The Dent-Liner
Volume 7 Issue 2
Spring 2003
A BULLETIN DEALING WITH ISSUES FOR DENTAL HEALTH
PROFESSIONALS
Bridge
Sectioning Attachment
The
bridge sectioning attachment from Bredent can be utilized to anticipate
future complications if a retaining abutments fails. During the
treatment planning phase of restorative dentistry a positive case can
be made for the use of one attachment with two objectives. One, the
bridge sectioning attachment is made of a gold alloy male attachment
that comes with a closing ring and a titanium screw that enables the
dental technologist to assemble a multiple unit segmented bridge. Two,
if in the future the abutment distal to the attachment fails and has to
be extracted, then the bridge sectioning attachment from the original
bridge can be utilized to accept a Vario Soft 3 female attachment that
is incorporated in a new removable cast partial. Therefore forward
thinking can help in salvaging existing crown and bridge work which can
save time and which will not burden the patient financially or
cause
the inconvenience of excessive appointments. The dental
technologist
will prepare the master models and dies from an accurate full arch
impression, then determine the path of insertion. This attachment
compensates for non-paralellism of abutment retainers as well as
segmenting bridges. Wax the crown patterns and then place the male in a
surveyor with paralleling instrument and position it on the master
model. Males should follow the path of insertion and should be
positioned over the crest of the ridge. Following the standards of
practice, cast and trim the crowns and check proper seating of the
crown attachment assembly. After applying the porcelain,the bridge
sectioning attachment is polished to a high lustre. Next, fix the
closing ring with the titanium screw and cover with modeling resin. The
rest of the bridge is waxed up around the modeling resin in order to
incorporate the pontic and molar abutments. Using a screwdriver, the
titanium screw is removed and set aside for final assembly. The
wax up
is sprued, cast and finished to the standards of practice. Then, the
segmented bridge is assembled, cemented and fixed in place with the
titanium screw. After many years, if the molar abutment fails, the
bridge can be disassembled and the molar extracted. When the ridge is
healed, the existing crowns and attachment will be suitable for a new
cast partial utilizing the Vario Soft 3 inserts. Bredent’s extra
coronal friction grip slide attachments are adjustable by three
different plastic inserts. There is no need for a milled bracing arm
support since the stress breaker is already integrated into the overall
attachment design, providing the opportunity for the patient to
practice good oral hygiene. Patients that have limited manual dexterity
when removing and inserting the prosthesis will find that the
insertion and removal of extracoronal precision attachments are easier
to handle. Also, extracoronal precision attachments are normally
resilient and allow for free movement of the prosthesis in order to
distribute potentially destructive forces or loads away from abutments
to supportive bone and tissue. Three characteristic movements are
defined as functional; (i) Hinge; (ii) Vertical and (iii) Rotational.
The female retention sleeve can easily be removed with a pointed
instrument and a new one replaced effortlessly with the insertion tool.
The cast partial can also be rebased utilizing standard techniques.
This scenario indicates that the bridge sectioning attachment is an
acceptable option for forward thinking treatment planning. Source;
Peter T. Pontsa RDT. For further information contact us at
1-800-250-5111 or e-mail us at info@dent-line.com
Successful
Overdenture Therapy
It is difficult to over emphasize the significance of dentures to the
wearer since they are one of the most challenging aspects of modern
dentistry. Where patient satisfaction is concerned, the studies from
the University of Florida, College of Dentistry, indicate that psycho
social variables, such as pre-treatment, expectations, satisfaction
with the dental care received and positive mental health showed a
strong relationship to a successful outcome. Patients are looking for a
well made complete denture with stability and retention. Rapid
deterioration of the alveolar ridge is the source of the problem for
retention loss. Using existing roots as anchors for an over denture is
a low cost treatment option over implant therapy. Implant treatment can
be ruled out if there is only inter occlusal space for bar placement
which leads to significant increases in denture thickness, a factor
which can adversely affect function and speech. Proper candidates
should be selected for implant bar therapy. Root supported over
dentures can solve the problems of retention, stability and
dislodgement while preventing bone loss and preserving the
alveolar
ridge. Only those candidates with a healthy periodontal environment
should be selected for this type of therapy. Endodontic treatment is
indicated in the preparation of an overdenture abutment while a healthy
periodontal ligament is essential. Requirements of position may be
predetermined as to what is available to proceed with. Two cuspids are
usually the most common, however there can be other variations when
considering cross arch stablization of the overdenture. One attachment
that is most readily used is the VKS-OC stud type that is retained
directly on the free standing roots. It has a hinging motion that
allows the denture to rotate over the stud and permits contact of the
gingiva mucosa. This action distributes the force or load over the
mucosa and away from the root borne abutment. As wear increases on both
plastic and metal parts, the retention sequence allows longer
attachment life. The VKS-OC attachment studs come in two sizes, the
standard is 2.2 mm in diameter and the mini, which is 1.7 mm in
diameter. The mini can fit into very small lateral or central incisor
root abutments or in areas with limited vertical dimension. Over all
advantages of improved stability, retention and preservation of the
aveolar bone make attachment treatment a successful overdenture
therapy. Source; Peter T. Pontsa RDT
New From
Bredent: Master-Sep
 |
Master-Sep
is one of the leading separating mediums in the market today. It is
excellent for separating plaster from die stone. It seals the pores of
the die stone, this in turn forms a tough protective coating that
creates a smooth surface which gives excellent separation. The smooth
flow of stone accurately duplicates every detail of the surface and
gives a cleaner breakout thus making Master-Sep a perfect insulator and
separator between the dental arch and the model base. For further
information or pricing call us at 1-800-250-5111. Source;
Dent-Line of Canada Inc. For more information and pricing call us at
1-800-250-5111 or e-mail us at info@dent-line.com |
The
Anatomy
of Aesthetics
The
fabrication of dentures is both a science and an art form. The
anatomy
of aesthetics can be defined as the way in which teeth are to be
replaced and is critical to any major transition from natural to
artificial teeth. An average patient’s concerns about appearance,
aesthetics and how they look to others is the single most important
outcome when fabricating complete dentures. Ideally the basic
objective is not just to restore missing teeth aesthetically, but to
restore the complete person to a healthy and happy individual.
There
are a number of contributing factors that should be reviewed starting
with “naturalness”. Elements that influence naturalness are
position,
dimension, alignment, form and shade.
Position: Tooth position is a
bio-mechanical
exercise that dictates lip support and determines the firmness of
muscle tone for facial muscle activity.
Dimension: The clinical practicioner must
carefully explain and
guide the patient into recognizing there is a harmonious relationship
between the size of anterior teeth and the size of the face. Long
teeth create at toothy appearance, small teeth on the other hand shows
excessive pink gingival. Scientific investigation indicates that
the
upper central should be one sixteenth the facial width for an optimum
pleasing appearance. Individual studies indicate that stock teeth
may
be too uniform and it would be prudent to select central, laterals and
cuspids individually rather than from the carded set provided by some
tooth manufacturers.
Shade: Consider the patient’s age
and complexion
and select teeth with several shades to give each tooth a distinctive
colour and texture. The closer an object is to the eye, the
lighter it
seems. Therefore, professional guidance is necessary to provide
the
patient with a tentative colour selection and get final acceptance at
the try-in stage.
Form: There is clinical evidence
to indicate that
harmony between tooth form and the shape of the face is the
exception
and not the rule. The system of classifying faces as square tapering
and avoid the corresponding carded tooth system attributed to it, may
be easy to use and is widely accepted by the dental profession,
however, it has no aesthetic merit or scientific basis. Since
there is
a lack of natural standardization and the fact the edentulous arches
are changing due to tooth removal, surgery and restoration, mold
selection whether square tapered or avoid cannot be selected by the
from of the residual ridge. According to A. Nelson, the
unchanging
from of the central position of the palatal vault is the most reliable
clue to the original from of the arch. Therefore, correct
alignment is
far more important than correct mold of tooth for the patient.
Alignment: Arrangement is the
most dominating
factor related to teeth and their aesthetic influence. The only
correct tooth position is where teeth were in nature. Start with
the
maxillary centrals which are always in front of and on either side of
the incisive papilla. Don’t position upper anterior teeth on top
of
the ridge crest since it will cause facial functional loss. Also,
analyze both the vertical tooth position and the labio- lingual
position while establishing phonetics. The patient’s old dentures
provide a lot of information or a photograph showing the natural teeth
in a smile is also welcome. Alignment in relating teeth in their long
axis or breaking their alignment follow examples found in natural
teeth. From studying natural dentition we can conclude there is a
definite relation between the form of the maxillary arch and the
alignment form of the upper anterior teeth. The arch then
indicates
the alignment of the natural teeth.
Final Waxing: the polished
surface area of a
complete denture influences retention as well as aesthetics. The
wax
around the teeth should indicate the form of the gingival
tissues.
Labial surface fullness is desirable without altering the original
borders. The lower denture lingual surface should beconcave
to provide a resting place for the tongue. Some festooning can
create
a natural look. There is no fool proof formula for achieving a perfect
result, however, each clinician following accepted standards of
practice can ensure patient satisfaction and make this experience more
enjoyable and rewarding for all concerned. Source;
Peter
T. Pontsa RDT, for additional information contact Dent-line of Canada
Inc.
at
1-800-250-5111 or 519-942-9315.
Trade News: DNA Test of
Dentures Left at Crime Scene Aids Police
A British gang decided to steal an ATM machine. The plan was for the
ring leader to crash his Rover 2000 through the building’s front door.
Unfortunately for him, he hit the entrance way so violently that
his
false teeth flew out. With police hot on their heals, the
villains
were unable to retrieve the dentures before fleeing. The police
technicians, discovered the dentures, ran a DNA test on the uppers and
were able to identify the leader which led to his subsequent arrest.
Source; Road & Track, January 2003
The Dent-liner; Vol. 7, No. 2
Publisher: Peter T. Pontsa RDT
Editor: A. Van Breemen BA
E-Mail: info@dent-line.com
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