Attachment-retained Removable Partial Denture Research Articles

What is the Best Tooth-Supported Attachment System for Distal-Extension Removable Partial Dentures? A Systematic Review with Meta-Analysis.

To evaluate the published literature on tooth-tissue supported removable partial dentures (RPDs) and determine the attachment system that provides the best clinical outcome. A comprehensive search of studies published up to November 2021 was performed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The study protocol was approved and was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42021268449). The PICO question was, "What is the best attachment system used in Kennedy class I and II removable partial dentures?" The search identified 871 articles, of which 21 met the inclusion criteria. The evaluation period in the studies ranged from 3 to 282 months. A total of 1,357 patients were included, of which 526 used prostheses with attachments. The mini SG attachment (extracoronal) was the most commonly used attachment, and the survival rate ranged from 37% to 98.1% in 10 studies, with no significant differences between the systems. Among the 10 studies selected for quantitative analysis, the meta-analysis revealed an overall failure rate of 16.6% (95% confidence interval: 10.4-25.4%), and heterogeneity of I²=65.725 (Q-value: 26.258, P=.002). Clinical studies comparing different attachment systems for rehabilitation are lacking. Our findings suggest that attachment-retained RPDs have good retention and better esthetics than conventional RPDs and that the extracoronal attachment system is the most viable choice for treatment at the free end.

Resin-bonded attachments made of monolithic zirconia ceramic: a minimally invasive and esthetic treatment approach.

The aim of this case report was to present a minimally invasive and esthetic treatment approach for the replacement of missing teeth removable partial dentures retained by zirconia ceramic resin-bonded attachments. The resin-bonded attachments were digitally designed and milled using CAD/CAM technology from monolithic 3Y-TZP zirconia ceramic. The resin-bonded attachments had an optimized attachment design approved for zirconia ceramic. The preparation was based on general preparation guidelines for resin-bonded attachments and resin-bonded fixed dental prostheses (RBFDPs). After placement of rubber dam, the resin-bonded attachments were bonded with a phosphate monomer-containing luting resin. The presented resin-bonded attachment-retained removable partial denture was successful over 30 months of clinical observation without any complications. The patient was satisfied with the minimally invasive treatment procedure. Zirconia ceramic resin-bonded attachments fabricated with a special attachment design are an esthetic and minimally invasive treatment approach. However, clinical data on the long-term outcome of zirconia resin-bonded attachments are still needed. (Quintessence Int 2023;54:220-226; doi: 10.3290/j.qi.b3819523).

Clasp Retained Versus Attachment Retained Removable Partial Dentures for Treatment of Mandibular Distal Extension Cases: Patient Satisfaction and Oral Health-Related Quality of Life

Clasp Retained Versus Attachment Retained Removable Partial Dentures for Treatment of Mandibular Distal Extension Cases: Patient Satisfaction and Oral Health-Related Quality of Life

Functional and Aesthetic Rehabilitation With Porcelain Veneers and Attachment-Retained RPD: 40 Months of Follow-Up

Background: Distal edentulous spaces can be challenging when rehabilitation with dental implants is limited. Attachment-retained removable partial dentures (RPD) work as a therapy that can compensate rotational movements and reduce the number of abutments.Case description: This clinical report addresses indications, selection and procedures for the rehabilitation of a partially edentulous maxilla, involving laminate veneers, fixed and removable prostheses.Practical implications: Attachment-retained RPDs provide sufficient retention and improved aesthetics compared to clasp-retained partial dentures. Careful aesthetic and functional planning and periodic follow-up are essential for patients’ satisfaction.

Comparison between Integrated and Parallel Interlock Designs of an Extracoronal Attachment-retained Distal Extension Removable Partial Dentures: A Clinical Trial.

ABSTRACTObjective:Precision attachments may exert unfavorable stresses on abutments in distal extension bases. This study compared between two reciprocation designs in attachment removable partial dentures (RPDs).Materials and Methods:Fourteen patients were allocated into two groups. Each patient received an attachment-retained RPD with one of the two types of attachments being studied. Group I received the integrated interlock type of reciprocation and group II received the parallel interlock type. Abutments were examined for modified plaque index, modified bleeding index, periodontal probing pocket depth, clinical attachment level, and modified papillary bleeding Index.Results:Comparisons of periodontal parameters between mesial and distal abutments within each group revealed no statistically significant difference. Means of these parameters were used for the comparisons. There was a significant difference at P < 0.05 in all parameters between the two groups at time of insertion and at 3, 6, and 9 months of follow-up with values of group (II) higher than group (I).Conclusion:RPDs of both designs showed an increase in periodontal parameters. Integrated interlock design showed better scores. It is preferable to use the attachment-retained RPD with integrated interlock instead of parallel interlock design.

A within-subject comparison of the conventional clasp-retained with attachment-retained removable partial dentures

ObjectiveThis study conducted to satisfaction with conventional clasp-retained and attachment-retained removable partial dentures (RPDs) among patients with partially edentulous maxilla. MethodsThe crossover trial recruited 10 patients with bilateral free-end partially edentulous maxilla who received a conventional RPD for 3 months, followed by an attachment-retained removable partial denture (ARRPD) for another 3 months. There was no washout period between the two interventions. During follow-up, patients were requested to complete a patient satisfaction questionnaire. This 9-item validated questionnaire measured patient satisfaction with the ease of cleaning, ability to speak, comfort, aesthetics, stability, ability to masticate different types of food, masticatory efficiency, oral condition, and general satisfaction. ResultsThe comparison of the two treatment modalities showed significantly higher satisfaction with the ARRPD than with the conventional RPD. The ARRPD was preferred due to the ease to clean, speech, comfort, aesthetics, stability, masticatory ability, and masticatory efficiency (p < .05). ConclusionThe study showed higher short-term satisfaction rates in patients with ARRPDs than with the conventional clasp-retained RPDs. The superior aesthetics of ARRPDs are recognized in conjunction with the restoration of the partially edentulous maxilla.

Attachment versus Clasp retained Removable Partial Dentures –A Randomized Controlled Clinical Trial

Purpose: to compare two retainer designs for free end removable partial dentures (RPDs) by measuring the patient satisfaction, abutment tooth survival, bone height loss and pocket depth.Materials and Methods: Group 1: Fourteen patients receiving attachment-retained RPDs while group 2: Fourteen patients receiving clasp-retained RPDs. The assessment included patient satisfaction, survival of the terminal abutments, bone height loss and pocket depth. All patients were evaluated clinically and radiographically at the time of RPD insertion, twelve months and 24 months thereafter. Mann Whitney U test for independent samples was used for comparison of % change of patient satisfaction. Wilcoxon signed rank test for paired (matched) samples was used within group comparison of patient satisfaction before and after treatment. Survival analysis was done using Kaplan Meier statistics. For bone height, independent t-test was used and student’s t- test was used for pocket depth comparison.Results: There was a significant difference before and after treatment scores in Oral Health Impact Profile-14(OHIP-14), Orofacial Esthetic Scale (OES) and Chewing Function Questionnaire (CFQ) questionnaires in the clasp retained RPD group with P value = (0.001, 0.001 and 0.003) respectively. Regarding the attachment retained RPD group, there was a significant difference before and after treatment scores with P value = 0.001 for the three questionnaires. Within group comparison it was found that there was a significant difference in OHIP-14 (P= 0.002) and OES (P<0.001) while there was no significant difference in CFQ between both groups (P=0.191). There was no statistically significant difference between both groups in terminal abutment survival (P=0.149) and percent change of the mean probing pocket depth from baseline to 24 months (P=0.05). However, regarding the effect of time on bone height change percentage for each group, a significant difference was found between groups at baseline-twenty-four month’s interval (P-value < 0.05).Conclusion: Within the limitations of the present study, all patients have shown improvement in OHRQoL, esthetics and chewing function after treatment with RPDs with better results in the attachment retained RPD. However, regarding the terminal abutment survival, mean probing pocket depth and bone height change, clinically significant better results were revealed in clasp-retained RPD compared to attachment-retained RPDs.

Treatment Outcomes Based on Patients' Self-Reported Measures after Receiving New Clasp or Precision Attachment-Retained Removable Partial Dentures.

To evaluate effects of a treatment taking into consideration esthetics, chewing, and oral health-related quality of life (OHRQoL) of two tooth replacement strategies for maxillary partially edentulous patients with clasp (C-RPD) and precision attachment (PA-RPD) retained removable partial dentures (RPD). The study included 150 patients (72 men, 78 women) who received maxillary RPDs; 88 patients received clasp and 62 patients received precision attachment retained RPDs. Patients completed three questionnaires before treatment and again 3 months after treatment: the Orofacial Esthetic Scale (OES), the Oral Health Impact Profile (OHIP-14), and the Chewing Function Questionnaire (CFQ). Statistical analysis comprised descriptive statistics, paired t-test, and two-factor ANOVA. Both RPD treatments yielded better after-treatment summary scores when compared with the baseline scores (p < 0.01); however, better results were obtained in the PA-RPD group. Gender, as a single factor, did not yield significant effects; mutual interaction of retention type and gender yielded significant effects. The PA-RPD female group assessed esthetics, chewing function, and OHRQoL significantly better than males, and significantly worse than males in the C-RPD group. The covariate baseline scores yielded statistically significant effects; patients with worse pretreatment condition benefited more from both therapies. Treatment outcomes were better in the PA-RPD group than the C-RPDs. Women showed greater concern for the treatment outcomes; their rates were significantly better than in male patients in the PA-RPD group; however, when their satisfaction was lower, their rates were significantly worse than in male patients (in the C-RPD group).

Maxillary Rehabilitation Using Fixed and Removable Partial Dentures with Attachments: A Clinical Report

Despite requiring dental crown preparation and possible root canal treatment, besides the difficulty of clinical and laboratory repairs, and financial burden, the association between fixed (FPD) and removable partial dentures (RPD) by means of attachments is an important alternative for oral rehabilitation, particularly when the use of dental implants and FPDs is limited or not indicated. Among the advantages of attachment-retained RPDs are the improvements in esthetics and biomechanics, as well as correction of the buccal arrangement of anterior teeth in Kennedy Class III partially edentulous arches. This article describes the treatment sequence and technique for the use of attachments in therapy combining FPD/RPD.

Attachment-retained Unilateral Distal Extension (Kennedy's Class II Modification I) Cast Partial Denture

ABSTRACT Attachment-retained removable partial denture (RPD) is not an outdated treatment modality. It is even more contemporary in today's appearance-oriented society than when it was first introduced. There is significant number of patients who could benefit from this treatment option, both short and long term. However, lack of proper knowledge, overwhelming number of attachments available in the market, multiple adjustments and repairs are making dentists reluctant to offer and provide attachment-retained RPD services. The purpose of this article is to provide an overview and a simplified approach to this treatment modality by way of a case report. How to cite this article Jain AR, Philip JM, Ariga P. Attachment-retained Unilateral Distal Extension (Kennedy's Class II Modification I) Cast Partial Denture. Int J Prosthodont Restor Dent 2012;2(3):101-107.

Provisional Prosthetic Management of Mobile Teeth in Conjunction with a Removable Partial Denture Using Orthodontic Wire

Precision attachment-retained removable partial dentures eliminate the use of visible clasps and improve the esthetic appearance of the smile; however, terminal abutment teeth may be subject to unfavorable stresses under function when misused. A provisional prosthetic management technique that incorporates an orthodontic wire to assist cross-arch support and stability of the periodontally weakened abutment teeth is described. This technique is simple, reversible, does not alter the esthetic appearance of the smile, and controls the mobility of the abutment teeth until a definitive treatment plan is established.

On functional strain in fixed and removable partial dentures. An experimental in vivo study.

Three rosette strain gauges were attached to a fixed bilateral cantilevered crossarch maxillary bridge and one linear strain gauge to an attachment-retained removable partial denture (RPD), to study the functional deformation pattern in this combined reconstruction. The deformation under clinical conditions at maximum habitual biting and at maximum unilateral loading was very complex, with both elongation and contraction in different parts of the fixed reconstruction. Even though this complexity in the functional deformation was found both with and without the RPD incorporated, the RPD seemed to provide a more even and favorable distribution of the masticatory forces in the fixed reconstruction.