Occlusion of artificial teeth in partial dentures in the "chewing center"--first exploratory population-based evaluations.

Occlusal performance is a substantial determinant of the quality of dental prosthetic restorations. In the follow-up (SHIP 1) to the Study of Health in Pomerania (SHIP), a representative population of 3300 subjects was studied in the first exploratory evaluation of the occlusion of artificial teeth in the chewing center (first molar region) of partial dentures. A digital analysis of interocclusal records of habitual intercuspation position (ICP) was performed using the Greifswald Digital Analyzing System (GEDAS), a software package that identifies contact points as transparent areas. 562 subjects (280 men aged 61.7 ± 11.9 years and 282 women aged 60.7 ± 10.7 years) had maxillary removable partial dentures (RPDs), and 619 (271 men aged 65.0 ± 11.5 years and 348 women aged 62.4 ± 10.6 years) had mandibular RPDs. Most RPDs were retained with either attachment retainers (11.7% maxilla, 11.7% mandible), cast clasps (38.4% maxilla, 40.7% mandible), telescopes with double crowns (15.7% maxilla, 19.1% mandible), or wrought wire clasps (16.4% maxilla, 8.2% mandible). Some had a combination of different retention elements. The mean number of artificial teeth was 7.8 ± 2.9 in the maxilla and 7.5 ± 3.0 in the mandible. Only the artificial teeth (first molars) in mandibular partial dentures showed differences in the frequency of occlusal contacts between groups (chi-square test). Of these, telescopic crown-retained RPDs had the highest frequency of occlusal contacts (74.4% at tooth 36 and 77.1% at tooth 46), and wrought wire-retained RPDs had the lowest (48.4% at tooth 36 and 45.2% at tooth 46). The results for RPDs with a free-end saddle were comparable and analogous; contact frequencies for those with an interdental saddle did not differ significantly. Notably, the overall frequency of occlusal contacts was greater for tooth 46 (62.9%) than for tooth 36. In conclusion, when replacing teeth in the chewing center, particularly in the mandible, telescopic crown-retained RPDs offer a distinct advantage in terms of occlusal contacts and thus provide better occlusal stability.

A survey of removable partial denture casts and major connector designs found in commercial laboratories, Athens, Greece.

PURPOSE: This survey was conducted to study the prevalence of partial edentulism, the type of removable partial denture (RPD) support, the type of major connectors, and the frequency of their use in relation to the partial edentulism classes encountered, concerning patients in Athens, Greece. MATERIALS AND METHODS: The material comprised 628 final casts for RPDs. Each cast was photographed in a way that would allow the number of existing teeth, the classification of partial edentulism, the RPD support, and the particular parts of the metal framework to be identified. Data collected were analyzed statistically using prevalence tables and the χ(2) test. RESULTS: Two hundred seventy six (43.9%) casts were for the maxilla and 352 (56.1%) for the mandible. The most frequently encountered group was Kennedy class I for both arches, while class IV was the classification least encountered (p < 0.001). Of all RPDs constructed, 96.8% had a metal framework (tooth-borne and tooth/tissue-borne), while 3.2% of the RPDs were frameless (tissue-borne, acrylic dentures). The U-shaped palatal connector (horseshoe) in the maxilla and the lingual bar in the mandible were the most frequently used for all partial edentulism classes, at 55.2% and 95%, respectively. CONCLUSIONS: Analysis of the casts revealed that the type of major connectors selected does not comply with the indications for their applications, considering the lack of dental history and clinical examination. This notes the need for further training dentists and dental technicians in aspects of RPD framework design.

Prevalence of removable partial dentures users treated at the Aracatuba Dental School-UNESP.

OBJECTIVES: The aim of this study was to evaluate the frequency of removable partial dentures (RPD) at the Aracatuba Dental School. METHODS: The study was conducted by analysing 412 clinical history of patients attended at the RPD clinics in the period from 2000 to 2007. RESULTS: 412 charts were analysed: 148 (35.9%) men and 264 (64.1%) women. The mean age was 53.8 years (men) and 52.4 years (women). A total of 556 dentures were made; of these, 233 (41.90%) were maxillary and 323 (58.09%) were mandibular dentures. The most frequent Kennedy classification found was Class III (maxilla) and Class I (mandible). In the maxilla, 55% (126) of the major connectors were of the anterior-posterior palatal bar, while in the mandible, 64% (202) were the lingual bar. As regards the claps, 401 were circumferential and 318 were bar claps. CONCLUSION: The mean age of the patients was 52.9 years with higher prevalence of female patients; the most frequent Kennedy's classification was Class I in mandible and Class III in maxilla; the most common major connector was anterior-posterior palatal bar for maxilla and lingual bar for mandible; the circumferential clasps were the most common retainer used in both jaws.

Survey of partial removable dental prosthesis (partial RDP) types in a distinct patient population.

STATEMENT OF PROBLEM: Current demographic information on the number and types of removable partial dentures is lacking in the prosthodontic literature. PURPOSE: This study was designed to investigate patterns of tooth loss in patients receiving removable partial dentures (RPDs) in eastern Wisconsin. MATERIAL AND METHODS: Digital images (1502) of casts at 5 dental laboratories in eastern Wisconsin were collected. Any prescription requesting fabrication of a removable partial denture was photographed twice. The first photograph was made immediately upon arrival at the laboratory, while the second photograph was made immediately before being returned to the prescribing dentist for the first time. A calibrated investigator analyzed all the photographs for Kennedy Classification, type of RPD, major connector, and other details. Data were analyzed with descriptive statistics. Fisher's exact test was used to confirm repeatability. RESULTS: Kennedy Class I was the most common RPD with a frequency of 38.4%. More than 40% of prescriptions had no design input from the dentist. One in 3 RPDs used acrylic resin or flexible frameworks. One in 5 RPDs had no rests. The horseshoe major connector was the most common maxillary major connector, while the lingual plate was the most common in the mandible. CONCLUSIONS: RPDs remain a common prosthodontic treatment in this region. Non-metal RPD frameworks are a common treatment type and rarely include rests. These data indicate a changing partially edentulous patient population and a variable commitment to standard levels of prosthodontic care.

Clinical methods for adjusting retention force of cast clasps.

Careless adjusting methods to increase or decrease retention by grinding, polishing, or bending the clasp arm can lead to instability of the removable partial denture, damage to the surrounding tissues, and fracture of the clasp arm. This article describes systematic evaluation criteria and adjusting methods of retention force of a cast clasp. Excessive retention can be reduced by using a proper adjustment method, which depends on the cause. Poor retention can be increased temporarily, but it will decrease again. Evaluations and adjustment of poor retention will contribute to the diagnosis of the cause and will establish clinical and laboratory procedures that will lead to making clasps with proper retention in the future.

Finite element analysis of the effect of vertical curvature on half-oval cast clasps.

High stresses in half-oval cast clasps are the main causes of deformation or fracture. A vertical curvature in clasps is said to be effective in reducing stress. However, such claims lack scientific basis. The purpose of the present study was to evaluate stress and stiffness in a three-dimensional (3D) finite element analysis (FEA) model of clasps with different vertical curvatures, cross-sectional forms and tapers, and to clarify the effect of vertical curvature on the half-oval cast clasp. Circumferential clasp arms for the mandibular second premolar were analysed by 3D FEA. The clasp arms were approximated by curved cantilever beams with a half-oval cross-section around a cylinder. The radius of curvature was set at 4 mm and the angle subtended by the clasp arm was 120 degrees. The clasp tip was set at a point 2 mm lower than the base. In the 'No-taper' half-oval clasp arm, stress increased and stiffness decreased with the increase in vertical curvature. In the shape of a preformed wax pattern (thickness/width = 0.80, tip/base = 0.70), stress and stiffness decreased slightly. In an 'Original' form (thickness/width = 0.33, tip/base = 0.80), vertical curvature had a very slight effect on stress and stiffness, and stress was the lowest. These findings suggest the superiority of the 'Original' form, with less stress and no effect of vertical curvature.

Evaluation of stresses and forces in selected I-bars using the finite element method.

PURPOSE: Three-dimensional models of half-round, tapered and full-round, untapered I-bar clasps of varying configurations and material properties were constructed. The purpose of this study was to examine the stresses and reaction forces produced within each model upon deflection to 0.01 in (0.254 mm), 0.02 in (0.508 mm), and 0.03 in (0.762 mm) at 1 mm from the tip using the finite element method. MATERIALS AND METHODS: Three-dimensional computer models of half-round and full-round clasps were constructed using solid eight-node brick elements. The half-round, tapered I-bar clasp model was 2.4 and 1.4 mm in diameter at the base and tip, respectively. The full-round, untapered I-bar clasp model was 1 mm in diameter. Three design groups were created for each clasp form. Group A had 25% of the total length in the straight anchor end of the I-bar clasp, B had 35%, and C had 50%. All models were 31 mm in length and had a radius of curvature of 5 mm. Different material properties were incorporated into the models. Each model was deflected at a point 1 mm from the tip to 0.01 in (0.254 mm), 0.02 in (0.508 mm), and 0.03 in (0.762 mm). RESULTS: The stresses and forces produced as a result of the deflection applied to each clasp were viewed and displayed graphically. The maximum von Mises stresses in megapascals and the reaction force in newtons (N) were recorded. Stresses varied in each clasp in the range of 0 to 154.3 MPa for the half-round, tapered I-bar clasp models, and 0 to 100.9 MPa for the full-round I-bar clasp models at 0.01-in deflection. Reaction force measured near the tip of the clasp models was between 1.60 N and 6.31 N for the half-round, and between 0.22 N to 2.13 N for the full-round I-bar clasp models. For all clasps studied, as the deflection increased, the location of stress within each group remained the same regardless of the material properties; however, the stress and force values increased linearly. CONCLUSIONS: The location of maximum stress varied with the length of the anchor portion of the clasps studied. Maximum stresses were located on the flat side of the half-round, tapered I-bar clasp model.

Fatigue resistance of titanium-nickel alloy cast clasps.

In this study fatigue resistance of experimentally prepared titanium-nickel (50.8% nickel and 49.2% titanium) cast clasps was evaluated in a simulated clinical situation. The change in force required to remove the titanium-nickel clasps was recorded under a repeated placement-and-removal test on steel model abutment teeth. Commercially-pure titanium, cobalt-chromium alloy, and gold-silver-palladium-copper alloy clasps were also tested for comparison. The tips of the clasps were located in the 0.25- and 0.50-mm undercut areas of the abutments. No significant changes in the retentive force were found in titanium-nickel clasps in the 1,010 repeated cycles, whereas the other three types of clasp revealed a significant decrease in the force required for removal during the test procedures (repeated analysis of variance P < 0.001). The results suggest that the cast titanium-nickel clasp may be suitable in removable prosthodontic constructions because of its significantly less permanent deformation during service. This report also discusses clinical applicability and some current problems with this new application.

Incidence of various classes of removable partial dentures.

The purpose of a classification for removable partial dentures (RPDs) is to simplify identification and enhance its teaching. A classification also allows a longitudinal comparison of various classes of RPDs to determine whether the teaching of RPD design is consistent with the relative frequencies of RPD use. This study surveyed the types of removable partial dentures being fabricated in a regional dental laboratory and compared these findings with data from previous studies. Results indicate that mandibular RPDs are more common than maxillary RPDs and the class I mandibular RPD is the most common type of RPD for either dental arch. A palatal strap was the most frequently used maxillary major connector and a lingual bar was used three times more often than a lingual plate in the mandibular arch. Cast circumferential clasps were used twice as often as RPI clasp designs. The percentage of Kennedy class I RPDs was 40%, class II 33%, class III 18%, and class IV 9%. Comparisons with a previous study indicate the percentage of Kennedy class II has increased, whereas class I, class III and class IV RPDs have not changed significantly. Findings of the study indicate that the frequency of use of the various types of RPDs have changed in the past 30 years.

Statistical investigation of lower distal free-end denture design used by general practitioners in Japan.

Tooth loss eventually occurs in most adults, and masticatory function is restored with a prosthesis such as a fixed crown & bridge, removable partial denture (RPD), or complete denture according to the extent of loss. For the RPD there are different structural-element combinations and different designs that can be applied to the same loss pattern, so that the effect and prognosis vary. Results from a statistical investigation of removable distal free-end dentures in Japan suggested that in many cases, insufficient consideration was given to mechanical stability and protection of remaining peripheral tissue in the design of removable partial dentures.