JIDAM

CASE REPORT

“An Official Journal of IDA - Madras

Available online

REHABILITATION OF PARTIALLY

EDENTULOUS PATIENT USING REMOVABLE

PARTIAL DENTURE WITH ESTHETIC

RETAINERS - A CASE REPORT

Dr.Ranjith.R, Dr.Devi Parameswari.B, Dr. Annapoorni.H

Department of Prosthodontics, Faculty of Dentistry,

Meenakshi Academy of Higher Education and Research Institute, Chennai, Tamil Nadu, India.

ABSTRACT

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The treatment options available for esthetic and functional

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rehabilitation of partially edentulous patients are fixed partial

dentures(FPD) and removable partial dentures, where fixed could

be conventional FPDs or implant FPDs. In some cases, where

fixed partial dentures are not possible, removable partial dentures

may be the only choice to the patients. Location of clasps in

the esthetic zone of the removable cast partial dentures, is not

aesthetically pleasant to the patients. Among many material

choices for removable denture fabrications, flexible partial

dentures provide superior esthetics especially for those patients

who are concerned more about esthetics.

KEYWORDS: Flexible denture, Dent flex, Nylon, Acrylic clasp,

Flipper.

Address for correspondence:

Dr.B.Devi Parameswari, MDS

Associate Professor,

Department of Prosthodontics,

Faculty of Dentistry, Meenakshi Academy

of Higher Education and Research Institute,

Chennai, Tamil Nadu, India.

Email id: drdeviparameswari@gmail.com

Received

: 18.05.2020

Accepted

: 13.06.2020

Published

: 27.06.2020

JIDAM/Chennai/Volume:7/Issue:2/Pages 67 - 70/April-Jun 2020

Ranjith et al: Rehabilitation of Partially Edentulous Patient With Esthetic Retainers

INTRODUCTION:

were made (Dentsply Zelgan 2002 Alginate) and casts

were made with Type III dental stone (Gem stone

Prosthetic

rehabilitation

partially

dental stone plaster type-III). Interocclusal record

edentulous patient restores patient’s masticatory

was done. Casts were mounted using the interocclusal

function and esthetics. Fabrication of a metal

record on the Hanau articulator. Shade selection was

framework of conventional removable partial denture

done and artificial acrylic resin teeth (SR Vivodent,

(RPDs) uses metal retentive clasps. On smiling,

Ivoclar vivadent) were arranged. Wax try-in was done

these metal clasps are usually visible which cause

to the patient, acrylic clasp extension was placed on

dissatisfaction to the patient which psychologically

the right central incisor and denture was processed

affect the patient’s social behaviour due to unpleasant

using the injection moulding technique (Dentcare

esthetics.¹The introduction of acrylic polymers and

Flex - Dentcare dental lab, India). Then the final

cobalt chromium alloys type of removable partial

denture was finished, polished and inserted. Figures

dentures have gained popularity among dentists these

4 and 5 show side and facial view after denture

days. Many years ago, removable partial denture

insertion. Occlusion was evaluated and adjusted.

was chosen by patients for their low cost and good

physiology. Modern era has led to the evolvement of

the removable partial denture from traditional hard

fitting denture bases to soft dentures by using nylon

based thermoplastic material. So, they have become

an excellent alternative to traditional removable

partial dentures which have many problems like

loss of chewing efficiency, hard denture bases and

less retention.² These flexible dentures provide

good function and esthetics, comfort and strength.

The flexible nylon resin has simple design, a built- in

stress breaker which provide better stress distribution

and a superior function. So flexible denture has

Fig 1: Intra-Oral View of Maxilla

become a good option not only for dentists, but also

for patients.³

This article describes about the restoration

of partially edentulous patients using a flexible

removable partial denture.

CASE REPORT:

A 65 year old female patient reported to the

Department of Prosthodontics with missing maxillary

and mandibular premolar and molar teeth bilaterally.

Fig 2: Intra-Oral View of Mandible

On intra-oral examination, the patient had missing

14, 16, 21, 22, 23, 24 and 26 (Kennedy’s class III

modification 3) (Fig 1), 36 and 44 (Kennedy’s class III

modification 1) (Fig 2) with facial view in occlusion

as in Fig 3. After complete examination, maxillary

flexible denture prosthesis was planned as patient was

concerned only about the maxilla and patient did not

want mandibular prosthesis.

PROCEDURE:

Fig 3: Facial View

Maxillary and mandibular alginate impressions

JIDAM/Chennai/Volume:7/Issue:2/Pages 67 - 70/April-Jun 2020

Ranjith et al: Rehabilitation of Partially Edentulous Patient With Esthetic Retainers

are derived from dicarboxylic acid, diamine, amino

acid and lactams.⁵The commonest technique used

for fabrication of flexible denture base prosthesis is

the Injection-molding technique.⁶Flexible denture

prosthesis has many advantages from others as it

requires minimum or no mouth preparation, resistant

to fracture, match with natural tissues, good retention,

comfortable for patient as it is thin and lightweight.

Acrylic resin teeth do not tend to bond chemically

Fig 4: Postop Intra-oral side view

with a flexible denture base resin and are retained by

making T shaped holes into which the resin flows to

retain teeth mechanically.⁷

Thin finger like extension of the flexible

partial denture extends into the undercuts that act like

a clasp. They can be used in patients having gingival

recession and in patients who are allergic to acrylic.²

However, they are contraindicated in patients with

insufficient inter-arch space i.e., less than

4mm

Fig 5: Postop Intra-oral facial view

space, and with prominent residual ridges where there

is less space for labial placement of teeth because T-

shape holes are necessary for mechanical retention of

teeth to denture base, and with flat-flabby ridges with

DISCUSSION:

poor soft tissue support which require more rigid

prosthesis.³

Removable partial denture is commonly

used for treating those patients where multiple teeth

One drawback of flexible prosthesis is that

are missing and where conventional fixed partial

they are difficult to repair, reline and rebase. They

dentures and implant supported prosthesis are not

are prone to staining from tea and/or coffee if it is

possible. For more than ten years, the removable

not polished properly and cleaned by the patient on

cast partial denture is being used in the treatment

a regular basis. The esthetics and cleanliness of the

of partially edentulous patients and its construction

prosthesis can be maintained by advising the patient

involves the use of cast metal alloy, acrylic resin and/

to practice good oral hygiene and clean his/her

or thermoplastic resins. Cast metal alloy consists of

prosthesis regularly after every meal and it should

a metal base with acrylic teeth linked to it and metal

be removed during brushing of natural teeth to

retentive clasp aids in holding the cast partial denture

avoid roughening of the prosthesis. A commercially

in position. Metal clasps give metallic appearance in

available denture cleanser

(Val-Clean®) where

the esthetic zone which is not acceptable by many

denture is soaked for 10-15 minutes daily can be

patients, especially those who are concerned about

advised.

their esthetics.⁴

CONCLUSION:

Acrylic resin prosthesis is also known as

temporary or interim removable partial denture or a

Flexible partial denture is a good treatment

‘’Flipper’’. It can function as a space maintainer and

option for partially edentulous patients, who are

also can be used to restore the form and function of

concerned about esthetics. In order to reduce staining

the tooth until the definitive prosthesis is fabricated.

of the prosthesis, proper care of the prosthesis is

Flexible denture materials are superpolyamides

required, as it affects the esthetics of the prosthesis

belonging to the family of nylon and are available

as time passes by. The fabrication depends on

in the form of granules that are packed in cartridges

the clinician’s skill in selection of the type of the

of varying sizes and first introduced by the name

prosthesis required for the patient. Flexible dentures

of valplast and flexiplast since 1956. These resins

while previously used were selected by only a handful

JIDAM/Chennai/Volume:7/Issue:2/Pages 67 - 70/April-Jun 2020

Ranjith et al: Rehabilitation of Partially Edentulous Patient With Esthetic Retainers

of patients and the clinician has gained its ground to

become an effective and often demanded treatment

option.

FINANCIAL SUPPORT AND

SPONSORSHIP:

Nil

CONFLICTS OF INTEREST:

There are no conflicts of interest.

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JIDAM/Chennai/Volume:7/Issue:2/Pages 67 - 70/April-Jun 2020