Flexible Removable Partial Denture Research Articles

POLYAMIDE FLEXIBLE DENTURES – A BETTER OR WORSE STRATEGY

Background: Polyamide dentures have added advantages over the acrylic dentures in terms of esthetics, comfort and versatility to adapt to the undercut areas. However, the effect of flexibility of these dentures from the view of residual ridge resorption has always been obscure. The aim of this study is to compare the type of denture base with the distribution of masticatory forces by examining the changes on the alveolar mucosa in the histological picture before and after insertion of two widely used dentures. Materials and methods: A total of 20 participants were included in the study, among which 10 patients were allocated for acrylic removable partial dentures and 10 patients were allocated for polyamide flexible removable partial dentures. The patients were asked to rinse their mouth and cement spatula was used to collect the epithelial mucous cells noninvasively by scraping the crest of the residual alveolar ridge with light pressure in premolar-molar area both before insertion and 2 weeks after insertion of the removable partial dentures. The said swab was then smeared on a clean glass slide and fixed in 95% ethyl alcohol and was stained by Papanicolaou (PAP) stain. The PAP-stained smear was analyzed for the presence of keratinized cells and the number of keratinocytes was counted for both acrylic and polyamide denture groups. Results: The results show that both types of denture bases altered the alveolar mucosal keratinization but there was a significant difference in number of keratinized cells between all the three groups. Polyamide flexible partial dentures showed more ortho-keratinized epithelium, which favours better occlusal load distribution. Conclusion: The results concluded that there was decreased masticatory load on the residual alveolar ridge under polyamide denture group due to the flexibility of the denture base material compared to that of the acrylic denture group.

Full mouth rehabilitation of a patient with Restorative Space Issues and loss of VDO by replacing maxillary arch with fixed prosthesis opposing a flexible removable partial denture in mandibular arch: A case report

Primary objective of full mouth rehabilitation is the restoring the teeth to optimal physiological and functional balance . Planning a comprehensive course of treatment for a number of missing teeth can be difficult, particularly when the vertical dimension (VD) of the occlusion is reduced. In this case report the sequential methodical interdisciplinary approach employed to treat multiple missing teeth with a loss of VD is described. The patient receives a temporary prosthesis by increasing the vertical dimension.A definitive reconstruction using a fixed prosthesis in the maxillary arch and mandibular ant region and a flexible partial denture in the mandibular arch was carried out following validation of the newly established restorative vertical dimension. A dentist can improve a patient's quality of life by providing functional harmony and aesthetic comfort through appropriate diagnosis and treatment planning

The effect of two different types of removable partial dentures on chewing activity and muscle efficiency.

Background and objectives: Cobalt chromium removable partial denture has been in use for years and despite of the advantages that cobalt chromium provides, it has many disad‐ vantages. In the recent years flexible removable partial denture has been introduced to dentistry with many advantages over cobalt chromium removable partial denture . The purpose of this study was to evaluate the effect of cobalt chromium and flexible removable partial denture on chewing activity and muscle efficiency. Methods: Ten patients were selected, all of them had completely edentulous maxilla and Kennedy Class I partially edentulous lower arch. eight male and two females with their ages ranging from 45 to 60 years. For each patient, an upper complete denture and two lower removable partial dentures (cobalt chromium and flexible) were constructed. Once the dentures were completed, muscle efficiency with the use of Electromyography and chew‐ ing activity by sieving method was performed in scheduled visits. Statistical analysis of data was achieved by means of (SPSS 25). And performing (independent sample T test, one‐way anova test, and multiple comparison Tukey test). Results: The chewing activity test, revealed a statistically significant difference (P< 0.05) between first and fourth visit concerning the flexible partial denture and improvement of chewing, for the cobalt chromium removable partial denture although there was improve‐ ment of chewing but it was not significant. Regarding the muscle efficiency test, this test revealed that there was no major significance between flexible and cobalt chromium re‐ movable partial denture and they are almost the same, but we can notice improvements of muscular efficiency specially in masseter muscle. Conclusions: Within the limitations of this study, it has been concluded that the muscle efficiency is improved within one month of insertion of both types of removable partial denture . Both flexible and cobalt chromium dentures increased muscle efficiency. Flexible removable partial denture increased chewing activity slightly better than cobalt chromium, while cobalt chromium was marginally better at chewing of hard food comparing to flexible denture.

Romanian dentists’ perception of flexible removable partial dentures

Introduction. A flexible partial denture, as a treatment solution for partial edentulousness, is a current alternative in dental prosthetics, due to simplified design, aesthetic and biomechanical qualities of resin materials, that contribute to the favourable distribution of masticatory forces on the dental and mucosal support. Objective. This study aims to highlight the medical perception of Romanian dentists regarding the evolution of patients treated with flexible partial dentures. Material and method. The research was carried out over a period of two years (2017-2019), on a study group composed of 84 Romanian dentists. Subjects were asked to answer an anonymous questionnaire consisting of 14 closed questions, to outline frequently aspects encountered in practice related to the clinical evolution of the patient rehabilitated with flexible partial removable dentures. Outcomes. Patient comfort (76%) and higher aesthetic properties (54%) were the main reasons why dentists chose a partially flexible prosthetic for the prosthetic treatment of the patient. In the evolution of prosthetic patient, the main problems found at the partial flexible prosthesis were food pigment impregnation of the base (51%) and limited possibilities of repair (34%). Changes in maintenance, support, stability, aesthetic or possible fractures of base and clasps were seen by 46% of respondents, at approximately 1 to 2 years after the application of flexible partial dentures. Conclusions. Flexible partial prosthesis is a method of treatment, whose main advantages are represented by esthetics and superior adaptation of the patients, but because of the deficiencies that occur over time, it is better to be recommended as a provisional treatment solution.

Oral rehabilitation of a parkinson disease patient: A case report

Parkinson’s disease is a progressive neurologic disorder. Compromised voluntary and involuntary control of the orofacial-pharyngeal musculature of patients with Parkinson’s disease may lead to difficulty in mastication, dysphagia and tremors of the mouth and chin. All of these problems represent major challenges for the clinician with regard to the Prosthodontic rehabilitation. This case report describes the use of implants to support mandibular complete denture along with flexible removable partial denture to rehabilitate totally and partially missing teeth in a patient with a Parkinson’s disease. Keywords: Flexible RPD, Implant supported over denture, Parkinson disease, Valplast.

Impact of Wearing Two Different Types of Partial Dentures on Oral Health-related Quality of Life in Geriatric Diabetic Patients – A Crossover Study

OBJECTIVE: This study aimed to evaluate oral health-related quality of life (OHRQoL) of partially edentulous elderly diabetic patients before and after wearing heat-cured acrylic resin and flexible partial dentures.
 BACKGROUND: In the past two decades, an increased concern about the effect of oral conditions on a patient’s quality of life leads to the development of a wide range of OHRQoL measurements. There is a necessity for evaluation required for setting the measurements that are recommended to be used for different needs of geriatric patients.
 MATERIALS AND METHODS: One hundred partially edentulous bilateral free-end saddle diabetic elderly patients have been randomly selected from the outpatient clinics of the Excellence Centre at National Research Centre. Heat-cured acrylic resin partial denture and flexible removable partial dentures were made for all patients. General oral health assessment questionnaire was completed before and after wearing the two types of partial dentures. The criteria of assessment were speech, mastication and associated pain, esthetics and physiological status, and general life satisfaction and practicing daily activity.
 RESULTS: The results revealed a significant improvement regarding all aspects of OHRQoL after wearing both partial dentures for diabetic elderly patients. More improvement was observed after wearing the flexible one.
 CONCLUSIONS: Our findings indicated that OHRQoL in diabetic elderly patients was markedly improved by restoring edentulous spaces using flexible partial dentures than using heat-cured acrylic resin partial dentures.

Flexible Denture: A Hope for Partial Edentulous Patient- A Case Report

The various treatment options for the aesthetic and functional rehabilitation of partially edentulous patients are conventional fixed partial dentures, implant supported fixed partial dentures and removable partial dentures. In some cases, removable partial dentures may be the only choice which is available other than implants and fixed partial denture. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps is not aesthetically pleasant. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning, insertion, wearing and maintenance of this prosthesis is very important.

Clinical evaluation of chewing efficiency for flexible removable partial dentures in bilateral free-end saddle cases

Statement of problem: Increasing flexibility of removable partial denture increase the patient comfort and esthetics at the cost of bite force and chewing efficiency. Purpose: To compare and study the variation of chewing efficiency in different types of thermoplastic denture base materials used for restoring Kennedy class I removable partial dentures. Materials and Methods: Eight patients were included in the study. Four types (groups) of removable partial dentures will be made for every patient in the test group: thermoplastic Nylon RPD, thermoplastic Acetal RPD, thermoplastic PMMA RPD and thermoplastic PMMA with hard PMMA combination. Nylon and Acetal dentures were made using thermo-injectable technique. F. PMMA and H. & F. PMMA dentures were made using compression moulding technique. Chewing efficiency was measured after 1 week, 3 months and 6 months follow-up period for the two types. Chewing efficiency was evaluated by colored chewing gum and computerized color analysis. The test data were collected and analyzed. Results: H. & F. PMMA and F. PMMA had higher chewing efficiency than Nylon and Acetal 1 week after insertion for all chewing cycles. Only 10 chewing cycles affected by increasing the follow up period and denture adaptation for all types. Conclusion: Combination of flexible denture base materials with hard denture base material is recommended to enhance chewing efficiency.

OUTCOMES OF FLEXIBLE PARTIAL DENTURE WITH ESTHETIC CLASPS AS AN IMPLANT PROVISIONAL PROSTHESIS IN THE ANTEROR MAXILLA

introduction: A patient submitted to delayed loading protocol ought to be given a provisional restoration at the interval between the first and second phase of implant therapy. This provisional restoration is made to satisfy the prerequisites of mastication, aesthetics, & to reduce the psychological trauma associated with teeth loss. The reason for this examination was to assess clinical & radiographic outcomes of the provisionally-used flexible removable partial denture (RPD) on both; the implants placed as well as the adjacent abutment teeth. Materials & methods: For the outcome of this clinical research study, ten patients with lost teeth in the anterior maxilla were treated by implant placement. Directly following sutures removal & gingival healing, every single patient received new flexible provisional RPD with aesthetic clasps (resting on adjacent abutment teeth) being fabricated in the usual manner. and mandibular complete dentures prior to implant placement. After common denture delivery adjustments, every patient was instructed to use the denture in a conventional manner for six months, with a follow-up appointment every month. After six months of implants placement (to ensure complete implants osseointegration), patients completed the implant restoration phase till receiving anterior fixed restorations. Clinical & radiographic outcomes for the implants and the abutments were measured Three times (at time of insertion, three months and six months, respectively)Results: For parametric data; Repeated measures Analysis of Variance (ANOVA) was used to study the changes by time, while for non-parametric data; Friedman’s test was used to study the changes by time. Those studies revealed that: There was no statistically significant changes in mean clinical & radiographic measurements around both the implants & the abutments throughout the whole study period. Conclusion: Using flexible RPD with aesthetic clasps as a provisional restoration during the period of implants osseointegration was favourable and preserved the health of supporting structures of the abutment teeth as well as the implants, in addition to enhanced aesthetics & psychological confidence of the patients.

DENTAL PROSTHESIS;

Objectives: To provide various means of retention in dental prosthesis for cleftpatients. Study Design: It was a descriptive type of study. Place and Duration of study: Thestudy was carried out at Hamdard University Dental Hospital, Karachi. Total duration of this studywas three years. Materials and Methods: Total 30 patients were selected after taking consentby random sampling technique. The age range varies from 01 month to 45 years. Among 30patients, 19 were female while 11 were males. Special designed Performa was made and filledby getting all related information from patient/ attendants. Then various treatment optionswere discussed with the patient or attendant & with mutual consent prosthesis was fabricatedutilizing various method of retention. Results: Feeding plate was fabricated for five patients,in which retention is achieved through maximum extension of prosthesis, using elastic band,utilization of favorable undercuts. Conventional removable partial denture was fabricated for17 patients. Mainly retention was achieved through retainers, considering esthetics maximumnumber of clasp is incorporated. To get better patient’s compliance flexible removable partialdenture was fabricated for 03 patients while precision attachment was provided to one patient.Speech bulb prosthesis was fabricated for one patient, its retention was mainly achieved bymeans of Adam’s clasp. Seven patients were provided with fixed prosthesis, in four cases pinkporcelain was added in cervical area to further improve esthetics & retention. Mainly due tofinancial status & poor compliance from the patients, implant supported prosthesis was notprovided to any patient. Conclusion: Utilization of various means of retention brings betteradaptation of prosthesis in cleft patients.

Removable partial dentures: Patient satisfaction and complaints in Makkah City, KSA.

ObjectiveTo assess the satisfaction level and complaints among patients using different types of removable partial dentures (RPDs) in Makkah city, KSA.MethodsIn this retrospective study, 551 patients who had received RPDs between February and December 2015 were contacted by telephone. One hundred patients responded, and 60 of them agreed to participate in the study. The participants were asked two questions to determine their satisfaction level and complaints with RPD usage, eating, communication, and aesthetics. Data were analysed statistically by chi-square, analysis of variance, and Scheffe's tests.ResultsOf 60 patients, 35% were very satisfied, 21.7% were satisfied and 23.3% were nearly satisfied. However, only 20% were not satisfied. There were no significant differences in mean RPD satisfaction among different age groups and between sexes (P > 0.01). There was a significant difference in satisfaction among RPD type (P < 0.01). However, no significant differences were recorded between either metal and acrylic, or acrylic and flexible RPDs (P < 0.01). As many as 26.7% of respondents complained of aesthetic problems, 16.7% complained of pain during mastication, 10% complained of gag reflex, and 8.3% complained of phonetic problems. However, the majority of respondents (38.3%) had no complaints.ConclusionThe majority of patients were satisfied with the quality of removable partial dentures treatment in Makkah city hospitals. Oral rehabilitation with RPDs should be applied with care when patients have high aesthetic demands.

Prosthetic rehabilitation of a patient with Type-I ectodermal dysplasia: A case report

Type-I ectodermal dysplasia (Christ-Siemens-Touraine syndrome) is characterized by clinical triad of hypohidrosis, hypotrichosis, and hypodontia or anodontia. Depending on the severity of the condition, various prosthodontic treatments are recommended to re-establish the masticatory function, appearance, speech, and also to improve the emotional and social aspects of the child. The various treatments may include removable partial/complete prosthesis, fixed and/or implant-supported prosthesis, or a combination of these. In this clinical report, an 11 year old girl is presented with hypohidrotic ectodermal dysplasia. Implant-supported restorations can improve the physiologic and psychosocial function, when compared with removable dentures; but their placement in growing jaws can cause complications. So, a maxillary flexible removable partial denture and a mandibular conventional complete denture with neutral zone technique were fabricated after considering her growth and the number and condition of her present teeth. Composite resin material was used to restore the conical maxillary canine for a favorable aesthetic appearance.

A Review: Flexible Removable Partial Dentures

In an era of implants and fixed prosthesis, removable partial dentures are still a treatment of choice for a wide range of patients and clinicians. As every other treatment option, removable prosthesis also has some disadvantages. But with introduction of flexible partial dentures, many of the disadvantages of conventional acrylic and cast partial dentures are taken care of. This article discusses about the material used in fabrication, indications and compares the flexible partial dentures with other removable partial denture options along with design and insertion technique of the flexible removable partial dentures. I. Introduction: The choice between several treatment options for replacing missing teeth is influenced by clinical, dentist- and patient-immanent factors. Replacement of missing teeth is one of the most important needs for patients attending clinics to restore esthetics and/or function. Many treatment modalities are available for replacing missing teeth; removable partial denture, fixed partial denture or dental implant. Each modality is a possible treatment option and has its own advantages and disadvantages. Removable partial dentures became popular many decades ago with the introduction of acrylic polymers and chrome cobalt alloys in dentistry. Many patients choose removable partial dentures due to factors ranging from cost to psychology. Dr. Walter Wright (1937) introduced Polymethyl methacrylate as a denture base material which became the major polymer to be used. Since ages, polymethyl methacrylate (PMMA) has been used to fabricate the dentures. Metal cast / metal frame / metal base dentures are also fabricated to restore the defects. Some of the problems with acrylic are difficult to address, such as insertion in undercut areas, brittleness of methyl methacrylate which leads to fracture, and allergy to methyl methacrylate monomer. In the recent times flexible removable partial dentures have become quite popular. Though search for the ideal option is still on, here is a review of viable option for replacing missing teeth known as flexible dentures.

Flexible Thermoplastic Denture Base Materials for Aesthetical Removable Partial Denture Framework

Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps may affect aesthetics. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior to flipper and cast partial dentures, may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning and insertion technique of this prosthesis is very important, which have been thoroughly described in this article.

Prosthodontic Rehabilitation of Hereditary Ectodermal Dysplasia in an 11-Year-Old Patient with Flexible Denture: A Case Report

Hereditary ectodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of two or more tissues of ectodermal origin such as hair, nails, teeth, and skin. The dental characteristics of this syndrome include anodontia or hypodontia of the primary and/or permanent teeth, hypoplastic conical teeth, and underdevelopment of the alveolar ridges. The options for a definitive treatment plan include fixed, removable or implant-supported prostheses, singly or in combination. This clinical report describes the prosthetic rehabilitation of an 11-year-old boy with hereditary ectodermal dysplasia. Maxillary flexible removable partial denture and mandibular conventional complete denture were fabricated to establish an acceptable masticatory function, speech, and esthetics for the patient.

Valplast® flexible removable partial denture for a patient with medically compromised conditions : a clinical report

연구목적: 현대의학의 발달로 고령 인구가 증가함에 따라 부분 무치악이나 완전 무치악 환자의 비율이 증가되고 있다. 고령 환자는 전신적 질환이 동반되는 경우가 흔하므로 보철 치료 시에도 전신적인 건강 상태 및 경제적 여건에 대한 고려가 필요하다. 고령의 환자나 전신적 질환자에 있어 임플란트 등의 치료보다 가철성 국소의치가 선호되고 실제로 많이 적용되고 있으나 기존의 금속-아크릴 국소의치는 많은 한계점을 가지고 있다. 전치부에 금속 클래스프가 위치하여 비심미적이고 미중합 레진에 의한 알레르기 반응이 있으며 지대치에 가해지는 응력이 크며, 파절 시 수리가 용이하지 않다. 또한 대부분의 경우 지대치에 주조 금관의 제작이 필요하며 이로 인해 추가적인 고가의 보철비용을 부담하여야 하고 제작과정이 복잡할 뿐 아니라 장기간의 치료와 여러 번의 내원이 필요하다. 반면, 최근 이용빈도가 증가하고 있는 Valplast $^{(R)}$ 탄성 국소의치는 Nylon 재질로 생체친화성이 높고 심미적이고 가벼우며 수리가 용이한 장점이 있다. 또 간단한 진료 과정과 짧은 제작기간 후 의치를 장착할 수 있다. 본 증례에서는 장기간의 치료기간과 다수의 내원이 어려운 전신 질환자 및 예후가 불량한 환자에서 Valplast $^{(R)}$ 탄성국소의치를 적용한 예를 보고하고자 한다. 결과 및 결론: 증례에서 환자들은 만성 질환, 암 등의 전신적, 소모성 질환을 앓고 있거나 개구 제한 또는 예후가 불량한 잔존 지대치 등 통상적인 보철치료가 힘든 경우였다. 이러한 환자들에게 기존의 금속-아크릴 국소의치는 신체적으로나 경제적인 이유로 적용이 어려워 대신 추가적인 보철물의 제작이 필요없고, 제작과정이 간단한 Valplast $^{(R)}$ 탄성 국소의치를 적용하였다. 환자들은 평균 1-2회의 주기적 체크를 했고 현재까지 동통이나 파절 등의 불편감이 없이 잘 사용하고 있다. 여러 증례에서 기존의 가철성 의치의 단점을 보완하는 탄성의치를 이용하여 만족한 결과를 얻었기에 보고하는 바이다. 【Statement of problem: As the number of elders is growing with the advancement of medicine, partially or fully edentulous patients have increased. Medically compromised conditions are common in the older population so that it should be taken into account in prosthetic treatment planning as well as their economic conditions. In the older patients, removable prosthesis has been preferred to implant prosthesis. However, cast metal based removable partial dentures also has several limitations. Purpose: In this report, we present several cases of Valplast $^{(R)}$ flexible denture which were fabricated in patients who had medically compromised conditions or whose remaining teeth showed a relatively poor prognosis. Results & Conclusion: This article describes an alternative treatment for a partially edentulous patient with mouth opening limitation, after cancer surgery, compromised general condition and questionable remaining teeth. In these patients, Valplast $^{(R)}$ flexible denture was used because of its unique characteristics and the results were all satisfactory. Patients had 1-2 check-up and there were no postoperative pain or fracture of denture up to now.】

Comparison of patient satisfaction with acrylic and flexible partial dentures.

Restoration of partial edentulous mouth may be done using a variety of treatment options. Removable partial denture (RPD) is commonly used because of its availability. RPDs from flexible resins unlike those from acrylic engage hard and soft tissue undercuts and feel more comfortable in the mouth. The aim of the study was to compare satisfaction with dentures made from these two types of materials. It was a quasi-experimental study among thirty patients at the Prosthetics Clinic, University College Hospital, Ibadan. Patients aged 16 years or more, requiring RPDs with one to three missing teeth in the anterior region of either the upper or lower arch participated. A modified semi-structured interviewer-administered questionnaire was used to collect data on sociodemographics and oral health variables. The level of satisfaction was assessed using a visual analogue scale. Data were analysed using descriptive and multivariate statistics at a significance level of P < 0.05. The participants' ages ranged between 16 and 51 years, mean age was 33.8 ± 10.01 years. Male: female ratio was 1:1 and mean duration of edentulousness was 11.37 ± 10.52 years (median - 9.50). Most 28 (93.3%) subjects delayed replacement of their missing teeth; reasons were indifference 13 (43.4%), financial constraint 10 (33.3%), ignorance 4 (13.3%) and fear of aspiration 1 (3.3%). Overall, 21 (70.0%) participants were more satisfied with the flexible dentures, 6 (20.0%) with acrylic dentures while 3 (10.0%) were equally satisfied with both types of dentures (P = 0.04). Subjects were more satisfied with the flexible RPD than the acrylic resin RPD.