Precision Attachments Research Articles

Use Of Precision Attachments Among Dental Students: A Survey

A custom made semi-precision attachment along with a partial denture offers strength and improved aesthetics if there is minimal space. A descriptive survey was conducted among undergraduate and postgraduate dental students using a well-structured questionnaire. The questionnaire gathered information on the respondents' knowledge regarding the use of precision attachments among dental practitioners in dentistry. Out of the 100 students who took up the survey 100% of them were MDS students. Out of the 100 students,60% of them believed that based on the geometric configuration and design of the attach-ment precision attachments can be classified as keyglock , 20% believed that they were classified as latch type attachments and the rest 20% believed that they were classified as ball and socket at-tachment. Out of the 100 students who took the survey, 80% believed that the advantages of using precision attachments were all except increasing the stress to abutment and 20% believed that the advantages were all except decreasing torsional forces. All the students who had taken part in the survey had knowledge about the use of precision attach-ments in dentistry.

Rehabilitation of Patient with Acquired Maxillary Defect Using Cast Partial Obturator with Precision Extra Coronal Attachment

The prosthetic rehabilitation of a patient with maxillary defect is a very challenging task. Obtaining proper retention when almost half the dentition along with the supporting bone is missing is difficult to obtain. Proper knowledge of the anatomy of both the structures lost in resection as well as the remaining portion helps in fabrication of an effective prosthesis. This article describes the management of acquired maxillary defect case with semi precision attachments enhancing the retention of the obturator prosthesis. Keywords: precision attachments, definitive obturator.

The Effect of Denture Cleansing Solutions on the Retention of Precision Attachments: An In Vitro Study.

This study aimed to investigate the effect of different cleansing solutions on the retention of precision attachments. A precision attachment patrix was embedded into acrylic resin and the matrix was placed onto the patrix. The red (high retention, 8 N), yellow (regular retention, 6 N), and green (reduced retention, 4 N) plastic matrixes of the attachments (n = 32) were soaked in three different denture cleansing solutions (sodium laureth sulfate, sodium bicarbonate-sodium perborate, sodium bicarbonate) for a duration simulating 6 months of clinical use. The control group was soaked in tap water. A universal testing machine was used to measure the retention values of attachments after they were soaked in denture cleansers. The retention values were compared among the groups with repeated-measures analysis of variance followed by the Tukey HSD test (p = 0.05). Yellow attachments were affected by sodium laureth sulfate, sodium bicarbonate-sodium perborate, and water (p = 0.012). Green attachments’ retention increased after immersion in sodium laureth sulfate (p = 0.04) and water (p = 0.02). Red attachments’ retention increased after immersion in sodium laureth sulfate or sodium bicarbonate-sodium perborate (p = 0.045). Water did not affect the retention of red attachments. Because sodium bicarbonate tablets did not affect the retention of attachments, clinicians may recommend their use as a cleanser. Clinicians also may inform patients using fixed and removable partial prostheses with precision attachments of a possible increase in retention after the use of sodium laureth sulfate or when using sodium bicarbonate-sodium perborate with yellow and red attachments.

Rehabilitation of congenitally missing teeth with precision attachment and fixed PFM bridge: Case reports

The definition of hypodontia is obvious and unambiguous: “one or additional congenitally absent teeth” it’s a genetic disease that denotes a stronger clinical expression of hypodontia, includes a wide and non-specific. To define oligodontia. The “absence of the many teeth, sometimes related to little size of the prevailing teeth and alternative anomalies”. The prevalence of genetic disease has been reported as zero.3%. It affects females the maximum amount as males, with a gender quantitative relation of 3:2.3. Genes accountable for non syndromic genetic disease area unit found to be MSX1 and PAX9 genes. Within the current edition of the glossary of dentistry Terms, the definition reads “the formation of less than full complete teeth. Several such teeth area unit smaller than normal”. Current article describe a case of genetic disease treated with jaw unilateral exactitude attachment on distal side of 11 and bar & clip maintained overdenture for the second quadrant with a 1 piece forged denture support of anterioposterior-palatal strap and mandibular complete arch rehabilitation with metal ceramic crowns.

Restoring Partially Edentulous Mandibular Arch Using Prefabricated Metal Posts, Extracoronal Precision Attachment and Computer-aided Design/Computer-aided Manufacturing Prostheses: A Case Report

Restoring Partially Edentulous Mandibular Arch Using Prefabricated Metal Posts, Extracoronal Precision Attachment and Computer-aided Design/Computer-aided Manufacturing Prostheses: A Case Report

Rehabilitation of Mandibular Partial Edentulous Arch Using Ceka Revax Semi-precision Attachment: A Case Report

There are many prosthetic treatments modalities in rehabilitating partially edentulous condition. It is a technically difficult task for any prosthodontist to treat partially edentulous condition because retention and stability are the two main problems. Attachments are available with small interlocking devices which connects prosthesis and abutments which improves retention and stability and esthetics. Ceka attachment can be used to obtain retention and stability for the prosthesis. A 48-year-old-female patient reported to the Department of Prosthodontics, Crown and Bridge with chief complaint of missing teeth with respect to teeth number- 12,13,14, 22,25,26,35,36,37,45,46,47. This case describes rehabilitating maxillary missing teeth and posterior edentulous mandibular arch using semi precision attachment (Ceka Revax Extracoronal Green). Precision attachments have two metal components which form an articulate joint with first component or matrix or keyway which is attached to clinical contours of a cast restoration and the second component of patrix is attached to the removable partial denture.This case required multidisciplinary approach, technical skills and treatment offered showed excellent patient acceptance and also met aesthetic demands too.

Mandibular overdenture retained with precision balls and bar attachment

Introduction. Milled precision bar with the lateral additions of two precision attachments could significantly contribute to the primary and secondary retention of partial denture and overdenture. This clinical case demonstrates stability of mandibular overdenture using milled precision bar and two coronally positioned precision attachments. Case report. A sixty-five years old male patient had two preserved canine roots in lower jaw. Semicircular metal-ceramic (PFM) bridge was previously fabricated for upper teeth. Decision for fabrication of milled bar and metal framework of overdenture was established due to the presence of PFM bridge in the upper jaw. The root canals of the two remaining mandibular canines were prepared for posts. After final mandibular impression using A-silicone in a custom tray, master cast with prepared canals of roots of canines was provided. Two posts connected with milled precision bar were designed. Coronal attachments-patrixs were positioned onto the tip of each coronal part of the construction with axial direction of precision attachments towards root canals. The construction was invested and casted. Metal framework of overdenture was designed and casted. After interocclusal record, the artificial anatomic teeth were selected and waxed model of overdenture with matrixes was provided for try-in clinical phase. Finally, the overdenture was flasked and polished. Metal construction of two posts and milled bar were cemented simultaneously with overdenture, using self-adhesive resin cement. Conclusion. Milled bar improves retention and stability of metal framework of overdenture. Coronally positioned patrix of attachment provides redirection of occlusal and other functional forces towards apical root parts.

Biting force of patients rehabilitated with Precision Attachments Unilateral Removable Partial Denture

Biting force of patients rehabilitated with Precision Attachments Unilateral Removable Partial Denture

Aesthetic and Functional Full Mouth Rehabilitation of a Patient Using Extra Coronal Attachments: a case report

Achieving aesthetic and functional requirements in full mouth rehabilitation using combined fixed and removable dentures is difficult. Strategic diagnosis and treatment planning are required to overcome this challenge. Numerous conventional and cutting-edge treatments can result in successful restorations. One such method of treatment is precision attachment retained partial dentures. Selecting strategic abutments is key to the success of the partial denture. This case report describes full-mouth rehabilitation of maxillary and mandibular arches using fixed and attachment retained cast partial dentures.

TOOTH SUPPORTED OVERDENTURES: COMPARISON OF DIRECT TECHNIQUE (RIGID) VERSES INDIRECT TECHNIQUE (RESILIENT) OF STUD ATTACHMENT

Several partially edentulous patients are advised extraction of sound teeth as these teeth are inadequate to provide support for a good prosthesis. An overdenture in such cases provides opportunity to preserve the sound teeth and still provide a successful prosthetic rehabilitation. Resilient precision attachments further provide additional advantage of improved retention and stability and their resiliency helps preserving the abutment teeth over a longer period of time. Various techniques are followed to fabricate and incorporate these attachments. This case report describes two partially edentulous patients rehabilitated with tooth supported overdenture by direct and indirect technique respectively.

Precision attachments

The lack of sta­bility and retention together with a decrease in chewing ability are the commonly problems experienced by many edentulous patients with their den­tures and removable partial dentures. To overcome this problem and the desire to balance between func­tional stability and cosmetic appeal gave rise to the development of Precision attachments. Precision attachments are small interlocking devices to connect prosthesis and abutments that offer a variety of solutions to the challenge of balance between functional stability and cosmetic appeal. Precision attachments have wide applications, used in fixed removable bridge, removable partial dentures, overdentures, implant retained overdentures, and maxillofacial prosthesis. This article discusses about the various precision attachments used in treating edentulous and partially edentulous patients.

Management of Long Span Kennedy’s Class IV Situation with a Fixed Removable Entity

The treatment modality for treating a patient within the Kennedys class IV with long edentulous span situation demands biomechanical level of balance followed by good aesthetics. The long edentulous span complicates the matter due to the unavailability of sufficient number of abutments to support the synthetic oral prosthesis. Conventional removable prosthesis is not advised for an equivalent reason. This case report describes a way for the fabrication of a custom attachment to retain prosthesis. A cast partial removable denture is retained by a custom attachment. The patrix a part of the custom attachment is fabricated using castable semi precision attachment Rhien 83. The matrix a part of the attachment is fabricated using castable precision attachment 83 which is constituted by embedding inside the tissue-fitting surface of the prosthesis. This manuscript describes custom attachment for rehabilitating the long-span Kennedy class IV situation.

Rehabilitation of partially edentulous arch using semi precision attachment: an aesthetic approach

The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth. In such situation, a fixed removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene and better postoperative care and maintenance. Prime function of attachment retained partial denture is to distribute the masticatory forces to the wide area thereby reducing the damage to the abutments, soft tissues and bony ridges in addition to improved esthetics and proprioceptive responses. In this case series patient’s esthetic and functional requirements were fulfilled with attachment retained cast partial denture using semi-precision attachments

Evaluation of Incorporating Bracing Arm in Precision Attachment Evaluation of Incorporating Bracing Arm in Precision Attachment Unilateral Removable Partial Denture

Purpose: This Randomized Control Trial study aimed to compare between two designs of Precision Attachment Unilateral Removable Partial Denture, one conventional design and the other modified with bracing arm and mesial rest. Materials and Methods: twenty male patients having Kennedy Class II mandibular edentulous ridges received the two designs in a split mouth study for a follow-up period of eighteen months. Probing Pocket Depth around abutment was measured. A standardized radiographic technique was used to evaluate bone height changes. Results: The results showed insignificant pocket depth and bone height changes in the two groups. Conclusion: Precision Attachment Unilateral Removable Partial Denture proved to be a viable treatment therapy in treating unilateral edentulous ridges

EVALUATION OF BALL TYPE PRECISION ATTACHMENT FOR LOWER CLASS I KENNEDY CLASSIFICATION USING NEW COMPUTERIZED METHOD

Introduction: Several types of attachments are accessible and they have been broadly used with removable partial/complete denture prosthesis, segmented fixed prosthesis. Yet, no single attachment is ideal for every case, so that the appropriate attachment should be selected for each individual situation. Objectives: To evaluate clinically the effect of using evaluation of ball type precision attachment for lower class I Kennedy classification using new computerized method (Image J program) by using panoramic x-ray and its effect on the bone height and changes at different sites. Material and Methods: Twelve patients ranged from 45-60 year old. Patients complaining from pain in some teeth, inability to masticate, chewing food and unsatisfactory esthetic. There are multiple missing teeth, the lower arch of the mandibular jaw is class I Kennedy classification without modification, fabrication of upper metallic casted partial denture and lower ball type precision attachment for lower bilateral distal extension Kennedy class I classification. Possessing of the upper and lower prosthesis, finishing, polishing and instruction for the patient. Results: By comparing between gender grouping by using ball type attachment, showed that the vertical height in the edentulous women were lower than that of the men. The statistical difference was evaluated with a P < 0.05 through t-test which detected between different groups. Conclusions: The use of ball type attachment for removable partial denture provide good retention support and stability of the partial denture improving function ability of mastication, showing and good esthetic acceptance for both gender groups.

English

The main aim of prosthetic dentistry is restoring the form, function, comfort and appearance of the patient by the placement of a prosthesis replacing the missing teeth and contiguous tissues.1 Various prosthetic options for partially edentulous patients include an interim removable partial denture (RPD) to a cast partial denture, a fixed dental prosthesis (FDP), and a more implant-retained prosthesis. However, FDP and implant-retained prosthesis are not always feasible, particularly in patients with excessive residual ridge resorption and jaw defects due to trauma and / or surgical ablation. In such a situation, a dentist may resort to another option of fixed-RPD prosthesis, to restore the defective hard and soft tissues to achieve natural aesthetics, phonetics, comfort, and better hygiene. This hybrid prosthesis fulfils the objectives of the rehabilitation such as support, stability, and retention characteristics similar to a fixed prosthesis and aesthetics and hygiene maintenance of a removable prosthesis.2,3,4,5 Any prosthesis designed or fabricated should be based on the prosthetic principles of support, stability, retention, and preservation of remaining structures.1 From the patient's perspective, retention is one of the important factors for its acceptability. These retentive options range from simple bar and clip attachments to more sophisticated spark erosion overdentures.6,7 Spark erosion prosthesis is technique sensitive, bulky, and requires expensive equipment.6,7 On the other hand, precision attachments provide better vertical support and stimulation to the underlying tissue through intermittent vertical massage.8 Treatment with a hybrid denture is an affordable choice to fulfil the patient's aesthetic demands along with providing a good prognosis for the prosthesis and preservation of the remaining dentition. This article presents two case reports of prosthodontic rehabilitation of a patient with mandibular defects using an attachment-retained fixed-removable hybrid prosthesis.

Stress Analysis of Implant-Supported Removable Partial Denture with Anterior Fixed Prostheses and Conventional Implant-Supported Overdentures in the Edentulous Mandible

Aim: To compare new design implant-supported removable partial dentures retained with anterior fixed prosthesis with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Materials and Methods: Seven edentulous mandibuler acryclic models prepared and divided into two main groups; two to four implant models, subgroup separation as stated; for two implant models overdenture with locator attachment, crown design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with precision attachment retention; and for four implant models prosthesis with bar attachment overdenture, fixed bridge design retained removable prosthesis with clasp retention, fixed retained removable prosthesis with precision attachment retention. A 300 N load was applied to the first premolars. Photoelastic stress analysis method that is a specific method concerning stress visualization, and does not require statistical analysis, was used. The stress distributions were seen in optically using a poloriscope. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. Nonsplinted implants caused high stress around the distal implant on the loading side. Conclusion: The stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design show lower stress distributions compared with bar retained prosthesis. These dentures appear to be advantageous in terms of stress transmission.

Treatment of Class I Kennedy lower jaw with precision attachment

Background: Rehabilitation of Kennedy Class I edentulous involves a variety of treatment alternatives such as overdenture, metal frame removable partial denture, RPD with precision attachment and implants. The combination of RPD and fixed dent-ture using precision attachment or semi-precision is one of the best forms of RPD. Case: A 59-year-old male came to the RSGM FKG UI clinic. He wants to have new denture to eat more comfortable and improve his appearance. Management: Anamnesis, extra-oral and intra oral examinations, and panoramic x-ray were performed. After that, bridge was removed, periapical x-ray and definitive treatment was determined using metal frame RPD in upper jaw and RPD with precision attachment in lower jaw. Conclusion: Patient feels satisfied and comfortable with his dentures both in upper and lower jaw with precision attachments.

Cast partial denture with attachment: a preventive prosthodontics

Cast partial dentures is one of several treatment options that can be applied to rehabilitate partial edentulism with distal extension. Cast metal as a denture base exerts stimulation to the underlying tissue, thus prevents alveolar atrophy. However, one of the disadvantages of partial dentures with metal framework is the obviously visible retentive components attached to it, which could interfere with esthetics. This problem could be solved by using precision attachment that helps improving the esthetics, retention, stability and durability of the denture. There are two types of attachments, namely the intracoronal and extracoronal attachments. In this article, extracoronal attachments were used because they provide better esthetics.

Rehabilitation using semi-precision attachment in fixed partial denture

The desire to balance between functional stability and cosmetic appeal in partial dentures gave rise to the development of precision attachments, since then, precision attachments have always been surrounded by an aura of mystery. A 35-year-old patient reported a chief complaint of missing upper anterior teeth and wants their replacement. Examination revealed the congenitally missing first and second premolars in the maxillary arch bilaterally, and canines were at first premolar place, which were brought there orthodontically. The patient was planned for 5-unit fixed partial denture from lateral incisor to first molar with semi-precision attachment distal to canine bilaterally, and canines were decided to be converted into the first premolar bilaterally. In this case, it was decided to use the semi-precision attachment and it was procured from Sterngold company, USA. Semi-precision attachments are used to reduce the detrimental stresses and excessive torque on pier abutment, thereby maintaining its health. The decision to use precision attachments in partial denture design should be carefully considered. It is alright to consider such sophistication where the facilities for this precise laboratory work and knowledge of using semi-precision attachment are available.