Conformity of removable partial denture designs from three laboratories to a set of design principles
DOI:
https://doi.org/10.17159/2519-0105/2022/v77no8a1Keywords:
removable partial dentures, design principlesAbstract
Purpose. The purpose of this study was to assess and to compare the technical quality of removable partial dentures (RPDs) servicing both public and private sectors in relation to biomechanically acceptable principles. A convenience sample of work carried out in three
commercial dental laboratories servicing both the private and government sectors was used to provide a descriptive study of the laboratory stage of fabrication of RPDs over a 3-month period. Prescription sheets, master casts and completed dentures of 114 cases were evaluated and procedural and design-related information data were captured for each case. The results were disappointing in that not one of the RPDs evaluated conformed to commonly accepted principles. Not one dentist prescribed the design of the denture.
Only one cast was surveyed to determine the path of insertion and any undercuts for the placement of clasps, yet 119 clasps were placed. Although 81 rests were used (in only 25 of the dentures), only 11 of those rests were pre-prepared on the teeth. Only 8 of the 95 acrylic-based dentures had any rests, making the remainder entirely mucosa-borne and therefore potentially iatrogenic.
The study suggests that principles of RPD design taught during undergraduate training are not being adequately practised in both private and public sectors; and if practised the RPDs are not designed, nor constructed to requirements guided by design principles. Further training of dental technicians and clinicians is clearly indicated, and consideration should be given to a system of clinical
audit to identify and prevent the malpractice observed in this study. In addition, ethical and legal guidelines emphasising the roles of clinicians and technicians in the prescription and design of RPDs in South Africa should be developed; and the mandatory comprehensive completion of laboratory work authorisation forms by dental clinicians should be considered.
Downloads
References
Campbell SD, Cooper L, Craddock H, Hyde TP, Nattress B, Pavitt SH et al. Removable partial dentures: The clinical need for innovation. J
Prosthet Dent 2017; 11: 273-280.
Douglass CW & Watson AJ. Future needs for fixed and removable partial dentures in the United States. J Prosthet Dent 2002; 87: 9–14.
Pellizzer EP, Almeida DA, Falcón-Antenucci RM, Sánchez DM, Zuim PR, Verri FR. Prevalence of removable partial dentures users treated at the Aracatuba Dental School-UNESP. Gerodontology. 2012; 29:140-144.
Walisezewski MP. Turning points in removable partial denture Philosophy. J Prosthodont. 2010; 462 > RESEARCH www.sada.co.za / SADJ Vol. 77 No. 819: 571-579.
Beaumont AJ Jr. Microcomputer-aided removable partial denture design: the next evolution. J Prosthet Dent 1989; 62: 551-556.
Rudd KD, Kuebker W, Stewart K. Clinical removable partial prosthodontics. 1983. 1st ed. St Louis, The CV Mosby company.
Jacobson TE. Periodontal considerations in removable partial denture design. Compendium. 1987; 8: 530–539.
Davenport JC, Hammond P, deMattos MG. The acquisition and validation of removable partial dentures design knowledge. II. Design rules and expert reactions. J Oral Rehabil 1996; 23: 811–824
Farao W and Geerts G. Conformity of removable partial denture designs to agreed principles based on materials used - A preliminary study. SADJ. 2020; 75: 253-259
Dullabh HD, Slabbert JCG, Becker PJ. Partial denture prosthodontic procedures employed by practicing graduates of the University of the
Witwatersrand, Johannesburg. J Dent Assoc S Afr. 1993; 48: 129-34.
Carlsson GE, Hedegard B, Koivumaa KK. The current place of removable partial dentures in restorative dentistry. Based on longitudinal
investigations of dento-gingivally supported partial dentures. Dent Clin North Am. 1970; 14: 553-568.
Battistuzzi P, Kyser A, Kanters N. Partial edentulism, prosthetic treatment and oral function in a Dutch population. J Oral Rehabil. 1987; 14: 549-55.
Rudd KD & O’ Leary T. Stabilizing periodontally weakened teeth by using guideplane removable partial dentures: a preliminary report. J Prosthet Dent. 1966; 16: 721-727.
Runov J, Kroone H, Stoltze K, Maeda T, El Ghamrawy E, Brill N. Host response to two different designs of minor connectors. J Oral Rehabil. 1980; 7: 147–153.
Chandler JA & Brudvik J. Clinical evaluation of patients eight to nine years after placement of removable partial dentures. J Prosthet Dent. 1984; 51: 736–743.
Stratton R & Wiebelt F. An atlas of removable partial denture design. 1988. 1st ed. Illinois, Quintessence Publishing Co.
Bergman B & Ericson G. Cross-sectional study of the periodontal status of removable partial denture patients. J Prosthet Dent. 1989; 61: 208-214.
Grasso J & Miller E. Removable partial prosthodontics. 1991. 3rd ed. St Louis, Mosby Year Book.
Becker CM, Kaiser DA, Goldfogel MH. Evolution of removable partial denture design. J Prosthod. 1994; 3: 158-166.
Witter DJ, De Haan AF, Kayser AF, van Rossum GM. A 6 year follow up study of oral function in shortened dental arches. Part 1: Occlusal stability. J Oral Rehabil. 1994; 21: 113-125.
Academy of Prosthodontics. Principles, concepts, and practices in prosthodontics 1994. J Prosthet Dent. 1995; 73: 73-94.
Sarita PT, Kreulen CM,Witter DJ, van’t Hof M, Creugers NH. A study on occlusal stability in shortened dental arches. Int J Prosthodont. 2003;
-380.
Carr AB, McGivney GP, Brown DT. McCracken’s removable partial prosthodontics. 2005. 10th ed. St. Louis, Elsevier. pp 77-94, 178-187, 106-113.
Dunham D, Brudvik JS, Morris WJ, Plummer KD, Cameron SM. A clinical investigation of the fit of removable partial dental prosthesis clasp
assemblies. J Prosthet Dent. 2006; 95: 323-6.
Jones JD & Garcia LT. Removable Partial Dentures. A Clinician’s Guide. 2009. 1st Ed. New York, WileyBlackwell.
Koyama S, Sasaki K, Yokoyama M, Sasaki T, Hanawa S. Evaluation of factors affecting the continuing use and patient satisfaction with removable partial dentures over 5 years. J Prosthodont Res. 2010; 54: 97-101
Stilwell C. Revisiting the principles of partial denture design. Dent Update 2010; 37: 682-690.
Mothopi-Peri M & Owen CP. Guide plane retention in designing removable partial dentures. Int J Prosthodont. 2018; 31: 145-148.
Owen CP. Fundamentals of removable partial dentures (5th edition) 2020. Available at www.appropriatech.com.
Winstanley RM, Barsby MJ, Ogden AR, Welfare D. Guidelines in Prosthetic and Implant Dentistry. 1996. 1st Ed. London, Quintessence Publishing Co. Ltd.
Owen CP, Naidoo N. Guidelines for the choice of circumferential wrought wire and cast clasp arms for removable partial dentures. Int Dent J. 2022; 72: 58-66.
Frank RP, Brudvik JS, Leroux B, Milgrom P, Hawkins N. Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction. J Prosthet Dent. 2000; 83: 521-7.
Bates JF. Retention of partial dentures. Br Dent J. 1980; 149:171-174.
Frank RP & Nicholls JI. A study of the flexibility of wrought wire clasps. J Prosthet Dent. 1981; 45: 259-267.
Matheson GR, Brudvik JS, Nicholls JI. Behaviour of wrought wire clasps after repeated permanent
deformation. J Prosthet Dent. 1986; 55: 226-231.
Brockhurst PJ. A new design for partial denture circumferential clasp arms. Australian Dental Journal. 1996; 41: 317-323.
Waldmeier MD, Grasso JE, Norberg GJ, Nowak MD. Bend testing of wrought wire removable partial denture alloys. J Prosthet Dent. 1996; 76: 559-65.
Farias-Neto A, Silva RSG, Diniz daCA, Batista AUD, Carreiro AdaFP. Ethics in the provision of removable partial dentures. Braz J Oral Sci. 2012; 11: 19-24.
Ozhayat EB, Gotfredsen K. Oral health-related quality-of life in patients to be treated with fixed or removable partial dental prostheses. Acta Odontol Scand. 2013; 71: 113–119.
Khan S. Minimising mechanical prosthodontic interventions for adult patients with a shortened dental arch in South Africa. SUNscholar Research Repository. 2017. Retrieved: 26 May 2019, DOI: RESEARCH < 463http://hdl.handle.net/10019.1/102799.
Bergman B, Hugoson A, Olsson CO. Caries, periodontal and prosthetic findings in patients with removable partial dentures: a ten-year longitudinal study. J Prosthet Dent. 1982; 48: 506-14.
Taylor TD, Matthews AC, Aquilino SA, Logan NS. Prosthodontic survey. Part I: Removable prosthodontic laboratory survey. J Prosthet Dent.
; 52: 598-601.
Haj-Ali R, Al Quran F, Adel O. Dental Laboratory Communication Regarding Removable Dental Prosthesis Design in the UAE. J Prosthodont. 2012; 21: 425–428.
Tulbah H, Al Hamdan E, Al Qahtani A, Al Shahrani A, Al Shaye M. Quality of communication between dentists and dental laboratory technicians for fixed prosthodontics in Riyadh, Saudi Arabia. Saudi Dent J. 2017; 29: 111-116.
Bohnenkamp DM. Removable partial dentures: clinical concepts. Dent Clin North Am. 2014; 58: 69-89.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
.png){kind=spacer}