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Removable partial denture in special clinical conditions.

Controversies concerning the prosthetic treatment through removable or fixed dentures until the age of 18 existed and continue to exist due to the structural instability of the stomatognathic system. In this communication we present a special experience, acquired about the treatment of some clinical situations in which the removable partial denture has been found appropriate with respect to certain features as bone substance loss as a consequence of traumatisms or tumor extirpations, oligodontia, cleft lip and palate. The clinical situations that will be presented refer to a group of 29 patients treated during a period of 10 years in the Department of Prosthetic Dentistry within the Faculty of Stomatology of Iaşi, Romania. Our conclusion is that the children and teenager patients prosthetic therapy differs with respect to the type and etiology of the teeth loss, the affected zone, the stage of the growth and development process of the stomatognathic system, the technological conditions, the patient social conditions, and last but not least, by his affective attitude regarding the teeth loss and the denture type. The removable partial denture for children and teenagers represents, with some exceptions, an emergency or transitory solution until the necessary conditions for other therapeutic stages are fulfilled. Taking into consideration the tissues lability on which it is applied, the removable partial denture requires a rigorous postprosthetic therapy.

Adolescent↗

Comparative clinical evaluation of removable partial dentures made from impressions with different materials.

Impressions for removable partial dentures (RPDs) should provide an accurate and detailed record of the teeth and soft tissues. Removable partial denture casts should be exact replicas of the mouth to ensure that RPD frameworks fit accurately and are fully adjusted to oral structures. A comparative clinical evaluation was performed on the oral fit of RPDs made from impressions with either irreversible hydrocolloid (alginate) or condensation silicone. The difference between the two groups was found to be statistically significant.

Alginates↗

Construction of a crown to fit a removable partial denture clasp.

This technique allows an accurate cast to be made of a prepared abutment tooth with the removable partial denture in place in the mouth. The partial denture is carefully removed from the cast, the crown waxed up, and the removable partial denture re-placed as many times as necessary during wax-up to obtain a crown that accurately fits the clasp.

Crowns↗

The mechanical behaviour of cantilever fixed partial dentures in shortened dental arch therapy: a 2-D finite element analysis.

In the present study two-dimensional finite element models of two- and three-unit cantilever fixed partial dentures were created to simulate the replacement of a maxillary second premolar in a shortened dental arch. The purpose of the study was to investigate the mechanical behaviour of the two designs of fixed partial denture using the finite element method. The results indicate that the mechanical behaviour of the three-unit fixed partial denture was more favourable than that of the two-unit fixed partial denture under similar conditions of occlusal loading. Prosthesis displacement and maximum principal stresses increased substantially when loading was limited to the pontic, in particular, in the model of two-unit fixed partial denture.

Bicuspid↗

Influence of cold working and thermal treatment on the fit of implant-supported metal-ceramic fixed partial dentures.

STATEMENT OF PROBLEM: The application of porcelain may alter the fit of metal-ceramic frameworks. In fixed partial denture frameworks, this altered fit may cause marginal opening and require sectioning and soldering of the prosthesis. PURPOSE: The purpose of this study was to compare the fit of implant-supported metal-ceramic fixed partial dentures when different thermal treatments were performed. MATERIAL AND METHODS: Fifteen implant-supported metal-ceramic fixed partial denture frameworks were fabricated and divided into 3 treatment groups: Group 1 = cold working and thermal oxidation; Group 2 = unrestrained thermal treatment, cold working, and oxidation; and Group 3 = investment-restrained thermal treatment, cold working, and oxidation. After the appropriate treatment procedures, porcelain was applied. Measurements were made with a digital caliper, with the help of fiduciary marks, after each step in 3 dimensions and at 2 locations. These measurements were compared with those of the as-cast framework (baseline) to determine framework distortion. Distortion data among groups were compared with repeated-measures analysis of variance and Tukey's Studentized range test (P<.05). RESULTS: Absolute values of distortion (regardless of direction) after thermal treatment and after porcelain application were not significantly different among groups. However, total raw values of distortion, which describe the specific direction of distortion, were significantly different for 4 of the 6 recorded measurements between Groups 1 and 3 (P<.05). Although the absolute distortion values did not differ among groups, heat treatment and finishing of the alloy affected the timing and direction of distortion. CONCLUSION: Within the limitations of this study, heat treatment of implant-supported metal-ceramic fixed partial denture frameworks before cold working did not decrease the total absolute distortion. Definite patterns of distortion were, however, found in Groups 1 and 3, suggesting that specific manipulations and heat treatments of the alloy affected the direction of distortion.

Analysis of Variance↗

Removable partial denture design involving teeth and implants as an alternative to unsuccessful fixed implant therapy: a case report.

Various dental implants have been used, and high success rates have been reported. However, as their uses increase, implant failures have been reported. There are partially edentulous patients with an initial treatment plan of an implant-supported fixed partial denture. At times, one or more strategic implants fail to osseointegrate. In situations where financial, systemic, or local conditions preclude the use of a fixed partial denture, a well constructed removable partial denture can be an excellent treatment alternative. It has been reported that prosthesis support can be improved with the use of osseointegrated dental implants, with improved preservation and maintenance of existing hard and soft tissues around dental implants. This article describes the prosthodontic rehabilitation of a partially edentulous patient by the use of a removable partial denture design involving teeth and implants as an alternative to unsuccessful fixed implant therapy. This treatment option solved a difficult clinical problem derived from the failure of two strategic implants and provided the patient with an esthetic and functional prosthesis.

Aged↗

[Adhesive attachments for removable partial dentures].

Since twenty years adhesive dentistry plays a certain role in the design of removable partial dentures. With the use of adhesive attachments the esthetics and retention of a removable partial denture can be improved. To apply these attachments successfully the contour of a sound abutment has to be corrected by grinding to provide retention and resistance. The procedures for constructing removable partial dentures with adhesive attachments are described. It is recommended to apply adhesive attachments in the general dental practice.

Adhesives↗

Using silicone impression material and acrylic resin to fabricate remount casts for removable partial dentures.

A technique is described for fabrication of a remount cast for a removable partial denture. This procedure consists of filling the occlusal/incisal third with acrylic resin and injecting polyvinylsiloxane impression material into the irreversible hydrocolloid impression. This technique provides a simple method for making a remount cast and enables the clinician to remove and easily place the partial denture on the cast during occlusal refinement procedures without damage to the removable partial denture or the remount cast.

Acrylic Resins↗

[Application of bolt-like casting post in posterior fixed partial denture].

OBJECTIVE: To study the manipulation procedure and application of a new post-core system in posterior fixed partial dentures. METHODS: Abutment tooth canals were firstly prepared according to respective canal directions and then complete crown preparation was made following standard procedures. The impression of prepared abutment teeth was taken with silicone and specially made syringe. The fixed partial denture and bolt-like post were fabricated respectively and lastly the two parts were glued together in patient after try-in. RESULTS: All the fixed partial denture with the new post-core system did not get loose and there was no abutment tooth fractured after 23 months in use. CONCLUSIONS: This new post-core system could improve retention of the posterior fixed partial denture if the inter-occlusion distance of the abutment tooth was shorter than 3 mm.

Dental Abutments↗

Patient use of removable partial dentures: two- and four-year telephone interviews.

Two telephone surveys requested patients to report on their use of removable partial dentures that were constructed by undergraduate dental students. In the first survey, of the 431 patients called, 290 were contacted and interviewed 24 to 33 months after their removable partial denture(s) had been inserted. Of these, 258 patients reported using their prostheses and 238 had no apparent problems. In the second survey, the 238 trouble-free removable partial denture wearers from the first survey were called and 169 were contacted and interviewed 48 to 57 months after the removable partial dentures had been inserted. Of these, 156 reported still using their prosthesis and 152 had no apparent problems. These data are provided, along with some interpretive caveats, for dentists to use in discussing treatment options with patients.

Consumer Behavior↗

Longitudinal study on torque transmitted from a denture base to abutment tooth of a distal extension removable partial denture with circumferential clasps.

Not only forces but also torque exerted on abutment teeth are important factors for planning the construction of distal extension removable partial dentures. The purpose of this study was to make longitudinal analysis of torque transmitted from denture base to a direct abutment tooth of these dentures with circumferential clasps. The results are summarized as follows: (i) Vertical Max. MT (maximal mean value of torque) was decreased and became constant after one or one and half months of the insertion of new dentures. (ii) Lateral Max. MT in one subject was changed from the lingual direction to the buccal direction while in another subject it was constant. (iii) In the vertical direction, there were no remarkable differences of Max. MT and Ave. T (average value of torque) between subjects. Max. MT was 5-10 x 10(-3) kgm-1 in the downward. Ave. T was 2-3 x 10(-3) kgm ss-1 in the downward and 0.3 x 10(-3) kgm ss-1 in the upward. (iv) In the lateral direction, there were considerable differences of Max. MT and Ave. T between subjects. Max. MT was less than 20 x 10(-3) kgm. Ave. MT was 2-8 x 10(-3) kgm ss-1.

Aged↗

The swing-lock removable partial denture in clinical practice.

The authors of this article consider that the swing-lock partial denture has a useful place in contemporary clinical dental practice and offers many advantages compared with conventional removable partial dentures in terms of retention and stability, especially in the extremely compromised dentitions. Here they describe the concept of the swing-lock removable partial denture, together with the indications, contraindications, technical and clinical considerations.

Dental Abutments↗

Fracture surface analysis of clinically failed fixed partial dentures.

Ceramic systems have limited long-term fracture resistance, especially when they are used in posterior areas or for fixed partial dentures. The objective of this study was to determine the site of crack initiation and the causes of fracture of clinically failed ceramic fixed partial dentures. Six Empress 2 lithia-disilicate (Li(2)O x 2SiO(2))-based veneered bridges and 7 experimental lithia-disilicate-based non-veneered ceramic bridges were retrieved and analyzed. Fractography and fracture mechanics methods were used to estimate the stresses at failure in 6 bridges (50%) whose fracture initiated from the occlusal surface of the connectors. Fracture of 1 non-veneered bridge (8%) initiated within the gingival surface of the connector. Three veneered bridges fractured within the veneer layers. Failure stresses of the all-core fixed partial dentures ranged from 107 to 161 MPa. Failure stresses of the veneered fixed partial dentures ranged from 19 to 68 MPa. We conclude that fracture initiation sites are controlled primarily by contact damage.

Compressive Strength↗

[3D finite element analysis of stress distributions in supporting tissues of clasp-type partial dentures of transferring occlusion force].

OBJECTIVE: To provide a theoretical basis for clinical application of the clasp-type partial denture of transferring occlusion force, the stress distributions in its supporting tissue were analyzed. METHODS: The 3D finite element model was made, and the features of stress distributions in the supporting tissues of the clasp-type partial dentures which had different rest recess angles were discussed. RESULTS: The medial stress component was significantly larger than the distal one in the supporting tissue around main abutment root. When the rest recess angles were equal or greater to 60 degrees, the stress values were greatly reduced in the supporting tissue around the roots of the three abutments. When the rest recess angle reached 75 degrees, the stress values in the supporting tissue around the main abutment root wore decreased by 30% than the angle 0 degree and by 52% than the angle 45 degrees, the stress values in the supporting tissue around the root of second abutment (adjacent to the main abutment) were wholly increased by 44% than the angle 0 degree and reduced by 23% than the angle 45 degrees, the stress values in supporting tissue around the root of third abutment (outside of the second abutment) were wholly increased by 53% than the angle 0 degree and decreased by 31% than the angle 45 degrees, the stress values in the medial root of the main abutment were reduced by 73%. CONCLUSION: The clasp-type partial denture can resolve part of the occlusion force into two components the medial and distal components, and the occlusion force is distributed to several abutments, at the same time the conversed force components can be canceled by each other. So the whole stress values are greatly reduced and the stress around abutment root is greatly decreased. As a result the damage to the abutment will be eliminated. A design with centralized multi abutments and multi fixed bodies are used in this denture, which are more fixed and stable and have no obvious sinkage in the plate base. Therefore, the mastication function can be satisfactorily recovered, and the reasonable rest recess angle for the clasp-type partial denture of transferring occlusion force is about 75 degrees.

Bite Force↗

Correction of prognathism with fixed and removable partial dentures.

Prognathism in those patients for whom surgical orthodontic procedures are contraindicated can be successfully treated by the use of fixed and removable partial denture prosthodontics. Careful neuromuscular evaluation of the patient is necessary for the success of the treatment rendered. The nonsurgical treatment of prognathism by this method was described.

Acrylic Resins↗

A stress-relieved resin-bonded fixed partial denture.

Reports of bonding failures with resin-bonded fixed partial dentures (commonly called the "Maryland Bridge") are common. Failures are due to individual tooth mobility as much as they are to bonding inadequacy. The incorporation of stress relievers in the design of resin-bonded fixed partial dentures has created a dramatic reversal in bonding failures.

Dental Abutments↗

Extracoronal removable partial denture service in Canada.

Remarkable uniformity exists in the teaching of removable partial denture prosthodont,cs in Canadian dental schools. The removable partial denture services requested by dentists and those provided by commercial dental laboratories do not appear to be as similar. A greater emphasis on continuing education for the dentist is needed, along with better and more detailed communication between the dentist and the dental laboratory. An educational program for dental laboratory technicians is also needed to further this goal.

Canada↗