Removable Partial Dentures (Quintessentials of Dental Practice)
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In recent years, the context of clinical partial denture provision has changed due to demographic changes, availability of alternative treatments and a growing evidence base for their long-term effectiveness. This book reviews these influences and presents a systematic, effective approach to removable partial denture provision.
clenched load on tooth-borne dentures is approximately half that on natural teeth suggest that they are not particularly effective. There is no convincing evidence to suggest that one design or position of a rest is more effective than any other. Clinical testing of such theories has been infrequent, contradictory and is possibly of limited clinical value. Pragmatically one simply uses the abutment teeth available, even severely periodontally weakened teeth can provide useful support. When this
of augmenting retention as the labial flange and the distal surface of the last molar are often undercut with respect to each other. Fig 7-9 The Every denture demonstrating clearance of the gingival margin, open saddle–abutment relationship and stainless steel arms making point contact on the distal surfaces of the last standing molar teeth. Clearance of the gingival margin makes this design useful, in particular, for those patients undergoing extensive periodontal therapy but who require
a result of overloading the impression material. • Poor recording of the lingual sulcus due either to inadequate modification of the tray or because the tongue was not elevated and forward when taking the impression. • Deficiency in the labial sulcus. The mouth was open too wide when the tray was being seated. The lip was not relaxed and lifted forward to allow impression material to flow into the sulcus. Preliminary Design Registration and Denture The objectives of this stage are to: •
There is good evidence to suggest that the dentist’s and patient’s view of what is or is not a satisfactory appearance can differ markedly (Fig 1-4). The key factor is, of course, the patient’s opinion and this is strongly linked to what they perceive is an acceptable appearance in their social environment, a concept of social ease and acceptability well described by social scientists as “passing”. The age of the patient does seem to influence the importance attached to appearance. For younger
connector is normally decided when the denture design is finalised and, in the lower arch, may sometimes be delayed until the working impression has been recorded. Suggestion Place rests at both ends of a bounded saddle. For lower free-end saddles, mesial placement of the rest is preferred. Step 2 Position the cast on the surveyor table with the occlusal plane approximating the horizontal (Fig 9-3). 182 Fig 9-3 Step 2: The cast positioned on the cast table with its occlusal plane horizontal.