The purpose of this study was to evaluate the removable partial denture prescriptions including surveyed crowns and design of component parts sent to the laboratory technician. A total of 351 casess with prescription forms and master cast in maxillary and mandibular semi-edentulous situations collected from dental laboratory by random sampling were selected for this study. The evaluation and study observed here involved the classification of edentulous situations, status of abutment splinting, form of rest seats and guiding plane of surveyed crows, location of maxillary major connectors and tripodig marks on the master casts. Removable partial denture prescriptions contained (1) general request (upper and lower cast framework), (2) types of metal, (3) location of retainer(retention, lingual bracing, rest area, guiding plane surface), (4) location and type of major connector, (5) relief area and amount, (6) and other specific instructions. The following informations based on the classified groups such as Group I was those cases sent with no real prescriptions. They say 'make a partial.' No prescriptions, no thought beforehand, Group II was those cases sent with a minimal prescriptions. They say 'make a partial with clasps on May be some preparations, usually inadequate. Group III was those cases sent with a moderately good prescription. Adequate but could be much better. No tripoding but it tell what clasps go where. Still not good prescriptions. Group IV was good cases, tripoded with adequate prescriptions and a prescription which exactly describes what is expected from the laboratory. The analyzed results were as follows: 1. The normal form of rest seats and guiding plane of surveyed crowns in Class. I and Class. II edentulous situations on the maxillary cast were observed 31.9% and 27.89%, respectively. The abutment teeth and retainer without occlusal rests of Class. I and Class. II were showed 11.58% and 8.86%, respectively. In mandibular cases, the normal form of rest seats and guiding plane of surveyed crowns showed 27.54% and 8.82% in Class. I and Class. II situation. The abutment teeth and retainer without rest seats were showed 15.19%, respectively. 2. The splinted surveyed crowns of Class. I and Class. II maxillary edentulous situations in distal extension cases were showed 34.51% and 28.85%, but 28.52% and 10.29%, respectively. 3. The location and type of maxillary major connector delineated on the master cast were 66 cases (44.89%). 4. The results of 351 cases were classified as Group I 146(41.59%), Group II 115 (32.76%), Group III 57 (16.23%), and Group IV 33 (9.48%). 5. The delineation of abutment tooth for clasping were 176 cases (50.14%) among total of 351 cases. 6. The delineation of height of contour line were showed 45 cases (12.8%) in Group II, 14 cases (3.98%) in Group III and 33 cases (9.40%) in Group IV with total 92 cases (26.21%). 7. In surveying procedure, the delineation of tripoding marks and reference line were showed 17 cases (4.84%).
Kim, Seong-Kyun;Yoo, Soo-Yeon;Park, In-Phil;Lee, Joo-Hee
The Journal of the Korean dental association
/
v.49
no.2
/
pp.77-84
/
2011
The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.
In removable partial dentures, many types of retentive systems have been studied and applied in clinical treatment. One of those systems is the double crown denture system which is widely used in European countries such as Germany and Sweden. Telescopic double crown dentures have several advantages such as convenience in maintaining oral hygiene, enabling to transfer occlusal force along the long axis of the abutment, and secondary splinting effect between the abutments which leads to higher clinical performance compared to conventional removal partial dentures. In this clinical case, the patient was initially restored with a maxillary hybrid telescopic double crown denture with friction pin using remaining natural teeth as abutments. After 7 years, due to lack of recall check-up and poor oral hygiene, the abutment teeth were affected by periodontitis and 4 out of 5 of the abutment teeth had to be extracted. 3 additional implants were placed and the original abutment tooth with the inner crown was maintained. The mandible had fixed prostheses including implants but nevertheless, with strategic implant placement, the patient adapted well and was satisfied with the new maxillary tooth-implant combined double crown denture.
Kim, Min-Jung;Huh, Jung-Bo;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Jo, Yong-Bum
The Journal of Korean Academy of Prosthodontics
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v.60
no.1
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pp.71-79
/
2022
Excessive crown height space increases can cause crestal bone loss and screw loosening after prosthesis is placed. Milled bar and implant overdenture can be used as a treatment method for partially edentulous patients who have severe alveolar bone loss and excessive crown height space. Milled bar can provide primary splinting effect and stability between implants. Also, milled bar with additional retention device such as Advanced Dental Device-Treatment Of Choice (ADD-TOC) and magnet can provide additional retention force for implant overdenture. In this case, the patient has a partially edentulous mandible that has severe alveolar bone loss and multiple number of teeth loss after excision due to leiomyosarcoma. Because of the long-term loss of mandibular molars, the opposing teeth were extruded. Maxillary left molars were corrected to the occlusal plane through molar intrusion, and mandibular left molar region were treated with implant overdenture, using milled bar with ADD-TOC and magnet after implant placement. The clinical result was satisfactory on the aspect of esthetic and masticatory function.
Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.
Park, Hyo-Jin;Cho, Young-Ye;Kim, Jong-Eun;Choi, Yong-Geun;Lee, Jeong-Yol;Shin, Sang-Wan
The Journal of Korean Academy of Prosthodontics
/
v.50
no.1
/
pp.61-66
/
2012
Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.
Kim, Seong-Kyun;Heo, Seong-Joo;Koak, Jai-Young;Lee, Jeong-Taek;Roh, Hyun-Ki;Kim, Hyo-Jin;Lee, Seok-Hyung;Lee, Joo-Hee
The Journal of Korean Academy of Prosthodontics
/
v.45
no.6
/
pp.753-759
/
2007
Statement of problem. In distal extension removable partial denture, the preservation of health of abutment teeth is very important, but abutment teeth are subjected to unfavorable stress under unilateral loading specially. Purpose. The purpose of this study was to investigate the biomechanical effects of mandibular removable partial dentures with various prosthetic designs under unilateral loading, using strain gauge analysis. Material and methods. Artificial teeth of both canines were anchored bilaterally in a mandibular edentulous model made of resin. Bilateral distal extension removable partial dentures with splinted and unsplinted abutments were fabricated. Group 1: Clasp-retained mandibular removable partial denture with unsplinted abutments Group 2: Clasp-retained mandibular removable partial denture with splinted abutments by 6-unit bridge. Group 3: Bar-retained mandibular removable partial denture Strain gauges were bonded on the labial plate of the mandibular resin model, approximately 2 mm dose to the abutments. Two unilateral vertical experimental loadings (30N and 100N) were applied subsequently via miniature load cell that were placed at mandibular left first molar region. Strain measurements were performed and simultaneously monitored from a computer connected to data acquisition system. For within-group evaluations, t-test was used to compare the strain values and for between-group comparisons, a one-way analysis of variance (ANOVA) was used and Tukey test was used as post hoc comparisons. Results. The strain values of group 1 and 2 were tensile under loadings. In contrast, strain values of group 3 were compressive in nature. Strain values increased as the applied load in increased from 30N to 100N (p<.05) except for right side in group 1. Under 30N loading, in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 100N loading in left side, group 1 showed higher strain values than groups 2 and 3 in absolute quantity (p<.05). And group 2 showed higher strain values than group 1 (p<.05). In right side, group 1 and 2 showed higher strain values than group 3 in absolute quantity (p<.05). Under 30N loading, group 2 and 3 showed higher strain values in right side than in left side. Under 100N loading, right side strain values were higher than left side ones for all groups. Conclusion. Splinting of two isolated abutments by bridge reduced the peri-abutment strain in comparison with unsplinted abutments under unilateral loading. Bar-retained removable partial denture showed the lowest strain of three groups, and compressive nature.
Kim, Myung-Seok;Heo, Seong-Joo;Koak, Jai-Young;Kim, Sung-Kyun
The Journal of Korean Academy of Prosthodontics
/
v.47
no.2
/
pp.222-231
/
2009
Statements of the problem: Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdentures using dental implants could help the improvement of denture function. Purpose: The purpose of this study was to compare the strains of abutment and bone on implant overdenture between splinted and unsplinted type of prosthesis. Additionally, the strain values of parallel placed implant model and unparallel placed implant model were compared. Material and methods: Two acrylic resin model were prepared and two implants were placed at the canine positions in each model. In the first model, two implant were placed parallel. In the second model, two implants were placed with 10 degree labiolingual divergence. Two types of abutment were connected to the fixtures alternatively. One was splint type of Hader bar, the other was unsplint type of ball abutment. Overdentures were fabricated with corresponding attachment systems and seated on abutments. Strains of abutments and labial bone simulants were measured with electric resistance strain gauges when static load from 100 N to 200 N were applied to overdentures. Results: 1. Splinted type of overdentures using bar and clip showed higher absolute strain values. But the strain was compressive and the load was shared by two implants(P<.05). 2. Unsplinted type overdentures using ball and O-ring showed low absolute strain values(P<.05). 3. Labially inclined implant showed higher tensile strain values in unsplinted type of prosthesis than in splinted type of prosthesis. Lingually inclined implant showed rather low strain values under load(P<.05). 4. Non parallel implant model showed higher absolute strain values than parallel placed implant model comprehensively(P<.05).
Statement of problem: A new implant impression technique which use abutments as impression coping, and use resin cement as a splinting material was described. Accuracy of this technique was compared with conventional closed tray and resin splinted open tray technique for a $15^{\circ}$ angled 3-implant model Material and methods: A dental stone master model with 3 linearly positioned implant analogue and a reference framework which was passively fitted to it were fabricated. The center analogue was perpendicular to the plane of model and the outer analogues had a $15^{\circ}$angulation forward or backward. 10 closed tray impressions, 10 resin splinted open tray impressions, 10 abutment-resin framework cementation impressions and 10 abutment-metal framework cementation impressions were made with additional silicone material and poured with dental stone. A light microscope with image processing was used to record the vertical gap dimension between reference framework and analogue of duplicated cast made with each 4 impression techniques. Statistical analysis used one-way ANOVA with post-hoc tests Tukey test of .05 level of significance Results: Significant difference in the vertical gap dimension was found between closed tray technique; 74.3 (${\pm}33.4$)${\mu}m$ and resin splinted open tray technique, and two other new technique. (P<.05) Abutment-metal framework cementation technique;42.5 (${\pm}11.9$)${\mu}m$ was significantly different from resin splinted open tray technique. (P<.05) Abutmentresin framework cementation technique;51.0 (${\pm}14.1$)${\mu}m$ did not differ significantly from resin splinted open tray technique;50.3 (${\pm}16.9$)${\mu}m$. (P>.05) Conclusion: Within limitations of this study, the accuracy of implant level impressions of resin splinted open tray technique was superior to that of closed tray technique. A new technique using abutment and metal framework cementation was more accurate than resin splinted open tray technique.
Journal of Dental Rehabilitation and Applied Science
/
v.27
no.4
/
pp.343-358
/
2011
As implant treatment has become popular, lots of different shapes and materials of the implant upper component have been supplied. And there are also diverse reports about failures including loosening of the abutment screw which is one of the most common reason. Purpose : The purpose of this study is to find out how different screw tightening orders and methods influence on screw loosening according to the different connection systems. The upper component was fabricated by casting method. After fabricating master models that are precisely attached to the upper component, 5 experimental models each for the external connection system and internal connection system were fabricated using splinting impression technique. First, to find out the influence of the screw tightening order, screws were tightened in 3 orders; 1-2-3-4, 2-3-1-4, 2-4-3-1. After tightening, removal torque values (RTV) of each group was measured. And also to find out the influence of screw tightening method, a model with 2-3-1-4 screw tightening order was tightened with 30 Ncm at one time(1-step method) and the RTV was compared with the same order group (2-3-1-4) in the 2 step method. In the external connection system, RTV appeared significantly lower in group 2-3-1-4 than group 2-4-3-1 (p<0.05). And also in the internal connection system, the RTV of group 2-3-1-4 appeared significantly lower than that of group 2-4-3-1 and 1-2-3-4 (p<0.05). When comparing the tightening number of the screw without considering the screw tightening order, the first tightened screw appeared significantly higher RTV than the second one in the external connection system (p<0.05), however there was no significant difference from the first tightened screw to the last tightened screw in the internal connection system. And there was no statistically significant difference between the two screw tightening methods in both internal and external connection system. In the comparison of external and internal connection system, each RTV appeared 16.27 Ncm and 14.25 Ncm and appeared as a statistically significant difference (p<0.05). There was a significant difference in RTV measured according to the screw tightening order. The lowest RTV appeared in the groups started tightening from the middle. There was also a significant difference in RTV between the two connection system groups. A further study is needed to find out the influence factors in RTV and also a study is required related to the load condition.
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