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The removable partial denture as a periodontal prosthesis.

Research has presented evidence to undermine the myth that the removable partial denture contributes to the progression of periodontal disease and is not suitable therapy for the treated periodontal patient. The properly designed removable partial denture for the periodontal patient can contribute to stability of mobile teeth and provide for an intact functional dentition. If the factors of plaque, pocket depth, transmitted forces to teeth, and tissue coverage are controlled by the therapist, it is conceivable that the result will yield long-term results by providing function with decreased expense, contingency for tooth loss, and prevention of full mouth extraction.

Biomechanical Phenomena↗

Microcomputer-aided removable partial denture design: the next evolution.

A microcomputer-based program for the design of removable partial dentures has applications in dental education and the clinical practice of dentistry. The program requires a Macintosh computer with a minimum configuration of one megabyte of random access memory and a hard disk drive with a HyperCard program. The instructional design uses an interactive, branching user interface to conduct a search of removable partial design data. The screen design is based on a dental laboratory work authorization, with graphic representations of partially edentulous dental arches and textual information that can be browsed in a nonlinear manner by the user. Approximately 160 removable partial denture designs are provided in the program, as well as the ability to modify the drawings and text to reflect various other clinical situations and to print the work authorization for submission to the dental laboratory.

Computer Systems↗

Release of chlorhexidine digluconate and flexural properties of glass fibre reinforced provisional fixed partial denture polymer.

The objective of this study was to determine the flexural properties and the release of chlorhexidine digluconate (CHX) of CHX laced unidirectional E-glass fibre reinforced provisional fixed partial denture polymer. Bar shaped test specimens (3.3 x 10.0 x 65.0 mm) were fabricated from provisional fixed partial denture polymer (mixture of poly[ethylmethacrylate] powder and n-poly[butyl methacrylate] monomer liquid) with E-glass fibre reinforcements. Poly(methyl methacrylate) preimpregnated continuous unidirectional glass fibre reinforcement was laced with CHX. The glass fibre reinforcements were incorporated into the polymer and the polymerised to the form of test specimens. In addition test specimens without CHX in glass fibre reinforcement were made for comparison. Control specimens did not contain glass fibres in the test specimens. Flexural strength and modulus of test specimens (n = 6) was tested with three-point bending test after storing the specimens dry or in water (two weeks). Released CHX was determined with high performance liquid chromatography during 180 days water immersion. In dry conditions, the flexural strength and the modulus of the polymer was 43 MPa and 1.7 GPa, and with glass fibre reinforcement 96 MPa and 3.5 GPa. With the reinforcement laced with CHX, the strength was 92 MPa and the modulus was 3.2 GPa. The water storage of test specimens did not weaken the reinforced polymer. The majority of the CHX released from the glass fibre reinforced polymer during the first days of storage in water. Flexural properties of provisional fixed partial denture polymer were increased using glass fibre reinforcement. The fibre reinforcement that was laced with CHX resulted in similar reinforcing effect.

Adhesives↗

Gingival recession related to removable partial dentures in older patients.

One hundred forty-six patients, living in the community and attending a general dental practice, were examined on two occasions separated by 3 years to determine relationships among removable partial dentures, their design, and gingival recession. This study confirmed the relationship between the presence of a partial denture and an increase of gingival recession, but was unable to demonstrate any predictable relationship to the lack of tooth support, the material used for the dentures, or covering the gingival margins with lingual plates. These design factors may be less important than the maintenance of good oral hygiene for the prevention of periodontal disease in patients wearing removable partial dentures.

Age Factors↗

The relevance of a new generation of monobloc posts and impression copings for implant-supported fixed partial dentures: a 2-year clinical prospective study with the FM-Clip system on EVL implants (SERF).

The use of monobloc posts for implant-supported fixed partial dentures is interesting for biomechanical and biological reasons, but it suffers from a lack of precision during the impression phase. The use of a new generation of monobloc posts associated with individual impression copings with a piston offers a simple and efficient impression procedure for small and medium implant-supported fixed partial dentures. This article presents the FM-Clip system for EVL implants composed of new straight monobloc posts and small impression copings with a piston for precise impressions and easy production of implant-supported fixed partial dentures.

Dental Abutments↗

Inlay fixed partial denture as a conservative approach for restoring posterior missing teeth: a clinical report.

Inlay fixed partial dentures luted by use of adhesive procedures offer a clinical alternative for the restoration of single missing posterior teeth. The introduction of ceromers and fiber-reinforced composites and the continuous improvement of adhesive systems and luting agents make this type of restoration possible, offering good aesthetic and functional results. The procedure is minimally invasive and conservative. This clinical report reviews the factors influencing the diagnosis and the clinical indications for an inlay fixed partial denture. In addition, a patient treatment is presented to illustrate the clinical procedures involved.

Adult↗

The acquisition and validation of removable partial denture design knowledge. I. Methodology and overview.

The authors report on the eliciting of the partial denture design expertise of teachers of prosthetic dentistry. Their approach was to identify 125 design rules and then to sample expert reaction by surveying 10 experts individually and by surveying the prosthetic departments in all 17 dental schools in the British Isles. The surveys achieved a return of 100% and revealed an unsuspected consensus concerning the rules. A majority of schools were in agreement on whether or not 111 (89%) of the rules could be supported. This design expertise will be disseminated through RaPiD, a knowledge-based assistant for the design of removable partial dentures. It is expected that by incorporating into this design assistant rules which have been shown to be widely supported, the acceptability and usefulness of RaPiD for clinical education and practice will be increased.

Artificial Intelligence↗

Use of aluminum strips to fabricate verification jig for an implant-supported fixed partial denture.

Verification of the accuracy of the master cast for an implant-supported fixed partial denture will reduce the chair time and laboratory costs of implant prosthodontic treatment. A wire is usually luted in the mouth to machined components that have been secured to the implants, and the luted assembly is then transferred to the cast to evaluate the positional accuracy of the implant analogs. Unless this wire is dead soft, inaccuracies as a result of elastic memory of the wire can occur. Also, if the wire is not completely rigid, it can be distorted during handling. This article describes a more reliable verification jig for an implant-supported fixed partial denture that can be fabricated with 1.5 mm thick aluminum strips that are luted to the implant components. The use of two aluminum strips creates a metal framework that is rigid and not easily distorted. Also the aluminum pieces do not have elastic memory because they were cut and not bent to shape.

Aluminum↗

Periodontal findings in patients 10 years after insertion of removable partial dentures.

The purpose of this retrospective study was to evaluate the changes in the periodontal conditions of patients wearing different designs of removable partial dentures over long-term. Seventy-four patients treated with 101 mainly conical crown-retained dentures (CCRDs) or clasp-retained removable partial dentures (RPDs) or a combination of conical crown and clasp-retained dentures (CRPDs) were re-examined 10 years after insertion. Periodontal findings were compared with baseline values at insertion. A deterioration of the probing depths (PDs) and tooth mobility was found. The abutment teeth of the RPDs suffered more severe deterioration than the abutment teeth of the CCRDs and the CRPDs. The absence of a regular recall system for the patients may be responsible for this outcome.

Alveolar Bone Loss↗

Use of dental implants to improve unfavorable removable partial denture design.

This study aimed to determine whether the use of a limited number of dental implants, with no rigid connection between implants and teeth and as few as possible prosthetic element requirements, is a viable solution for improving unfavorable removable partial dentures (RPD) design. Fifteen partially edentulous patients with an unfavorable number and distribution of abutment teeth were treated, each with a limited number of implants, from 1997 to 2004, resulting in an improved RPD design. Implant survival rate was 100%, and prosthetic complications were minor. All patients reported great satisfaction with the partial dentures and good chewing efficiency. The results indicate that the use of dental implants to improve unfavorable RPD design is a viable and cost-effective treatment modality.

Dental Abutments↗

A comparative study of the centrifugal and vacuum-pressure techniques of casting removable partial denture frameworks.

A study was undertaken to evaluate two techniques for casting accuracy on removable partial denture frameworks: centrifugal casting and vacuum-pressure casting. A standard metal die with predetermined reference points in a horizontal plane was duplicated in refractory investment. The casts were waxed, and castings of nickel-chrome alloy were fabricated by the two techniques. Both the casts and the castings were measured between the reference points with a measuring microscope. With both casting methods, the differences between the casts and the castings were significant, but no significant differences were found between castings produced by the two techniques. Vertical measurements at three designated points also showed no significant differences between the castings. Our findings indicate that dental laboratories should be able to use the vacuum-pressure method of casting removable partial denture frameworks and achieve accuracy similar to that obtained by the centrifugal method of casting.

Chromium↗

Construction of temporary crown for transitional removable partial dentures.

Often restoration requires maintaining patient function with the old partial denture while constructing permanent crowns and a new removable prosthesis. The technique described here allows the practitioner to produce temporary crowns to maintain function with the old partial during prosthetic reconstruction.

Crowns↗

A clinical overview of removable prostheses: 1. Factors to consider in planning a removable partial denture.

This is the first article in a series on the prescription of removable partial dentures. It addresses basic clinical and patient-related factors involved in decision-making before commencing active prosthodontic treatment. Further papers will outline a variety of impression techniques for primary and definitive impression, discuss designing principles, give an overview of some technological aspects of removable partial denture-making and provide guidelines on how to diagnose and manage common clinical problems associated with removable partial dentures.

Adaptation, Psychological↗

Caries and periodontal status in patients fitted with removable partial dentures.

A 6-year follow-up study was carried out on 28 patients fitted with removable partial dentures. Prior to the prosthetic treatment all patients were given oral hygiene instruction and periodontal therapy where indicated. The removable partial dentures were carefully planned and designed. During the follow-up period the patients were examined at yearly intervals when remotivation, scalings, conservation and prosthetic adjustments were carried out as required. Patient cooperation was excellent and no significant deterioration of the periodontal status of the remaining teeth could be found. In addition the number of newly registered carious lesions was low. A certain degree of deterioration of occlusion, articulation, stability and clasp retention of the dentures fitted did occur, however.

Adult↗

A new clapsing system for unilateral distal-extension removable partial dentures.

The background, rationale, and technique for fabricating the remodified Hart-Dunn attachment system have been presented. This subpontic attachment is a product of clinical experience in managing the unilateral distal extension removable partial denture patient. Minimal retention, reduced torque throughout the arch during function, and distribution of force according to sound mechanical principles make this remodified subpontic attachment the preferred method of treating most unilateral distal extension removable partial denture patients.

Dental Abutments↗

The removable partial denture equation.

This article describes the benefits and risks of providing RPDs. It emphasises the importance of co-operation between the dental team and patient to ensure that the balance of this 'equation' is in the patient's favour.

Dental Plaque↗