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Southern Illinois University Carbondale

5-2002

Aesthetics in Removable Partial Dentures

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Recommended Citation
Desiniotes, Andrew, "Aesthetics in Removable Partial Dentures" (2002). Honors Theses. Paper 250.

This Dissertation/Thesis is brought to you for free and open access by the University Honors Program at OpenSIUC. It has been accepted for inclusion
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" ."

Andrew Dcsiniotes

Associate Professor: John R Winings

5/2/02

 The importance of a good first impression is always understated. A smile is a

gesture people perform in order to set a mood, settle a business transaction, or begin a

conversation with someone. Smiling is a trait that is often overlooked because of its

frequent use. A healthy smile, one that is natural, stainless and shinny portrays confidence

and good hygiene. It is important and beneficial to an individual to have the healthiest and

most beautiful smile that a person can have. The healthy confident smile is not appealing

with many metal parts showing and plastic just setting n the mouth. Accidents happen to

people that involve the loss of teeth which leads to the disruption of a healthy and

beautiful smile. Through modem medicine and state of the art technology a smile can be

saved.

A partial denture belongs to the category of removable prosthesis. Removable

partial dentures are prosthesis made for an individual that can be removed and reinserted

into the mouth at the patients discretion. A partial denture is a prosthetic restoration

which usually replaces several missing teeth and derives its support from the surrounding

tissue and to a lesser degree from the remaining teeth (partial Dentures 200 I). All crown

and bridge prosthesis and veneers go into the category of fixed prosthetics.

At the present point in time there are two different methods of making a removable

partial denture. One method is to make a metal substructure and build acrylic around it

and the other method is to make a partial denture without a metal substructure using only

acrylic. The patient's concerns and budget is the deciding factor that limit the technician

and dentist in deciding what type of prosthesis shall be fabricated. Masticatory function

and aesthetics are prime considerations in developing the design of the RPD in addition to

replacing missing teeth, restoring function and improving aesthetics (Rossi et ai, 2001).
 Missing teeth is a severe problem for the patient. Missing teeth can cause

numerous problems. Among the problems that can occur is extrusion of opposing teeth,

tilting of adjacent teeth and disturbances in the overall strength of the adjacent tissues and

remaining teeth (Shugars et a1., 2000). Extrusion of the opposing dentition can cause

severe malocclusion which can lead to devastating temporomandibular joint problems.

Replacing missing teeth will restore balance to the occlusion and prohibit further occlusal

and temporomandibular problems.

Restoring function to a patients occlusion is priority one for the dentist and

technician. A functioning occlusion includes restoring speech and returning the patient's

occlusion to normal occlusion. A normal occlusion includes and is not limited to an

absence of disease and to pathologic occlusion. Balanced masticatory forces along with a

whistle free speech is the desired goal when restoring function. Aesthetics are improved

by meeting the following criteria of replacing missing teeth, restoring function to the

occlusion and reducing pathologic susceptibility. Aesthetics should be taken one step

further than the conventional form of removable partial dentures. The conventional

removable partial denture is constructed with a metal substructure and has an acrylic built.

The more aesthetically correct RPD is manufactured with an acrylic base making hard to

tell there is a prosthesis in the mouth and allowing for a more natural aesthetically pleasing

dentition.

A major concern for most patients is aesthetics. Aesthetically pleasing removable

partial dentures (RPD) is a partial denture that blends in with the natural dentition and one

that does not show any indications of being a removable partial denture. Removable

partial dentures made without a metal substructure are more aesthetically pleasing.
 In most cases the only part of a removable partial denture that is visible are the

retentive clasp arms. A new technician and product has hit the market a few years ago

that eliminates the use of a metal clasp arms. The clasp arms can be made of a composite

resin that can be made to look like a tooth. A clasp arm terminates in the undercut of the

tooth; if the clasp is made of metal then it will be visible and aesthetically poor. A clasp

made of this new composite can be made to look like a real tooth. If the technique is done

properly then the clasp arms of the partial denture can be made to resemble the natural

tooth and the clasp will be practically undetectable by the untrained eye.

A partial denture with a metal substructure has a severe disadvantage with regard

to being aesthetically pleasing. A removable partial denture is not aesthetically pleasing

because of the use of an alloy to make the substructure. The alloy does not allow the

translucency that an acrylic can provide. Translucency deals with amount of transparency

the substructure has. An acrylic is easier to see through than a metal is. An example of

the difference of translucency between an acrylic is like looking through a sheet of tracing

paper or looking through cardboard. The difference is obvious and monumental.

An alloy is metal that is comprised of many constituent metals (Applegate 1954).

For example, a chrome-cobalt alloy is a metal made from mixing chrome and cobalt as

well as other metals together to obtain the alloy/metal. Throughout this paper removable

partial dentures made with attachments will not be discussed and are excluded.

All RPD are made with major connector, minor connectors and clasp or retentive

tips. Major connectors are used to unite the separate quadrants of the partial denture.

There are thirty-two permanent teeth in the mouth, a quadrant is a set of eight. Minor

connectors connect the clasp arms to the major connector (Applegate 1954). The teeth
used to make a partial denture are surrounded by acrylic. There are many different types

of major connectors and clasp arms. The visible parts of the removable partial denture are

the clasp arms and the acrylic that surround the prosthetic teeth. The most visible parts of

the RPD is the critical aspect of the removable prosthesis when discussing aesthetics and

determining the aesthetic value of a removable partial denture.·

Aesthetically pleasing RPD is a partial denture that blends in to the natural

dentition and one that does not show indications of being a removable partial denture.

The conventional method of making partial dentures is by the use of a metal substructure

with an acrylic build on the metal substructure. The new technique in making RPD is to

make the substructure from an acrylic base or compomers. Compomers are made from a

glass ionomer cement and a light polymerized resin composite.

When I write about the new method or nonmethylmethacrylate partial denture I am

referring to the press packing removable partial denture by Ultraflex. Ultraflex is a resin

material without methylmethacrylate and can be used in a very simple manner in

conjunction with the conventional method of processing a removable partial through the

use of the pack and press method. The prosthesis should be waxed on the model as usual

(refractory model). The three pour flasking method and boil out is followed as normal.

The separator is applied as normal after boil-out. The Ultraflex should be mixed (five to

eight min.), and packed. The packing schedule is the same as the conventional method.

The flask is cured for two hours in 130° Fahrenheit and then cooled for fifteen minutes

under cold running tap water. Finishing is easy. The Ultraflex removable partial denture

is finished in the same manner as an acrylic (Aston Dental Corp.). The only caution for

the use of the Ultraflex system is to store the Ultraflex material in the refiigerator until
"

use.

The Ultraflex system is very accommodating to the dental laboratory because its

method of use is similar to the conventional method of making a removable partial

denture. The aesthetic value of an Ultraflex removable partial denture is great because

there is no metal. Without metal the supporting tissue can be seen. Thus a more

translucent removable partial denture is reached.

Another great partial denture material that adheres to strict aesthetic value and

functional restoration of the patients occlusion is the Lucitone- FRS offered by

DentsplyTrubyte. The Lucitone-FRS has a major difference by the method packing the

denture. Lucitone-FRS is not packed through the conventional method, instead it is

injected into a mold. The RPD is waxed as normal than duplicated and invested into a

flask by use of the two layer pour method that is used with the DentsplyTrubyte system.

The duplicated model provides a mold for the resin to be injected. The Lucitone-FRS is

aesthetically valuable and occlusionally functional.

The last of the acrylics that are on the market for removable partial dentures is the

Thermoflex by Austenal. Thermoflex is a revolutionary acrylic that has the greatest

variance of tooth colors and tissue color. This Thermoflex acrylic from Austenal is a

techno polymer which is an improved acetal resin product that combines the benefits of

acrylic and nylon. Among the advantages that Thermoflex has over the other brands is:

it's weight, finishing is identical to finishing acrylic and it is monomer free, This extremely

stable brand is has all the aesthetic value and functional restorative strengths that

removable partial dentures should have.

Removable partial dentures that are fabricated with metal have a major problem
 "
"

with blending the clasp arms into the surrounding dentition. Clasp arms usually terminate

in an undercut of a tooth. The undercut of a tooth is the area under the maximum

protrudence of the tooth. From a facial or frontal view, clasp arms that are made through

the conventional method are easily visible (Goldstein 1976). Another major concern is the

acrylic which was formed on the metal substructure and its ability to blend in with the

natural dentition. A properly finished RPD has a mirror like finish which resembles a

chrome bumper. The alloy is a silver color and will reflect light which will make the

conventionally fabricated removable partial denture visible to the naked eye.

There are few products out there as well as new techniques that can be used to

make a removable partial denture, A RPD can be made without using a metal

substructure that would eliminate the obvious silver gleam that a conventional partial

denture has, The removable partial denture that does not use a metal substructure is made

of an acrylic that can be tinted to look like the natural gums, The conventional method

has acrylic built around a metal substructure which makes the acrylic a dark color.

Without a metal substructure to darken the acrylic, the tinting of the acrylic can be made

more life-like and would blend with gums and natural dentition to a greater degree and be

much more aesthetically pleasing.

The conventional technique of making a removable partial denture has the major

advantage of the ease of cleaning and caring. All removable partial dentures have to be

taken out of the mouth every night for cleaning purposes. The conventional method uses

a metal substructure which is easier to clean; with the use of a denture brush and

toothpaste cleaning is made simple (Caring for Your Partial 2001). A removable partial

denture made without a metal substructure must be soaked every night in addition to
" .'

brushing it clean with a denture brush and toothpaste. With the conventional method

cleaning is a step easier than with the new evolved technique.

Caring for a conventional removable partial denture is basically the same as caring

for a removable partial denture made without a metal substructure. The advantage that a

conventional partial denture has over the non methylmethacrylate partial denture is the

simple fact that a metal is easier to clean than a resin. The conventional partial denture is

made with metal parts has low wet-ability thus it can be cleaned of plaque and calculus

build through the use of a tooth brush. The contact angle that forms from saliva and other

liquids that are in the mouth determine the wet-ability of the substructure. The lower the

contact angle the lower the wet-ability and the easier to clean.

To clean a conventional partial denture should: be removed from the mouth at

night preferable, brushed with a denture brush and toothpaste along with flossing in

between the teeth on the partial. Occasionally the partial denture should be soaked in a

disinfectant or a mouthwash (Caring For Your Partial 2001). Another advantage a

conventional partial denture has over the resin or nonmethymethacrylate denture is its

advantage to deter bad odor build on the denture. A resin or plastic has microscopic

pores that can trap plaque and bacteria that can produce bad breath.

Conventional removable partial dentures are at a severe disadvantage of being

aesthetically pleasing because of the metal substructure. The instant that a substructure is

made from a composite or acrylic then a partial denture becomes more aesthetically

pleasing. An aesthetically pleasing partial denture is a partial denture that blends in to the

natural dentition and a removable partial denture that does not show any indications of

being a removable partial denture.

Andrew Desinitoes
5/2/02

Works Cited

Applegate, C., Oliver. Essentials of Removable Partial Denture Prosthesis.

Philadelphia and London: W. B. Saunders Company, 1954.

Caring For Your Partial Denture. July 30,2001. http://www.stenedds.com/dentures_and

partials.htm

Goldstein, Ronald, D. D. S., F. A. C. D. Esthetics in Dentistry. Philadelphia: J. B.

Lippincott Company, 1976.

Journal of Dental Technology, 19, 19-21. (March 2002).

Partials Dentures. July 18, 2001. http://lw7fd.Lawhotmail.com/cgi-

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Pouring or press-packing a partial denture using Ultafex flexible composite resin. July 30,

2001. http://www.dentaproducts.net/xmVOI05/astronOI05.asp.

Removable Partial Dentures. July 18,2001. <http://lw7fd.law7.hotmailmsn.com/cgi-

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Rossi, et al. (November 200 I). Esthetic options for the fabrication of removable partial

dentures: A clinical report. Journal of Prosthetic DentistI)', 86, 465-467.

Shugars, et al. (September 2000). The consequences of not replacing a missing posterior

tooth. Journal of American Dental Association, 131. 1317-1323.