Abutment tooth and base movement witl attachment retained removable partial dentures

Using a laboratory model for the distal extension removable partial denture situation, the effect of resilient and rigid precision attachment retainers on abutment tooth and denture base movement was studied. It was found that both abutment tooth and denture base movement was least with the rigid and semi-precision attachments used compared to the resilient attachments. Abutment tooth movement was generally towards the mesial, except for the C and L attachment which produced distal movement.     

Custom precision attachment housings for removable partial dentures

Limited space for extracoronal attachments is a serious complication in the design and fabrication of a precision attachment removable partial denture. A custom metal-ceramic housing joined to the partial framework with laser welding offers strength and improved esthetics while requiring minimal space. This article presents the technical aspects of custom housing construction.     

Adhesive attachments for removable partial dentures

Since twenty years adhesive dentistry plays a certain role in the design of removable partial dentures. With the use of adhesive attachments the esthetics and retention of a removable partial denture can be improved. To apply these attachments successfully the contour of a sound abutment has to be corrected by grinding to provide retention and resistance. The procedures for constructing removable partial dentures with adhesive attachments are described. It is recommended to apply adhesive attachments in the general dental practice.     

Composite resin root coping with a keeper for magnetic attachment for replacing the missing coronal portion of a removable partial denture abutment

Numerous methods for replacing missing removable partial denture abutments have been introduced, however, most of them are time consuming and require several visits to complete the procedure. Since magnetic attachments can provide support and bracing as well as retention for overdenture abutments, the remaining tooth root structure can be used to support the coping with the keeper. Through the use of composite resin and adhesive material, improved retention of the keeper to the root may be achieved, along with improved esthetics. This article describes a method for replacing the missing abutment of a removable partial denture with a magnetic attachment, and a composite resin coping with a keeper.     

MK1附着体在老年患者单侧远中游离缺失修复中的临床应用

目的：评价MK1附着体修复老年患者单侧远中游离缺失的临床效果。方法：采用MK1附着体为23例单侧后牙游离缺失的老年患者进行修复治疗,经过8-44个月的随访,从主观感受、临床及X线检查评价修复效果。结果：所有患者对MK1附着体义齿的美观舒适性、固位力、咀嚼效能均感到满意;21例患者认为其摘戴方便。经配对t检验,MKl附着体义齿与原可摘义齿相比在美观舒适性、固位力、咀嚼效能方面均有明显优势（P〈0．05）;而在摘戴方面基本没有差别妒〉0．05）。2例患者出现了牙龈炎症,牙周治疗后炎症消失。3例患者进行了义齿可摘部分的重衬,其余患者基牙及缺牙区牙槽嵴无异常。结论：MK1附着体义齿稳定及固位性能良好,是一种较理想的修复老年患者单侧后牙游离缺失的修复体。     

Review of attachments for removable partial denture design: 1. Classification and selection

An attachment is a mechanical device, other than a clasp assembly, that functions as a direct retainer. Attachments for removable partial denture treatment are reviewed and a method for classifying different types of attachments is provided. Attachments are categorized as precision or semiprecision, depending upon the method of manufacture; internal or external, according to their intracoronal or extracoronal location relative to the abutment tooth; and rigid or resilient, as determined by the amount of movement allowed between the component parts. They are also classified by design. The advantages and disadvantages of attachment use as well as indications and contraindications are considered. Additionally, the conventional clasp-type direct retainer is compared to attachments.     

Resilient Attachments as an Alternative to Conventional Cast Clasp Removable Partial Denture: 3-Year Follow-up

The present clinical report describes the prosthodontic management for a patient with uncontrolled bleeding and diabetes mellitus treated with a maxillary complete denture and a mandibular partial fixed dental prosthesis designed to interface with a removable cast framework partial denture retained by 2 ERA attachments. This approach was undertaken to improve both retention and stability of the distal extension Kennedy Class I removable partial denture. The rehabilitation provided better anterior esthetics than if treated with a conventional clasp retained removable partial denture, by employing a simple, practical design and offering a significant biomechanical advantages, restoring both oral health and function. Thus, this treatment modality, involving an ERA system and transfixation in fixed crowns, is an effective treatment and can be indicated as a clinical alternative for edentulous and partially edentulous patients with systemic disorders or for patients in economic situations that might preclude implant-based rehabilitation.

     

The milled surface as a precision attachment

The creation of paralleled, milled surfaces in natural or restored abutment teeth, coupled with removable partial denture castings that have optimal contact with these preparations, results in a path of insertion and removal that is controlled in a manner similar to one using conventional precision attachments. Because the milled surfaces are primarily extracoronal, little if any, additional tooth reduction is required for adequate mouth preparation. Avoiding additional tooth reduction minimizes later abutment fracture. The great increase in stability and resistance to rotational movements, when combined with conventional posterior clasping, provides a reasonable alternative to the precision attachment in providing maximal esthetics for the partially edentulous patients.     

Precision Attachment: Retained Overdenture

Precision attachments are small interlocking devices to connect prosthesis and abutments that offer a variety of solutions to the challenge of balance between functional stability and cosmetic appeal. Precision attachments have wide applications, used in fixed removable bridge, removable partial dentures, overdentures, implant retained overdentures, and maxillofacial prosthesis. Attachment retained overdentures helps in distribution of masticatory forces, minimizes trauma to abutments and soft tissues, attenuate ridge resorption, improves the esthetics and retains proprioception. The following case report discusses the use of resilient stud attachments to retain maxillary and mandibular overlay complete dentures.     

An implant-supported removable partial denture for a patient with post-inflammatory scar contracture caused by burn complications: a clinical report

The scars and contracture around the oral-facial region may cause difficulty in prosthodontic treatment to restore esthetics and function for the patients, who suffered severe burns. This article presents a technique that uses a fixed partial denture prepared with a conventional milling technique and an attachment to support anterior cantilever removable partial denture, thereby providing a more esthetically acceptable and functional result.     

Comparison of load transfer by maxillary distal extension removable partial dentures with a spring-loaded plunger attachment and I-bar retainer.

This study photoelastically compared the stress distribution characteristics of two maxillary bilateral distal-extension removable partial denture designs, one using I-bar retention and the other using a semiprecision spring-loaded plunger attachment. Each prosthesis was subjected to vertical and horizontal extension-base loads. Comparisons were made from photographic recordings of isochromatic fringe distributions. The two retention designs produced comparable stresses with splinting of abutments for the plunger attachment. The attachment-retained prosthesis proved less stable with some loadings. Stress patterns followed three trajectories in the maxilla. A basis for stress distribution comparisons to other maxillary removable partial denture attachments is established.     

A Technique for Retrofitting a Metal Ceramic Crown to an Attachment‐Retained Removable Partial Denture: A Clinical Report

In dental applications, precision attachments have been used to retain removable partial dentures (RPDs) for several decades. Various types of extracoronal attachments are commonly used in combination with fixed partial dentures and RPDs to achieve retention and stability. Fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention are common reasons for a failed attachment‐retained RPD. Another complication of metal ceramic crowns with precision attachment is decementation of the crowns. When fixed components of the attachment‐retained RPD fail, the traditional treatment approach requires remaking both the fixed and removable components of the attachment‐retained RPD. This technique describes retrofitting of a metal ceramic crown to a resilient attachment‐retained RPD.     

Alternative method for connecting a removable gingival extension and fixed partial denture: a clinical report

In terms of esthetics and hygiene, defects in the alveolar ridge can complicate the design and fabrication of fixed partial dentures. When missing anterior teeth are restored, it may be difficult to achieve a satisfactory appearance without the correction of soft tissue and alveolar defects. When surgical intervention is not an option, a removable gingival extension and fixed prosthesis may be considered. This clinical report describes the use of a custom-made pin system (rather than intra- or extra-coronal attachments) to esthetically connect a removable gingival extension to a fixed partial denture.     

A Viable Treatment Alternative in Distal Extension Cases: A Case Report

Dentures requiring support from teeth, the mucosa and the underlying alveolar ridges are subjected to many forces that adversely effect the abutment teeth and the residual ridges during functional and parafunctional activity. A number of designs of the framework and the direct retainers were used to improve the comfort and acceptance of the patient wearing a removable partial denture. Attachment retained removable partial denture is one of the viable treatment alternative through which significant number of patients could be benefited. In this particular case of distal extension, attachment retained removable partial denture was chosen as a treatment modality. This article provides an overview and a simplified approach to this treatment through a case report and the criteria followed for selection of the particular attachments for treating the patient.

     

OT球帽状附着体固位型活动义齿的临床应用

目的 介绍OT球帽状附着体固位型活动义齿的设计，制作方法，评价其临床效果。方法 采用OT球帽状附着体为15例患者设计制作18件义齿。结果 最长者经2年零6个月观察。临床效果良好。结论 患者戴用该义龄后，咀嚼功能良好。摘戴方便，美观舒适，基牙无病变。     

Fabrication of a replacement for a broken attachment

A clinical and laboratory procedure is described for remaking a lost attachment for a removable partial denture rather than remaking the entire denture. This method enables continued use of the removable partial denture while the new attachment is made in the laboratory.     

附着体固位可摘义齿临床应用

目的：观察不同类型附着体固位可摘义齿的临床效果。方法：采用冠外精密附着体、磁性附着体、套筒冠作为固位装置制作可摘义齿,对游离端缺失下颌义齿和多牙缺失病例32例进行修复。随访6个月～3年,对义齿美观舒适性、固位力、咀嚼功能、摘戴适应情况及基牙松动、义齿下沉加衬情况进行观察。结果：所有病例对义齿美观舒适、固位力、咀嚼功能均感满意。30例对义齿摘戴适应（93．75％）,2例感到义齿摘取不便（按扣式、套筒冠义齿各1例）。结论：附着体固位可摘义齿兼有固定、活动义齿的优点,能达到良好的临床修复效果。     

磁性附着体义齿修复的五年观察及并发症防治

目的:评价磁性附着体义齿修复的长期疗效,探寻其并发症防治策略。方法:对33例共使用61副Magfit磁性附着体行可摘局部义齿修复的患者完成5年随访观察。结果:磁性附着体活动义齿舒适、稳定,长期临床效果满意,但有4副附着体磁体脱落,19颗基牙出现龈缘炎,基牙临床指数除牙龈指数有显著差异外,出血指数、牙周袋指数、松动度均与修复前无明显差异。结论:应用磁性附着体进行活动义齿修复5年观察疗效满意,但磁体粘固方式有待改进。     

三种不同连接方式的天然牙—游离端种植体联合支持的 固定义齿集中载荷应力分析

目的 研究三种不同连接方式的天然牙——游离端种植体联合支持的固定义齿在集中载荷下的应力值和应力分布。方法 应用三维有限元应力分析法。结果 ①固定连接式固定义齿的种植体基牙应力峰值高于天然牙;②刚性栓道式固定义齿的种植体基牙应力峰值最高;③缓冲式固定义齿的种植体基牙应力峰值最低。结论 ①固定连接式固定义齿设计可能损伤种植体基牙,需采取适当措施;②刚性栓道式固定义齿设计对种植体基牙损伤最大;③缓冲式固定义齿设计有利于保护种植体基牙。     

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。