Removable partial denture framework try-in

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Removable partial denture framework try-in

• Dr Balendra Pratap Singh
• BDS, MDS, MAMS, FISDR, FPFA, FAAMP, ICMR-IF
• Assistant Professor
• Department of Prosthodontics
• King Georges Medical University, Lucknow

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Introduction

• The removable partial denture is a viable and
  effective treatment modality
• The objectives of a successful removable partial
  denture are
• Preservation of health of remaining oral
  structures
• Restore function
• Restore esthetics

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Try-in Steps

• Inspect the framework off the master cast
• Inspect for bubbles and other defects on the
  intaglio surface
• Check for abraded areas on the master cast
• Check polished and non-polished areas
• Check for adequate thickness

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• 2) Check the framework on the master cast
• Verify the design of the framework with the
  laboratory prescription or diagnostic cast.
• Inspect the rests (Be certain that all rests fit
  perfectly and simultaneously into rest
  preparations).
• Rests should not be overcontoured causing
  unnecessary bulk or overextension, nor
  undercontoured causing weakness and possible
  fracture.

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• Examine the relationship between the framework
  and the soft tissue areas.
• Check for proper adaptation and placement of
  clasps. (Clasps should have perfect adaptation to
  the teeth and all retentive areas and should be
  properly placed in relation to the height of
  contour.)
• Check the ease of framework removal.

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• 3) Check the framework in the mouth
• If the framework fits the cast but does not fit
  in the mouth, it is likely the cast is not an
  accurate reproduction of the mouth.
• Causes
• Distorted impression,
• an improperly poured cast,
• an abraded cast, and/or
• shifting teeth.

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• The fitting of the framework to the mouth should
  be done in two phases
• (1) fitting the framework to the abutment teeth
  and soft tissue and
• (2) adjusting the framework to the opposing
  occlusion.

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• 4) Fit the framework to the abutment teeth
• The best aid in trying in the framework is the
  use of a disclosing medium.
• There are numerous acceptable disclosing media on
  the market
• Occlude (Pascal, Bellevue, Wash.),
• Accufilm (Parkell, Farmingdale, N.Y.),
• disclosing wax (Kerr/Division of Sybron Corp.,
  Romulus, Mich.),
• pressure-indicating paste (Mizzy Inc., Clifton
  Forge, Va.),
• Fit Checker (GC Dental Industrial Corp., Tokyo,
  Japan), and
• chloroform and rouge.

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• 4) Fit the framework to the abutment teeth
  (contd.)
• Seat the framework in place in incremental steps
  with minimal force.
• Check for rocking of the framework in both
  anteroposterior and buccolingual directions.
• Check for close adaptation of rests, clasps arms,
  and lingual plates.
• Check for physiologic relief on distal extension
  frameworks.
• Check retention.
• Check soft tissue contact or relief.

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• 5) Adjusting the framework to the opposing
  occlusion.
• Identify natural tooth contacts in the centric
  occlusion (C0) or maximum intercuspation
  positions (MIP).
• Adjust the framework in the CO/MIP position.
• Adjust the framework during eccentric movements.
• Occlusal adjustment of two frameworks (if present
  in both arches).

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• 6) Materials
• The framework can be adjusted with various burs,
  coarse Carborundum stones, or both. All adjusted
  areas should be repolished with rubber points and
  wheels.
• When relieving and polishing, avoid staying in
  one spot for extended periods of time to prevent
  the generation of localized areas of high
  temperature.

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Summary

• The ultimate success of a properly designed
  removable partial denture depends on how well it
  fits and adapts to structures in the mouth. One
  of the most important steps to ensure an accurate
  fit is the seating of the framework.

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Scientific answer Based on trials meeting the
inclusion criteria for this review, there is
insufficient evidence to recommend a particular
method of tooth replacement for partially
edentulous patients.General answer Nothing is
better than other one in terms of durability,
function, comfort and appearance

• Take home message

What is your opinion to prescribe RDP, FDP
(tooth supported) to replace missing teeth?
Reference Iabt E, Carr AB, Worthington HV.
Interventions for replacing missing teeth
partially absent dentition. Cochrane Database
Syst Rev2012 Feb 152CD003814.