Partial dentures 6 new Flashcards
What are free end saddles?
➡️ Free end saddles refer to a type of partial denture where there are no teeth posterior to the saddle for support. Common in Kennedy Class I & II dentures.
Why do patients usually end up with free end saddles?
➡️ Posterior teeth (molars) are more prone to caries,
periodontal disease, and extractions compared to anterior teeth, leading to free end saddle situations. 🦷❌
Why are free end saddle dentures less successful in the lower arch?
➡️ Gravity, tongue movement, and mucosal support make lower free end dentures unstable and often uncomfortable. Patients frequently discard them. 😖⬇️
more fissures
furcations
difficult to keep clean
difficult to create
What problems are associated with lower free end saddle dentures?
Lack of resistance to distal forces ➡️
Saddle rotation 🔄
Denture support differential
Loading of abutment teeth 🏋️
Discomfort in the denture bearing area 😣
Torque forces on abutment teeth 🔧
What happens when food is chewed with a free end saddle denture?
➡️ Forces generated during chewing can drive the saddle into the soft tissue, and twist the denture causing strain on abutment teeth. 🍽️➡️😣
What is the role of bracing in free end saddles?
➡️ To prevent side-to-side movement of the denture and reduce strain on abutment teeth. Bracing wraps around the ridge but may still be insufficient. 🛡️
What is the result of uneven support in free end saddles?
➡️ The saddle sinks into tissue, and components anterior to the saddle may rise, leading to instability. 📉
What impression techniques are recommended for free end saddles?
➡️ Differential pressure impressions:
Primary impression: putty/compound to record edentulous areas 🧱
special tray made close-fitting over edentulous areas and lined with green/pink stick.
Greenstick for mucocompressive technique 💚
Final impression with alginate 🎯
Ensure record maximum denture bearing area
Why avoid mucostatic impressions for free end saddles?
➡️ Mucostatic impressions result in uneven loading during function, causing discomfort and instability. 🚫📏
What are some denture design strategies for free end saddles?
Cover maximum denture bearing area 🦷
Reduce occlusal table :
Use narrower teeth, leave out 7s 🍬
RPI system to reduce torque 🔄
Include indirect retention 🧲
Use rests on mesial surfaces when possible 🧩
Obtain impression of saddle In compressed state
- differential pressure impression
- reline saddle at fit
What does the RPI system consist of?
R: Mesial Rest
P: Distal Guide Plate
I: I-Bar clasp 🧲
What is the purpose of indirect retention?
Prevents the denture from rotating around clasp axis by resisting lifting forces (e.g., sticky food). 🍬🛑
Increases clasp effecitveness
Required when direct retention cannot eb provided at both ends of the saddle
What is the clasp axis?
The line between the most efficient clasp tips. Denture rotates around this axis. Indirect retainers should be placed on the opposite side of this axis from the displacing force. ➖⚖️
Which connector to use for partial dentures?
Depends on sulcus depth:
Lingual bar if ≥7mm clearance 👅
Sublingual bar or plate if <7mm but ≥5mm 🧬
What extra considerations for upper free end saddles?
Gravity can help retention but risk remains with sticky foods. Use wide coverage, indirect retention, and plate designs. ☁️👅
What should be checked during a wax try-in?
Occlusion ⚖️
Shade, shape, and mould of teeth 🎨
Patient satisfaction 😊
Modifications before final processing 🔧
What to check during denture fitting?
Examine impression surface for irritation 🚨
Check for acrylic pearls or spicules 🧼
Shop borders or spicules due to processing of resin.
Test occlusion, appearance, and retention 😬
What to advise patients post-insertion?
Teach correct insertion/removal 🔄
Emphasise oral & denture hygiene 🪥
Soak overnight 💧
Gradually adapt to eating 🍽️
Remove at night or for periods during the day 🌙
verbal and written instructions need to be given
What to do if patient experiences pain from the denture?
➡️ Mild pain: persevere 🤕
Severe pain: leave out & reinsert before review to identify sore areas 🔎
When should the denture be reviewed after fitting?
➡️ After 1 week 🗓️
Assess comfort, hygiene, retention, and tissue health ❤️
Make any necessary adjustments 🛠️
What makes a good denture case selection?
Good oral hygiene 🧼
Perio status
Caries status
Motivation 🙌
Stable abutment teeth 🦷
Radiographs & perio assessment 📸
✅ Golden Rules for Denture Design
✔️ Adequate support 📐
✔️ Simple and rigid design 🧱
✔️ Gingival clearance 🚿
✔️ Minimal damage to supporting teeth and tissues 😇
✔️ Aesthetic and comfortable 😊
What are post insertion instructions
