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International Poster Journal of Dentistry and Oral Medicine
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Int Poster J Dent Oral Med 11 (2009), No. 3     15. Sep. 2009

Int Poster J Dent Oral Med 2009, Vol 11 No 3, Poster 452

Prosthetic rehabilitation with slide attachments and free-end saddle casted partial mandibular denture

Language: English
 

Authors:
Associate Prof. Dr. Srdjan Postic, Associate Prof. Dr. Aleksandar Todorovic,
University Clinic of Dental Prosthetic, The Faculty of Stomatology, University of Belgrade

Date/Event/Venue:
4-6 of September, 2008
32nd Annual Congress of European Prosthodontic Association
Pecs
 

Introduction

Precision slide attachment could be successfully used as the retainer for RPD, providing beneficial axial loading. Regardless restorations opposed by a denture, where one single tooth on each side of the arch would be needed as a retainer, in the case where bony support of abutment could be compromised 3, or more abutment teeth have to be included in design on each side.
 

Objectives

The aim of this study is to present prosthetic rehabilitation of partially edentulous patient by mandibular cobalt-chrome partial denture with non-adjustable intracoronal slide attachments and upper CD.
 

Results

Case report. 5 anterior teeth of mandibular arch of the patient, 59 yrs., were prepared for MCC. Elastomeric impression (Oranwash L, Zhermack) was taken in customized tray, and poured than using a stone (Gipsogal, Galenika a.d.,Serbia). The model was placed on parallelometer (Heraeus CL-MF2000, Germany) and the path of insertion was determined. Wax patterns were completed on dies and precision attachment was held in a mandrel with wax built up to contact the attachment (Patrix Vario soft 3 VKS 1.7 Bredent, Germany). After investing and casting, metal castings of 3 splinted copings to the right side of arch and 2 splinted copings on left incisors abutments were placed back to working cast. The patrix was placed in the matrix housing, with care being taken to ensure the fully seated patrix (Patrix and yellow matrix Vario-Snap Bredent, Germany), and lingual extensions fitting on milled metal surfaces. After completion of MCC (Vita Germany), matrix was processed in metal framework (WisilM, Germany) of mandibular denture, and complete trial of metal components was carried out in the mouth of the patient, than. Functional impression of edentulous upper jaw was provided using paste (Zn-oxide Vikopres, Galenika) in custom tray (Palavit L, Galenika).Transfering face-bow (Artex) was positioned to provide transfer of working cast in articulator (Semi-adjustable Artex articulator, Germany). Jaw relationships were established in the mouth. After checking for aesthetic, denture teeth (Biogal, Galenika) were set up in wax on the articulated master model and tried in his mouth for fit and occlusion. The bilateral free-end saddle mandibular denture with milled MCC and upper acrylic CD were fitted in the mouth. Controls were taken 6 and 12 months after baseline to assess retention.

Fig. 1: 5 anterior lower teeth after preparation Fig. 2: Combined silicone and zinc-oxide-eugenol paste impression of his mandible
Fig. 3: Patrix elements in matrix housing Fig. 4: Metal framework attachments and MCC in the mouth
Fig. 5: Framework in position Fig. 6: Patrix elements on MCC and metal framework with matrix housing
Fig. 7: Face-bow positioned towards reference points
 
Fig. 8: Face-bow towards center of rotation
 
Fig. 9: Occlusal rim on metal framework in the mouth Fig. 10: Wax of occlusal rim and inner surfaces of crowns

Conclusions

Conclusion.Suitable orientation of slide attachments and fitting free-end saddle mandibular casted RPD, opposed by a CD, is very satisfactory prosthodontic approach in therapy and rehabilitation of partially edentulous patients.

Fig. 11: Relationship of jaws Fig. 12: Situation after mounting of upper master cast into articulator and positioning of occlusal rims, subsequently
Fig. 13: Occlusal rims separately showing the positions of wax and metal-ceramic crown's surfaces Fig. 14: Trial
Fig. 15: 12 months control
 

Literature

  1. Graber, G. Color Atlas of Dental Medicine 2. Removable Partial Dentures. 1st edition. Graber G.,Haensler U., Wiehl P., Rateitschak KH. Thieme Medical Publishers, 1988. ISBN 9780865772762 / 9783137110019. Fundamentals-retainers for partial dentures, pp.6-23.
  2. Jenkins, G. Precision attachments-a link to successful restorative treatment. 1st edition. Jenkins G. London:Quintessence Publishing Co.,1999. ISBN1850970386. Bilateral free-end saddle dentures, pp.23-27.
  3. Nastić, M. Vezni elementi parcijalne proteze. 2nd edition. Kandić M., Nastic M. Beograd:ISRO Privredno-finansijski vodic, 1996. Sliding attachments-klizaci, pp.81-102.
  4. Preiskel, H. Overdentures made easy-a guide to implant and root supported prostheses. 1st edition. Preiskel H. London:Quintessence Publishing Co., 1996.ISBN1-85097-039-4. Screws, cantilevers and retention systems, pp.67-80.
  5. Stamenković, D. Stomatoloska protetika - parcijalne proteze. 1st edition. Stamenković D., Nastić M. Beograd: Zavod za udžbenike i nastavna sredstva, 2000. ISBN86-17-07437-X. Sliding attachments-precizni vezni elementi,pp.45-110.
  6. Stamenković, D. Stomatoloska protetika - parcijalne proteze. 1st edition. Stamenković D. Beograd: Interprint, 2006. ISBN86-82263-47-5. Sliding attachments-precizni vezni elementi,pp.282-289.
  7. Vanzeveren C, D\'Hoore W, Bercy P, Leloup G (2003) Treatment with removable partial dentures: a longitudinal study. Part II. J Oral Rehabil, Vol 30, No 5:459-469.
     

Abbreviations

RPD – Removable Partial Denture
MCC – Metal-ceramic Crowns
CD – Complete Denture
 

This Poster was submitted by Associate Prof. Dr. Srdjan Postic.
 

Correspondence address:
Associate Prof. Dr. Srdjan Postic
University of Belgrade
University Clinic of Dental Prosthetic, The Faculty of Stomatology
Rankeova Street, 4
11000 Beograd, Serbia