Lower Removable Partial Dentures Research Articles

Atención odontológica humanizada a un paciente con neurofibromatosis tipo 1 atendido en una clínica de odontología de especialización infantil: reporte de Caso

This work aims to report an individualized, inclusive and humanized dental approach, emphasizing the importance of treating a child of 4 years and three months, with a diagnosis of neurofibromatosis type 1, who was referred and treated at the clinic of the Specialization Course in Pediatric Dentistry of the Graduate School, Faculty of Dentistry, University of the Republic in the city of Montevideo, Uruguay. The clinical examination revealed scars from the surgical treatment of the plexiform neurofibroma affecting the child's neck and oral muscle hypotonicity. At intraoral clinical examination, fifteen deciduous teeth were absent and five with early childhood caries lesions as well as a generalized presence of microbial biofilm on the tooth surfaces and provoked gingival bleeding. A necessary dental treatment was carried out for the patient, with the pertinent care, and rehabilitative therapy with an upper and lower removable partial denture. We conclude that educational, preventive, restorative and rehabilitative dental treatment was satisfactory and empathy, as a dynamic process, involved cognitive, affective and behavioral mechanisms and was recognized for its positive effects in promoting the patient's oral health.

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.

Tratamento reabilitador com prótese total imediata maxilar e prótese parcial removível mandibular

Immediate complete denture (ICD) is a mucosa-supported prosthesis manufactured before the removal of natural teeth and installed soon after their extraction. This paper aims to describe a clinical case of oral rehabilitation with upper ICD and lower removable partial denture (RPD). A 57-year-old female patient sought treatment with dissatisfaction with her aesthetics and mobility of the upper teeth. After anamnesis, intra and extra-oral examinations, radiographic examination and analysis of study models mounted on a semi-adjustable articulator, periodontal pockets were found in the upper teeth and extensive bone loss. So, upper tooth extraction, superior ICD and lower RPD were indicated as treatment. For ICD preparation, anatomical and functional moldings were made, made up of orientation and intermaxillary relationship plans for the assembly of the semi-djustable articulator models. The remaining upper teeth were removed from the model for assembly of the artificial teeth and the ICD was polymerized and polished. The lower RPD was made following the standard steps. After dentures manufacturing, the surgery for upper tooth extraction was performed and prostheses installed immediately after surgery. The results demonstrated that the performed treatment provided aesthetic, phonetic, and functional restoration to the patient avoiding her to undergo a period of edentulism. It was concluded that ICD is a good indication for prosthetic rehabilitation of patients with advanced periodontitis, whose planning is the exodontia of all the teeth of an arch.

Implant- and tooth-supported removable partial dentures: a case report

ABSTRACT This study aimed to report treatment of a patient with Kennedy’s class l maxillary and class II mandibular arch with removable partial dentures supported on an external hexagon (HE) anterior type implant of regular diameter fitted with an O’ring type of attachment. This clinical case reports the oral rehabilitation of a senile patient whose clinical examination revealed missing dentition in the upper and lower arches, attrition of the lower anterior teeth, caries, and motor impairment affecting hygiene, mastication, and esthetic functions. Due to few severely impaired teeth, the pre-prosthetic preparation included extractions and restorations, followed by the fabrication of upper and lower removable partial dentures supported by an HE-type implant. This study is important because it addresses the current challenges faced in the implementation of treatment involving removable partial dentures combined with implants, which is a topic that still needs long-term follow-up and research.

Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy

OBJETIVO: O objetivo deste estudo foi determinar a prevalência das desordens temporomandibulares em pacientes com prótese parcial removível, de acordo com a classificação de Kennedy. MÉTODO: A população estudada consistiu de pacientes que procuraram tratamento na Universidade Estadual de Ponta Grossa. Os pacientes selecionados eram usuários de prótese total superior e prótese parcial removível inferior, e esse uso, à época do estudo, fazia entre 1 e 5 anos. Os pacientes foram divididos em cinco grupos (n = 15): G1: usuários de prótese total superior e prótese parcial removível inferior Classe I (Kennedy); G2: usuários de prótese total superior e prótese parcial removível inferior Classe II (Kennedy); G3: usuários de prótese total superior e prótese parcial removível inferior Classe III (Kennedy); G4: usuários de prótese total superior e prótese parcial removível inferior Classe IV (Kennedy), e G5: pacientes totalmente dentados (grupo controle). O questionário de Fonseca foi aplicado para verificar o grau de DTM. O teste qui-quadrado (α = 0,05) foi usado para avaliar a associação entre as variáveis. RESULTADO: Nenhuma diferença estatística (P > 0,05) foi encontrada entre os grupos. Em todos os grupos, os pacientes apresentaram DTM leve ou moderada. CONCLUSÃO: Os resultados deste estudo clínico mostraram que a presença de DTM em pacientes usuários de prótese não pôde ser correlacionada ao uso de prótese, já que a presença de DTM para pacientes desdentados e dentados apresentou-se semelhante.

Removable Partial Denture with Bar or Plate: How should We Decide?

ABSTRACT Aim Although there is evidence that covering teeth by parts of a denture may damage teeth and the periodontium, the lingual plate is still common in clinical practice in many countries. The aim of this study was to compare the lingual plate and lingual bar type major connectors in the lower jaw as reflected in the literature. Materials and methods A literature search was carried out in PubMed for articles focusing on the possible effects of lingual plate major connector on the oral environment. Case and technical reports were excluded. Results The lingual plate which covers the soft tissues of the periodontium and the hard tissues of teeth results in increased plaque accumulation, development of caries and gingivitis, which in turn results in periodontal breakdown. The lingual plate functions as a barrier to saliva circulation, decreasing selfcleaning of teeth on the covered surfaces. Wearing a linguoplate denture increases the likelihood of halitosis, corrosion and metallic taste. Patients have to wear a large volume of metal, which may cause difficulties in speech and may impair touch and form perception. The lingual plate may not satisfy the patient's esthetic expectations either. These issues are uncharacteristic for the use of lingual bar connector for removable partial denture. Conclusion A lingual bar should always be used in the lower removable partial denture, thus providing a hygienic denture design, comfort and esthetic appearance. How to cite this article Radnai M, Saini R, Gorzo I. Removable Partial Denture with Bar or Plate: How should We Decide? Int J Experiment Dent Sci 2013;2(2):104-109.

Prevalence of temporomandibular disorder signs in patients with complete versus partial dentures

To determine the prevalence of signs of a temporomandibular disorder (TMD) in completely edentulous patients wearing upper and lower complete dentures (CD) and to compare this to the prevalence of signs in partially edentulous patients wearing upper and lower clasp-retained acrylic removable partial dentures (RPD). A questionnaire and a clinical examination were used to assess 200 patients. One hundred of these were complete denture wearers being treated for the provision of replacement CD. The other 100 patients were partially edentulous patients, who had RPD replacing upper and lower partially missing teeth and their supporting structures. It was shown that there was a statistically significant difference between the two groups regarding the presence of temporomandibular signs. Partially edentulous patients wearing upper and lower RPD had a significantly higher prevalence of TMD signs than edentulous patients wearing CD (36% compared to 17%). They also exhibited significantly (P<0.04) more signs of joint tenderness (18%) on clinical examination compared to (5%) only in the CD-wearing patients. Tenderness upon palpation in the periauricular region was the most common site reported in both groups. The partially edentulous patients (wearing RPD) exhibited more TMD signs when compared with the CD-wearing patients. Significantly, more partially edentulous patients had joint tenderness (P<0.04) than did CD-wearing patients. The masseter muscle most commonly demonstrated muscle tenderness.

A new experimental restoration model in man for studying enamel reactions.

A new model of experimental restoration is suggested for testing the marginal imperfections of composite resin, for examining the surface morphology of composite restorations and of sound, etched and remineralized enamel. Enamel-dentine samples with standardized cavities and composite restorations were placed on lower removable partial dentures using the etching technique. After 12 and 28 days the specimens were examined in a scanning electron microscope (SEM), operated at 15 kV. After 12 days the examination of the conventional composite resin by SEM showed extremely rough structures. The use of the enamel etch techniques produces acceptable marginal conditions with tags and some minor gaps. Etching the enamel emphasizes its prismatic structure and reveals the typical pattern of demineralization, involving prism cores and the preferential dissolution of prism peripheries. After 12 days the SEM appearance of uncovered etched enamel suggested that incomplete remineralization had occurred. After 28 days the mineral recoating, which had progressed further, predominantly involved prism-orientated repair. The experimental model described here is more accurate, highly standardizable and easily accessible, compared with conventional clinical and replica techniques.

こう合採得法の相違による水平的下がく位の変動

The purpose of this study was to compare and evaluate the relative reproducibility and equality as well as jaw relationships produced by four jaw guiding methods; the gothic arch tracing, the voluntary tapping, the myomonitor centric and to occlude warm wax bite rim by light habitual closure. Four patients were selected whose remaining teeth had already lost the maximum intercuspation. The intraoral tracer was fixed on upper complete denture base and lower removable partial denture in three cases. Only in one dentulous case needed complete occlusal rehabilitation, the appliance was fixed on transfer coping crowns.The mandibular position guided by each methods was measured to the nearest 0.1mm in laterally and anteroposteriorly (x and y components). The accuracy of this experiment was estimated at 0.22mm (±2σ) or 0.34 mm (±3σ). This error was derive from width of tracing line, area of tapping point, mobility of denture base and mounting on articulator. Within the limits of this investigation, it is concluded that;1. Each guiding methods determined different mandibular position in case 1, 2 and 4. But in case 3, they terminated in the same mandibular position.2. The gothic arch tracing produced the least variable and the voluntary, tapping the most variable. The habitual closure tended toward eccentric position laterally. The myo-monitor centric produced more variable than the gothic arch tracing but less than the habitual closure.3. The estimated region of apex point was 0.57mm in laterally and 0.45mm in anteroposteriorly, the myo-monitor centric showed 0.62mm in laterally and 0.76mm in anteroposteriorly, the habitual closure determined 0.97 mm in laterally and 0.96mm in anteroposteriorly and the voluntary tapping produced 0.95mm in laterally and 1.59 mm in anteroposteriorly in an average of rejection ellipse (α=0.05).4. In an average of mandibular positon in anteroposteriorly, the gothic arch apex was the most retruded. The distance between apex point and the habitual closure was 0.4mm, the myo-centric was 0.7mm and the voluntary tapping was 0.9mm anterior.5. An average distance between apex point and mean points of each methods produced more consistent mandibular position that ranged within 0.15mm in laterally.

The effects of variations in the opposing dentition on changes in the partially edentulous mandible. Part II. Densitometric measurements

Distal-extension lower removable partial dentures were used to study the effects of various types of opposing dentitions on the residual mandibular ridge. The opposing-dentition groups included complete upper dentures, removable partial upper dentures, and natural teeth. Changes in the bone of the lower residual ridge were measured by means of densitometry. A significant densitometric difference was found in the bone of the partially edentulous mandible between the group of subjects wearing complete upper dentures and the group with natural upper teeth. The reason for this difference is uncertain; however, several theories can be offered. These are (1) an inherent bone difference between the subjects in the two groups, implying a difference in the bone of the group that retained their natural upper teeth longer than did the complete denture group, (2) an increased frequency and/or duration of muscle pull on the mandible due to clenching of the teeth to stabilize the upper complete denture, and (3) the possibility of coincidence. None of the densitometric changes measured at +18 months was significant.