Conformity of removable partial denture designs to agreed principles based on materials used - A preliminary study
DOI:
https://doi.org/10.17159/2519-0105/2020/v75no5a4Keywords:
removable partial denture designs, edentulism, Academy of Prosthodontics, Removable partial denture (RPD)Abstract
Removable partial denture (RPD) designs may differ based on types of materials used. The aim of the study was to investigate how a sample of non-metal clasp (NMC), acrylic and metal RPD designs complied with biomechanical design principles. This cross-sectional study examined 60 clinical designs of NMC, acrylic and metal RPDs at 3 commercial dental laboratories in the Cape Town Metropole, at the stage when the dentures were ready for transport to dentists. Retention, indirect retention, support, soft tissue cover, and cross-arch design features were recorded and compared with “ideal” control designs developed by 2 experts in the specialty of prosthodontics. Fifty five % of the clinical designs had no rests, hence were mucosa supported. None of the NMC and only 35% of acrylic RPDs had some rests. A total of 35 clinical designs required indirect retention, but it was only provided in 14 (40%) of them. Eighty five % of acrylic RPDs had no clasps; metal RPDs had more clasps than required while NMC RPDs had slightly less clasps than required. Ratio teeth covered/replaced was most favourable for metal (0.91), followed by acrylic (1.83) and NMC (1.80) RPDs. Cross – arch stabilization was absent in 22% of clinical designs, all of them from the NMC group. Of the 3 types of RPDs, metal RPDs complied best with requirements in terms of tissue support (mostly tooth and mixed tooth/mucosa), retention, cross-arch stabilization and “open” design. Acrylic RPDs provided crossarch stabilization but were lacking in all other aspects. Except for direct retention, NMC RPDs did not conform to any of the agreed biomechanical requirements for RPDs assessed in this study.
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References
Campbell SD, Cooper L, Craddock H, et al. Removable partial dentures: The clinical need for innovation. J Prosthet Dent. 2017; 118: 273-80.
Jacobson TE. Periodontal considerations in removable partial denture design. Compendium 1987; 8: 530-4, 536-9.
Budtz-Jorgensen E, Bochet G. Alternate framework designs for removable partial dentures. J Prosthet Dent. 1998; 80: 58-66.
Owall B, Budtz-Jörgensen E, Davenport J, et al. Removable partial denture design: a need to focus on hygienic principles? Int J Prosthodont. 2002; 15: 371- 8.
Davenport JC, Hammond P, de Mattos MG. The acquisition and validation of removable partial denture design knowledge. II. Design rules and expert reaction. J Oral Rehabil. 1996; 23: 811-24.
Academy of Prosthodontics. Principles, concepts, and practices in prosthodontics. 9th ed. J Prosthet Dent. 1995; 73: 73-94.
Kapur KK, Deupree R, Dent RJ, et al. A randomized clinical trial of two basic removable partial denture designs. Part I: Comparisons of five-year success rates and periodontal health. J Prosthet Dent. 1994; 72: 268-82.
Frank RP, Brudvik JS, Leroux B, et al. Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction. J Prosthet Dent. 2000; 83: 521-7.
Mojon P, Rentsch A, Budtz-Jørgensen E. Relationship between prosthodontic status, caries, and periodontal disease in a geriatric population. Int J Prosthodont. 1995; 8: 564-71.
Yeung AL, Lo EC, Chow TW, et al. Oral health status of patients 5-6 years after placement of cobalt-chromium removable partial dentures. J Oral Rehabil. 2000; 27: 183-9.
Zlataric DK, Celebic A, Valentic-Peruzovic M. The effect of removable partial dentures on periodontal health of abutment and non-abutment teeth. J Periodontol. 2002; 73: 137-44.
Akaltan F, Kaynak D. An evaluation of the effects of two distal extension removable partial denture designs on tooth stabilization and periodontal health. J Oral Rehabil. 2005; 32: 823- 9.
Do Amaral BA, Barreto AO, Gomes Seabra E, et al. A clinical follow-up study of the periodontal conditions of RPD abutment and non-abutment teeth. J of Oral Rehabil. 2010; 37: 545-52.
Preshaw PM, Walls AW, Jakubovics NS, et al. Association of removable partial denture use with oral and systemic health. J Dent. 2011; 39: 711-19.
Orr S, Linden GJ, Newman HN. The effect of partial denture connectors on gingival health. J Clin Periodontol. 1992; 19: 589-94.
Bergman B, Hugoson A, Olsson CO. A 25 year longitudinal study of patients treated with removable partial dentures. J Oral Rehabil. 1995; 22: 595-9.
Wilson VJ. Acrylic partial dentures--interim or permanent prostheses? SADJ. 2009; 64: 434, 436-8, 440.
Davenport JC, Basker RM, Heath JR, et al. The removable partial denture equation. Br Dent J. 2000; 189: 414-24.
Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin-part I: definition and indication of non-metal clasp dentures. J Prosthodont Res. 2014; 58: 3-10.
Fueki K, Ohkubo C, Yatabe M, et al. Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures. J Prosthodont Res. 2014; 58: 71- 84.
Takabayashi Y. Characteristics of denture thermoplastic resins for non-metal clasp dentures. Dent Mater J. 2010; 29: 353-61.
Singh JP, Dhiman RK, Bedi RP, et al. Flexible denture base material: A viable alternative to conventional acrylic denture base material. Contemp Clin Dent. 2011; 2: 313-7.
Fueki K. Non-metal clasp dentures: More evidence is needed for optimal clinical application. J Prosthodont Res. 2016; 60: 227- 8.
Davenport JC, Basker RM, Heath JR, et al. Indirect retention. Br Dent J. 2001; 190: 128-32.
Uludag B and Celik G. Technical tips for improved retention and stabilization of a unilateral removable partial denture. J Oral Impl. 2007; 33: 344-7.
Dullabh HD, Slabbert JC and Becker PJ. Partial denture prosthodontic procedures employed by practising graduates of the University of the Witwatersrand, Johannesburg. SADJ. 1993; 48: 129 -4.
Owen CP. Fundamental of Removable Partial Dentures. 2nd ed. Landsdowne: Cape Town University, Cape Town Press, 2000; 25.
Mothopi-Peri M, Owen CP. Guide-Plane Retention in Designing Removable Partial Dentures. Int J Prosthodont 2018; 31: 145- 8.
McCord JF, Grey NJ, Winstanley RB, Johnson A. A clinical overview of removable prostheses: 3. Principles of design for removable partial dentures. Dent Update. 2002 Dec; 29: 474-81.
Goodacre CJ, 1987. A dislodged and swallowed unilateral removable partial denture. J Prosthet Dent. 1987; 58: 124-5.
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