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PubMed2002

Quality of removable partial dentures worn by the adult U.S. population.

STATEMENT OF PROBLEMS: Research-based assessments of the quality of removable partial dentures (RPDs), especially within a large patient population, are lacking. PURPOSE: This study evaluated the prevalence and quality of RPDs by use of the National Health and Nutrition Survey (NHANES III) data set. MATERIAL AND METHODS: Estimates of the health and nutritional status of the American population were obtained from the NHANES III data set (1988-1994). Calibrated dentists performed dental examinations on 17,884 adults. If the subject wore an RPD, its quality was assessed with 5 criteria: integrity, tooth wear, the presence of temporary reline material or adhesive, stability, and retention. In this study, the data on RPD defects were used to assess the prevalence of problems. The original population was divided into 4 subgroups: paired RPD data = subjects wearing both maxillary and mandibular RPDs (n = 600 prostheses, 300 maxillary and 300 mandibular); single RPD data = subjects with only one RPD (n = 1003 prostheses, 511 maxillary and 492 mandibular); maxillary versus mandibular RPD data = all subjects with all RPDs (n = 1603 prostheses, 811 maxillary and 792 mandibular); and pooled RPD data = all subjects with a single RPD plus subjects with 2 RPDs, counting only the RPD with the most defects (n = 1303 prostheses, 674 maxillary and 629 mandibular). The subjects were analyzed with descriptive statistics. The distribution of defects in the RPDs was examined for possible associations with chi(2) tests. The paired data for patients with both maxillary and mandibular RPDs were analyzed with Wilcoxon signed rank tests. The prevalence of RPDs as a function of patient age and the association between RPD defects and patient age were analyzed with chi(2) tests. The results were considered highly significant at P<.0001 and significant at P<.05. RESULTS: Of the 17,884 adults who underwent a dental examination, 1306 had RPDs. Three patients were excluded because their records were incomplete, leaving 1303 patients available for analysis. Most of the prostheses examined (65%) had at least 1 defect. Lack of stability was the most prevalent single defect. Distinctions in the type and prevalence of defects were observed between mandibular and maxillary RPDs. Mandibular RPDs had significantly more problems related to retention, whereas maxillary RPDs had significantly more problems related to the presence of reline material and to integrity defects. Tooth wear defects were significantly associated with patient age (P<.0001). Only one third of the RPDs were considered satisfactory according to NHANES III criteria. CONCLUSION: A review of the database used in this study indicated that, in spite of a decline in tooth loss, RPDs are still used in all age cohorts, including young adults. A large number of RPDs were found to have defects.

Adhesives↗
PubMed2003

Rehabilitation of occlusal support by removable partial dentures with free-end saddles.

This study aimed to assess the level of restored occlusal support by removable partial dentures with free-end saddles. The maximal clenching force of 61 subjects was measured using pressure sensitive film with and without their dentures. The restored level of occlusal support was estimated from the shift of the occlusal load centre. In comparison with previous results of experimental occlusions using splints for eight normal dentate subjects, the restored level using dentures ranged from 40-60% of that of natural teeth. The analysis of the shift of the occlusal load centre could reasonably evaluate the prostheses from the standpoint of occlusal support.

Adult↗
PubMed2006

[Stress analyses and comparison of the Kennedy III dentition defect restored with removable partial denture].

PURPOSE: To investigate the stress distribution of the abutment and oral mucosa in Kennedy III, restored with removable partial dentures, either unilateral or bilateral designed. METHODS: Five FEA models were established for the partial edentulous and RPDs, which were divided into group A and group B. According to the denture design, bilateral (B) or unilateral (A) designed. The 3-D finite element analyses were proceeded and calculated with the help of the software ANSYS. Paired t test was used for statistical analysis using SAS 6.2 software package. RESULTS: The maximum stress appeared near the cervical mesial area of the first bicuspid and the second molar. There was no significant difference between the two groups in the stress distribution of the abutment and oral mucosa (P>0.05). CONCLUSION: In regard to the stress of the abutments, unilateral designs have no excess stress formed when RPD was used to restore Kennedy III dentition defect.

Bicuspid↗
PubMed2006

Removable partial denture abutments restored with all-ceramic surveyed crowns.

All-ceramic crowns are used as alternatives to conventional metal-ceramic crowns for the restoration of single teeth. Traditionally all-ceramic restorations possessed physical properties that contraindicated their use in many treatment situations. The strength that zirconia ceramics exhibit seems to support the hypothesis that, in specific situations, an all-ceramic crown may be used to restore removable partial denture (RPD) abutments in areas previously reserved for metal or metal-ceramic restorations. Abutments for RPDs may now be fabricated with Procera AllZirkon with the classically prepared guide planes and rest seats. This article provides an overview of a technique for the fabrication of a zirconia-based crown to be used in conjunction with removable partial dentures using the Procera CAD/CAM technology.

Ceramics↗
PubMed1997

Wear of visible light-cured restorative materials and removable partial denture direct retainers.

PURPOSE: This study measured the in vitro wear of visible light-cured restorative materials and removable partial denture direct retainers. MATERIALS AND METHODS: An aluminum test die was produced by replicating the facial contours of an extracted human molar (model). The replica's cervical contour was modified by placement of a restorable Class V cavity preparation. The test die became a fixed component of a testing apparatus. The restorative materials tested were Z100 (fine particle filled resin composite), Silux Plus (microfilled resin composite), and Photac-Fil (hybrid glass ionomer). Cast round, half round, I bar, and wrought-wire retainers were designed to engage a 0.254-mm undercut. Caliper measurements of the wear of restorative materials were made at intervals during testing, and after 7,500 retainer placements and removals. The measurements of material- and retainer-wear were subjected to ANOVA and Tukey tests. RESULTS: Generally, retainers with round profiles caused less wear of the restorative materials than those featuring flat contact surfaces. Wear of the materials ranged from 14 +/- 5.5 microns (Silux Plus by cast round) to 70 +/- 10.0 microns (Photac-Fil by cast half round). Mean wear of retainers, however, ranged only from 2 +/- 4.5 microns for six of 12 possible retainer-material pairings up to 12 +/- 4.5 microns (cast half round by Z100). CONCLUSIONS: Regardless of their design features, the direct retainers of this study exhibited little wear when paired with any of the restorative materials. Overall, material wear appeared to be greater than retainer wear by a factor of five. When paired with practically any retainer type, the hybrid glass ionomer (Photac-Fil) exhibited more wear than either of the two resin composites (Z100 or Silux Plus). Although not established clearly, retainers with round profiles (wrought-wire and cast round) appeared to produce less wear of restorative materials than their I bar and cast half round counterparts.

Analysis of Variance↗
PubMed1995

Removable partial denture design by Canadian dental laboratories: a retrospective study.

Identical, unilateral, distal extension base (DEB) maxillary and mandibular casts with a posterior modification area were mailed to 15 Canadian commercial dental laboratories. Each cast was accompanied by a letter explaining the purpose of the study and a request for the laboratory to design a RPD-U and RPD-L framework. The package also included a questionnaire on the techniques commonly used by dentists in the construction of a removable partial denture prosthesis, as well as the laboratory procedures they requested from laboratory technicians. Compared to the findings of previous studies by McCracken and others, the results of this study indicate an improvement in the dentists' understanding of the fundamental principles of an RPD framework design. However, the questionnaire also revealed the need for improved communication between the dentist and the technician. The study suggests that the basic principles for the construction and design of removable partial dentures, as taught in dental schools across Canada, must be respected by dentists.

Communication↗
PubMed1989

An analysis of rotational movement of asymmetrical distal-extension removable partial dentures.

An axis of rotation is created through the most distally placed occlusal rests when a distal-extension removable partial denture is loaded. If the residual ridges are of unequal lengths, this axis of rotation may not be perpendicular to the residual ridges. The resultant movement of asymmetric denture bases and their effect on the tissues are discussed. Movement of I-bar retainers located on the mesiobuccal aspect of asymmetrical abutment teeth may torque the abutment teeth as the denture base moves tissueward. Use of L-shaped direct retainers on the distobuccal surveyed undercut will create a more favorable class II lever effect on the abutment tooth.

Dental Abutments↗
PubMed1997

Unilateral rotational path removable partial dentures for tilted mandibular molars: design and clinical applications.

This article describes the design of a unilateral rotational path removable partial denture to restore a single edentulous space with a tilted mandibular molar. It is modified from an original bilateral rotational path design and consists of several components, which are (1) the rotation axis, (2) the long occlusal rest, (3) the short bracing arms, (4) the rigid retainer and extended proximal plates, (5) the conventional direct retainer assembly, and (6) optional auxiliary rest. The stability and retention of the denture are controlled anteriorly by the buccal retentive clasp and lingual guide plate of the conventional direct retainer, and posteriorly by the rigid retainer and its buccally and lingually extended proximal plates. The clinical results of the dentures used in strictly selected situations are excellent; however, it is emphasized that a unilateral denture is only an alternative rather than a routine application. The risk of accidental aspiration is also of concern.

Deglutition↗
PubMed2006

Determining "need" for a Removable Partial Denture: a qualitative study of factors that influence dentist provision and patient use.

OBJECTIVE: To identify factors that influence Removable Partial Denture (RPD) provision, and patient use of RPDs in the UK. DESIGN: Exploratory qualitative interview study. SUBJECTS AND METHODS SUBJECTS: There were two sample groups. A purposive sample of 16 male and female dentists was categorised in terms of level of RPD provision, experience, and practice characteristics. A purposive sample of 17 male and female partially dentate patients was categorised in terms of RPD use and demographic characteristics. DATA COLLECTION: Semi-structured in-depth interviews. RESULTS: For dentists, RPD provision was indicated by patient demand and physical function of the remaining teeth, but was mediated by NHS fee structures and professional satisfaction. For patients, RPD use was influenced by the trade-off between improved appearance and the unpalatable presence of an RPD in their mouth. The location of the gap(s) was important, but other issues were relevant such as ability to "manage" without the RPD. CONCLUSION: When defining "need" for an RPD, dentists focused on physical function of the teeth whereas patients focused on social meanings of the mouth. These differing priorities may improve understandings of patient non-compliance in RPD use. Further research on the relationship between denture use and social identity could be beneficial.

Attitude of Health Personnel↗
PubMed2002

Retrofitting crowns to an existing removable partial denture clasp: a simple technique.

The fabrication of a new crown to replace an existing abutment tooth for a removable partial denture is one of the most labor-intensive chairside and laboratory procedures. The process can become more complicated when the patient requests a tooth-colored esthetic restoration. Numerous techniques are described in the literature, some for all-metallic restorations and others for metal-ceramic restorations. This article describes a simplified technique that makes use of a polymer ceramic material.

Crowns↗
PubMed1994

Relationship between wearing a removable partial denture and satisfaction in the elderly.

Natural dentitions of elderly people are often reduced, remaining teeth heavily restored and removable partial dentures (RPD's) frequently used to replace absent teeth. Lack of knowledge exists on how the elderly experience the comfort of these replacements. To get more insight 320 dentate noninstitutionalized subjects between 55 and 75 yr of age were clinically examined and interviewed by means of a questionnaire. Data showed that only 13% of the subjects had a complete dentition from the right to the left first molar; 50% had less than four occlusal units. 39% of the subjects was wearing a RPD. Analysis showed that subjects with a RPD were in general less satisfied with their dental state than subjects without a partial denture. However, when the RPD added occlusal units to the dentition, satisfaction increased significantly. No differences in satisfaction were found between subjects with a metal frame prosthesis and an acrylic denture, nor between tooth-bounded and distal extension prostheses. The conclusion can be drawn that the indication for a RPD should be limited in elderly people, unless the RPD increased the number of the occlusal units.

Aged↗
PubMed2006

Trial fitting of a removable partial denture framework made using computer-aided design and rapid prototyping techniques.

Previous studies of CAD/CAM-produced sacrificial patterns for removable partial denture frameworks have been documented but to date, no such restorations have been test-fitted to a patient. This paper provides details of the first trial fitting to a patient of an RPD framework, the sacrificial pattern of which was produced by CAD/CAM and RP technologies. A cast of the patient was scanned and the normal procedures of dental surveying and pattern build were undertaken with reference to the scanned model using computer-aided design. A sacrificial pattern of the design was produced by rapid prototyping technology. After spruing the pattern, investment-casting and finishing techniques were carried out according to conventional principles. The framework was successfully trial-fitted to the patient and clinically judged to be acceptable for the next stage of denture fabrication, that of adding acrylic bases and artificial teeth.

Computer-Aided Design↗
PubMed2002

Custom precision attachment housings for removable partial dentures.

Limited space for extracoronal attachments is a serious complication in the design and fabrication of a precision attachment removable partial denture. A custom metal-ceramic housing joined to the partial framework with laser welding offers strength and improved esthetics while requiring minimal space. This article presents the technical aspects of custom housing construction.

Dental Soldering↗
PubMed2006

[Design of geometric models of the removable partial denture framework].

PURPOSE: The aim of this study was to introduce a method on computer aided design (CAD) of removable partial denture(RPD) framework based on domestic CAD/CAM software system, which contributes to the further research to develop the domestic software system applied in restorative dentistry. METHODS: Point cloud data of a partially edentulous cast, a mandibular Kennedy Class II modification 2 arch, was captured by an optical scanning system with projective grating and high-resolution digital camera. Using domestic CAD/CAM software system, the above point cloud data was reduced, digital surveying line and inserting path were determined. In terms of the principle of clinical design, the tissue surfaces and polishing surfaces of every component of RPD were built such as clasp, rest, lingual bar, and mesh construction, et al. As well as the characteristic structures of the framework, including the half-pear shaped cross section of lingual bar, the internal and external finish lines, the tissue stop at the tissue surface of mesh construction and so on, were fabricated on the base of reduced data model. 3-D surface model of the RPD framework was created. RESULTS: Geometric model of the RPD framework was fabricated successfully, which took on good fitting, high visibility and editing conveniently. And the data converted to STL file format that could be read by any other CAD/CAM software system and was in preparation for subsequent computer aided manufacture (CAM) of RPD framework. CONCLUSIONS: It is suggested that this method based on domestic software in CAD of RPD framework be feasible.

Computer-Aided Design↗
PubMed1997

Mastering the precision removable partial denture. Part Two. Connection of partial dentures to the abutment teeth.

Because the arrangement of the remaining dentition may vary tremendously, the design of a removable partial denture is complicated with regard to function, esthetics, hygiene and oral comfort. Part One of this article, published in the January/February issue of JDT discussed how disassembling the RPD into its structural components and defining their functions could help the dental technician with RPD planning. Part two discusses the connection of partial frameworks to the remaining dentition and breaks down the components of a combination case.

Dental Abutments↗