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.     

Stress analysis of a cantilevered fixed partial denture with normal and reduced bone support

A two-dimensional finite element model was constructed to analyze the simulated mechanical behavior of a cantilevered fixed partial denture. The variations of the models were made by altering the degree of bone support, the number of splinted abutments, and the length of the pontics. High stress concentrations were observed around the connectors of the fixed prosthesis and the tooth closest to the cantilever. Reduced bone support increased the deflection and stress concentrations. There was reduction in displacement and stress concentration when the teeth were splinted together. To improve the prognosis of the fixed partial denture cantilever, the number of abutments should be increased and the number of pontics decreased.     

An indirect procedure for making a crown under an existing partial denture

Direct procedures to make a crown under an existing partial denture are inconvenient for the patient. A process is described that uses an irreversible impression of both the crown preparation and the removable prosthesis to fabricate a crown indirectly. The process is efficient and inexpensive.     

Y;16 translocation breakpoint associated with a partial Turner phenotype identifies a foamy virus insertion

We have previously identified YACs containing the Y breakpoint in a male patient with Turner-like hydrops in the newborn period and a Y;16 translocation (Erickson et al., 1995). We have now subcloned these YACs and built a lambda contig across the Y breakpoint. A subclone near the Y;16 breakpoint of our patient shows great evolutionary conservation by hybridization to a zoo blot. We have sequenced the region responsible for the hybridization and found a foamy (spuma) virus sequence. These viruses are known to be xenotropic and a very similar cross-species hybridization (using the same commercial zoo blot) was recently reported with a human foamy virus clone (Cordonnier et al., 1995). Thus, we have identified a foamy virus insertion near the Y heterochromatin boundary.     

Bend testing of wrought wire removable partial denture alloys

The flexibility of the wrought wire clasp is related to a number of factors, including the type and gauge of the alloy. The purpose of this study was to compare the bend behavior of five wrought wire alloys used in removable partial dentures. The alloys and their gauge diameters (in millimeters) were Ticonium (18, 19, 20), platinum-gold-palladium (18, 19), Wironium (18, 20), Jelenko Standard (18, 19, 20), and Denture Clasp (18, 19, 20). A total of 12 to 15 samples of each dental alloy were tested. Three-point bending was performed on a servohydraulic testing system controlled by a computer at 1.00 mm/sec until fracture or actuator contact occurred. Maximum stress and elastic modulus in bending were determined for each gauge diameter. Analysis of variance and post hoc Scheffe statistical analyses revealed significant maximum stress and elastic modulus in bending differences for different alloys of the same gauge and for different gauges of the same alloy. The choice of material and the gauge diameter significantly influenced the mechanical property of bending for wrought wire removable partial denture alloys. The Ticonium alloy had the greatest elastic modulus (stiffest) at all levels and the Denture Clasp and the Jelenko Standard alloys had the lowest elastic modulus (most flexible). These data indicate that knowledge of the bending properties of an alloy is equally as important as the gauge size when selecting a wire clasp.     

Fabrication of a fixed partial denture in the Class II partial edentulous mandible using the UCLA abutment: a clinical report

Several methods are currently available to restore the partially edentulous patient with osseointegrated implants. The UCLA abutment eliminates the unesthetic, traditional transmucosal abutment and can provide esthetic crowns, fixed prostheses, and subgingival porcelain margins without the need for excessive instrumentation and components. A clinical report for the fabrication of a direct, implant-borne fixed prosthesis using the UCLA abutment is presented.     

Tooth recontouring/reshaping a must in the preparation for removable partial denture

OBJECTIVE: To assess the extent of functional and vocational rehabilitation achieved by elderly inner-city patients sustained on maintenance hemodialysis. DESIGN: Inception cohort study of elderly patients who have end-stage renal disease using a modified Karnofsky rating system. The need for a wheelchair, participation in household activities, and effect of comorbid conditions were noted. Current status was compared with patient's recollection of functional activity level 2 years before commencing maintenance hemodialysis. SETTING: Seven outpatient, hospital-affiliated and private hemodialysis units in Brooklyn, NY. PATIENTS: One hundred four patients aged 65 years or older who were receiving maintenance hemodialysis for at least 6 months. MAIN OUTCOME MEASURES: A score of 76 or greater on a modified Karnofsky scale indicated independent function at a level that permitted participation in activities beyond those mandated by the hemodialysis regimen. A comorbidity score 6 or greater on a newly constructed index correlated with severe debility. Employment status was also recorded. RESULTS: Present functional activity had deteriorated to a modified Karnofsky score of 66 +/- 12.3 (+/- SD) compared with patients' recollection of a mean score of 84 +/- 14.3 (P < .001) 2 years before initiation of hemodialysis. Diabetic patients had a lower score than nondiabetic patients. The mean comorbidity index of the entire study group was 7.8 +/- 2.9 (mean +/- SD). Within the diabetic subset, severe debility constrained 71 patients (68%) to limit all activity to their residence with the exception of travel to and from their dialysis facility. By contrast, 2 years prior to commencing dialytic therapy, 81 diabetic patients (78%) had interests and activities that took them outside their homes (P < .001). Generalized weakness was the most common explanation given for the lack of outside activity by nine patients (9%) who were wheelchair bound. Erythropoietin, though regularly administered to 87 patients (84%) in the study group, was unsuccessful in raising mean hematocrit reading above 0.28 +/- 0.05 (mean +/- SD). CONCLUSIONS: Maintenance hemodialysis does not return inner-city elderly patients to their predialysis level of functioning. Few elderly, diabetic hemodialysis patients conduct any substantive portion of their lives outside their homes. For nondiabetic patients, the modified Karnofsky score of whites (70.4 +/- 11.9) and blacks (66.5 +/- 15.3), though low, was equivalent (P < .4).     

Tendinous insertion of semimembranosus muscle into the lateral meniscus

Forty-two cadaver knees were used for morphologic and MRI observations of the tendinous distal expansions of the semimembranosus m. and the posterior capsular structures of the knee. A tendinous branch of the semimembranosus m. inserting into the posterior horn of the lateral meniscus was found in 43.2% of the knees dissected, besides five already known insertional branches; capsular, direct, anterior and inferior, as well as the oblique popliteal ligament. The tendon had three morphologic types; thin, broad and round. All three types moved the lateral meniscus posteriorly when pulled on. Thus, the semimembranosus m. may also have a protective function for the lateral meniscus as well as the already well established function of protecting the medial meniscus in knee flexion. When a semimembranosus tendon attachment to the posterior horn of the lateral meniscus is present, its normal insertion is difficult to differentiate from a lateral meniscus tear in MRI and this may cause misdiagnosis.     

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.     

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.     

Intrusion of teeth in the combination implant-to-natural-tooth fixed partial denture: a review of the theories

Experimental designs in clinical investigation are discussed in this article. Guideline examples have been used in the area of Cardiology using always the same one only one whenever possible. We have looked for a different perspective from what is generally used in the discussion of the general characteristics of experimental designs, and more specifically of clinical trials and we deal with the aspects of clinical trials which are usually ignored due to their marginal character. We also discuss those characteristics which differentiate clinical trials in respect to other designs and types of questions which are answered by clinical trials. And we finally discuss various aspects such as randomization and its various types (simple, block, stratified, pre-randomized) and variable types of evaluating the answers, masking and the problems in its maintenance, with certain kinds of designs, sample size, etc. There is a brief mention of two particular cases: factorial and cross over designs are both discussed, mentioning their strong and weak points. Likewise, we discuss community trials as another experimental design and examples are provided. Finally, we discuss aspects of criteria: such as, When to stop the trials? or Who are the results applicable to?, and we suggest points to take into consideration when these decisions are made.     

Wear of visible light-cured restorative materials and removable partial denture direct retainers

Parenteral nutrition is a part of the nutritional support regimen of patients with AIDS-associated wasting syndrome and gastrointestinal dysfunction. The cholesterol (CHOL) level in human immunodeficiency virus (HIV) membrane is very high, and recent lipid formulations with high phospholipid (PL) content have demonstrated the ability to trap CHOL from endogenous sources, modifying the composition of cell membranes. We administered lipid-based home parenteral nutrition for 3 mo to malnourished AIDS patients. The patients were randomly divided into two groups: 23 received the regular 20% fat emulsion formulation, and 27 received a 2% formulation enriched 10-fold with PLs but containing the same amount of triglycerides. All patients gained weight and improved their activity level. Those receiving the high-PL composition showed increased serum CHOL concentrations (from 147 to 241 mg/dL; P < 0.01), but no increase was seen in the number of CD4 cells or improvement in immune function. HIV infectivity was not modified. Patients receiving regular PLs had significantly decreased (P < 0.02) IgA concentrations (from 776 to 300 mg/dL) and improved mitogen response to phytohemagglutinin and to concanavalin A. This formula, too, had no effect on HIV infectivity. We conclude that standard parenteral nutritional influences the nutritional and immune status of malnourished AIDS patients. A PL-enriched parenteral formulation can trap CHOL, but it does not affect the immune profile or HIV infectivity in patients with advanced disease.     

Ischemic osteonecrosis under fixed partial denture pontics: radiographicand microscopic features in 38 patients with chronic pain

We have previously shown erythropoietin (Epo) and its receptor (Epo-R) to be present in the fetal human central nervous system (CNS), and Epo to be present in the spinal fluid of normal preterm and term infants. To investigate the cellular specificities and developmental patterns of expression of these polypeptides in the human brain-areas that have not been well researched-we designed the following study. Human brains ranging in maturity from 5 weeks post-conception to adult were preserved at the time of elective abortion, surgical removal (tubal pregnancy, or removal for temporal lobe epilepsy), or autopsy. Immunohistochemistry was used to localize Epo and Epo-R reactivity in brains of different stages of development. Astrocytes, neurons, and microglia were identified in sequential tissue sections by specific antibodies. At 5 to 6 weeks post-conception, both Epo and Epo-R localized to cells in the periventricular germinal zone. At 10 weeks post-conception, Epo immunoreactivity was present throughout the cortical wall, with the most intense immunoreactivity present in the ventricular and subventricular zones. Epo-R, in contrast, was localized primarily to the subventricular zone, with little staining evident in the ventricular zone. In late fetal brains, Epo-R reactivity was most prominent in astrocytic cells, although modest reactivity was observed in certain neuron populations. In contrast, Epo staining localized primarily to neurons in fetal brains, although a subpopulation of astrocytes was also immunoreactive. In postnatal brains, both astrocyte and neuron populations were immunoreactive with antibodies to Epo-R and Epo. From these results it is clear that Epo and its receptor are present in the developing human brain as early as 5 weeks post-conception, and each protein shows a specific distribution that changes with development. We speculate that Epo is important in neurodevelopment, and that it also plays a role in brain homeostasis later in life, functioning in an autocrine or paracrine manner.