This is the presentation of my graduating thesis.

1. TITU MAIORESCU UNIVERSITY OF BUCHAREST
FACULTY OF MEDICINE AND DENTAL MEDICINE
The Flexible Denture
Supervisor: Author :
Univ.Assist PhD. Smătrea Oana Ursu Mihaela Catalina

2. Agenda
✓ 1 Introduction
2 Partially edentulous
3 Materials used in obtaining the flexible partial denture
4 Clinical stages in obtaining the partial denture
5 Clinical cases
6 Conclusionss

3. 1 Introduction
Purpose of the paper
• This paper is about partial edentations, presenting
treatment options with advantages and disadvantages.
•The paper is far from exhaustive because on one hand the
technology is relatively new in Romania, and on the other
hand considerable financial effort is needed to acquire and
implement.
• For this reason we believe that there is room for
improvement in many of the concepts presented here.

4. 2
The partial edentulous. Definition
Partial edentulous is a pathological condition arising from the
loss of one or more teeth in an arch.

5. 2.1
Causes for partial edentations
• decay and its complications;
• marginal periodontitis;
• vertical and horizontal migrations
exaggerated;;
• excessive abrasion;
• iatrogenic causes;
• occlusal dysfunction.

6. 2.2 Classification of the edentulous jaws - I
CLASS II -
 CLASS I - Unilateral
Bilateral Posterior
Posterior Edentulous Area
Edentulous
Areas
 ;
CLASS III - CLASS IV - Single
Unilateral or Edentulous Area
Bilateral Anterior to
Edentulou Remaining Teeth
Area(s) and Crossing the
Bounded by Midline
In 1923. E.Kennedy published a simple
Remaining
Tooth/Teeth and practical classification, reducing the
number of clinical forms to only four
groups, according to topography :

7. 2.2 Classification of the edentulous jaws - II
Costa proposed a simple terminology that names partial edentations, terminology applied in
our country:
• edentulous frontal • edentulous subtotal - 1-2 remaining teeth on arch;;
• the lateral edentulous • edentulous stretched - the missing teeth in
• terminal edentulous edentulous a hole more than three teeth ..
Based on this classification of Costa
Ionita made ​some changes in 1998:
• extended edentulous - in the same gap
are missing teeth from two different areas
(frontal and lateral);
• reading is in order of the edentulous
quadrants, while the Costa classification
reading is from right to left on both jaws..

8. 2.4
Indications for the flexible denture
 class I
 class II
 class III
 class IV
 combined edentations

9. 3 Materials used in obtaining flexible partial denture - I
✓ Thermopress 400 injection unit
The injection moulding technique or
the proper term of injection moulding
describes a procedure in which a
heated high-performance plastic
(resin) material is injected into a
hollow mould under very high
pressure. The materials used in the
injection moulding technique - so-
called thermoplastic resins - enable
dental technicians to fabricate Thermopress 400 injection unit
restorations for sensitive
personswithout the use of chemical
additives or catalysts.Four underlying
factors sync procedure: temperature -
time - speed – power.

10. 3 Materials used in obtaining flexible partial denture - II
✓ Bio Dentaplast ,the semi-crystalline
thermoplastic material with a linear structure
characterized by high crystallinity .
The exceptional physiological behavior and
the wide range of mechanical characteristics
permit the use in numerous areas of dental
prosthetics.
The material shows good physical and
chemical properties such as increased
hardness, stiffness considerable tensile
strength, capability restoration and a very
good dimensional stability. The material is Bio Dentaplast
opaque and prevents glare color metal.
We find it available in shades A2, A3,
B2, B3 (shades similar to VITA)

11. 3 Materials used in obtaining flexible partial denture - III
✓ Flexiplast,is a monomer-free denture
base material for the fabrication of
unbreakable flexible partial restorations.
The color pigments used for this material
do not contain anymetal oxides and comply
The flowable thermoplastic resin exhibits
outstanding flow properties.with the
requirements for dental products.
Indicated for removable partial restoration
with a highly esthetic appearance, which
fulfils all requirements on proper function
and wearing comfort.
Excellent temporary during the healing
Flexiplast
phase of implant-supported restorations.
Almost invisible flexible partial denture -
without metal clasps. Can be used in
combination with metal frameworks or
precision attachments.

12. 4
Clinical stages in obtaining the flexible partial
denture
8.The wax try-in
6. The skeleton
probe of
thermoplastic
partial denture 9
8
4. final or 7
functional 6
impression
5 9. Applying the
7.maxilomandibular flexible partial
2. Preliminary
4 relation record denture in oral
impression 5. The analysis of cavity
3 the percise
topological or
2 3.The analysis of
functional model
the study model
1 and the design of
the partial denture
1. Examination of the made of bio
patient, radiographs, dentaplast
diagnosis and
therapeutic indication

13. 4.1
Examination of the patient, radiographs,
diagnosis and therapeutic indication - I
Clinical examination of patient,diagnosis and
treatment plan
Develop a diagnosis can be made not only based on
historical data but also on the clinical examination. Clinical
examination is done in a certain sequence:
• general medical examination;
• local exam.
Local exam
Includes two main stages :
A.Facial exam:
• Inspection begins with assessing facial symmetry, proportionality
floors of the face, observing aspects of facial tics or oral breathing.
Mouth opening amplitude is observed, if the opening is straight,
deflected or painful. In TMJ exam we can identify auscultatory
crepitation, which can betray occlusal dysfunction or degenerative
phenomena of joint.

14. 4.1
Examination of the patient, radiographs,
diagnosis and therapeutic indication - II
Local Exam
B. Oral exam:
Soft tissue examination
Radiographs
Remaining teeth
Bone density
Periodontal diseases

15. 4.2
Preliminary impression
✓
Is the negative copy of
the partially edentulous
prosthetic field and it is a
clinical stage which
includes all oral structures .
It is made ​with elastic
materials such as
irreversible hydrocolloids

16. 4.3
The analysis of the study model/cast
✓ The study model is
used in:
- Diagnosis
- Treatment plan
development
- But is also a legal
evidence.

17. 4.4
The final or functional impression
✓ Is the prosthetic field’s copy
obtained by very precise
impression material placed in
customized final impression
tray,materials that can be Addition
Silicones or Tissue Conditioners

18. 4.5 The analysis of the percise topological or
functional model and the design of the partial
denture made of bio dentaplast - I
✓ On the model are being performed all the technical stages until the completion
of the partial denture. If the partial denture will be made out of Biodentaplast ,a
duplicate model it will be necessary to create the skeleton of thermoplastic material
for the partial dentures.
Manufacture of duplicate
model

19. 4.5 The analysis of the percise topological or
functional model and the design of the partial
denture made of bio dentaplast - II
The biodentaplast skeleton of the denture is obtained on the duplicate model by injecting under
pressure

20. 4.6 The skeleton probe of thermoplastic
partial denture
✓ It's an extra step when using Biodentaplast material ,at this time the doctor is
checking the correctness of thermoplastic skeleton.

21. 4.7 Maxilomandibular relation record
✓ The maxilomandibular relation record is made with wax occlusal rims that have
as a baseplate the Bio dentaplst skeleton.

22. 4.8
The wax try-in
✓ The purpose of the wax try-in appointment is to verify all aspects of the denture
tooth setup – the appearance, phonetics, occlusal relationships and patient comfort
and in this stage the doctor with the patient can make changes related to aesthetics.

23. 4.9 Applying the flexible partial denture in
oral cavity
✓ This is not the last step in the patient’s edentulous treatment , he is invited to
return to practice after 24-48 hours to verify the correctness of performance and
realization of the dentures and retouching the denture where necessary.

24. 5
Clinical cases
CASE 1: M.V. 70 years old
Diagnosis of edentulous:
- Total edentulous upper
jaw untreated
- Class 1 edentulous lower
jaw
Tratament:
• Polyan total upper
denture
• Biodentaplast lower
denture with clasps on
33.43

25. 5
Clinical cases
Study model Customised impression tray
Customised impression tray Functional impression

26. 5
Clinical cases
Biodentaplast skeleton Biodentaplast skeleton
The wax try-in The wax try-in

27. 5
Clinical cases
Flexibility appreciation of theBiodentaplast clasps
Flexible
Wax try-in probe Applying the flexible partial
Biodentaplast clasps denture in oral cavity

28. 5
Clinical cases
CASE 2: D.L. 70 years old
Diagnosis of edentulous:
• latero-lateral upper jaw
edentation treated with two
metal-acrylic fixed prostheses
with the aggregation elements
17,16,13 and 23.27. 12,11,21,22
presents metal-acrylic crowns
sided;
• edentulous lower jaw, class 1
untreated
Tratament:
• Biodentaplast dentureon the
lower jaw with clasps on 33.43

29. 5
Clinical cases
Biodentaplast
Preliminary impression skeleton
The clasps position
Skeleton’s probe

30. 5
Clinical cases
Maxilomandibular relation record
Wax try-in

31. 5
Clinical cases
Applying the flexible partial denture in oral cavity
The clasps position

32. 5
Clinical cases
CASE 3: F.N. 71 years old
Diagnosis of edentulous:
• superior edentulous
partial treated with metal-
acrylic bridge,aggregation
elements 21,12,13 with
15 extension, and
aggregation elements of
another bridge on
22,23,24. 26 and 27 have
metal crowns sided
• 2nd class edentation with
1 modification on the
lower jaw untreated.

33. 5
Clinical cases
Tratament:
• 21,12,13 bridge removal and its
restoration without distal extension
• Biodentaplast partial denture on upper
jaw with clasp on the 13, 27
• Biodentaplast denture on lower jaw
with clasps on33.43 ,33.43 that were in
advance covered with acrylic crowns
and 47 was previously covered with a
metal crown
Superior denture
The denture applied in the oral cavity - I
Clasps position

34. 5
Clinical cases
The denture applied in the oral cavity - II
Clasps position

35. 6
Conclusions
Advantages :
- biocompatibility - the materials used do not give allergy
- patient adapt much easier to the dental prosthesis
- resistance to fracture, flexible, unbreakable, comfortable, highly
accurate, no metalic taste, tooth-colored clasps or gum colored.
- very good price quality ratio. The price is on average 40-50%
higher than a conventional denture.

36. 6
Conclusions
Disadvantages:
- are that it is difficult to repair and implies a broader technological
process
- the price is higher than conventional partial dentures

37. 6
Conclusions
Thank you for
your time !