Biomechanics in Removable Partial Dentures: A Literature Review of FEA-Based Studies.

Mohammed A Mousa,Nafij B Jamayet,Mohammad Khursheed Alam,Kiran Kumar Ganji,Mohamed I El-Anwar,Adam Husein,Johari Yap Abdullah,Vincenzo Iorio Siciliano

doi:10.1155/2021/5699962

Abstract

The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.

Highlights

The main objective of removable partial dentures (RPDs) is to provide prosthetic rehabilitation of missing teeth and associated structures, with avoidance of further loss of remaining teeth
The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it
The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments

Summary

Introduction

The main objective of removable partial dentures (RPDs) is to provide prosthetic rehabilitation of missing teeth and associated structures, with avoidance of further loss of remaining teeth. RPDs are indicated (in terms of aesthetic and masticatory efficiency) when the edentulous span is extensive, horizontally and vertically, to be treated with conventional fixed dental restoration because of the excessive resorption that may happen following extraction [1, 2]. RPDs are still considered a cost-effective treatment option in partially edentulous patients, compared to fixed and implant-retained restorations [3]. There was no worldwide metaanalysis report about the prevalence of patients wearing RPD, up to the authors’ knowledge, there was an agreement that the number of partial edentulism is increasing in the United States and the United Kingdom [4,5,6], with more prevalence in female patients [7]. As per the mentioned reports, RPDs still provide realistic and predictable treatment options, and all efforts should be done to design adequate prostheses that serve efficiently with no or minimal damage

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