Contemporary partial denture designs

Abstract

I have attempted to excuse the shortcomings of the commercial dental laboratory by pointing out the responsibilities of the dentist for biologic partial denture design and his frequent failure to provide the laboratory technician with casts of properly prepared mouths and adequate prescriptions for him to follow. By “prescription” I am referring to penciled outlines (Fig. 15, A), diagrams (Fig. 15, B), and written instructions prepared by the dentist for the dental technician. 13 Now I must also make a statement regarding the responsibilities of the commercial dental laboratory in the hope that they, too, may find some motivation for improving their services. [Display omitted] Fig. 15.— A, The outline form of the denture framework has been carefully drawn in pencil on the surveyed master cast. The laboratory technician has only to duplicate this design in his casting so that when the casting is placed on the master cast it matches the penciled outline. B, The framework design is drawn on a chart with colored pencils. Labels and written instructions are used to supply the specific details. In the average commercial dental laboratory today, mass production is an economic necessity. It is augmented by the use of stereotyped designs and plastic pattern forms. Added to this, the salary level of the skilled dental laboratory technician is not high by today's economic standards, and the training facilities for dental laboratory technicians are woefully inadequate. In many areas, adequate training facilities are nonexistent. However, despite this, quality partial denture and mouth rehabilitation service is needed now more than ever before. Teeth that would have been lost in the past by periodontal disease, caries, or by pulpal involvement are being saved now by the thousands. Increased life expectancy has placed us on the threshold of geriatric dentistry, with its many implications and challenges for the future dental care of an aging population. 18 Human mouths are not stereotyped, and neither are the problems in mouth reconstruction. Stereotyped partial denture service must be replaced with individualized treatment planning and rehabilitation service. 19 Dentists must do more than make a single impression, send it to the commercial dental laboratory, and receive a finished appliance to be inserted in the mouth. Also, it seems a little bit incongruous to spend a great deal of time and effort on elaborate research in the testing of some of the clinical principles in partial denture design, when these very principles are being so flagrantly violated by those responsible for their clinical application. If training facilities and increased salary standards for dental laboratory technicians are needed, then let the dental profession have the courage and the integrity to lead the way toward their improvement. But also, let the profession demand standards of individualized service from the commercial dental laboratory in keeping with competent and informed leadership.