teeth to accept additional stresses. 3. Whenever a potential abutment is tilted so that axial loading is questionable, no restoration should be made.

Dental Abutments↗

Surveying removable partial dentures: the importance of guiding planes and path of insertion for stability.

STATEMENT OF PROBLEM: Although removable partial dentures are a favored option for the restoration of many situations that involve partial tooth loss, some patients are not satisfied with a removable partial denture, especially when it is not stable during mastication. A dental surveyor can be used to prevent countless problems related to the production of removable partial dentures. Many professionals working with oral rehabilitation fail to take advantage of the many uses of a surveyor in planning and designing chromium alloy and other metal removable partial denture frameworks. PURPOSE: This article uses an academic approach to describe the criteria used to determine the path and removal of a removable partial denture. A fundamental requirement for understanding the correct use of the dental surveyor is to prevent indiscriminate use of a path of insertion perpendicular to the occlusal plane, and extreme inclinations of the cast in the attempt to create undercuts on some teeth.

Chromium Alloys↗

Aesthetic clasp design for removable partial dentures: a literature review.

Removable partial dentures (RPD) are an effective and affordable treatment option for partial edentulism. If the main reason for seeking treatment is the need for improved aesthetics, treatment should be geared towards achieving this goal. This article is the result of a literature study on aesthetic clasp design for the conventional RPD. In this context, the position of the clasp on the tooth, clasp types, clasp material and alternative methods of retention are reviewed. Although published in reputable journals, the authors report that many articles published on this subject are of a descriptive nature and lack scientific evidence. Therefore, clinicians are encouraged to be critical in their interpretation of literature and the application of published information in their clinical practices.

Dental Clasps↗

Fit discrimination of implant-supported fixed partial dentures fabricated from implant level impressions made at stage I surgery.

STATEMENT OF PROBLEM: The implant level impression can shorten the overall time frame of implant treatment. PURPOSE OF STUDY: The purpose of this study was to analyze the accuracy of fixed partial dentures constructed from impressions taken at implant installation surgery in partially edentulous dogs. The study compared the fit of welded titanium fixed partial dentures with that of cast gold alloy fixed partial dentures. MATERIAL AND METHODS: Three implants were placed on each side of the mandible in six adult greyhound dogs during stage I surgery. Impressions were taken of the implant positional relationships and two types of fixed partial dentures were fabricated for each side of the mandible. Stage II surgery was performed after 3 months. RESULTS: Both types of fixed partial dentures compared favorably with the fit of implant-supported fixed partial dentures in the edentulous jaw or traditional cast fixed partial denture frameworks. CONCLUSIONS: Impressions taken at implant installation surgery provide a valid transfer of information for the laboratory fabrication of the final restoration when the implants are placed to fulfill the requirements of primary stability.

Animals↗

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↗

[Fixed partial denture on osseointegrated screw implants].

There are many differences between full dentures on Brånemark implants and fixed partial dentures built on the same type of implants: due to some more critical anatomical conditions, the choice of number, position and length of the implants is more delicate; the need of an harmonious crown-gingival tissue relationship; higher occlusal forces than in edentalous cases; difficulty in satisfying aesthetic requirements and ease of hygiene. The surgical treatment plan, a pre-requesite to any surgery, permits to determine the length of implants, their number, their position, their long axis direction and the design of the surgical guide, which will indicate to the surgeon the location and the axis for drilling. If this axis is nearly parallel to the sagittal plane for mandibular implants, it will be angulated to that same plane for maxillary implants. In the latter cases, it is often necessary to use angulated transepithelial abutments in order to prevent the abutment screw from having an occlusal access. In order to perform the prosthetis, an impression should be taken with the transepithelial abutments. The final reconstruction can be preceded by a temporary prosthesis, then (or) transitory to await gingival stabilization and not overload the implant immediately after it has been connected with the abutment. The fixed partial denture can be secured with screws or cemented when it is of small size and it must satisfy the functional and aesthetic requirements of the patient. The choice of the material used on the occlusal surface is very important and varies depending on the case. Aesthetics should not be prevent an in easy hygiene. These objectives are not reached at the time the prosthesis is made but during the course of the surgical and prosthetic treatment. Single restorations are subjected to the rules pertaining to any fixed partial denture on implants, but have particular characteristics, such as the almost systematic elimination of the abutment and the absolute necessity of the correct placement of the implant. The single units are more easily subject to unscrewing for mechanical reasons. Although the use of implants is a valuable aid in cases of partial fixed restoration, it requires particular attention with regard to precision.

Dental Implantation, Endosseous↗

Extracoronal resilient attachments in distal-extension removable partial dentures.

Esthetics is often compromised in patients who wear removable partial dentures with metal clasps placed on anterior teeth. Clinical procedures are presented for a new design of a removable partial denture that improves esthetics and function through a new dental attachment. The extracoronal resilient attachment system offers vertical resiliency and universal stress relief for use where a resilient prosthesis is indicated. The removable partial denture retained by these attachments provides esthetics, vertical resiliency, and easy replacement of worn attachments.

Dental Abutments↗

Minimizing postinsertion problems: a procedure for removable partial denture placement.

A procedure for removable partial denture placement has been described. This procedure involves correction of pressure spots and overextensions, harmonizing of occlusion, and patient home-care instructions. Use of this procedure does not eliminate the need for postinsertion observations. Postinsertion adjustments, however, may be minimized by careful attention to each step at the placement visit.

Dental Occlusion, Balanced↗

Occlusion and craniomandibular function among patients treated with removable partial dentures.

Forty patients treated with removable partial dentures (RPDs) at the Institute of Dentistry, University of Oulu, were selected for this study. The type of occlusion, horizontal and vertical overlap, the slide between retruded contact position and intercuspal position, and the occlusal interferences were investigated as occlusal parameters. Helkimo's anamnestic and clinical indices were used to measure the craniomandibular function and the clinical index score was used to compare the differences between different groups. The RPD-generated occlusal interferences seemed to cause most harmful effects in point centric, interference free occlusions, when the damage was directed at the temporomandibular joint. These interferences were most frequently found in the retruded contact position and caused by the RPD teeth.

Adult↗

The claspless partial denture.

1. A simple design for partial dentures has been presented using cobalt samarium (Co5Sm) magnets as both retention and reciprocation units. 2. The magnets are totally enclosed within a thin veneer such as hard dental gold so that the magnet alloy is completely isolated from the oral and tissue fluids. 3. The magnets are arranged in attracting pairs, one member is cemented into a standing abutment tooth while the other member is processed into the denture base directly opposite. 4. Retention is positive, inconspicuous, and oral hygiene problems are minimized.

Cobalt↗

Influence of connector design on fracture probability of ceramic fixed-partial dentures.

Fracture of ceramic fixed-partial dentures (FPDs) tends to occur in the connector area because of stress concentrations. The objective of this study was to test the hypothesis that the radius of curvature at the gingival embrasure of the FPD connector significantly affects the fracture resistance of three-unit FPDs. Two three-dimensional finite element models (FEMs), representing two FPD connector designs, were created in a manner corresponding to that described in a previous experimental study (Oh, 2002). We performed fractographic analysis and FEM analyses based on CARES (NASA) post-processing software to determine the crack initiation site as well as to predict the characteristic strength, the location of peak stress concentrations, and the risk-of-rupture intensities. A good correlation was found between the experimentally measured failure loads and those predicted by FEM simulation analyses. Fractography revealed fracture initiation at the gingival embrasure, which confirms the numerically predicted fracture initiation site. For the designs tested, the radius of curvature at the gingival embrasure strongly affects the fracture resistance of FPDs.

Ceramics↗