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Design consideration in acrylic partial denture/ cosmetic dentistry training


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Design consideration in acrylic partial denture/ cosmetic dentistry training

  2. 2. INTRODUCTION.INTRODUCTION.  Various type of denture designed forVarious type of denture designed for partially edentulous patients using varietiespartially edentulous patients using varieties of denture base material.of denture base material.  Although the cast partial dentures are moreAlthough the cast partial dentures are more accurate and satisfactory, more of acrylicaccurate and satisfactory, more of acrylic partial dentures are used because of itspartial dentures are used because of its simplicity and various other factors.simplicity and various other factors.  The frequency of acrylic partial denture isThe frequency of acrylic partial denture is more than 90 to 95% in routine clinicalmore than 90 to 95% in routine clinical cases when compared to cast partialcases when compared to cast partial denture.denture.
  3. 3. NEED FOR ACRYLIC PARTIALNEED FOR ACRYLIC PARTIAL DENTURE.DENTURE.  SOCIOECONOMIC STATUS ; Most of theSOCIOECONOMIC STATUS ; Most of the patient prefer acrylic partial denturepatient prefer acrylic partial denture because, they are less expensive whenbecause, they are less expensive when compared to others.compared to others.  They can be constructed in any casesThey can be constructed in any cases irrespective of the length of span or theirrespective of the length of span or the condition of the adjoining hard and softcondition of the adjoining hard and soft structures.structures.  In young patients where extensive toothIn young patients where extensive tooth preparation is not advisable as well as inpreparation is not advisable as well as in old patients whose health contraindicatesold patients whose health contraindicates the lengthy and physically tryingthe lengthy and physically trying appointments.appointments.  Because of the most expensive laboratoryBecause of the most expensive laboratory equipments and technique sensitivity of theequipments and technique sensitivity of the cast partial dentures.cast partial dentures.
  4. 4. When there is need for replace teethWhen there is need for replace teeth immediately after their extraction.immediately after their extraction. Relining and rebasing can be possible.Relining and rebasing can be possible. All these factors makes necessity forAll these factors makes necessity for construction of acrylic partial of acrylic partial denture. The three dimensional denture teeth mayThe three dimensional denture teeth may have life like appearancehave life like appearance When aesthetic is of primary concern .ItsWhen aesthetic is of primary concern .Its possible to attain a more natural toothpossible to attain a more natural tooth position by placing a denture tooth on aposition by placing a denture tooth on a denture base.denture base.
  5. 5. Factor influencing the constructionFactor influencing the construction of better acrylic partial denture.of better acrylic partial denture. Nature of support.Nature of support. It is classified as.It is classified as. 1). Tooth borne.1). Tooth borne. 2). Tooth and mucosa2). Tooth and mucosa borne.borne. Tooth borne dentures canTooth borne dentures can carry loads nearly equalcarry loads nearly equal to those normallyto those normally imposed on natural teeth.imposed on natural teeth.
  6. 6.  A mucosa borne upperA mucosa borne upper denture can usually spreaddenture can usually spread the vertical load tothe vertical load to underlying mucosa.underlying mucosa.  Larger the area covered byLarger the area covered by the mucosa borne denturethe mucosa borne denture the smaller the load perthe smaller the load per unit area for any givenunit area for any given load.load.  It is reasonable to assumeIt is reasonable to assume that it is impossible tothat it is impossible to construct a denture in suchconstruct a denture in such a way that vertical load isa way that vertical load is evenly distributed b/w theevenly distributed b/w the teeth and mucosa.teeth and mucosa.
  7. 7. Diagnosis and treatment plan.Diagnosis and treatment plan.  Diagnosis and treatment plan begin with aDiagnosis and treatment plan begin with a thorough health history and history of pastthorough health history and history of past dental experience.  The complete oral examination mustThe complete oral examination must include both clinical and roentgen graphicinclude both clinical and roentgen graphic interpretation of endodontic, periodontalinterpretation of endodontic, periodontal and surgical consideration.and surgical consideration.  Additionally, evaluation of occlusal plane,Additionally, evaluation of occlusal plane, the arch form and the occlusal relationshipthe arch form and the occlusal relationship of the remaining natural teeth must beof the remaining natural teeth must be meticulously accomplished.meticulously accomplished.
  8. 8.  After the complete examination has beenAfter the complete examination has been accomplished ,and a removable acrylicaccomplished ,and a removable acrylic partial denture has been agreed.partial denture has been agreed.  Then a treatment plan and a design canThen a treatment plan and a design can be developed and sequenced that isbe developed and sequenced that is based on the support available for thebased on the support available for the partial denture.partial denture.  Sufficient difference exist between toothSufficient difference exist between tooth supported and tooth and tissuesupported and tooth and tissue supported acrylic partial denture.supported acrylic partial denture. 1)1) Manner in which the prosthesis isManner in which the prosthesis is supported.supported. 2)2) Type and extent of mouth preparation.Type and extent of mouth preparation.
  9. 9. Impresion procedure.Impresion procedure.  Almost all acrylic partialAlmost all acrylic partial dentures take support fromdentures take support from the underlying mucosa.the underlying mucosa.  Simple alginate impressionSimple alginate impression will not be sufficient towill not be sufficient to record the tissue in bothrecord the tissue in both functional and anatomicalfunctional and anatomical form.form.  So dual impression is mustSo dual impression is must in case of acrylic partialin case of acrylic partial denture base design.denture base design.
  10. 10. Surveying.Surveying.  Surveying is an importantSurveying is an important procedure not only for castprocedure not only for cast partial dentures but also forpartial dentures but also for acrylic partial dentures.acrylic partial dentures.  The prime purpose ofThe prime purpose of surveying is locate thesurveying is locate the under cut for the path ofunder cut for the path of insertion and removal.insertion and removal.  To locate the position ofTo locate the position of the clasp below the heightthe clasp below the height of contour.of contour.
  11. 11.  it will demonstrate underit will demonstrate under cut area which can becut area which can be used for retention of theused for retention of the denture.denture.  Surveying isSurveying is accomplished by holdingaccomplished by holding a vertical marking edgea vertical marking edge such as graphite rod insuch as graphite rod in contact with the crown ofcontact with the crown of the tooth and movingthe tooth and moving either the cast or rod, soeither the cast or rod, so that the side of graphitethat the side of graphite draws a line around thedraws a line around the circumference of thecircumference of the crown. also to measurecrown. also to measure soft tissue and bonysoft tissue and bony undercutundercut
  12. 12. Component of acrylic partialComponent of acrylic partial denture.denture.  Unlike cast partial denture, acrylic partial dentureUnlike cast partial denture, acrylic partial denture contains onlycontains only 1) Acrylic denture base1) Acrylic denture base 2) Teeth2) Teeth 3) Direct retainer( clasps).3) Direct retainer( clasps).
  13. 13. Acrylic denture base.Acrylic denture base.  The purpose of denture baseThe purpose of denture base is for unification ofis for unification of components.components.  Secondly it serves asSecondly it serves as retentive factors. It acts asretentive factors. It acts as major, minor connector andmajor, minor connector and some times as indirectsome times as indirect retainer.retainer.  Distribution of the load evenlyDistribution of the load evenly over the underlying mucosa.over the underlying mucosa.  Stabilization of the denture byStabilization of the denture by resisting the horizontal forces.resisting the horizontal forces.
  14. 14. Natural retentive factors.Natural retentive factors.  Frictional resistance bw theFrictional resistance bw the denture and lingual surfacedenture and lingual surface of the posterior tooth.of the posterior tooth.  The contour of the hardThe contour of the hard palate and character of thepalate and character of the palatal mucosa.palatal mucosa.  Interfacial surface tensionInterfacial surface tension b/w the denture base andb/w the denture base and mucosa.mucosa.  Area of coverage of theArea of coverage of the denture base.denture base.
  15. 15. Design consideration in denture base.Design consideration in denture base.  Design of the denture baseDesign of the denture base mainly depends on the nature ofmainly depends on the nature of the support or extent ofthe support or extent of edentulous space.edentulous space.  The denture base well extendedThe denture base well extended into the interproximal areas andinto the interproximal areas and onto the tooth surface above theonto the tooth surface above the survey line.survey line.  Always the denture base shouldAlways the denture base should be extended extended bilaterally.  In case small edentulous spaceIn case small edentulous space the orthoplated design can bethe orthoplated design can be preffered.preffered.
  16. 16.  The denture base canThe denture base can be extended onto thebe extended onto the cingulum the anteriorcingulum the anterior teeth for the indirectteeth for the indirect retention.retention.  It should be of sufficientIt should be of sufficient thickness to avoidthickness to avoid distortion duringdistortion during function.function.  The denture baseThe denture base should be large enoughshould be large enough to prevent prevent aspiration.  Also it should be radioAlso it should be radio opaque to detect in suchopaque to detect in such condition.condition.
  17. 17. Teeth selection.Teeth selection.  Teeth selection can beTeeth selection can be broadly classified asbroadly classified as Anterior teethAnterior teeth posterior teeth.posterior teeth. customized teeth are mostcustomized teeth are most preferable than pre –preferable than pre – fabricated teeth.fabricated teeth. pre fabricated teeth can bepre fabricated teeth can be selected based onselected based on material, shade andmaterial, shade and mould.mould. acrylic teeth are moreacrylic teeth are more preferred as they can bepreferred as they can be customized accordingcustomized according opposite natural teeth.opposite natural teeth.
  18. 18. Scraping of the ridge helps intimate contactScraping of the ridge helps intimate contact of the teeth with the underlying tissueof the teeth with the underlying tissue The buccolingual width of teeth selectedThe buccolingual width of teeth selected should be smaller than opposing naturalshould be smaller than opposing natural teethteeth Modification of acrylic teeth. acrylic teeth with amalgam stopsacrylic teeth with amalgam stops;; amalgam is condensed on the preparedamalgam is condensed on the prepared acrylic teeth. This prevents wearing ofacrylic teeth. This prevents wearing of acrylic teeth.acrylic teeth. IPN ( Inter penetrating polymer network ).IPN ( Inter penetrating polymer network ). it has got quality of acrylic and has got quality of acrylic and porcelain. And it said to be less wearable than acrylic.And it said to be less wearable than acrylic.
  19. 19. Direct retainer.Direct retainer.  The components that engages anThe components that engages an abutment tooth and in doing so resistabutment tooth and in doing so resist dislodging forces applied to a removabledislodging forces applied to a removable partial denturepartial denture It is generally preferable not employ clasp toIt is generally preferable not employ clasp to retain the partial denture unless naturalretain the partial denture unless natural retentive factors are exceedinglyretentive factors are exceedingly unfavorableunfavorable Clasps will strain the abutment tooth due toClasps will strain the abutment tooth due to improper tooth preparation and claspimproper tooth preparation and clasp Caries may develop beneath the claspCaries may develop beneath the clasp component, especially if the patient fails tocomponent, especially if the patient fails to keep the prosthesis clean.keep the prosthesis clean.
  20. 20. CLASPS.CLASPS. Clasp can be made eitherClasp can be made either of wrought wire or castableof wrought wire or castable clasp or combination ofclasp or combination of both .both . The most common designThe most common design employed is the simpleemployed is the simple circlet clasp with 18 gaugecirclet clasp with 18 gauge wire.wire. Material used for clasp.Material used for clasp. wrought alloy wire iswrought alloy wire is superior to cast by virtue ofsuperior to cast by virtue of its internal structure. It isits internal structure. It is more flexible, minimummore flexible, minimum friction compared castfriction compared cast clasp.clasp.
  21. 21. Requirements of clasp design.Requirements of clasp design. Retention ; to provideRetention ; to provide retention againstretention against dislodging forces.dislodging forces. The amount of retention isThe amount of retention is depends ondepends on Flexibility,Flexibility, The amount of clasp armThe amount of clasp arm that extends below thethat extends below the height of contourheight of contour The depth that retentiveThe depth that retentive terminal extends into theterminal extends into the under cut.under cut.
  22. 22.  Flexibility.; it's a mostFlexibility.; it's a most variable factor invariable factor in determining retention.determining retention.  Greater the length greaterGreater the length greater will be flexibilitywill be flexibility  It is inversely proportionalIt is inversely proportional to the diameter of the diameter of clasp.  Cross sectional form.Cross sectional form.  Material of the clasp;Material of the clasp; wrought alloy are morewrought alloy are more flexible when compared toflexible when compared to cast alloy.cast alloy.
  23. 23. Positioning of the clasp.Positioning of the clasp.  Encirclement.; claspEncirclement.; clasp should be designed toshould be designed to encircle more thanencircle more than 180*(more than half of180*(more than half of the tooth.)the tooth.)  Passivity. A clasp mustPassivity. A clasp must be completely seated onbe completely seated on a tooth to be passive.a tooth to be passive.  Location of the retentiveLocation of the retentive tip.tip.  It should be placedIt should be placed such that resultant forcesuch that resultant force should fall near center ofshould fall near center of gravity of denture.gravity of denture.
  24. 24. Modification in clasp design.Modification in clasp design.  Double wire clasp.Double wire clasp. Indicated when the gaugeIndicated when the gauge of the wire is less.of the wire is less.  Ball end clasp; whenBall end clasp; when undercuts are not presentundercuts are not present for conventionalfor conventional clasp(0.040 inch).clasp(0.040 inch).  Zig zag shaped clasp;Zig zag shaped clasp; they also acts as occlusalthey also acts as occlusal  Single wire clasp withSingle wire clasp with blunt end. (thick gauge)blunt end. (thick gauge)
  25. 25. Try in acrylic partial denture.Try in acrylic partial denture.  A try-in appointment shouldA try-in appointment should be used on a routine basisbe used on a routine basis for acrylic partial denture.for acrylic partial denture.  The patient should beThe patient should be seated in a pleasant, quiet,seated in a pleasant, quiet, room to alleviateroom to alleviate unnecessary tension.unnecessary tension.  Try in helps in correction inTry in helps in correction in tooth size, tooth position, ortooth size, tooth position, or tooth shade can betooth shade can be accomplishedaccomplished  Also verification of the jawAlso verification of the jaw relation records that wererelation records that were made at last appointments.made at last appointments.
  26. 26.  Denture base is waxed toDenture base is waxed to neat anatomicneat anatomic appearanceappearance  Anterior teeth must beAnterior teeth must be looked for adequate liplooked for adequate lip support and naturalsupport and natural appearance.appearance.  Accurate vertical andAccurate vertical and horizontal overlap must behorizontal overlap must be checked.checked.  Midline, formed byMidline, formed by proximal surface ofproximal surface of incisors must be inincisors must be in harmony with midline ofharmony with midline of face.face.
  27. 27. Trimming and polishing partial dentureTrimming and polishing partial denture  Three areas of primaryThree areas of primary concernconcern 1).external surface of1).external surface of denture base.denture base. 2).periphery or borders of2).periphery or borders of denture base.denture base. 3) finish lines or contact3) finish lines or contact area b/w teeth andarea b/w teeth and denture base.denture base. Care should be taken notCare should be taken not create dead spaces orcreate dead spaces or leading food trapment.leading food trapment.
  28. 28. Insertion of partial denture.Insertion of partial denture. Objectives.Objectives. Correcting the fit of theCorrecting the fit of the denture base to thedenture base to the edentulous ridge.(pressureedentulous ridge.(pressure indicating paste.)indicating paste.) To correct the occlusalTo correct the occlusal discrepancydiscrepancy To adjust the retentive claspTo adjust the retentive clasp if necessary.if necessary. To instruct the patient inTo instruct the patient in home care and care of thehome care and care of the prosthesis.prosthesis.
  29. 29. Post insertion observation.Post insertion observation. Soft tissue irritation,lacerationSoft tissue irritation,laceration or ulceration.or ulceration. Use the pressure indicatingUse the pressure indicating paste to locate and relivepaste to locate and relive the area.the area. Irritation to teeth due toIrritation to teeth due to pressure from partialpressure from partial denture.(disclosing wax).denture.(disclosing wax). Articulating papers are usedArticulating papers are used to locate the area ofto locate the area of occlusal interference.occlusal interference.
  30. 30.  Check for problems withCheck for problems with phoneticsphonetics  Correction of cheek orCorrection of cheek or tongue biting.tongue biting.  Can be corrected byCan be corrected by rounding mandibularrounding mandibular buccal cusp.buccal cusp.  Difficulty in chewing.Difficulty in chewing.  Loose denture.- becauseLoose denture.- because retentive clasp tip thatretentive clasp tip that were not adjustedwere not adjusted accurately or completelyaccurately or completely into the undercut area.into the undercut area.
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