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Esthetic designs of removable partial dentures.

The increased emphasis on physical appearance in contemporary society has increased the demand for esthetic dental restorations. Although the success of implant dentistry has expanded the scope of esthetic fixed prostheses, many patients demand a removable partial denture (RPD) for health, anatomic, psychological, or financial reasons. Fabricating an esthetically pleasing RPD while avoiding the unsightly display associated with conventional clasp assemblies often presents a challenge to dentists. This article examines using lingual clasps, proximal undercuts (also known as rotational path insertion), and acetal resin clasps as simple and effective means of improving RPD esthetics.

Adult↗

Prosthetic rehabilitation of a bone defect with a teeth-implant supported, removable partial denture.

The use of teeth-implant, mucosa-supported removable dentures for rehabilitation of partially edentulous patients involves highly complex biomechanical aspects. This type of prosthesis associates 3 kinds of support that react differently to the functional and parafunctional forces developed in the oral cavity. Although the construction of removable partial dentures may seem paradoxical when osseointegrated implants are placed, in some cases, this option is an excellent alternative to solve difficulties related to the anatomic, biologic, psychomotor, and financial conditions of the patient. This article reports on a case in which a teeth-implant, mucosa-supported removable partial denture was the option of choice for a patient with financial and anatomic limitations, having a large structural loss of the residual alveolar ridge caused by trauma by a gunshot injury at the mandible. The 5-year follow-up did not reveal any type of biomechanical or functional problem.

Adult↗

Direct retainers for distal-extension removable partial dentures.

Clinical observations at the University of Washington indicated that the wrought wire clasp assembly, the I-bar clasp assembly, and the L-bar clasp assembly yield similar results. A periodic recall system for patients with removable partial dentures has been in effect since 1976. Several thousand observations have been made by the faculty, and no special trend of problems has been noted that would cause one clasp assembly to be favored over another. These three types of clasp assemblies work satisfactorily when properly chosen and carefully applied.

Denture Bases↗

Stereophotogrammetric analysis of abutment tooth movement in distal-extension removable partial dentures with intracoronal attachments and clasps.

This study applied the three-dimensional measurement technique of stereophotogrammetry to measure abutment tooth movement under occlusal loading as a function of intracoronal attachment and clasp design. Six distal-extension removable partial denture designs were studied: (1) RPI-mesial occlusal rest, proximal plate, buccal I-bar; (2) cast circumferential clasp; (3) P.D. locking semiprecision attachment; (4) Thompson dowel nonlocking semiprecision attachment; (5) McCollum precision attachment; and (6) Stern G/L precision attachment. The movement in microns was determined by computer analysis. The Thompson dowel semiprecision attachment generated the most abutment movement in a gingival direction. The clasp-retained designs generally had less total movement than the attachment designs. Clasps and attachments for the abutment teeth adjacent to the distal-extension bases generally moved more than the abutment teeth.

Analysis of Variance↗

[A study on the cariogenic bacteria of plaque on abutment teeth of casting and wrought wire clasp removable partial dentures].

OBJECTIVE: The effect of clasp on the health of abutment teeth. METHODS: To analyse and compare the cariogenic bacteria plaque getting from the buccal cervical third of casting and wrought wire clasp teeth before and one week after wearing removable partial dentures. RESULTS: The average percentages of Streptococcus Mutans and Actinomyces Viscosus in total culturable bacteria rised significently in statistical analysis, but there was no significent difference of Lactobacilli. The average percentage of Actinomyces Viscosus increased less after wearing casting clasp RPD than that of wrought wire clasp. CONCLUSION: Clasps of RPD increased the risk of root caries of abutment teeth. However the influence of casting clasps was smaller than that of wrought wire clasps.

Bacteria↗

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↗

[The effect of removable partial denture on the composition of bacteria on the apt-to-decay site of abutment teeth].

This study was aimed at the composition of plaques which were on the base teeth's carious sensitive sites, just after the insertion of the removable partial denture (RPD). The results showed that the ratios of bacterial detection in different teeth at the same period and those on the different sites of same teeth at different periods were not significantly different. There was a tendency that the detection ratio of the stomatococcus at the early period was higher than that of other bacteria, but at the middle period the ratios declined, and at the late period it was higher again. The detection ratio of the bacillus was on the contrary in the study. At the same time, the composition of the plaques changed significantly after the dentures had been used for 7, 14, and 21 days and 3 months. After 3 months, the ratios of the stomatococcus and the bacillas returned to their normal levels. The 3 main cariogenic bacteria were all detected in this study. The Streptococcus mutant was the dominant bacterium in the plaques and its ratio went up with the time duration. The ratio for the lower second molar was higher than that for the mandibular second premolar (P < 0.05). The detection ratios of the Actinomyces viscosus and lactobacillus were lower. In conclusion, after the insertion of RPD, the oral microbial ecosystem would be changed and the cariogenic bacteria began to implant on the surface of the base teeth. So RPD is a potential factor to cause the caries.

Actinomyces viscosus↗

The influence of some demographic and clinical variables on psychosomatic traits of patients requesting replacement removable partial dentures.

The purpose of this study was to investigate the influence of some demographic and clinical variables on psychosomatic traits of the patients who visited the prosthodontic section of the Dental Hospital at Tokyo Medical and Dental University for replacement of their removable partial dentures (RPDs). Sixty-six patients with 50 maxillary and 44 mandibular RPDs completed the psychological measurements concerning their dentures using visual analogue scales (VAS). Female patients rated significantly lower satisfaction with the comfort of their dentures than males. Younger patients expressed less satisfaction with the aesthetics of their dentures than the older patients. The period of wearing the present denture significantly correlated with psychological measures of pain, comfort, and general satisfaction, suggesting that this clinical variable may be an important factor. There was no significant correlation between the patients' general satisfaction with dentures and the retention/stability scores assessed by the examiner.

Adult↗

Metals used to fabricate removable partial denture frameworks.

This article will help the dental technician choose from among the many alloys available for fabricating dental prostheses. It will explain terminology and compare and explain inherent properties and characteristics of alloys. Although all of the materials discussed produce a clinically acceptable removable partial denture framework, the predominantly base alloys dominate the market because of the low cost of the metal, case of casting, high yield strength and modulus of elasticity.

Chemical Phenomena↗

Sprue design in removable partial denture casting.

OBJECTIVES: Correct sprue design is a major factor in the reduction of defects in castings of cobalt-chromium alloy. The purpose of this study was to investigate the sprue arrangements decided by a group of dental technicians, for a series of proposed removable partial denture castings, in order to determine if there was any consistency between them which would suggest the application of criteria in their design. METHODS: Information was gathered by postal inquiry with recipients asked to indicate their sprue designs on diagrams of patterns for proposed cobalt-chromium partial denture castings. RESULTS: Replies were received for 260 proposed castings from dental schools, technical colleges and commercial laboratories which gave an overall response rate of 52%. Results displayed a wide range of responses in relation to sprue number and dimension, attachment site and the intended direction of metal flow. CONCLUSION: It was concluded that the group of technicians studied arbitrarily chose sprue arrangements for the castings proposed rather than following definite design criteria that seek to minimize potential problems during casting procedures.

Chromium Alloys↗

Effect of age and removable partial dentures on gingivitis and periodontal disease.

The periodontal disease variables manifested in the individuals with partial dentures were more severe, which suggests that the contribution of denture status is significant. Age, while related to increased bone loss, did not appear to be of significance. Common sense suggests that poor oral hygiene in persons wearing removable partial dentures also is a contributing factor.

Adult↗

Comparison of bond strengths of denture base resins to nickel-chromium-beryllium removable partial denture alloy.

PURPOSE: In vitro bond strengths of a traditional denture base resin (Lucitone 199) and three adhesive denture base resins (Meta-Dent, Meta-Fast with liner, and Meta-Fast without liner) to treated nickel-chromium-beryllium (Ni-Cr-Be) partial denture alloy were tested with four alloy surface pretreatments (sandblast, Met-etch, Rocatec with silane, and Rocatec without silane), with or without primer (Dentsply). The Lucitone 199 resin bonded to the nonprimed sandblasted group was the control group. The hypothesis was the use of alloy pretreatments and/or primer does not improve the bond strength of denture base resins to sandblasted Ni-Cr-Be partial denture alloy. MATERIAL AND METHODS: Primed and nonprimed bonded specimens were prepared and finished, stored in 37 degrees C distilled water for 24 hours, then debonded in tension on a testing machine. The bond strength was calculated in megapascals (MPa). Five specimens were prepared and tested for each experimental condition, both with and without primer, for a total of 160 specimens. RESULTS: For three-way analysis of variance, the main effects of resins and treatment were statistically significant (p < 0.05), but the main effect of primer was not statistically significantly (p > 0.05). Without primer, the control group had the lowest bond strength (0 MPa). The three adhesive resin groups produced significantly higher bond strengths than the Lucitone resin groups. For the treated groups, nearly all sandblasted groups produced significantly lower bond strength than the other three treated groups. Meta-Dent to Met-etch treated group had the highest bond strength (23.9 MPa). With primer, the bond strengths of the Lucitone resin groups were significantly higher than the nonprimed groups, and the Lucitone resin-primed Rocatec treated group had the highest bond strength (14.8 MPa). For the three adhesive denture base resins, nearly all primed treated groups had significantly lower bond strengths than nonprimed groups. CONCLUSIONS: Without primer, the Lucitone resin-sandblast treated group (control) had the lowest bond strength (0 MPa). The Meta-Dent denture base resin with the Met-etch treated group had the highest bond strength (23.9 MPa). With primer, the Lucitone resin-primed Rocatec-silane treated group had the highest bond strength (14.8 MPa). For the adhesive denture base resins, nearly all bond strengths of the primed treated groups were significantly lower than the values of the nonprimed groups.

Acid Etching, Dental↗

Prefabricated metal intracoronal semiprecision attachments for removable partial dentures.

The inaccuracies of the casting and fitting processes associated with semiprecision intracoronal attachment systems may compromise the fit of the completed prosthesis. The objective of using metal prefabricated intracoronal semiprecision attachments is to improve the adaptation between the matching attachment surfaces used in the fabrication of removable partial dentures. In milled dovetail or waxed dowel rests, the attachment of one side is completed and the other is cast to match. The prefabricated attachment system presented uses a matching component cast directly against the precast metal rest-mandrel. This reduces the inaccuracies resulting from waxing, investing, and casting.

Denture Design↗

Biologic sequelae of tooth replacement with removable partial dentures: a case for caution.

The evolution of denturism in many parts of the world may present a serious challenge to the oral health of many patients. Recent demands by denturists for permission to provide a full removable prosthodontic service directly to the public has met some success. This article reviews the health hazards associated with removable partial dentures, and presents the biologic arguments against the expansion of denturist activities to treatment that repeatedly tests the knowledge and skills of the most experienced dentists.

Adult↗

New telescopic crown design for removable partial dentures.

STATEMENT OF PROBLEM: Special technical skills and experiences are required to fabricate a telescopic crown to provide adequate retention with precise frictional retention ("conus friction force") between coping and telescope. It is also difficult to control clinically alterations of retentive forces after prolonged usage. PURPOSE: This study examined an innovative telescopic crown system for removable partial dentures that can be fabricated without special technical skill or experience and readily adjusted retentive forces. The retention of telescopic crowns was investigated after repeated insertion/separation tests. MATERIAL AND METHODS: Ten telescopic crowns were constructed to evaluate retentive forces. Each telescopic crown was adjusted to provide a retentive force of approximately 9.8 N. Each telescopic crown was then subjected to 10,000 insertion/separation cycles, and retentive force of each telescopic crown was recorded initially and after every 1,000 cycles. The retentive force of each telescopic crown was re-adjusted after these measurements to provide a retentive force of approximately 9.8 N. The retentive force was recorded a second time after each 1,000 insertion/separation cycles up to 10,000 cycles. RESULTS: Retention of the telescopic crowns gradually diminished, depending on the number of insertion/separation cycles. The mean retentive force after 10,000 insertion/separation cycles was over 2 N. All 10 telescopic crowns were re-adjusted to exert a retentive force of 9.8 N after the initial 10,000 cycles, and the retentive force also diminished on the second 10,000 cycles. CONCLUSIONS: Reduction of retention was dependent on insertion/separation cycles. This new telescopic crown with reduced retention could be easily readjusted. Readjusted retentive forces were at least equivalent to the initial retention.

Analysis of Variance↗

A comparison between videotaped and live demonstrations, for the teaching of removable partial denture procedures.

AIM: This study was devised to test the effectiveness of videotaped demonstrations as opposed to live demonstrations, to small groups of undergraduate dental students. The outcome was assessed by comparing the students' understanding of the clinical and laboratory technical stages of the altered cast impression technique, which is used in the construction of removable partial dentures. METHOD: 31 students watched a series of videotaped demonstrations and 30 received a similar series of live demonstrations. The altered cast procedure was divided into 5 distinct stages, each of which was assessed with the aid of agreed criteria, initially by the students and then by 2 staff assessors and these results were compared. The students were subsequently asked to rate how helpful the videotaped or live demonstration had been on a 5-point scale. RESULTS: The live demonstration group showed better agreement between the students' assessment and the assessors' assessment of the quality of the work for the first part of the clinical stage. There was no difference in the groups' assessment of the final outcome of this clinical stage and the subsequent laboratory technical stages. Students who observed the live demonstrations indicated higher scores for its helpfulness in performance of all the stages of the technique, when compared to those who had observed a videotaped demonstration. CONCLUSION: Both teaching methods developed a similar level of understanding of the principles behind the exercise, although the students preferred the live demonstrations. A carefully produced videotaped demonstration can be a useful alternative to a live demonstration in teaching the short and clear cut technique selected for this study.

Chromium Alloys↗