International Journal of Dental Sciences and Research, 2014, Vol. 2, No.
2, 32-35 Available online at http://pubs.sciepub.com/ijdsr/2/2/2 Science and Education Publishing DOI:10.12691/ijdsr-2-2-2
The Advantages of Partial Dentures Made of Cast
Framework Cr-Co toward those Made of Resin Based Dentures Gjergj BOARI1,*, Neada HYSENAJ1, Alesio BOARI2 1 Univeristy Dental Clinic, Tirana, Albania 2 Private Dental Clinic Nobel, Tirana, Albania *Corresponding author: gjbocari@yahoo.com Received March 26, 2014; Revised April 12, 2014; Accepted April 13, 2014 Abstract Many investigations have shown that the cooperation of the denture design between the dental clinic and laboratory is often inadequate, with many dentists leaving it to the technician to decide the denture design. The aim of this study was to compare the stability of the removable partial dentures, made of cast framework base of Cr-Co toward those from acrylic resin-base. Through this study, we show the importance of a good planning and design of RDP, the evaluation of direct retentions, especially those of clasps and precise attachments for their impact on the longevity of the supporting teeth and tissues in different clinical cases, classified by Kennedy. The removable partial dentures evaluated in the study are either with or without a cast framework. In this study, are taken into observation 65 prostheses from 53 patients (28 maxillary and 37 mandibular) aged 38-70 years old. We have analyzed the type of clasps used and evaluated mobility scale and periodontal and clinical conditions of the abutment teeth in each case. After clinical examination we concluded that the abutment teeth where correct choice of clasp types were applied, had a mobility scale within physiological parameters and overall better clinical conditions compared to the abutment teeth were different type of clasps were used. Keywords: direct retainers, denture design, Kennedy classification Cite This Article: Gjergj BOARI, Neada HYSENAJ, and Alesio BOARI, The Advantages of Partial Dentures Made of Cast Framework Cr -Co toward those Made of Resin Based Dentures. International Journal of Dental Sciences and Research, vol. 2, no. 2 (2014): 32-35. doi: 10.12691/ijdsr-2-2-2. But there are many other removable partial authors who emphasize the dentures. importance of the RPD In our study we 1. Introduction design principle that takes evaluated these principles in consideration plaque in different types of partial T Nowadays, the scientific research is more focused oncontrol especially for caries dentures and grouped by the fixed prosthetics and mainly on dental implants.prevention and periodontal the Kennedy classification Implant supported dentures are becoming popular for health. These principles of the defects. prosthetic restorations in partially edentulous patients. Butmake up the hygienic however, removable partial denture (RPD) is still thedesign principles and are primary treatment option from the patients view becausecharacterized by simplicity an implant-supported dentures are relatively expensiveand openness of the 2. Material and from a financial point of view and require a surgical gingival margins [9] . In Methods procedure that not in every case can be done, and a longer general textbooks, these treatment time compared to treatment with removable 2.1. Subjects two principles are known partial denture. As we know, a partial denture is supported as the fundamentals of by the abutment teeth and residual ridges which have In this study, are taken different support characteristics while being underRPD design [2,4,8,9,10]. into observation 53 patients pressure. When a force is applied at the base of the saddleAnother factor to take in it generates rotational movements of the RPD and it can consideration is the type of (34 female and 19 male) exert harmful forces on the supporting teeth and residualmaterial used in with a total number of 65 ridges. In order to minimize the non physiological forces constructing the RPD. In prostheses divided in 28 and preserve the health of the tissues many authors havegeneral practice we maxillary and 37 been focused on biomechanical principles of removable encounter: mandibular dentures. The partial dentures design and particularly on the distribution 1. Resin-based age group of the patients is of the excessive forces to the abutment teeth, but also the removable partial between 38-70 years of support, stability, and retention of the denture RPD [4,8]. dentures age. 2. Cast-framework International Journal of Dental Sciences and Research 33
applied clasps type E. The
2.2. Design of Removable Partial indirect retainers help stabilize Dentures Figure 2. Kennedy the denture and in this case are Class II defect used the occlusal clasps placed From the 65 partial dentures, 44 were of cast on the distal teeth. framework base of Cr-Co, and 21 were from2.2.3. Kennedy Class III acrylic resin-base. Most of the extension based Defects dentures covered the lingual sides of abutment Unilateral/bilateral teeth and their adjacent teeth with plates to minimize denture mobility during function. The posterior edentulous area(s) methods and materials used depend on the type bounded by remaining teeth. of the defect. In these cases we have We have analyzed the type of clasps used and evaluated mobility scale and clinical conditions of the abutment teeth in each case. Four different groups of Kennedy classification, we have used different type of clasps [1,2,5,6].
2.2.1. Kennedy Class I Defects
Bilateral posterior edentulous areas. The primary retention is placed on the teeth near the Figure 3. Kennedy defect. We used clasp type G and the indirect Class III defect retainer is placed in the frontal teeth at their 2.2.4. Kennedy Class IV palatial surfaces. The goal is to minimize the Defects deviation of the denture base toward the alveolar ridge mainly while chewing sticky food. Single anterior edentulous area. As primary retentions are used clasps type E placed at the first premolars (distally to the defect) meanwhile the indirect retainers are Bonwille clasp applied ate the molars on both sides.
Figure 1. Kennedy Class I defect.
2.2.2. Kennedy Class II Defects
Unilateral posterior edentulous area. The primary retention is placed on the teeth near the defect using clasp type G, and Bonwille clasps at the molars of the other part. In this case as indirect retainer is used a clasp at the first Figure 4. Kennedy Class IV defect premolar on the opposite side of the defect. 3. Results based dentures and the other 54 were of cast framework Cr-Co. Figure 5. Resin-based RPD From the 65 partial dentures Almost 90% of the acrylic resin- applied, only 11 of them resin based dentures required at least 2 extra appointments for 34 International Journal of Dental Sciences and Research cannot be obtained The main forces retouches and after 3 months, 60%[3,7,10]. that the dentures are of the patients had discomfort and The statistical data submitted are the mobility problems which requiredregarding the cast chewing forces. But in our intervention. In one case wasframework RDPs will the planning of a recorded fracture of the denture. It be published in a partial denture it is permits immediate visualization offollow-up study after important to consider the partially edentulous arch andthe recall of all the also the action of allows easy distinction tooth-patients and thorough horizontal and supported versus tooth-tissueexamination of the rotational forces. The supported prostheses. The patientsabutment teeth. vertical forces are well with cast framework Cr-Co toward Till now, tolerated by the those with resin based denture had approximately two supporting teeth these differences: years after completing because the 1. Accurate tissue adaptationthe restorations, no periodontal fibers get (better retention). significant evidence of into action. It is problems regarding important that the 2. Easy to clean. our discussion about construction of the 3. Strong. cast framework RDPs denture has a 4. Heat conductivity are reported. controlled distribution (physiologic tissue stimulation). of the force along the On the other hand, the cast axial direction of the framework based dentures 4. Discussion tooth (made possible showed overall much better by the supporting arm stability with no evidence of Before constructing of the clasp). The fractures, of discomfort after thean RDP, a thorough forces are also first month. All the modelstudy is needed. This distributed by the preparations were made using thestudy must include the retention arm of the dental surveyor. evaluation of the type clasp and the denture of the defect, body itself over the evaluation of the alveolar ridge [1,7]. different forces that Horizontal forces will be applied on the are harmful forces and denture and the applied on the defining of the supporting teeth and retentive elements to the alveolar ridge. To be used. minimize their effect is important that the retentive and the stabilizing arm of the clasp to be fitted correctly in the Figure 6. Graphite marker appropriate areas on of the surveyor the tooth and also is important to find the right direction of insertion of the denture itself. Rotational forces may occur in the absence of distal teeth, mainly in Kennedy class I and II [1,3,8]. These forces provoke the rotation of the base of the denture over the surface of the edentulous ridge. In Figure 7. Undercut gauge of this case it is the surveyor necessary the use of The angle formed between the indirect retentions by maximal tooth convexity and the using supporting arms cylindrical instrument is called the as far as possible on angle of gingival convexity. the other side of the When the convergence angle is axle of the rotation. less than 10 the clasp retention Other factors that help minimizeemphasize the resistance in their effect are: a wide base of the necessity to focus on resin base denture, smaller denture tooth'sthe long-term effects materials. The surface, and by taking aof the restorations. A reduced thickens compressed impression during thefew studies of cast provides more clinical phase in order to minimizeframework RPDs have sensation and the the tissue resilience. shown that with a flexibility of the The elimination of the mesial-good design and metal absorbs the distal movement is achieved whencareful monitoring of shock exerted by the denture base has good contactthe patient, the results the chewing with the proximal surfaces of thecan be predictably forces. The supporting teeth and the claspssuccessful. patient has ease include the tooth perimeter by over of use from the 180. In the lower jaw these forces first day and does are better controlled by including not experience the mandibular tuberculum at the5. Conclusion difficulties base of the denture. caused by rigid Cast framework partial dentures The advantages of base materials. have demonstrated a relativelycast framework partial 2. Durability. These short longevity. In many casesdentures made of Cr- restorations are there are reports of 50% survivalCo toward the resin very durable to rate 10 years after treatmentbased dentures are: regarding clasp retained removable 1. Patient Comfort. compressive and partial dentures and 50% survival Partial dentures bending forces rate after 4 years for resin based constructed with and do not removable partial dentures without Cr-Co are thin, deteriorate cast metal frameworks. These thus reducing the chemically when studies do not give particulars thickness they come in regarding the contraindications or required for contact faulty design of the RPDs, but they International Journal of Dental Sciences and Research 35
[2] Beck retention
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