Partial dentures: a removable partial denture, which is better
The absence of several teeth – diagnosis, which occurs in patients of all age groups, but is particularly common in people late adult (46-60), elderly (60-74), old-old (75-89). Typically, these patients are looking for the easiest, painless and fastest way to make prosthetics. The best and most popular solution in this situation are partially removable dentures. Its production adds to patient confidence, improve the aesthetics of the face, both visually and psychologically reduces the age of a person, enables you to eat and socialize with other people. The feature of the partial removable denture is that it replaces a missing jaw teeth subject to the preservation of at least one healthy tooth. The more saved own of the abutment teeth – the better the conditions for fixing and use, however dubious, inflamed teeth leave as a support is impractical. The decision on the choice of the abutment teeth and the removal of devitalized doctor takes on the basis of x-ray or tomographic images, assessing the state of the root and surrounding bone tissue.
Types of partial dentures
- Laminar partial removable denture:
- Acrylic partial denture;
- Nylon partial denture;
- Clasp dentures:
Acrylic and metal partial dentures are made virtually every lab in Russia. Nylon, acetal and other plastic materials are much rarer, but have their advantages, indications, a niche in the dental prosthetics. To determine which best fit a particular patient need to visit the dentist-orthopedist.
Acrylic partial dentures
Design based on polymethylmethacrylate or, to put it simply, acrylic is the most common type of removable prostheses successfully used to replace literally any number of missing teeth.
In the case where it is necessary to remove a front tooth, and the patient plans implants or a bridge design, just need a temporary removable disc or immediat-prosthesis. The cast for it is removed 1-2 days before removal, and superimposed partially removable dentures in the first few hours after you stop bleeding from tooth. Otherwise it’s called a vanity plate, because it applies exclusively to restore the aesthetics of a smile. To wear it is only up to the moment until it is made permanent construction.
Laminar partial removable dentures for permanent use are composed of pink plastic parts that mimic the mucosa, plastic white teeth and bent wire clasps hooks that hold konstruktsiyu on your own teeth. To strengthen the plastic base material sometimes at the manufacturing stage carried out the reinforcement in the thickness of the plastic packs of thin metal mesh, protecting the denture from breakage. The more the abutment teeth is preserved, the more stable it keeps, however, its significant drawback is that the chewing load it places into the bone tissue of the jaw, what causes it to atrophy. In connection with the constant changes in the bone tissue, the patient is forced to frequently visit the doctor for correction of the prosthesis, and at the end of its life (usually around five years) denture should be replaced.
The distinctive positive features of this type of prostheses is their relative cheapness and simplicity of manufacture, easy to adjust, to adapt the prosthesis to the conditions in the oral cavity. Unfortunately, some patients have encountered allergic reactions to the material of manufacture. As a rule, sensitivity is manifested to the pink dye in the composition of the plastic. In this case, the patient can be offered a similar process with a colorless base, the vast majority of cases this solves the problem. If there is still a negative reaction, consider other designs.
For acrylic dentures in a small number of preserved teeth there is an option telescopic fixation. The method lies in the fact that their teeth are covered with metal caps – crowns, and denture base in place of the projection data of the teeth leave indentations, the grooves, when comparing which is the fixation of the prosthesis.
Nylon partial dentures
Nylon is a very flexible polymer material in the graft represents the basis and clasps as a whole. This option is suitable for a removable prosthesis, people with a gummy smile, because pink nylon clasps not stand out against the mucous membranes.
Nasonova structure of the prosthesis makes it more pliable, supple, it is less traumatic to the mucous membranes of the gums and the hard palate. In addition, the material is practically hypoallergenic. Disadvantages are high cost, difficulty in fabrication and correction by the individual characteristics of the patient. Not every laboratory has the tools and materials for working with this type of prosthesis, and many doctors believe the correction is complicated and time-consuming, because the material at the place of grinding is divided into fiber, you need certain tools to process it and give the required smoothness.
Metal clasp dentures
Denture is the cast metal base in the form of an arc, echoing the shape of the dentition with acrylic bases and artificial teeth. Clamp the handle are cast together with the arc as a whole. This makes them more durable, perfect in shape to your own teeth. The advantages of the structure before the laminar removable partial dentures is that masticatory stress is distributed evenly between the gingival part and own teeth, which is considered profesionalnim the method of recovery of function. However, in order for the abutment teeth withstand the required load, they must be covered with crowns, even if they are healthy.
The metal part greatly strengthens it, but can cause phenomena of galvanism in the mouth of a patient, according to symptoms resembling an allergic reaction. This happens due to the occurrence of a potential difference of the metal and the electrolytes of saliva.
Locking fasteners are also used in the manufacture of clasp dentures, providing a more secure fit, to prevent tipping of the denture. The manufacture of such a prosthesis is much more time consuming and expensive, so rarely in demand.
Clasp dentures acetal
Modern, but less common at the moment polymeric material, combining the aesthetics of plastics and strength of metal products. Acetal allows to combine the gingival shades and white color close to the tooth. Thus, the hooks of this material can be painted so that they were not allocated neither in the background mucosa, nor on the background of their own teeth. The absence of metal components eliminates the phenomenon of appearance of electric potentials. On the physical properties of acetal close to the ceramic masses. Physiological load distribution, aesthetic appearance and durability of the material, bioinertness make it the almost perfect option. The disadvantages include the high cost, a small number of technicians who are able with this material to work, as well as the fragility of the material, the impossibility of correction. What is better to choose materials for each patient individually, in accordance with his wishes and possibilities.
The stages of
In the first visit to the orthopedic surgeon determines the necessity of reorganization, and indicates which teeth to treat, which to delete and which to choose as a support. Before the prosthesis is also necessary to visit a periodontist is to remove dental plaque and reduce inflammation of the gums.
After preparation of the mouth the question about the need for removable dentures – part teeth usually need to be covered by crowns. Dentures a removable partial denture to the remaining dentition defect made in the last turn.
- The first step the doctor takes imprints of the upper and lower jaw with quickly solidifying the alginate mass.
- In the lab made models and wax cylinders to determine the occlusion (i.e. the ratio of the jaws, the usual for the patient). In the case of the manufacture of the prosthesis, at the same stage is applied to the frame of the arc.
- Then technician makes a wax billet basis with artificial teeth.
- The doctor tries on this stock and makes the appropriate adjustments.
- Then the wax is melted in a plastic, she, in turn, polymerized, then in the lab is polishing and the finished work is given to the doctor.
- Now the patient is given recommendations for care and adaptation, training on the imposition and removal of the denture. Next time you visit.
The first days of wearing even the very best dentures for the most severe addiction. After the prosthesis given to the patient is assigned an appointment the next day. During the day the prosthesis is worn without removing for the doctor to easily identified areas of the prosthesis to be adjusted.
Next visit with the purpose of correction are performed on the patient’s sensations. Is that the basis fits perfectly and does not cause discomfort from day one. If still occurs a trauma of mucous, you need to remove the design from the oral cavity and apply for 3-4 hours before the appointment. This will enable visualization of problem areas.
The first phase of adaptation lasts 2-3 days, manifested a pronounced irritation, rejection of structure as a foreign body. It is important to force yourself to wear it as long as possible to relieve addiction in the future.
This is followed by phase partial braking, which shifts to a full brake application and full addictive comes at the end of the month. The more the patient eats the food, speaks out loud and spent the night with the prosthesis in the mouth, the faster and easier flow in the data phase. To improve the violated the diction should be as much to talk, to read aloud in front of a mirror.
Caring for dentures
To partial dentures lasts as long as possible, you must give them no less attention than your own teeth. After a meal you should always rinse them with water, and twice a day to clean with a toothbrush and toothpaste. This will save the jewelry and the abutment teeth from excessive formation of plaque and Tartar.
Acrylic plates can be placed in a moist environment for the period of sleep that the plastic will last longer. For this purpose, perfect clean kitchen sponge moistened with tap water.
At least once a month is to dissolve in a glass of water specially designed for cleaning tablets, antibacterial, disinfectant properties.
Repair of dentures
If the basis is made of acrylic plastic, it is easy to repair in case of breakage of the base or clasps. Sometimes you have to remove part of the abutment teeth. In this case there is no need to redo all the work, enough to make the additional welding of the tooth. The possibility and feasibility of repair can be determined only by the doctor. In some cases, when the service life has passed, more reliable and better to make a new design.
Contraindications to the manufacture of
- Mental illness;
- Neurological diseases (especially epilepsy);
- Infectious or neoplastic diseases in the oral cavity;
- Profession, which require clear, intelligible speech.
Currently, more and more patients refuse the prospect of a partial removable prosthesis, because it does not want to associate themselves with old age.
If the conditions in the oral cavity does not allow to restore the dentition with bridge prosthesis, the solution may be dental implants. This method is enhanced so that virtually has no strict contraindications. The most negative sides of his are high cost and duration of engraftment.