Kim, Hak-Cheon;Noh, Kwantae;Kwon, Kung-Rock;Kim, Hyeong-Seob
The Journal of Korean Academy of Prosthodontics
/
v.51
no.4
/
pp.323-331
/
2013
Soft tissue collapse around prepared teeth and pontic is inevitable after removal of the provisional restoration during the impression taking procedures. When inserting gingival retraction cord, soft tissue is displaced to an undesired contour. Viscosity of impression material also causes gingival displacement. Therefore, the consideration to transfer the prosthetically contoured soft tissue to master cast is required, especially in the esthetic area. In this report, the methods to maintain the soft tissue contour and transfer to the mastercast will be introduced. Harmonious contour of the soft tissue can be achieved with provisional restoration and be transferred to the master cast with two different techniques mentioned in this case report.
Statement of problem: In distal extension removable partial denture, the preservation of health of abutment teeth are very important, but they are always subjected to unfavorable stress. Purpose: The purpose of this study was performed to investigate the effects of abutment splinting and design of direct retainer on the stress distribution of abutments in unilateral distal extension removable partial dentures. Material and method: Abutments were splinted by different method. In group 1, autment teeth were not splinted, in group 2, canine and 1st premolar were splinted, and in group 3, canine, 1st and 2nd premolars were all splinted. Three different types of direct retainer such as Akers clasp, RPI clasp, and wrought wire clasp were designed. Strain was measured with Switch & Balance Unit(SB-10, Measurement Group Instruments Division, Raleigh USA) and Strain Indicator(P-3500, Measurement Group Instruments Division, Raleigh, USA) 15kg of vertical and oblique loads was applied at central fossa of missing 2nd molar area. Results : The strain on lingual side of 2nd premolar was the greatest, and abutment splinting induced decrease of strain on buccolingual side of 2nd premolar. The strain of loaded area was decreased by abutment splinting and there was no statistical difference of strain between Group2 and Group 3, and strain on 2nd premolar in wrought wire clasp was the least. Conclusion: Within the limitations of this study, splinting of two distal abutment teeth is enough for stress distribution widely, and wrought wire clasp was more benefitable than others.
For the purpose of evaluating the effect of both direct retainer design and bony absorption degree around abutment of indirect retainer on the supporting tissue of abutment of indirect retainer, dislodging force was transmitted to unilateral distal extension RPD bases. Analysis of stress distributed within the supporting tissue around abutment of indirect retainer was carried out. Using three-dimensional photoelastic stress analysis method and the conclusion is a follows. 1. According to the extent of force which the direct retainer of the most distal abutment tooth, the amount of force transmitted to the abutment tooth of indirect retainer was small. 2. Of all the cases, Mandibular first premolar which was used abutment tooth of indirect retainer, buccal, mesial and distal sides represented compression stress and lingual side represented tensile stress. 3. The more bone resorption of abutment tooth of indirect retainer, the more distortion of buccal and distal side of abutment tooth was existed and the extent of compression stress which was existed and distal side to abutment tooth was large. 4. When the alveolar bone around the abutment with indircet retainer is normal. The amount of force transmitted on abutment with indirect retainer was small in the order of Akers clasp, RPA clasp, RPI clasp. 5. When the alveolar bone around the abutment with indirect retainer has been absorbed 20% and 30%, the amount of force transmitted on abutment with indirect retainer was small in the order of RPA calsp, RPI clasp, Akers clasp. 6. When denture is displaced, shape of the direct retainer reciprocating abutment affect much the function of indirect retainer.
The purpose of this study was to evaluate the stress distribution developed in the supporting structures by mandibular distal extension removable partial dentures with 2 different direct retainer designs and with or without indirect retainer and abutment splinting. The examined direct retainers on the second bicuspid abutment tooth were Akers clasp and RPA clasp, the indirect retainer was located on the mesial fossa of the first bicuspid, and the first and second bicuspid were splinted in case of tooth splinting. Total 8 cases were compared and analyzed with 3-dimensional finite element method. 150N were applied vertically on the artificial teeth of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows : 1. The forces transmitted to the abutment tooth were primarily from the occlusal rests. 2. The abutment tooth was displaced distally when the force was applied. The compressive stress was observed at the distal root surface of the abutment tooth and the tensile stress, at the mesial root surface. 3. The denture base was displaced posteriorly and inferiorly when the force was applied. At the more distal portion of the denture base, the greater displacement was observed.And the anterior portion of the major connector was displaced superiorly. 4. The occlusal rest placed on the distal part of the abutment tooth tended to tip the tooth more posteriorly than did one on the mesial part of that tooth. 5. Severe superior displacement was observed at the anterior portion of the major connector in case of removable partial dentures without indirect retainer. 6. In case of tooth-splinting, the stress was distributed through all the root surface of both abuments. In case of no tooth-splinting, the stress was concentrated on the distal root surface of the primary abutment.
Splint therapy, the immobilization of teeth, has been done for patient's masticatory comforts and an adjunctive aid in periodontal therapy. Mandibular premolars are frequently splinted in many distal extension removable partial denture cases. But splinting is an extensive restoration that may not be conservative of tooth structure and may prove to be quite costly to the patient. The two dimensional finite element analysis method was used to determine the magnitude and mode of distribution of the stresses of the periodontal ligament and supporting alveolar bone when abutments with different periodontal supports were splinted and distal-extension removable partial denture was subjected to different loading schemes. The results were as follows : 1. When abutments were splinted, stresses moved from apico-distal to apico-mesial of terminal abutment on a vertical force and from disto-alveolar crest to apex on a distally directed force. But stresses were generally diminished on a mesially directed force. 2. As vertical bone loss was proceeding, most of stresses were transmitted to residual ridge and the rest of stresses were concentrated on apex of distal abutment. But these apical stresses were minimized when abutments were splinted. 3. As mesially inclined bone loss was proceeding, it seemed to be dangerous that many stresses were concentrated on the distal alveolar crest, especially in the distally directed load case. Abutments splinting decreased the alveolar crestal stresses but not enough. 4. For all vertical stresses were effectively decreased on splinting, stresses were concentrated as highly on apico-mesial area of distal abutment in distally directed load cases as the distal inclination of bone level was severe. 5. The directions and magnitudes of abutment movements were decreased with teeth splinting.
The collapse of the posterior occlusion destroys the normal occlusal plane and causes excessive wear reducing the vertical dimension. Reduced vertical dimension of occlusion causes not only aesthetic and functional problems but also overloading on the temporomandibular joints and abnormalities of muscle nerve system. In order to improve the collapsed occlusal relationship, it is necessary to consider the change of the vertical dimension. It is necessary to make a precise diagnosis and analysis before the treatment and to evaluate the adaption of patient to the new vertical dimension of occlusion. A patient with excessive overbite often has occlusal problems of tooth wear and tooth eruption. Considering these considerations, overall prosthodontic restoration is required to solve the problem. A patient of 68 year old man in this case who suffered major tooth wear and maxillary posterior teeth loss was treated with elevation of vertical dimension of occlusion by maxillary removable dental prosthesis and mandibular fixed prosthesis.
Distal extension partial dentures are supported by both the relatively rigid teeth and the resilient mucosa. So impression techniques of residual alveolar ridge in case of distal extension partial denture have particular importance in order to broad distribution of the masticatory force. McLean recognized the need for recording the tissues supporting distal extension partial denture base in functional form to equalize the resilient and non-resilient support, and this was called functional impression. Many investigators proposed various techniques of the functional impression for a distal extension partial denture, but only a little studies were performed about displacement of soft tissue under distal extension partial denture base. The purpose of this study is to investigate the amount of vertical displacement of the soft tissue under distal extension partial denture base by different functional impression techniques. Impression techniques used were Z.O.P. Impression, Selective Tissue Placement Impression, Functional Relining Impression. Measurement of the vertical displacement of soft tissue were made with Depth Gauge and Measuring Platform. A Anatomic Impression was used as a control. The results were tested statistically using 3 way ANOVA and Scheffe test. The followings were the results obtained from this study. 1. The greatest amount of soft tissue displacement was observed in the center of the retromolar pad. 2. No significant differences were found between the crest of alveolar ridge and the buccal shelf area. 3. The greatest soft tissue displacement was observed in Functional Relining Impression using Iowa wax, and the least displacement was observed in Selective Tissue Placement Impression using murcaptan rubber base. 4. No significant differences were found between finger pressure and biting pressure in Z.O.P. Impression, but greater displacement was observed by biting pressure than finger pressure in Functional Reling Impression.
There were many studies that distribute the partial edentulous states and examine the removable partial denture designs in the planning of removable partial denture treatment. This study was performed in the point of removable partial denture prescription to evaluate partial edentulism and its removable partial denture designs. The data was collected from the dental laboratory of each three dental colleges in Seoul and from two dental laboratories only for removable partial dentures as a prescription form. A total of 1411 cases with prescription form collected from dental laboratories were distributed for this study, then 788 cases were selected for this study. The case selection was done according to the contents of prescription form. The selected cases were divided into maxillary arch and mandibular and classified in terms of types of major connector and direct retainer, unbroken anterior teeth, Kennedy classification, the number of remaining teeth, and distribution of age and sex. The analyzed results were as follows : 1. The Kennedy classification I showed highest frequency both in maxilla and mandible. 2. The arch distribution of removable partial denture was 50.08% for maxilla and 49.92% for mandible. 3. The highest frequency in the distribution of direct retainer was the RPA clasp design. 4. The frequency of unbroken anterior 6 was 73.36% for maxilla and 82.30% for mandible. 5. The design of broad palatal strap and lingual bar revealed the highest prevalence in the major connector construction. 6. The mean number of remaining teeth per arch was 8.25 for maxilla and 8.37 for mandible. 7. The mean age of the patients supplied with removable partial denture was 52.25 years for men, 51.68 years for women, 52.11 years for maxilla, and 51.76 years for mandible and women showed more prevalence.
The purpose of this study was to evaluate the mechanical effects when one implant fixture was connected to the natural teeth with reduced alveolar bone height. This study also examined the effects of increasing the number of abutment teeth and the effects of the intramobile connector and the titanium connector as they were inserted between the implant superstructure and the fixture. The distribution and concentration load was applied to the fixed partial denture(FPD) supported by implant and the natural teeth with reduced alveolar bone height. The stress and displacement of each element was observed and compared by the two-dimensional finite element method. The following results were obtained : 1. The greater the loss of alveolar bone in natural teeth area, the greater the displacement of FPD and the stress concentration in alveolar bone around implant, especially at the stress concentration in the mesial alveolar bone crest around implant fixture. 2. The displacement of FPD was increased more and that of implants fixture was decreased more when intramobile connector was used than titanium connector was used. Also the stress concentration in alveolar bone around implant fixture was greater when intramobile connector than titanium connector. One implication of this finding was that the difference in stiffness of implant and the natural teeth with reduced alveolar bone height could be partially compensated in case of the POM intramobile connector. 3. The amount and direction of displacement and the stress distribution of the 4-unit FPD was better than those of the 3-unit FPD. It implied that the difference of stiffness of implant and natural teeth with reduced alveolar bone height could be partially compensated in case of the 4 unit FPD.
Although attachments have been utilized for a retainer of removable prostheses during several decades, there is little information on the force distribution by the attachments. This study was undertaken to evaluate the stress patterns developed by partial dentures employing rigid attachments on the supporting structures. Four types of the mandibular removable partial dentures were designed depending upon the position of the rigid attachment and the existency of lingual bracing. Under 100N of vertical and 25N of lateral loads on the 1st and 2nd lower molar of partial denture, stress distribution patterns and displacement were analysed with three dimensional finite element method by ANSYS version 5.3. 1. The highest stresses were concentrated on the distal alveolar crest of posterior abutment and the second stresses on the apical region of posterior abutment in the models. 2. The greatest displacement were shown on the distal alveolar crest of posterior abutment and the second displacement on the distal alveolar crest of anterior abutment in the models. 3. There was little difference between the models with intraoral attachment and those with extracoronal attachment. 4. There was little difference between the models with and without the lingual bracing.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.