REMOVABLE PARTIAL DENTURES: UTILISING THE DSD TREATMENT CONCEPT FOR BETTER AESTHETICS. NON-IMPLANT OPTION.
Removable solutions are very much ‘out of fashion’ in our high tech, implant frenzy dentistry culture of today.This type of restoration is less expensive but doesn’t function as well as a fixed prosthesis (1) . Removable partial dentures may also affect your speech and eating in ways that are challenging. But, the demand is always there . Removable partial dentures have issues regarding stability and comfort. It should also be noted that the bone underneath a removable partial denture may deteriorate over time changing the appearance of your smile and face (2). Before choosing a denture, check with an experienced dentist because the bone loss can change your appearance.
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This case is about the traditional clinical concepts for the design and fabrication of removable partial dentures (RPDs) and a small three unit bridge . Although classic theories and rules for RPD designs have been presented and should be followed, excellent clinical care for partially edentulous patients may also be achieved with digital smile design DSD for better aesthetics outcome.
A removable partial denture should restore function, phonetics, and aesthetics. To assist the clinician in providing a restoration that is as aesthetic as possible, despite the limitations of the conventional removable partial denture. It had to provide an aesthetic restoration, including diagnosis and treatment planning; surveying; mouth preparation; framework and clasp alloys; clasps; rests; major connectors; minor connectors; prosthetic teeth; and denture base resin and flanges (5).
The digital blueprint guides the laboratory technician in the placement of teeth onto a model taken of your mouth.
Digital Smile Design
We believe, here at our clinic that this type of aesthetic analysis and test drive procedure is the gold standard for any type of cosmetic dental treatment today. This technique is applicable from restoring a single tooth right through to complex full mouth rehabilitations (6).
Using these records we acquired from the first visit , we then designs the changes in the computer using a series of aesthetic considerations (tooth height to width proportions, the length of teeth and display at rest etc). Not only are these aesthetic considerations important – but also designing the tooth shaping relevant to the emotional personality of the patient (7). For more dominant personalities this can involve a more rectangular tooth shaping, whilst for softer personalities – this translates to a more rounded tooth shaping. Conversely – this can be inverted and those dominant personalities wishing to balance this trait can test a softer tooth shaping (8).
Smile design process
All records are compiled and used to formulate a digital blueprint with Digital Smile Design
The ideal smile is based on facial landmarks and the chosen teeth shape, shade and form.
Smile design preview and feedback
The digital smile blueprint is presented to the patient using computer-generated images of his new teeth
Adjustments to the design are made if necessary based on feedback from our patient
The treatment plan details, including appointment numbers, timing and costs, are fully discussed with our patient.
Creating his smile
The teeth are prepared according to the digital blueprint.
The wax-up is used to transfer resin to the teeth before preparation. The test drive resin is now used to direct precisely where and how much preparation is required.
Accurate impressions are taken of the prepared teeth which are sent to the laboratory.
Temporary bridge and prosthesis are placed onto the mouth that will look exactly like the digital design.
Our dental technician uses the information from the digital smile design set the artificial teeth and the wax-up to produce perfectly proportioned denture.
Finally, the bridge is cemented and denture issued to the best aesthetics possible.
References
Abt, E., Carr, A.B., Worthington, H.V. Interventions for replacing missing teeth: partially absent dentition. Cochrane Database Syst Rev. 2012;2:CD003814.
Benso, B., Kovalik, A.C., Jorge, J.H., Campanha, N.H. Failures in the rehabilitation treatment with removable partial dentures. Acta Odontol Scand. 2013;71:1351–1355.
Bohnenkamp, D.M. Removable partial dentures: clinical concepts. Dent Clin North Am. 2014;58:69–89.
Coachman C., Calamita M. Digital smile design: A tool for treatment planning and communication in esthetic dentistry quintessence of dental technology. United States: Quintessence; 2012. pp. 103–12.
Hosman, H.J. Influence of clasp design of distal extension removable partial dentures on the periodontium of the abutment teeth. Int J Prosthodont. 1990;3:256–265.
Goyal M.K., Goyal S., Hegde V., Balkrishana D., Narayana A.I. Recreating an esthetically and functionally acceptable dentition: a multidisciplinary approach. Int. J. Periodontics Restorative Dent. 2013;33(4):527–532. doi: 10.11607/prd.0381.
Becker, C.M., Kaiser, D.A., Goldfogel, M.H. Evolution of removable partial denture design.J Prosthodont. 1994;3:158–166.
Meereis CTW, De Souza GBF, Albino LGB, Ogliari FA, Piva E, Lima GS. Digital Smile Design for Computer-assisted Esthetic Rehabilitation: Two-year Follow-up. 2016; 41-1, 000-000.
REMOVABLE PARTIAL DENTURES: UTILISING THE DSD TREATMENT CONCEPT FOR BETTER AESTHETICS. NON-IMPLANT OPTION.
Removable solutions are very much ‘out of fashion’ in our high tech, implant frenzy dentistry culture of today.This type of restoration is less expensive but doesn’t function as well as a fixed prosthesis (1) . Removable partial dentures may also affect your speech and eating in ways that are challenging. But, the demand is always there . Removable partial dentures have issues regarding stability and comfort. It should also be noted that the bone underneath a removable partial denture may deteriorate over time changing the appearance of your smile and face (2). Before choosing a denture, check with an experienced dentist because the bone loss can change your appearance.
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