Fabricating abutment crowns for existing removable partial dentures using custom resin clasp analogs

A universal approach for fabricating abutment crowns for existing removable partial dentures is described. A replica (analog) of the clasp assembly is generated and transferred to a traditional working cast, which includes the abutment die. The analog is incorporated into the working cast as a removable component to allow the formation of the crown contours. The article reviews in detail the procedures required to transfer accurately all the essential components and information from the mouth to the working cast while allowing the patient uninterrupted use of the removable partial denture. Prestabilizing the removable partial denture, creating the analog impression, avoiding errors due to soft tissue components, forming a precise analog base, selecting materials, generating a rigid resin analog, and prescribing a path of insertion and withdrawal to the analog are described. The method replicates all types of clasps and can generate all types of fixed prosthodontic retainers to function harmoniously with the existing partial denture.     

Status of the tick-borne diseases in sheep and goats in Turkey

A patient treatment is presented to demonstrate a technique using visible-light-cured (VLC) resin to create a characterized denture base for an interim denture. This indication for characterization is routinely seen with African-Americans with dark-pigmented gingiva. Using a combination of blue VLC tray resin and pink VLC denture base resin, the mixture achieves a darker-colored denture base. This technique was used for the fabrication of an interim denture for a patient who required an immediate interim denture. The prosthesis was worn during the healing phase and allowed the patient to function while the definitive prosthesis was being fabricated.     

Repair with a surveyed cast clasp while patient retains the partial denture

A technique is described that allows a removable partial denture with a broken clasp or a removable partial denture in which an abutment has been extracted to be restored by the reattachment of a new cast clasp component or a complete surveyed clasp assembly. The technique is applicable to most clasp designs and can include attachment to the acrylic denture base or the metal major connector. The technique is distinguished from other repair techniques by (1) providing a cast clasp replacement, (2) allowing the patient to retain the prosthesis during the repair, (3) generating a precisely formed surveyed clasp assembly by the laboratory, and (4) including an efficient transfer mechanism for the precision clasp created in the laboratory to be attached to the removable partial denture in the dental office. A two-step impression procedure is used to ensure proper relation of the partial denture to the abutments.     

Patients with epilepsy who die suddenly have cardiac disease

This paper describes the design and fabrication of a soft liner-retained, implant-supported overdenture used in 10 patients over a period of 1 to 6 years. A final complete denture impression is made of the dental arch, including implant abutments extending 5 mm above the gingival tissue. The master cast is fabricated with actual abutments placed in the impression. After the final wax try-in, the denture is flasked in the usual manner with the metal abutments in place. Before packing with acrylic resin, plastic tubing 1 to 2 mm thick is placed around each abutment. The denture is trial packed and allowed to bench cure over night. The plastic tubing is then removed and a soft denture lining material is placed in these areas only. The flask is closed and cured according to the manufacturer's recommendation. The denture is delivered as a conventional overdenture.     

A comparison of fluconazole and itraconazole in the management of denture stomatitis: a pilot study

OBJECTIVES: To compare fluconazole capsules (50 mg daily for 14 days) and itraconazole capsules (100 mg daily for 15 days) in the treatment of denture stomatitis, using objective clinical and mycological outcome measures. METHODS: Twenty complete denture wearers with denture stomatitis were enrolled. At baseline, palatal erythema was measured with an electro-optical instrument, a denture disc specimen was collected from the fitting surface of the denture for culture and an oral rinse and imprint cultures were collected for mycological culture. Ten patients received fluconazole capsules (50 mg daily for 14 days) and 10 received itraconazole capsules (100 mg daily for 15 days). Palatal erythema was reassessed and the microbiological specimens re-collected on day 14. RESULTS: The most common form of denture stomatitis seen in this group of patients was Newton's Type II. All patients responded to advice to leave their dentures out at night but there was a poor overall improvement in denture hygiene. There was an objective reduction in palatal erythema following treatment with both fluconazole and itraconazole. A wide range of yeasts were isolated from the mouths of all the denture stomatitis patients before treatment. C. albicans was the most common isolate. A mycological cure was achieved in only five of the 20 patients, one in the fluconazole group and four in the itraconazole group. A further eight patients in the fluconazole group and three in the itraconazole group had reduced yeast counts by the second visit. CONCLUSION: Fluconazole and itraconazole were of comparable efficacy in the treatment of denture stomatitis, on the basis of reduction in palatal erythema and mycological culture.     

Constructing cast crowns to fit existing removable partial denture clasps

A step-by-step procedure has been presented for fabrication of a cast crown to fit an existing partial denture clasp. The procedure can be accomplished in two appointments, and the patient need not be subjected to the incovenience of being without the partial denture between office visits. It is an accurate and easy technique which gives uniform results and eliminates the need for remaking an adequate removable partial denture.     

Shock-absorbing behavior of four processed soft denture liners

The cushioning effect of soft denture liners was evaluated with the use of a free drop test with an accelerometer. The materials tested included SuperSoft, Kurepeet-Dough, Molteno Soft, and Molloplast-B brands. All materials were found to reduce the impact force when compared with denture base resin. A 2.4 mm layer of soft denture material demonstrated good shock absorption. The Molloplast-B and Molteno Soft materials showed excellent shock absorption. When the soft denture liner was stored in distilled water for 180 days, the damping effect recorded for all materials tested was increased. The aging of all materials also affected the cushioning effect.     

Laser welding in the dental laboratory: an alternative to soldering

Only recently has laser welding been applied to dental technology, primarily as an alternative to soldering. This article addresses how the laser is used for welding, the effect welding has on metals as the energy is converted into heat and reacts with the alloy's surface and the practicality of laser welding in the dental laboratory. A step-by-step procedure for accomplishing laser-welded connections in a fixed partial denture is included. A laser-welded clasp repair using wrought wire and the addition of custom cast parts welded to an existing removable partial denture framework on the master model are also shown.     

Effect of glutamine on protein synthesis in isolated intestinal epithelial cells

The purpose of this study was to determine the etiologic factors of denture stomatitis. Fifteen subjects with clinical evidence of localized simple denture stomatitis, fifteen subjects without clinical signs of denture stomatitis, and forty-five subjects with clinical evidence of generalized simple denture stomatitis were investigated clinically and mycologically. Subjects were evaluated according to age, sex, duration of denture usage, smoking habits, frequency of denture brushing, overnight denture wearing, pH level of saliva and degree of candidal colonization and candidal formation. Salivary samples and swabs were taken from the palate and the mucosal surfaces of the dentures investigated mycologically in order to identify the yeast colonies. Smears were taken from the palate and investigated in order to identify candidal formation. No statistically significant relationship was found between denture stomatitis and age, sex, duration of denture usage, frequency of denture brushing, overnight denture wearing or pH level of saliva. There was however, a statistically significant relationship between denture stomatitis and denture hygiene, smoking habits, candidal colonization and candidal formation.     

Peroperative manometric evaluation of posterior fundoplication by celioscopy

A severe allergic reaction to a porcelain-fused-to-metal fixed partial denture containing 79% palladium, 2% gold, and 19% copper, resulting in a variety of symptoms and hospitalization of the patient, is reported. The reaction occurred 4 hours after cementation of the fixed partial denture. Suggestions for use of nongold metal alloys are discussed.     

A follow-up study on changes in mastication after insertion of mandibular bilateral free end saddle denture by EMG]

The purpose of this study was to investigate changes in the mandibular shortened arch, whose occlusal deficit had been reconstructed by removable partial denture, during mastication by using the EMG analyzing system. A total of 5 shortened dental arch patients was provided with RPDs, and observed by a sophisticated masticatory analyzing system using EMG, before and one day, about 2 weeks, 3 months, after denture insertion. The conclusions were as follows: i) The elements of the shortened arch during mastication, that is, the duration, interval, and cycletime, were prolonged at the time of insertion of RPD, but 3 months after denture insertion, they were shortened to almost the same state as before treatment. ii) Prosthetic treatment for shortened dental arch improved revitalization of functional musculatures, and their rhythmicity of functional procedure. iii) The functional tongue room for optimal bolus position in mastication was provided by insertion of mandibular bilateral free end saddle removable partial denture.     

Mechanical considerations for the implant tooth-supported fixed partial denture

The implant tooth-supported fixed partial denture presents a biomechanical design problem, because the implant is rigidly fixed within the alveolus, and the tooth is surrounded by a periodontal ligament that allows movement. Nonrigid fixed partial denture designs are advocated by some dentists as a method of compensating for this differential movement. Rigid fixed partial denture designs, however, are advocated by many clinicians. Studies have failed to show the advantage of one design over the other. This study developed an in vitro method for testing such prosthesis designs and measured movement of a natural tooth abutment during simulated function. The movement of the natural tooth abutment was not found to change substantially with the fixed partial denture designs tested.     

Effectiveness of two methods of denture sterilization

Species of Candida and in particular Candida albicans may be involved in the aetiology of denture stomatitis. Studies have shown that Candida and other oral micro-organisms including Streptococcus gordonii are associated with denture plaque; hence denture hygiene is an important factor in the prevention and treatment of the disease. The aim of this investigation was to test in vitro the efficacy of two methods of denture sterilization: (1) microwave irradiation and (2) sodium hypochlorite soak. Twenty upper acrylic dentures were prepared for microbiological assay; 10 were inoculated with C. albicans H1 and 10 with S. gordonii LGR2. Within each group, five dentures were tested in a domestic microwave oven for optimal exposure time and temperature to ensure sterilization; the five control dentures were not microwaved. Microbiological analyses showed that the inoculated dentures became sterile after six min of irradiation at medium setting (2450 MHz, 350 W). Damage to the microorganisms after microwave irradiation was clearly visible by scanning electron microscopy (SEM). Following the same protocol as above, experimental dentures were soaked for 8 h in either 0.02%, or 0.0125% sodium hypochlorite solution and control dentures soaked in distilled water. Microbiological analyses showed that the experimental dentures inoculated with C. albicans H1 became sterile. By contrast, those inoculated with S. gordonii LGR2 did not become sterile, and the SEM procedures confirmed these findings. The results of this study indicate that microwaving may be a more effective method of denture sterilization than denture soaking in sodium hypochlorite. However, compared with microwaving, hypochlorite reduces the levels of residual non-viable micro-organisms attached to the denture surface.     

The effect of removable partial denture framework design on gingival inflammation: a clinical model

A clinical trial using the experimental gingivitis model developed for periodontal clinical research was performed to evaluate the effect of a removable partial denture mandibular major connector design on the surrounding gingival tissues. A comparison of the state of health of adjacent gingival tissues was made between the linguoplate (control) and cingulum bar (test) major connectors. Clinical parameters were recorded in a single-blind crossover experimental gingivitis trial. Subjects were brought to a level of optimal gingival health and then randomly assigned to use one framework design while refraining from any oral hygiene. Measurements were made at 7-day intervals for 21 days. The subjects were returned to optimal oral health and repeated the experimental period with the alternate design. Results showed a greater increase in mean gingival inflammation with the control than with the test removable partial denture, suggesting that the cingulum bar has fewer detrimental effects on gingival tissues than the linguoplate major connector. Results of this study suggest that the experimental gingivitis model can be a useful and valid system for studying the potential effects of a removable partial denture design on surrounding oral tissues.     

Commercial denture cleansers--cleansing efficacy against Candida albicans biofilm and compatibility wit soft denture-lining materials

Chemical cleansing has been suggested as one of the most effective methods for plaque control, particularly for resilient denture-lining materials. These materials are known to be easily colonized and infected by Candida albicans. Maintaining the cleanliness of such materials is difficult because of porosity and incompatibility with some types of denture cleansers. Therefore, denture cleansers used for soft liners must address both microbiologic and physical requirements. This study evaluated the antifungal efficacy of 11 commercial denture cleansers on C albicans biofilm, studied the compatibility of tissue conditioners with denture cleansers, and makes suggestions for the chemical cleansing of dentures lined with tissue conditioners.     

Effects of cordocentesis on inferior vena cava velocity waveforms: differences between normally grown and growth-retarded fetuses

PURPOSE: The purpose of this investigation was to evaluate complete denture patients at pretreatment and postinsertion, 6 months and 18 months after denture delivery in order to develop an explanatory model of successful denture therapy to better understand patient acceptance of complete dentures. MATERIALS AND METHODS: Sixty complete-denture patients treated at a dental student clinic were followed through denture therapy and for 18 months thereafter. Subjects were examined and completed pretreatment questionnaires and posttreatment interviews. Three outcome measures of denture success were tested, and factors considered substantive in achieving a successful denture outcome were examined using multivariate analyses. RESULTS: At post-insertion, 76.7% of subjects were satisfied with their dentures, 74.6% said their expectations were met, and 66.7% said they adjusted easily to their new dentures; reports at 6 and 18 months were similarly high. Logistic regression findings suggest that psychological and interpersonal factors are more important determinants of denture satisfaction than anatomic or clinical factors. CONCLUSIONS: Subject characteristics including age, gender, race, income level, education, marital status, and maxillary and mandibular anatomy were not significantly associated with denture success as defined by the three outcome measures used in this study. Although these variables may represent important co-factors in the patient's acceptance of dental services and may affect the way a patient perceives dental care outcomes, statistically significant relationships were not found within our sample. Psychosocial variables, such as pretreatment expectations, satisfaction with the dental care received, and mental health showed a stronger relationship to a successful outcome.     

A procedure for relining a complete or removable partial denture without the use of wax

Various procedures are used to reline removable dentures. Some of these involve the use of wax to seal the denture to the cast for flasking and processing. This necessitates the use of high temperatures for an extended period and involves the risk of warpage of the denture. It is also relatively time-consuming. This article describes a procedure that uses polyvinyl siloxane instead of wax. The procedure is more time efficient and decreases the risk of warpage of the denture.     

A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part I: Methodology and clinical outcomes

STATEMENT OF PROBLEM: Scientific evidence is lacking to support the general application of implant-supported mandibular overdentures. PURPOSE: This randomized clinical trial was undertaken to compare the efficacy of conventional mandibular and implant-supported overdentures in diabetic edentulous patients with clinically acceptable metabolic control. METHOD: A total of 102 diabetic patients, treated with or without insulin, were randomized to receive a new maxillary denture and either a conventional or an implant-supported removable mandibular overdenture. Treatment was completed for 89 patients, 37 with the conventional and 52 with implant-supported dentures. Detailed examinations, tests, and questionnaires were given before and at 6- and 24-months after treatment completion. Comparisons between the two treatment groups were made for treatment failures based on prespecifed criteria and the type and amount of maintenance care provided. RESULTS: The insulin and noninsulin treated groups were collapsed because of the lack of significant differences at entry. The conventional denture and implant-supported overdenture groups were similar in terms of general demographics, medical status, quality of their original dentures and denture support, several functional measures, and patient satisfaction. Treatment was judged to be successful in 56.9% of patients with conventional dentures and 72.1% with overdentures. This difference in success rate was not statistically significant (p > 0.05). Patients with treatment failures in both groups required excessive maintenance care. Those with conventional dentures needed frequent denture base adjustments and relines, whereas those with overdentures required frequent clip replacements and repairs. Although significant improvements were seen with both treatment modalities, a higher percentage of patients with implant-supported overdentures than those with conventional dentures reported improvements in chewing comfort and moderate-to-complete overall satisfaction.     

Allosteric nicotinic receptors, human pathologies

The purpose of this study was to investigate the biomechanical significance of major connectors and base mucosal contacts on the mechanical behaviour of maxillary removable partial dentures in vivo. Six subjects wearing maxillary dentures retained by conical crowns were selected for the study. Reflective photoelasticity and strain gauges were used to monitor the development of strain/stress during functional loading. Loading tests were performed initially with a denture design including a palatal major connector and denture bases and then repeated after removal of the major connectors and denture base alveolar muccosa contacts. The palatal major connector and the denture bases mucosal contacts contribute significantly to the rigidity and stability of removable partial dentures retained by conical crowns.