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A multifunctional, provisional, implant-retained fixed partial denture.

This article describes the modification of a procedure for fabricating a laboratory-processed, metal-reinforced, acrylic resin provisional restoration that becomes an implant-retained fixed partial denture. The modification involves the incorporation of patrix and matrix components into a cast metal framework. The prosthesis can be used as an alternative to a removable radiologic stent and surgical guide. It can function as a surgical guide during implant placement and help retract the buccal mucogingival flap during implant placement. The prosthesis also can be used as an aid in locating the implant during stage II surgery. Finally, the pontics can be converted into an implant-supported provisional restoration immediately after the implant prosthetic components are attached to the uncovered implants.

Adult↗

The pontic-splinted procedure for tooth and denture base additions in denture repair.

Various methods for adding teeth to existing dentures have been used clinically. Although a direct, single-tooth addition method saves time, it often is difficult to achieve an esthetic appearance when adding several missing anterior teeth with this technique. Indirectly adding teeth may achieve a better esthetic result, but this method is time-consuming. This article describes the pontic-splinted procedure, an indirect method for replacing several anterior teeth and part of the denture base that can save time and, at the same time, help the clinician achieve acceptable esthetics.

Acrylic Resins↗

Vacuum-formed tooth position record as an index for the fabrication of an endosseous implant-supported prosthesis.

An endosseous implant-supported prosthesis usually requires a metal substructure and/or retentive elements in addition to the prosthetic teeth and soft tissue substitute. It is crucial that the metal substructure and all of the prosthetic components of an implant-supported prosthesis be confined within the contour of the prosthesis. This article describes a procedure for fabricating an index to record and maintain the anatomic contour of the trial denture to the master cast.

Acrylic Resins↗

Technique for fabricating a prosthetic tooth on a removable partial denture framework.

When removable partial dentures are fabricated, a custom-made tooth may be needed to fill a space too small or irregularly shaped to allow the use of a prefabricated prosthetic tooth. This article describes a simple technique in which visible light-polymerized composite is used to custom build a prosthetic tooth that is both esthetic and durable.

Composite Resins↗

The relationship between intercanthal dimension and the widths of maxillary anterior teeth.

STATEMENT OF PROBLEM: One of the difficult aspects of complete denture prosthodontics is the selection of appropriately sized maxillary anterior teeth. Many attempts have been made to establish methods of estimating the combined width of maxillary anterior teeth and/or central incisors. PURPOSE: The aim of this investigation was to determine whether a relationship exists between the intercanthal dimension and 4 mesiodistal width combinations of the maxillary anterior teeth. MATERIAL AND METHODS: The maxillary anterior teeth of 443 adult subjects were examined. Intercanthal distance was measured between the median angles of the palpebral fissure. The mean widths of the 2 central incisors, the combined widths of the central incisors, the combined width of the 4 incisors, and the combined width of the 6 anterior teeth were determined intraorally at their widest dimension. Pearson correlation coefficients were calculated to determine the relationship between intercanthal distance and the 4 measurements of maxillary anterior teeth (alpha=.05). RESULTS: Although the Pearson correlation coefficients were relatively small, a significant relationship existed between intercanthal dimension and the 4 maxillary teeth dimensions (P<.0001). It was found that biometric ratios of 1:0.267 and 1:1.426 could be used to estimate the central incisor width and the combined widths of the 6 anterior teeth, respectively. CONCLUSION: Within the limitations of this study, the results suggest that intercanthal distance can be used as a preliminary method for determining the width of the maxillary anterior teeth for edentulous patients.

Adult↗

Onlay partial denture technique for assessment of adequate occlusal vertical dimension: a clinical report.

Clinical treatments that require restoration of occlusal vertical dimension pose a challenge to prosthodontists. This article describes the modification of existing removable partial dentures into onlay interim prostheses. This process allowed the patient's tolerance to the restored occlusal vertical dimension, esthetics, and phonetics to be evaluated before irreversible changes were made to the dentition.

Acrylic Resins↗

A procedure for making trial dentures.

A procedure is presented for making trial dentures by arranging denture teeth in soft wax rather than hard baseplate wax. The drawbacks of using hard wax are thereby avoided.

Dental Articulators↗

Maxillary and mandibular overlay removable partial dentures for the treatment of posterior open-occlusal relationship: a clinical report.

This clinical report describes the use of maxillary and mandibular overlay removable partial dentures to treat a patient with class III skeletal malocclusion and a posterior open-occlusal relationship. Overlay removable partial denture therapy was used as an alternative to other options such as orthodontics and combined orthodontic/oral surgery procedures; it satisfied the esthetic and functional requirements of the patient and provided a stable occlusion. Overlay removable partial dentures are a reversible and relatively inexpensive treatment for patients with congenital or acquired anomalies, but the potential disadvantages of these prostheses include compromised esthetics when the dentures are removed; caries and periodontal disease as a result of poor oral hygiene; and veneer material fracture, debonding, discoloration, and wear.

Chromium Alloys↗

Tensile bond strength of acrylic resin denture teeth to a microwave- or heat-processed denture base.

STATEMENT OF PROBLEM: Fracture of acrylic resin prosthetic teeth from acrylic resin denture bases can be a problem for some patients. The optimal combination of acrylic resin denture tooth, denture base material, and processing method is not known. Purpose. The objective of this study was to compare the tensile bond strengths of heat- and microwave-polymerized acrylic resins among 4 types of acrylic resin denture teeth. MATERIAL AND METHODS: Heat-polymerized (Lucitone 199) and microwave-polymerized (Acron MC) acrylic resins were used. Four types of acrylic resin denture teeth (IPN, SLM, Vitapan, and SR-Orthotyp-PE) were milled to a fixed diameter according to ADA specification no. 15. Ten specimens of each tooth type were processed to each of the denture base materials according to the manufacturers' instructions. Ten additional resin control specimens without teeth also were fabricated. Specimens were thermocycled and tested for strength until fracture with a custom alignment device. Data were analyzed with analysis of variance and Duncan's multiple range test. A scanning electron microscope was used to identify adhesive and cohesive failures within debonded specimens. RESULTS: The mean force required to fracture the specimens ranged from 5.3 +/- 3.01 to 21.6 +/- 5.2 MPa for the microwave-polymerized base and 11.2 +/- 3.0 to 39.1 +/- 5.1 MPa for the heat-polymerized base. The most common failure was cohesive within the denture tooth. With each base material, Orthotyp and IPN teeth exhibited the highest bond strengths; SLM and Orthotyp bond strengths were similar. In general, heat-polymerized groups failed cohesively within the denture base resin or the tooth, and microwave-polymerized groups failed adhesively at either the ridge lap or occlusal surface of the denture tooth. CONCLUSION: Within the limitations of this study, the results suggest that the type of denture base material and denture tooth selected for use may influence the tensile bond strength of the tooth to the base. Selection of more compatible combinations of base and resin teeth may reduce the number of prosthesis fractures and resultant repairs.

Acrylic Resins↗

The ovate pontic design: a histologic observation in humans.

STATEMENT OF THE PROBLEM: Fixed partial dentures with an ovate pontic design contacting the underlying soft tissue may interfere with long-term mucosal health. PURPOSE: The purpose of this study was to examine the clinical and histologic characteristics of the human alveolar ridge mucosa adjacent to an ovate pontic-designed restoration. MATERIAL AND METHODS: Twelve patients requiring maxillary fixed partial dentures (either implant- or tooth-supported) with a pontic site in the premolar or molar region were studied. The pontics had an ovate design and were adapted to the underlying mucosa with tight but noncompressive contact. Patients used Super Floss once a day to clean the infrapontic area. After 12 months, soft tissue biopsy specimens about 3 x 3 mm in size were obtained (1) from the ridge mucosa in contact with the pontic (test site) and (2) from an adjacent uncovered masticatory mucosal area (control site). Histometrically, the thickness of the epithelium and the keratin layer and the height of the connective tissue papillae were measured. Morphometrically, the composition of the connective tissue of the specimens was analyzed in a 200-microm-wide zone immediately subjacent to the epithelium (zone A) and in a 200-microm-wide central connective tissue portion (zone B). A point-counting procedure was used to calculate the relative proportions occupied by collagen, fibroblasts, vascular structures, inflammatory cells, and residual tissue. Differences between the tissue fractions in test and control sites were analyzed with the Wilcoxon signed rank test (.05 level of significance). RESULTS: At 12 months, only 3 pontic sites showed clinical signs of mild inflammation, whereas the other test sites and all control sites appeared healthy. A thinner keratin layer was observed in pontic sites than in control sites (8 microm vs 22 microm). Larger tissue fractions of inflammatory cells were found in pontic sites than in control areas in the zone immediately subjacent to the epithelium. CONCLUSION: Within the limitations of this study, restoring an edentulous space with an ovate pontic supported by adequate oral hygiene measures was not associated with overt clinical signs of inflammation. Histologically, however, this pontic design was associated with a thinner keratin layer and with changes in the composition of the connective tissue compartment subjacent to the epithelium.

Adult↗

Quality of fixed prosthodontics after twenty-two years.

After an observation period of 22 years, this study was conducted to clinically examine and interview patients who in 1984 and 1989 had participated in similar investigations regarding the quality, over time. of treatments with fixed partial dentures. The patients were examined by two standardized and experienced clinicians using thc California Dental Association quality rating system, their results indicating that after 22 years the overall survival rates were 46.5% and 41.1% for the originally placed crowns and pontics, respectively. However, a continuing decrease of the crown quality rating was noted during the more than 20-year-long observation period. Restorative treatments with common types of fixed partial dentures can therefore be regarded as both safe and reliable over long periods of time.

Aged↗

An investigation into the bonding of orthodontic attachments to porcelain.

This study assessed bonding of orthodontic brackets to porcelain teeth using two different surface preparation techniques and comparing two bonding systems, Fuji Ortho L.C. and Transbond. Four groups of 20 porcelain premolar teeth were bonded with metal orthodontic brackets (0.022 inch Minitwin, 3M Unitek) according to the following protocol: Transbond with a phosphoric acid etch (group 1), Transbond with a hydrofluoric acid etch (group 2), Fuji Ortho L.C. with a hydrofluoric acid etch (group 3), and Fuji Ortho L.C. with a phosphoric acid etch (group 4). All groups were bonded with a silane coupling agent. The teeth were debonded with an Instron universal testing machine. Bond strength, site of bond failure and adhesive remnant index (ARI) were recorded for each group. Differences between groups were analysed statistically. The composite resin groups (groups 1 and 2) had the highest mean bond strength values at 7.9 and 9.7 MPa, respectively. The resin-modified glass ionomer cement groups (RMGIC; groups 3 and 4) had the lowest mean bond strength values at 6.3 and 1.8 MPa, respectively. The mean bond strength of group 3 was significantly lower than all other groups (P < 0.0001). The Fuji groups had also significantly (P < 0.001) lower ARI scores than the composite groups (groups 1 and 2). Most samples experienced porcelain surface damage, except group 4. In conclusion, the highest bond strength levels were achieved with a conventional composite resin cement (groups 1 and 2). No significant differences in bond strength were found between the hydrofluoric and phosphoric acid etch technique.

Acid Etching, Dental↗