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Arjun Dhiman
Content
Introduction
Support
Factors affecting support for distal extension
partial denture
Introduction
Class I: bilateral edentulous areas
located posterior to the natural teeth
Class IV:
SUPPORT
Resistance
to
the
vertical
components of masticatory force
which prevents the partial denture
from being displaced toward the soft
tissue
both
are
important
for
Mandible
Lining mucosa restricts both lingual and
CREST CANCELLOUS
Maxilla
CREST CANCELLOUS
Oral tissues firm , dense nature
(similar to mucosa of hard palate)
Anatomic
Functional
Dual impression
technique
Physiologic or
functional
Selective tissue
placement impression
techniques
Not only equalizes support but
has an added advantage of
directing forces to areas most
capable of withstanding the
force
Movements of distal
extension base
Components of partial
design
3 Essentials of design:
Support
Connectors
Retainers
Support :
resistance to vertical force.
During
function
,
force
is
transmitted through saddles of
partial denture and is ultimately
resisted by the bone.
Connectors
Major connector
Location:
MC should be free of movable tissue
Impingement of gingival tissue should be avoided
Bony and soft tissue prominences should be avoided
during placement and removal.
Relief should be provided beneath a major connector to
prevent its settling into areas of possible interference,
such as inoperable tori or elevated median palatal sutures.
MC should be located and or relieved to prevent
impingement of tissue because the distal extension
denture rotates in function.
The part of the framework adjoining the tooth surface
should be hidden in embrasures to avoid discomfort
Intentional relief:
maxillary-6mm
mandibular-3mm
Design
procedures for
maxillary major connector
(Blatterfien 1953)
Criteria of selection.
1. Requirement for indirect retention
2. horizontal stability and stress distribution.lingual
plate and double lingual bar
4. Esthetics
5. Phonetics considerations
6. Patient preference factor.
Minor connector
Minor connector should be rigid for distribution of forces
MiC
Form
and
location:
It should be located
in embrasure where
it will be least
noticeable to the
tongue
It should be thickest
towards the the
lingual
surface,
tapering
towards
the contact area
Retainers
Direct retainer
Indirect retainer
Direct retainers
A direct retainer is any unit of a removable
partial denture that engages on abutment tooth
in such a manner as to resist displacement of
the prosthesis away from basal seat tissues
To
retain
prosthesis
against
reasonable
dislodging forces without damage to abutment
teeth
when
denture base moves tissue ward under function.
Thus the retainer may act as a stress breaker
Tripod configuration
Used primarily for class 2 arches.
Bilateral configuration
Used in class 1 cases.
In this configuration the
clasps exert little
neutralizing effect on the
leverage induced stresses
generated be the denture
base. These stresses must
be controlled by other
means.
Quadrilateral
configuration
Is indicated in class 3
A retentive clasp is
positioned on each
abutment tooth adjacent
to the edentulous spaces.
RPI CONCEPT
Rest, Proximal Plate & I bar concept
They are
An occlusal rest arising from a
minor connector on the side of
abutment
away
from
edentulous space
Purpose
This clasp configuration was designed to allow
extension base removable partial denture some
degree of tissue ward rotational freedom without
torque to the clasped teeth
Indirect retainers
The component of removable partial denture that assists
the direct retainer in preventing displacement of the
distal extension denture base by functioning through
lever action on the opposite side of the fulcrum line
when the denture base moves away from the tissues in
pure rotation around the fulcrum line.
Class 1.
It must always be
used and positioned
as far anteriorly as
possible.
Class 2
its use is not as critical as in
class 1
definite
rest seat
positioned
even
farther
anterior ,if possible, may
increase the effectiveness of
the indirect retention.
Denture base
denture base should cover maximum area of the
supporting tissue as possible
Stress breakers
A device which relieves the abutment teeth of
all or part of the occlusal forces. -- GPT.
Group II
Devices with
hinges, sleeves,
cylinders or ball and
socket joint.
Harmonious
Methods of establishing
occlusion
Functionally generated pathway technique
Articulator or static technique
Steps:
Analysis of existing occlusion
Correction on existing occlusion disharmony
Recording of the functional dynamic occlusion
Procedure :
directly under supervision of dentist
At home, movements performed and evaluated by
dentist after 24 hours
Advantages:
Easy approach
Eliminates recording of interocclusal relationship &
transferring to articulators
No use of face bow
Disadvantages:
Occlusion in one arch must be formulated before other
Movement of distal extension base results in inaccurate
recording
Verification of pathway is difficult
Static / articulator
technique
Determination of vd
Determination of horizontal jaw relationships
Centric relation & intercuspal position coincides
with no evidence of occlusal pathology
Limitations:
Exaggerates existing Occlusal disharmony
Maxillary Complete
Denture
Opposes
The
Removable
Partial Denture.
Bilateral
occlusion
positions
However
in
balanced
eccentric
simultaneous
contacts in a protrusive
relationship
do
not
receive
priority
over
appearance , phonetics,
and or a favourable
occlusal plane.
Mandibular
Distal
Extension
Denture
Working
side
contacts.
These
contacts
should
occur
simultaneously with
working
side
contacts
of the
natural
teeth
to
distribute the stress
over the greatest
possible area
formulated
for
the
Summary
Design Principles for distal extension cases
For Class I
1. Clasps
2 clasps on each terminal tooth are sufficient.
For distobuccal undercut a vertical projection clasp is
indicated
For mesiobuccal undercut wrought wire clasp.
Reciprocal arm should be rigid. Can also be replaced
with lingual plate.
For Class II
1. Clasps
Usually 3 clasps are designed.
The distal extension side can be designed similar to
Class I
The tooth supported, or modification side should have
two retentive clasps:
cleanliness,
and
6. Occlusion
Centric relation and occlusion should coincide.
Artificial teeth should be positioned to reduce stress.
Positioned to enhance comfort, direction of stress along long
axis, and efficiency of mastication.
7. Denture Base
Broad coverage for equal stress distribution.
Borders should not interfere with the functional movements of
the tissues.
References
McCrackens Removable Partial Denture Alan
B. Carr, Glen P. McGivney