[Bite registration with a centric template in complete dentures, partial dentures, and fully dentulous jaws (I)].
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The article "Partial denture designing and preparation of master model for duplication in surveyor" is the last of four articles from a series which deals with application of surveyor in designing partial denture. The aim of this article is to describe partial denture designed as "step by step method". The operation with the surveyor, which supposes obligatory analysis of stady casts in order to prepare the supporting tissues, determination of the optimal part of denture insertion and finding of 2 heights of contour, gives this concept a biological character. Such designed partial dentures meet the prophylaxis requirements and have desired retention; they are comfortable and look well. As the suggested concept of partial denture design in surveyor represents the present achievements, in the conclusion of this paper its obligatory application is suggested.
OBJECTIVES: Loss of posterior teeth may result in the loss of neuromuscular stability of the mandible, reduced masticatory efficiency, loss of vertical dimension of occlusion and poor aesthetics. Prosthetic rehabilitation should aim at restoring the vertical dimension and increasing the occlusal contact area in the premolar/molar region. Overdentures are particularly indicated in patients with a severe loss of periodontal attachment, uncertain periodontal prognosis and complicated functional or aesthetic conditions. Removable partial dentures are particularly indicated in Kennedy Class I cases when there is need for a simple and economic solution. Placement of a removable partial denture with occlusal overlays is a simple way to restore occlusal face height. Cross-arch cantilevered fixed partial dentures are primarily indicated for stabilization of periodontally weakened abutments. Short unilateral or bilateral bridges are a solution in patients who refuse removable appliances and who cannot afford more extensive rehabilitation with fixed prosthodontics. Rehabilitation with a fixed partial denture supported by means of osseointegrated implants is the optimal solution in Kennedy Class II cases provided that the bone conditions are appropriate. For any prosthetic treatment, a definite recall system should be established depending on the patient's degree of cooperation, caries susceptibility, periodontal status and the rate of residual ridge resorption. This is essential in order to obtain a satisfactory prognosis. In a patient with poor oral hygiene, the best solution, with regard to the prognosis of the remaining teeth, is to abstain from any prosthetic treatment. METHODS: This manuscript reviews the current literature to identify treatment options for the Kennedy Class I and II partially edentulous patient.
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Partially edentulous patients are frequently restored with implant-supported restorations between and opposing natural teeth. Differences in horizontal and vertical mobility of teeth and dental implants necessitate occlusal contact modification to create prostheses that harmonize with the opposing dentition. This article describes a functionally generated path technique to achieve optimal articulation between an implant-retained fixed partial denture and the patient's dentition.
This study compared the tactile sensitivity of splinted abutment and denture teeth of 16 fixed partial dentures (FPD) supported by blade implants and 16 removable partial dentures (RPD) in patients with Kennedy Class I and Class II edentulous conditions. No significant differences were noted between the tactile thresholds of the natural abutment teeth and artificial teeth in the FPD and RPD groups. The splinted abutment teeth required 45.4 g, or 5.4 to 5.8 times higher occlusal loads than did those needed for the comparable nonsplinted teeth, to detect the stimulus. A further increase of 54% in thresholds with the FPD and over 100% with the placement of the RPD indicated the superiority of the RPD in terms of load distribution as a result of the cross-arch splinting and mucosal support. Moderate positive correlations (r = 0.37 to 0.46; P < .05) between tactile thresholds and masticatory performance were found, signifying that reduced tactile perception was not responsible for the incomplete restoration of the masticatory function with RPDs or FPDs but might be contributing to increased masticatory performance within both treatment groups.
Partially edentulous mouths with distal-extension ridges present the challenge of correctly registering two tissues as dissimilar as teeth and edentulous ridges. A technique is described that makes it possible to make impressions with a combination of different impression materials within the same tray and have a firm support that assures even distribution of the impression material and faithfulness of reproduction.
Prosthesis function and dental conditions were observed for 5 years in 27 elderly patients treated with mandibular cantilevered fixed partial dentures (FPDs) and in 26 elderly patients treated with distal-extension removal partial dentures (RPDs). All patients were treated with a complete upper denture. The patients were assigned randomly into two treatment groups that had the same composition with regard to sex, age, and distribution of teeth. The patients were under supervised oral hygiene and prosthodontic care. Clinical examination of prostheses, masticatory system, periodontal status, and caries was carried out yearly. Oral hygiene was good, and the periodontal status was maintained in both groups. Caries was observed six times more frequently in the RPD group than in the group with fixed restorations, however. Occlusal and functional conditions deteriorated in the RPD group only. Eight of 42 fixed partial dentures (19%) failed; of these, six were recemented with composite resin. Generally the need for dental and prosthetic follow-up treatment was more pronounced in the RPD group than in the FPD group.
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An indirect technique for fitting a new cast gold crown or fixed partial denture (FPD) to an existing removable partial denture (RPD) is presented. This method uses an acrylic resin coping made on a definitive cast fit directly to the patient's RPD intraorally, with the new FPD subsequently completed on the cast. The patient does not have to relinquish the RPD for laboratory procedures, although an appointment is required to fit the coping intraorally where contact is made with the RPD.
Several studies have shown that swinglock removable partial dentures are effective for stability of the abutment teeth and the surrounding tissues including alveolar bone. This efficacy has been thought to be due to the dynamic structure of the swinglock attachment. Individual biting force was measured to determine the physiological efficacy of teeth splints by use of the attachment. The results showed that individual biting forces with the swinglock removable partial denture were 10-25% higher than those without the denture. Furthermore, statistical analysis showed that the individual biting forces with the swinglock removable partial denture were significantly higher. The swinglock attachment can stabilize partially edentulous dentition by splinting all residual teeth. In addition, when physical forces are applied to the abutment teeth and the artificial teeth, this attachment can deliver and distribute the stress to the other abutment teeth and alveolar mucosa. The present findings suggest that the swinglock attachment augments the ability to withstand physical forces such as those occurring during biting and mastication.
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An easy, one-appointment procedure for the modification and conversion of a failed 10-unit FPD into a complete interim overdenture has been described. The benefits to the patient and advantages to the dentist have been noted.
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