Removable prosthesis

November 12, 2012

Removable prosthesis

The removable prosthesis are artificial substitutes of the teeth, designed for functional and cosmetic reasons, recommended for patients with partial or total absence of the teeth. They can be removed from the oral cavity by the doctor or by the patient himself.

They are recommended for a partially edentulous dental patient who desires to have replacement teeth but cannot afford to have a bridge (a fixed partial denture) for any number of reasons, such as a lack of required teeth to serve as support for a bridge (i.e. distal abutments) or due to financial limitations.

Removable prosthesis is of two types

  • Partial

  • Total

Today, the removable prosthesis are often used thanks to their advantages. They contribute to the improvement of:

  • the cosmetic appearance

  • speech

  • mastication

  • the maintenance of the health of the oral cavity.

Still, they also have a series of disadvantages:

  • The appearance and the accumulation of plaque.

  • Injuries caused by the use of the prosthesis.

  • Excessive forces caused by an incorrect design.

  • Errors in determining the occlusion.

Women outrun men in the statistics.

The most common situations which require them are:

  • Cases of partial absence of teeth

  • Cases of total absence of teeth

  • Post traumatic cases

  • Advanced caries which leads to tooth loss

  • Diseases of the marginal tissues that lead to the loss of the teeth.

A partial prosthesis is made up of the following individual parts:

  • The retainers (manufactured and individually made attachments as well as cast clasps).

  • The body of the prosthesis

- major connectors (arch bars, palatal strap, etc.)

- tooth-carrying bases (saddles)

- minor connectors that join the body of the prosthesis to the retainer.

Retainers serve to hold the prostheses to the selected abutment teeth in such a way that it can be removed by the patient. A retainer may fit directly over a natural tooth or it may fit indirectly around or into an artificial crown which has been cemented onto a prepared tooth. Retainers can be either custom-made or prefabricated. Retainers consist basically of a positive portion and a negative one which fits around the positive.

Retainers must fulfill the following requirements:

  • Adequate size

  • High hardness

  • Resistance to abrasion

  • Resilience

  • Possibility of hardening or self-hardening

  • Resistance to corrosion.

Retainers must hold the prostheses securely in place during chewing, swallowing, speaking and other oral functions.

The body of the partial denture is comprised of tooth-carrying denture basis, minor connectors and a major connector (stabilizing element). It is attached to the selected abutment teeth through retainers. For proper integration of a partial denture body into the stomatognathic system, the following principles must be observed:

  • No part of the body of the partial denture should lead to irritation of the marginal gums of the remaining teeth. Access for optimal cleansing of these areas must be assured.

  • Irritation of the mucosa over the alveolar ridges, the palate and the sublingual region must be avoided.

  • The remaining teeth should retain their proprioceptive function during oral activity as completely as possible.

  • Forces falling on the artificial teeth should be transmitted to the alveolar ridge and the hard palate over as broad an area as possible.

In conclusion a removable prosthesis could be partial or total, depending on how many teeth it will replace, and it could be made of acrylics, with or without the use of metal. It could obtain its retention and support in the mouth from other teeth, from soft tissues, from implants, or from a combination of these options.

In designing a partial prosthesis we should take in consideration simplicity, suitability and strength of the structures.

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