A technique for fabrication of an extracoronal attachment-retained removable partial denture to fit an existing fixed partial denture

Precision attachments have been used for many years to retain removable partial dentures (RPDs). Common reasons for a failed attachment-retained RPD are fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention. When an RPD framework major connector has been fractured, it should be remade. This article describes a technique to remake a fractured mandibular RPD using cast round profile attachment analogs without the need for replacement of the fixed partial denture.     

Distal implants to modify the Kennedy classification of a removable partial denture: a clinical report

Dental implants or precision attachments can be used to resolve the bilateral distal extension removable partial denture (RPD) dilemma. This report describes the fabrication of a mandibular implant-supported chromium-cobalt RPD with a combination of bilateral single molar implants and metal ceramic crowns using the principles of the channel-shoulder-pin system. The maxillary arch was restored with splinted metal crowns and a conventional RPD retained by extracoronal precision attachments.     

Maxillary Rehabilitation Using Fixed and Removable Partial Dentures with Attachments: A Clinical Report

Despite requiring dental crown preparation and possible root canal treatment, besides the difficulty of clinical and laboratory repairs, and financial burden, the association between fixed (FPD) and removable partial dentures (RPD) by means of attachments is an important alternative for oral rehabilitation, particularly when the use of dental implants and FPDs is limited or not indicated. Among the advantages of attachment‐retained RPDs are the improvements in esthetics and biomechanics, as well as correction of the buccal arrangement of anterior teeth in Kennedy Class III partially edentulous arches. This article describes the treatment sequence and technique for the use of attachments in therapy combining FPD/RPD.     

Precision attachment-retained removable partial dentures. Part 3. General practitioner results up to 2 years

PURPOSE: The aim of this study was to analyze the techniques, production problems, and 2-year results of attachment-retained removable partial denture (RPD) treatment provided by general practitioners in Sweden. MATERIALS AND METHODS: At a major dental laboratory, consecutive cases involving new production of crowns, or of fixed partial dentures (FPDs) and RPDs retained with precision attachments, were studied. Parameters of the dentition, crown or FPD, type and brand of attachment, etc, as well as early satisfaction by dentist and patient, were recorded using specially designed forms at the dental laboratory and questionnaires for the dentists. After 2 years, questionnaires were again sent out to the dentists to record complications and patients' and dentists' opinions of the results. The sample gathered totaled 83 constructions. After 2 years, responses for 57 patients, all of whom had distal-extension RPDs, were received. Most drop-outs in the study were explicable. RESULTS: The most frequently cited reasons for using attachments were esthetics and need for crowning the teeth abutting the RPD. McCollum rigid slide attachment was the predominant brand used (43% of constructions). Dentists and patients were dissatisfied with 6% of the constructions. During the first 2 years, 22 of 57 constructions were complication-free. Seventeen had attachment complications and 9 had serious complications related to the abutment teeth or RPDs. A comparison between these 2 groups revealed that those with complications had every second abutment root-canal treated and a root post, while the group without complications had every fifth abutment root-canal treated. CONCLUSION: There were many technical and biotechnical complications and failures; the exact ratio, however, depended on the definition of "complications" and "failure." The 2-year results also deviated considerably from the dentists' opinions of the early results.     

Design of removable partial dentures: a survey of dental laboratories in Greece

The aim of this study was to compare data on design and fabrication methods of removable partial dentures (RPDs) in two major cities in Greece. A questionnaire was sent to 150 randomly selected dental technicians. The participation rate was 79.3%. The anterior palatal strap, the lingual bar, and the Roach-type clasp arm designs were preferred. Half of the RPDs fabricated were retained using precision attachments. Differences between the two cities were observed in types of major maxillary connectors used, types of attachments and impression materials used, as well as the design of distal-extension RPDs. Postdoctoral education was found to have an impact on RPD fabrication. Despite the differences observed, design and fabrication of RPDs followed commonly used principles.     

插销式附着体的临床应用

目的 探讨插销式附着体在双侧远中游离端局部活动义齿中的固位和稳定性。方法 制作带有插销式附着体底座的基底冠,并通过平行研磨仪确定附着体的工仙就位道。结果 以插销式附着体为固位体的双侧远中游离端局部活动义齿的固定和稳定性高于普通三臂卡环为固位体的义齿。结论 插销式附着体是一种结构简单,固位和稳定性较好的固位体。值得临床推广应用。     

Radicular Stud Attachment: An Alternative to Improved Retention and Esthetics

With the increasing demand and popularity of dental implants, the use of removable partial dentures in replacing missing teeth has become less popular. One of the obvious limitations of RPD is the unsightly view of metal used for the retentive clasp and the difficulty in obtaining a good fit. This case report describes the use of a radicular stud attachment as an alternative method to obtain improved retention and esthetics.     

游离端义齿修复中太极扣附着体对基牙牙周的影响

目的研究单侧后牙游离缺失修复中太极扣附着体对基牙牙周健康的影响。方法选择肯氏Ⅱ类缺损患者20例,采用太极扣附着体修复。纵向观察修复前、修复后2周、修复后6个月第一、二、三基牙的牙周指数及牙槽骨吸收情况,并进行统计学分析。结果太极扣附着体修复后牙游离缺失后2周和修复后6个月内,义齿稳定,固位良好。第一、二、三基牙牙龈指数、菌斑指数、探诊深度在治疗前、修复后2周之间的差异,以及治疗前、修复后6个月之间的差异均无统计学意义;基牙X线根尖片未见根尖病变,未见明显牙周膜增宽、牙槽骨吸收或高度降低;修复前基牙的松动度在进行联冠修复后有所降低。结论太极扣附着体应用于游离端义齿修复对基牙牙周健康未见不利影响。     

精密附着体固位型可摘义齿

目的:介绍精密附着体固位型义齿的设计原则,制作方法,评价其临床效果。方法:采用Bredent球状和杆状精密附着体系统,为21名患者设计制作了30件义齿,53副精密附着体。结果:最长者经3年零10个月观察,临床效果良好。结论:患者戴用该型义齿后,咀嚼功能好,稳固、摘戴方便、美观舒适,基牙无病变     

Removable partial denture abutments restored with all-ceramic surveyed crowns.

All-ceramic crowns are used as alternatives to conventional metal-ceramic crowns for the restoration of single teeth. Traditionally all-ceramic restorations possessed physical properties that contraindicated their use in many treatment situations. The strength that zirconia ceramics exhibit seems to support the hypothesis that, in specific situations, an all-ceramic crown may be used to restore removable partial denture (RPD) abutments in areas previously reserved for metal or metal-ceramic restorations. Abutments for RPDs may now be fabricated with Procera AllZirkon with the classically prepared guide planes and rest seats. This article provides an overview of a technique for the fabrication of a zirconia-based crown to be used in conjunction with removable partial dentures using the Procera CAD/CAM technology.     

Combined prosthodontic and orthodontic treatment of a patient with a Class III skeletal malocclusion: a clinical report

This clinical report describes a multidisciplinary approach for the treatment of a patient with Angle Class III skeletal malocclusion and decreased occlusal vertical dimension. An overlay removable partial denture (ORPD) was used to reestablish the occlusal vertical dimension (OVD). After the trial and adjustment period, the reduced lower anterior dentofacial height was orthodontically increased and the negative horizontal overlap was corrected. A maxillary precision attachment RPD and a mandibular fixed partial denture and metal ceramic crowns were fabricated to satisfy esthetic and functional requirements.     

Stress distribution of abutments and base displacement with precision attachment- and telescopic crown-retained removable partial dentures

Five types of removable partial dentures (two attachment dentures, two telescopic dentures and one clasp denture) were designed. The two attachment dentures were retained by the rigid-precision attachments with or without a stabilizing arm, and the two telescope dentures were retained with cone telescope crowns with or without cross-arch stabilization. The stresses acting on abutment teeth and denture bases and the movements of denture bases were investigated, and the influences of denture design were clarified. The stress acting on a terminal abutment tooth retained by a rigid-precision attachment or cone telescopic crown was larger than that acting on a terminal abutment tooth retained by a clasp. The attachment dentures tended to concentrate more stress at the terminal abutment tooth than did the telescopic dentures. The stress of denture base of an attachment denture and a telescopic denture was less than that of a clasp denture. There was no difference between the stresses of attachment and telescopic dentures. The displacement of the denture base tended to be less when the denture was designed with a rigid connection for the retainer and with cross-arch stabilization.     

Esthetic removable partial dentures

This article provides information regarding the many ways that removable partial dentures (RPDs) may be used to solve restorative problems in the esthetic zone without displaying metal components or conspicuous acrylic resin flanges. The esthetic zone is defined and described, as are methods for recording it. Six dental categories are presented that assist the dentist in choosing a variety of RPD design concepts that may be used to avoid metal display while still satisfying basic principles of RPDs. New materials that may be utilized for optimal esthetics are presented and techniques for contouring acrylic resin bases and tinting denture bases are described.     

A telescopic crown concept for the restoration of the partially edentulous arch: the Marburg double crown system

PURPOSE: This article describes the concept of the Marburg double crown system (MDC system) in the treatment of partially edentulous patients. Long-term success is assessed by a review of patient records. MATERIALS AND METHODS: Double crowns with clearance fit are used to retain tooth-, mucosa-, and implant-supported removable partial dentures (RPD). To achieve retention, an additional attachment, the TC-SNAP system, is used. All metal components are fabricated in a single cobalt-chromium-molybdenum alloy; the framework (including outer crowns) is cast in one piece. Because of the framework's rigidity, the RPD can be constructed without major and minor connectors. The denture base adjacent to the abutments is fabricated using a perioprotective design that is similar to fixed partial dentures. One hundred eleven dentures, of which 49 (44%) were fabricated for patients with intraoral defects, were evaluated by reviewing patient records. RESULTS: The mean age of the patients at the time of insertion was 57.5 years (+/- 12.3). The mean number of double crowns per denture was 3.5 +/- 2.1 (range, 1 to 9). The probability that a patient will have lost all abutment teeth 10 years after insertion of the denture is 4%. The probability that a patient will have kept all teeth that abut the denture 5 years after insertion is 87%; 10 years after insertion the probability is 80%. CONCLUSION: The Marburg double crown system is a versatile and successful means of achieving the long-term restoration of the partially edentulous jaw. Insertion and removal of the denture and routine oral hygiene are easy to perform, even for patients with limited manual dexterity. As a full-arch reconstruction, the MDC system enables easy adjustment, modification, and relining with low follow-up costs.     

慢性牙周炎患者磁性附着体基牙牙周状况分析

目的 了解慢性牙周炎患者磁性附着体基牙的牙周状况。方法 选取2009年1月至2011年1月于中国医科大学附属口腔医院口腔修复门诊接受治疗的19例慢性牙周炎患者的45颗磁性附着体基牙作为研究对象,修复后随访观察3年,比较磁性附着体基牙在义齿修复前后的牙周袋探诊深度（PD）、牙齿松动度及义齿的稳定性状况。结果 磁性附着体基牙在口内3年的存留率达91.11%。磁性附着体基牙在义齿修复前及修复3年后的PD值分别为（2.17 ± 0.77）mm和（1.89 ± 0.67）mm,修复后较修复前的PD值减小,差异有统计学意义（P < 0.05）。部分基牙松动度在义齿修复3年后较修复前增大,可能与可摘局部义齿功能稳定性变差有关（P < 0.05）。结论 磁性附着体义齿对慢性牙周炎患者的弱基牙有保护作用。     

Implant‐Retained Removable Partial Dentures: An 8‐Year Retrospective Study

Purpose: To evaluate the long‐term outcomes of removable partial dentures (RPDs) retained (but not supported) by dental implants. Materials and Methods: We retrospectively evaluated 32 consecutive patients who received implant‐retained RPDs. Each patient received one to four endosseus implants; the sample included a total of 64 implants. Follow‐up was conducted for a minimum of 8 years, during which satisfaction, implant survival, and prosthetic success were evaluated. Results: Patient satisfaction systematically increased. The implant success rate was 93.75%, and 100% of the prostheses were successful. Conclusion: Implant‐retained RPDs are a reliable intermediate solution that can reduce biological and economic costs while maintaining implant treatment benefits and the ease of RPD procedures.     

Extracoronal resilient attachments in distal-extension removable partial dentures.

Esthetics is often compromised in patients who wear removable partial dentures with metal clasps placed on anterior teeth. Clinical procedures are presented for a new design of a removable partial denture that improves esthetics and function through a new dental attachment. The extracoronal resilient attachment system offers vertical resiliency and universal stress relief for use where a resilient prosthesis is indicated. The removable partial denture retained by these attachments provides esthetics, vertical resiliency, and easy replacement of worn attachments.     

Present status of titanium removable dentures--a review of the literature

Although porcelain and zirconium oxide might be used for fixed partial dental prostheses instead of conventional dental metals in the near future, removable partial denture (RPD) frameworks will probably continue to be cast with biocompatible metals. Commercially pure (CP) titanium has appropriate mechanical properties, it is lightweight (low density) compared with conventional dental alloys, and has outstanding biocompatibility that prevents metal allergic reactions. This literature review describes the laboratory conditions needed for fabricating titanium frameworks and the present status of titanium removable prostheses. The use of titanium for the production of cast RPD frameworks has gradually increased. There are no reports about metallic allergy apparently caused by CP titanium dentures. The laboratory drawbacks still remain, such as the lengthy burn-out, inferior castability and machinability, reaction layer formed on the cast surface, difficulty of polishing, and high initial costs. However, the clinical problems, such as discoloration of the titanium surfaces, unpleasant metal taste, decrease of clasp retention, tendency for plaque to adhere to the surface, detachment of the denture base resin, and severe wear of titanium teeth, have gradually been resolved. Titanium RPD frameworks have never been reported to fail catastrophically. Thus, titanium is recommended as protection against metal allergy, particularly for large-sized prostheses such as RPDs or complete dentures.     

Parallel bonded cast attachments for removable partial dentures

The original design of a semi-precision extra-coronal attachment for partial dentures is illustrated, and its fabrication in a cast non-precious bondable alloy is described. A step-by-step method is also described of bonding multiple attachments in parallel for the retention and support of removable partial dentures. Clinical cases are illustrated. The results of trials indicate that the method is clinically viable and, in selected cases, appears to offer distinct advantages over existing retention systems.     

冠外附着体在游离端牙列缺损修复中的临床应用及近期观察

目的：探讨游离端牙列缺损患者进行冠外附着体义齿修复的临床效果。方法：对18例游离端牙缺失的患者,设计5种冠外附着体作为固位体进行修复治疗。随访1～3年,观察患者对义齿使用的满意情况,复查检查基牙和修复体的情况。结果：患者对冠外附着体义齿的美观非常满意,对义齿的固位稳定效果和咀嚼功能均满意。临床检查未见基牙松动,1年后,出现2例基牙牙龈炎,1例附着体阳性构件松动;2年后,出现2例义齿松动和1例义齿下沉;3年后,出现1例基牙牙龈炎,3例义齿松动和2例义齿下沉。所有出现异常的患者经对症治疗后义齿均能继续使用。结论：对于游离端牙缺失的患者,采用冠外附着体义齿修复可获得良好的临床效果。