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Acrylic Partial Dentures
Acrylic Partial Dentures
discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/42387887
Article in SADJ: journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse
Tandheelkundige Vereniging · November 2009
Source: PubMed
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Vivienne Wilson
University of the Western Cape
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VJ Wilson: BChD, MChD. Principal Specialist, Associate Professor, Head of Restorative Cluster, Faculty of Dentistry, University of the Western Cape, Bellville.
Tel: 021 370 4414 or 021 937 3077, Fax: 021 392 3250 or 021 937 2287. E-mail: vwilson@uwc.ac.za.
Table 1: Selection of Wrought wire diameter (in mm) for Molar Clasps for a b
different clinical situations:
0.25mm undercut 0.50mm undercut
Clinical situation Gold C/C S/S Gold C/C S/S
Tooth supported bases
Good periodontal support - - - - - 1.0
Table 2: Selection of Wrought wire diameter (in mm) for Premolar Clasps for
different clinical situations
0.25mm undercut 0.50mm undercut
Clinical situation Gold C/C S/S Gold C/C S/S Potential disadvantages of
Tooth supported bases Acrylic Partial Dentures
Good periodontal support 0.9 0.9 0.9 - - 0.8
Acrylic due to its nature is a porous material and thus has an
Compromised periodontal - 0.8 0.8 - - -
increased area for plaque accumulation. Upper APD’s appear to
support
have a better prognosis mainly due to the larger surface area that
Distal extension bases
Good periodontal support - - 1.0 0.9 0.9 0.9 is covered. It was also found that maxillary APD’s can function
over prolonged periods of time if a thorough, routine oral hygiene
Compromised periodontal 0.9 0.9 0.9 - - 0.8 regimen is followed.2 If a proper oral hygiene and rigorous recall
support
regimen is not followed, the potential for damage to the tissues
effective materials to enable the socio-economically disadvantaged increase (Figure 2)
to have access to lasting, non-iatrogenic prostheses. Some of the Poor laboratory technique and/or poor communication between
design principles of the APD are adapted from the Every Denture8. the dentist and the technician has also been reported as another
Every designed an upper mucosa-borne denture for bounded problem in the construction of APD’s.1 Technicians should block
saddles and with specific features such as gingival margin relief out unwanted undercuts and interdental spaces on the master
and clasps distally to provide horizontal stability (Figure 1). This model, pour a duplicate cast and process the denture on the
design however, cannot be applied to all acrylic partial denture duplicate cast. Failure to block out these unwanted undercuts
patients as it requires bounded saddles and patients do not usually lead to problems in seating the denture with the dentist
necessarily present with these criteria. APD’s are designed using adjusting the acrylic and inevitably grinding away too much
some of the features of the Every denture as well as additional of the acrylic and thus compromising the acceptability of the
features to accommodate the needs of the patient who is missing denture. This has been illustrated by Davenport et al (Figure 3)10.
more teeth than what the Every denture allows for. Clinically this can be seen as a space between the denture and
For support and retention similar principles as in metal- the abutment teeth with subsequent trauma to gingival tissues
based partial dentures, are advocated but with the use of cost- (Figures 4 and 5).
effective materials.3 Goolam, as part of her Masters’ research Lower APDs present an additional problem: the surface area is
project, investigated the appropriate use and flexibility of metal
much smaller compared to an upper denture and there can be
components (used as active clasp components) and made
no relief of gingival margins. The acrylic major connector has to
recommendations as to the required diameters of these wire
cover all the abutment surfaces to provide additional strength
components to provide adequate retention in the acrylic partial
denture. (Table 1 and 2).9 to the acrylic. Support must be gained from the remaining teeth
otherwise the denture will tend to “sink” into the tissues with a
a b c resultant stripping of the gingivae
from the abutment teeth.11
Lower APD’s tend to break more
often and have the potential of
causing more damage to the
periodontal tissues if optimum
design principles and clinical and
Figure 1: Every Denture (a) Wire stops on distal surface of most distally placed natural teeth – help prevent anterior movement of denture
laboratory procedures are not
base as well as distal movement of natural teeth; (b) and (c) gingival relief areas - minimum clearance of 3mm is regarded as satisfactory. 8
adhered to (Figure 6).
Principles in Acrylic a b
Partial Denture design
and construction
It is the joint responsibility of
the dentist and the technician to
construct a prosthesis that will
be a success both biologically Figure 7: Design sheets upper and lower arches:
Figure 4: Too much relief of the acrylic with
and mechanically. The dentist, a. indicating the survey line. b. indicating gingival margin.
resultant gaps between the abutment teeth and however, due to the nature of
the denture – creating a possible food trap. a b
his /her training must assume
a greater responsibility for the
patient’s welfare.12 The dentist
as the leader of the dental
team treating the partially
dentate patient must take
responsibility for the design of
partial dentures, appropriate to Figure 8: (a) Design sheet of a mucosa-supported acrylic partial denture. (b) Acrylic Partial
Denture – with no rests and no clasps.
the needs of each patient.12,13
The patient as the third party in a b
b this treatment is responsible for
the proper maintenance of the
prosthesis and should exercise
good plaque control.
Surveying the diagnostic cast
is essential for effective diagno-
Figure 9: (a) Intraoral view of a mucosa-supported acrylic partial denture. (b) Gingival margin
sis and treatment planning and inflammation of 14 and 24 - denture removed.
therefore the use of a dental
Figure 10: (a) Fitting
Figure 5: (a) Inappropriate fit of denture around surveyor in the dental surgery / a b
surface of upper
abutment teeth. (b) Inflammation of gingival
marginal tissues of abutment teeth.
clinic is mandatory. These casts acrylic partial den-
ture with ½ round
should be articulated to assist stainless steel pre-
with the designing of the den- molar rest;
(b) Intraoral view
tures. Design sheets with the of denture in situ
appropriate design for the APD with mesial pre-
molar rest
must accompany the study casts
to the laboratory (Figure 7).
surface of the tooth that has been prepared such that the forces
The same principles as for the
exerted by the denture will be directed along the long axis of
design of the metal-based
Figure 6: Lower acrylic partial denture, with the abutment. Rests in the APD can either be metal (half-round
partial denture are applied
poor tooth support and spaces between stainless steel) (Figure 10), or acrylic rests – the latter can only be
the major connector and lingual surfaces of when designing an APD.
13
a b a b
Figure 11: (a) Intra-oral view of an upper acrylic partial denture with an acrylic cingulum rest
on 23. (b) Extra-oral view of acrylic partial denture.
Figure 15: (a) Design sheet and (b) Lower
Acrylic Partial denture with ring clasp engaging
mesiolingual undercut on 47 (and C-clasps on
44 and 35).
CONCLUSION 4. Picton DCA, Wills DJ. Visco-elastic properties of the periodontal ligament
and mucous membrane. J Prosthet Dent 1978; 40(3):263 - 272.
Taking into consideration the financial constraints faced by so 5. McCord JF, Grey NJA, Winstanley RB, Johnson AA. A Clinical overview
many potential partial denture patients in South Africa, upper APDs of Removable Prostheses III: Principles of Design for removable partial
can be considered as a permanent prosthesis, provided that: dentures. Dent Update 2002; 29:474-481.
6. Patel N, Bredenkamp B, Yengopal V. A survey of Removable Partial Dentures
(i) the principles of support and retention in the design of the produced by Commercial Laboratories – poster presentation. IADR – South
denture are adhered to African Division 2001 (Unpublished Abstract).
(ii) patient selection and education (especially the importance of 7. Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz P O, Hammond P.
post insertion visits) is given special attention by the dentist Communication between the dentist and the dental technician. Br Dent J
2000; 189(9):471-474.
(iii) the patient adhere to a thorough oral hygiene program 8. The Every Denture. www.brisbio.ac.uk/bblt/tutorials/pstelford/everycase.html.
(iv) the laboratory construction of the acrylic partial denture 9. Goolam R. The Selection of Wrought Wire Clasps for Removable Partial
is optimal with the routine blocking out of undercuts and Dentures. Unpublished Thesis (1992), University of the Western Cape.
10. Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz PO. A Clinical Guide
pouring of duplicate models
to Removable Partial Dentures. 2nd Ed. ISBN 0-904 588599. British Dental
(v) the dentist takes responsibility for the careful designing Journal 2000; p.115-121
of the prosthesis that will succeed both biologically and 11. Dyer M. The lower acrylic partial denture. Dent Update 1984; 11:401-410
mechanically. 12. McCracken WL. Contemporary partial denture designs. J Prosthet Dent 2004;
92 (5):409-417.
Lower APDs, due to the small surface area and the bulk of material 13. McCord JF, Grey NJA, Winstanley R B, Johnson AA. A Clinical overview of
Removable Prostheses: Introduction. Dent Update 2002; 29:375.
required to improve the strength of the prosthesis, and should
14. Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz PO. Surveying. Br Dent
mainly be constructed as an interim prosthesis. J 2000; 189 (10):532-542.
Declaration: No conflict of interest was declared 15. Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz PO.Tooth preparation:
Br Dent J 2001; 190(6):288-294.
REFERENCES 16. Öwall B, Budtz –Jörgensen E, Davenport J Mushimoto E, Palmqvist S, Renner
1. Walmsley AD. Acrylic Partial Dentures. Dent Update 2003; 30:424-429. R, Sofou A, Wöstmann B. Removable Partial Denture Design: A Need to Focus
2. McCartney JW. The all-acrylic resin mandibular removable partial denture: on Hygienic Principles? Int J Prosthodont 2002; 15:371-378
Design considerations. J Prosthet Dent 1997; 77(6):638.
3. Owen CP. Fundamentals of Removable Partial Dentures, 2nd Edition. ISBN
1-919713-58-1. University of Cape Town Press, Landsdowne, South Africa; 2000.
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