Clinical and radiographic assessment of implant retained removable partial denture

The use of dental implant-supported restorations has given an expanded ability to provide predictable replacements for missing teeth. New designs will expand the use of this treatment modality further, especially in the areas of poor bone quality. Implant retained prostheses have become a well-established option to treat the partially edentulous patients and often represent an improvement over traditional removable partial dentures. This article describes implant alternatives and prosthesis design for a group of patients with mandibular unilateral -free end edentulous ridge with one modification on the opposite side. Each patient received removable partial denture retained by telescopic crowns on osseointegrated implants inserted in the edentulous spaces. Implants were used as supporting and retentive elements for mandibular distal extension prostheses. In these cases, sufficient retention gained from telescopic crowns on the implant abutments. A clinical and radiographic evaluation is performed for each patient. Results indicated consistent increased satisfaction in all patients, no radiographic evidence of excessive bone loss, and stable peri-implant soft tissues

Comparative evaluation of removable partial overdentures with and without attachments in anterior long span partially edentulous maxilla

Patients attitudes, medical, surgical and financial considerations lead to the use of a removable partial denture [RPD] as the chosen prosthetic restoration even in the [dental implant era]. There is an unlimited RPD design options. Choosing the right one involves considering biochemical factors, aesthetics and patients' comfort. Treatment with a removable partial overdenture [RPOD] is an affordable choice to fulfill the patient's esthetic demands together with providing good prognosis for the prostheses and preservation of the remaining dentition. This article presents a restorative option to optimize the aesthetic by using auxiliary attachments for retention of RPDs. Precision attachment system provides esthetics, vertical resiliency, and easy replacement of worn attachment. The flexi post attachment offers direct retention for the partial overdenture and at the same time providing direct tooth support via the overdenture abutments. Partial overdenture with these attachments has the advantage of being more stable and retentive than partial overdenture without attachments. Ten male patients having long span maxillary anterior edentulous area were selected. The patients were divided into two groups; for group A, removable partial overdentures retained with flexi post attachments were constructed while for group B, removable partial overdentures with conventional bar clasps were used on the abutment teeth. The objective of this work was to study the effect of the two designs on the abutment teeth and supporting structures. Clinical, radiographic and finite element stress analysis examinations were done. The results revealed that both groups showed no significant differences as presented by clinical, radiographic and stress analysis examinations. The patients wearing dentures with flexi-post attachments gained the added advantages of good esthetic and retention

Effect of complete denture on the supporting oral mucosa and alveolar bone in-patients with hypohidrotic ectodermal dysplasia [HED]

Four young male children [10-13 years] referred from dermatology clinic for prosthetic management .The children were diagnosed as hypohidrotic ectodermal dysplasia with complete an-odontia of their deciduous and permanent dentition. Full upper and lower acrylic dentures were constructed for those children for physiologic and psychosocial reasons .Cytological and radiographical evaluations were carried out before and after denture wearing. Cytological examination before denture insertion showed the presence of large prickly and rounded epithelial cells indicating either incomplete differentiation of the covering surface epithelium, that is normally keratinized. After denture insertion the predominant exfoliated cells were found to be spindleform flattened cells. This may reflect the protective effect of denture wearing on the integrity, of the surface epithelium. Radiographic examinations showing slight increase in the amount of alveolar bone loss after denture insertion

Modified intraoral prosthetic appliance to retract protruded premaxillae and prolabium in babies with bilateral cleft lip and palate [BCLP]

Management of the protruded and rotated premaxilla and prolabium in patients with bilateral cleft lip and palate [BCLP] presents a challenging problem for the reconstructive team. Prosthetic intervention to retract a protruded premaxilla before surgical correction may improve the bony base for tissue molding, avoid excess tension at the surgical site and permitting a one-stage surgical repair. An extraoral and intraoral prosthetic appliance has been used to move the premaxilla and prolabium to a more favorable position. Resilient denture liners were used to cover the part of the elastomeric chain covering the prolabium in intraoral appliances. These liners always need frequent replacement due to lost resiliency, irritation to the skin and their contamination with nasal discharges and sweet. The aim of this study is to improve this design of an intraoral traction appliance to align the protruding premaxilla in infants with bilateral cleft lip and palate. Five babies were selected for this study from pediatric clinic -Tanta University. Their age ranged from 2-10 months. All the babies had bilateral cleft lip and palate. Silicone rubber impressions were made, palatal base plate was constructed using light-cured resin, and two orthodontic buttons were placed in the middle alveolar ridge area of the plate medial to the alveolar crest. A flat rubber tube was cut nearly the same size of the prolabium, the elastomeric chain was passed through this part of the rubber tube. Using a flat rubber tube instead of resilient denture liner is non- irritant to the skin, easy to clean and allows a free movement of the elastomeric chain