A Kennedy class I removable partial denture with a resilient liner.
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In several clinical studies on RPDs, great attention was paid to the occurrence of reactions in periodontal tissues. Some early studies reported extensive periodontal breakdown, often a short time after insertion of a prosthesis. Other studies reported moderate or practically no harmful periodontal changes. In articles on causes of periodontal breakdown related to RPDs, the three main factors discussed were (1) plaque and oral hygiene, (2) coverage of the marginal gingivae by parts of an RPD, and (3) occlusal forces that are transmitted to the remaining teeth and their periodontal tissues by the prosthesis. Longitudinal studies have shown that it is possible for patients provided with RPDs to maintain good plaque control. If plaque control is established, and if the prostheses are regularly checked and indicated procedures performed, the forces transmitted to abutment teeth do not seem to induce periodontal breakdown. However, the scientific documentation about the effects of RPDs in patients with extremely reduced periodontium is scanty.
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This investigation studied vertically placed magnets that act simultaneously as guiding plates and retentive devices. The retention of vertically placed magnets was less than that of horizontally or obliquely placed magnets, but comparable to that of I-bar retainers. Load-induced stresses were lower, transmitted more axially to the abutments and were generally more equitably distributed than stresses produced by magnets in other orientations to the abutment tooth. The force distribution characteristics were less stressful than those of a comparable RPD with distal guiding plates, mesial rests, and I-bar retainers. Although the investigators were initially concerned about the relative capabilities of the vertically placed magnets, in vitro and in vivo studies demonstrated that retention was as good if not better than that of conventional clasp designs.
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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.
The mesial rest may be an excellent method of reducing unfavorable occlusal forces acting on the abutment tooth. However, when anatomic conditions and therapeutic necessity require alternatives, the distal rest may be used. The use of the distal rest demands that additional procedures be used to reduce the occlusal trauma to the abutment tooth.
Several features of RPD design that augment direct retainer design were identified. They are as follows: 1. The duplication of direct retainer function by other prosthesis components 2. Physiologic adjustment of the framework to assure contacts with abutment teeth that are consistent with the design and intended functions of the components and that transfer stress in a manner those teeth are designed to accept 3. Intimate adaptation of denture bases to the residual mucosa, with recall visits to monitor this adaptation 4. Specific loading of the denture bases through selective placement of artificial teeth 5. Splinting of abutment teeth
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