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可摘局部活动义齿是一种修复牙列缺损的大众化传统实用方案,尽管价格平民化,但由于微笑或言语时唇颊侧金属卡环臂的暴露而缺乏美感,造成了患者不愿选择,且不少医生也缺乏热情设计、专业体会肤浅,活动义齿几乎成为不美观修复体的代表。如何按不同层次需求,设计改良各档次美观活动义齿修复方案,挖掘各种可行修复技术方法,有效地提升活动义齿修复的美观效果,已经成为我国修复专业下一步发展思路中不能继续淡忘的专业途径。本文将对不同类型档次的美观活动义齿进行总结归纳,为美观活动义齿修复的临床应用提供参考。     

The swing-lock partial denture: an alternative approach to conventional removable partial denture service.

There are many common problems associated with the use of conventional clasp removable partial dentures. An alternative modality in many instances is the swing-lock removable partial denture. Its advantages, disadvantages, indications, and contraindications are discussed. The procedures of fabrication, placement, and adjustments are described.     

Rotational path removable partial denture (RPD): conservative esthetic treatment option for the edentulous mandibular anterior region: a case report

It can be esthetically and financially daunting for patients to lose teeth in an anterior region of the mouth. For these patients, traditional treatment options presented in the past have included fixed partial denture, implants, and conventional removable partial denture (RPD). For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully with a rotational path RPD. Rotational path RPD designs have often been overlooked by the dental profession due to its complex concepts involving the prosthetic design and sensitive laboratory techniques. With better understanding of the concepts and design, the dental clinician can deliver the highest esthetic outcome in compromised areas in which other treatment options may often face limitations. This paper reviews the method used to esthetically design and plan a posterior-anterior rotational path RPD in an edentulous mandibular anterior region for a patient missing the mandibular incisors. CLINICAL SIGNIFICANCE: Due to inadequate understanding of the mechanics of rotational path RPDs, many clinicians have not adapted the application of this advantageous prosthesis. When correctly designed and fabricated, the rotational path RPD provides improved esthetics, cleanliness, and retention for patients who may not be suitable candidates for implants or fixed partial dentures in tooth-supported edentulous regions.     

An esthetic removable partial denture retainer for the maxillary canine

The use of a distofacial ridge on a maxillary canine abutment for a distal-extension base of a removable partial denture is described. The distofacial ridge will permit the placement of a less conspicuous I-bar arm on the distofacial surface of the tooth. The ridge provides bracing against distal movement during function and thus prevents the subsequent loss of retention for the prosthesis. It also permits a more precise path of insertion and withdrawal for the prosthesis. Three methods of establishing a distofacial ridge on a canine abutment are described.     

Rotational path of insertion for removable partial dentures with an anterior saddle

The provision of removable partial dentures remains a viable treatment modality for many partially dentate patients. Replacing missing anterior teeth with a removable partial denture using a rotational path of insertion provides improved retention and appearance. The use of a rotational path of insertion also provides additional retention for a removable partial denture restoring combined anterior and posterior bounded saddles. Two case reports demonstrate the use of the rotational path of insertion for partial denture design.     

Improving the esthetic replacement of missing anterior teeth: interaction between periodontics and a rotational path removable partial denture

The rotational path of insertion concept for removable partial dentures (RPDs) can be used in esthetically demanding situations. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a rotational path RPD. To optimally improve gingival esthetics and to allow proximal retention on the surveyors, a crown-lengthening surgical procedure was performed prior to prosthetic treatment on all teeth involved in this rehabilitation. When correctly planned and fabricated, this prosthesis allows excellent functional and esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation.     

Design variations of the rotational path removable partial denture

The rotational path removable partial denture is a convenient design to use when restoring anterior edentulous spaces and can produce excellent esthetic results. In situations that are not ideal for the conventional rotational path, design alterations can be made that will allow the same excellent results to be achieved.     

T-bar clasp-retained removable partial denture as an alternative to implant-based prosthetic treatment

This article reports the case of a 55-year-old female patient who presented with unsatisfactory temporary crowns in the right mandibular premolars and molars, and a premolar-to-molar fixed partial denture in the left side. The clinical and radiographic examinations revealed a fracture of the left first premolar that was a retainer of the fixed partial denture and required extraction. Initially, the acrylic resin crowns were replaced by new ones, and a provisional RPD was made using acrylic resin and orthodontic wire clasps to resolve the problem arising from the loss of the fixed partial denture. Considering the patient's high esthetic demands, the treatment options for the definitive prosthetic treatment were discussed with her and rehabilitation with implant-supported dentures was proposed because the clinical conditions of the residual alveolar ridge were suitable for implant installation, and the patient's general health was excellent. However, the patient did not agree because she knew of a failed case of implant-retained denture in a diabetic individual and was concerned. The patient was fully informed that implant installation was the best indication for her case, but the arguments were not sufficient to change her decision. The treatment possibilities were presented and the patient opted for a clasp-retained removable partial denture (RPD) associated with the placement of crowns in the pillar teeth. The temporary RPD was replaced by the definitive RPD constructed subsequently. Although RPD was not the first choice, satisfactory esthetic and functional outcomes were achieved, overcoming the patient's expectations. This case report illustrates that the dentist must be prepared to deal with situations where, for reasons that cannot be managed, the patient does not accept the treatment considered as the most indicated for his/her case. Alternatives must be proposed and the functional and esthetic requirements must be fulfilled in the best possible manner.