Adjustment of framework of  clasp prosthesis.

Overlay of clasp prosthesis.

 


Prior to imposing clasp dentures in the mouth it is necessary to look at it carefully, paying attention to the surface that is adjacent to the mucosa, which should be smooth and polished.

 

 Often, denture on grafted is not imposed  as plastic base is limited by defect of the dentition from aproximal side, at gum edge is wider and comes in the niche under the tooth equator. It can be explained by the following- the parallelity of aproximal sides is artificially created on the working models  when casting frame. When the skeleton has been casted, it is set on a working model in occludars and have retention points on the teeth. Base plastic fills them when casting   and prevents the imposition of denture on the jaw. These plots are removed with mill.

 

 When the prosthesis has been applied to abutment teeth correlation of artificial teeth and antagonists is checked. If an increase of bite or second violation of articulation is observed, they are eliminated  by general rules. Prosthesis mustn't cause pain, and if it does the prosthesis correction must be done..

 

 Preferably,first day the patient removes the prosthesis only for oral cavity hygienic examination. This regime is possible only by industrious hygienic care of mouth and dentures. Not less than 2 times a year the patient should contact a doctor to check the status of the remaining teeth and mucosa. It is known that clasp dental prostheses, held on teeth, which are not covered by artificial crowns, require careful hygienic examination to prevent teeth from caries in areas of base attachment from the proximal side of the tooth. Because of this each day after meals they should be thoroughly cleaned with a toothbrush and toothpaste - teeth and clasp dental prosthesis.

 

 Patients with periodontal disease and general organism disease with their manifestations in the mucous membrane of the mouth should not use the prosthesis every day, and must take them off at night to reduce the load on the supporting tissue. Often such patients' mucous membrane becomes inflamed, injured by prosthesis, often ulcers appear. In such cases, if the prosthesis usage regulation  does not address complications it should be along with the general treatment to change the design of prosthesis.

 

 Prosthesis in the mouth causes  to a range of subjective sensations with the patient. As usual in its  fixing day only gross defects in prosthesis design  are eliminated  - improving occlusion with occlusive pads or the other frame parts and artificial teeth. Only on the second day one may conduct more diligent preparation of clasp dental prosthesis. Often on the prosthesis fixing day the frame do not precisely embraces teeth,there is a gap between occlusive pads and clamps shoulders  . After daily use such frame begins to be exactly adjacent to the prosthetic bed. It is explained by tooth physiological mobility.

 

 The patient must know that in the early days clasp dental prostheses can lead to nausea, vomiting, enhanced salivation, speech impaired and disorder of taste sensations, polluted nibble and food  chewing . All of this suggests that the prosthesis causes local and general tissue and nerve endings irritation.

 

 Adaptation of the patient to clasp dental prosthesis occurs gradually. Note the three phases of adaptation to the denture. The first phase - irritation. It is observed on a fixing day of clasp dental prosthesis in the patient mouth. Phase II - partial inhibition: salivation comes to standards, the purity of the language is restored, the nausea disappears, increasing of chewing efficiency. The second period is short and takes 2-3 days. The third phase -full braking phase, it comes from the time when the patient ceases to feel the prosthesis as foreign body. Chewing efficiency is at maximum. This period, depending on the type of nervous activity continues 1-2 weeks.

 

 For faster patients adaptation to clasp dental prostheses is advised not to take off them at night for 3-4 days, limiting only to hygienic care.

 

 Adaptation period when using the clasp dental prostheses twenty-four-hour is shorter. Good adaptation promotes rapid restoration of masticatory efficiency.

Looking After your Dentures

 

You need to care for complete and partial dentures as carefully as you would look after natural teeth.

Clean them every day. Plaque and tartar can build up on false teeth, just like they do on natural teeth.

 

Take them out every night. Brush your teeth and gums carefully, using a soft toothbrush. Be sure to clean and massage your gums. If your toothbrush hurts you, run it under warm water to make it softer OR try using a finger wrapped in a clean, damp cloth.

 

Soak them overnight. They can be soaked in a special cleaner for false teeth (denture cleanser), in warm water or in a mix of warm water and vinegar (half and half). If your denture has metal clasps, use warm water only for soaking. Soaking will loosen plaque and tartar. They will then come off more easily when you brush.

 

Fitting the clasp dental prosthesis

Prior to imposing clasp dentures in the mouth it is necessary to look at it carefully, paying attention to the surface that is adjacent to the mucosa, which should be smooth and polished.

Often, denture on grafted is not imposed  as plastic base is limited by defect of the dentition from aproximal side, at gum edge is wider and comes in the niche under the tooth equator. It can be explained by the following- the parallelity of aproximal sides is artificially created on the working models  when casting frame. When the skeleton has been casted, it is set on a working model in occludars and have retention points on the teeth. Base plastic fills them when casting   and prevents the imposition of denture on the jaw. These plots are removed with mill.

When the prosthesis has been applied to abutment teeth correlation of artificial teeth and antagonists is checked. If an increase of bite or second violation of articulation is observed, they are eliminated  by general rules. Prosthesis mustn't cause pain, and if it does the prosthesis correction must be done..

Preferably,first day the patient removes the prosthesis only for oral cavity hygienic examination. This regime is possible only by industrious hygienic care of mouth and dentures. Not less than 2 times a year the patient should contact a doctor to check the status of the remaining teeth and mucosa. It is known that clasp dental prostheses, held on teeth, which are not covered by artificial crowns, require careful hygienic examination to prevent teeth from caries in areas of base attachment from the proximal side of the tooth. Because of this each day after meals they should be thoroughly cleaned with a toothbrush and toothpaste - teeth and clasp dental prosthesis.

Patients with periodontal disease and general organism disease with their manifestations in the mucous membrane of the mouth should not use the prosthesis every day, and must take them off at night to reduce the load on the supporting tissue. Often such patients' mucous membrane becomes inflamed, injured by prosthesis, often ulcers appear. In such cases, if the prosthesis usage regulation  does not address complications it should be along with the general treatment to change the design of prosthesis.

Prosthesis in the mouth causes  to a range of subjective sensations with the patient. As usual in its  fixing day only gross defects in prosthesis design  are eliminated  - improving occlusion with occlusive pads or the other frame parts and artificial teeth. Only on the second day one may conduct more diligent preparation of clasp dental prosthesis. Often on the prosthesis fixing day the frame do not precisely embraces teeth,there is a gap between occlusive pads and clamps shoulders  . After daily use such frame begins to be exactly adjacent to the prosthetic bed. It is explained by tooth physiological mobility.

The patient must know that in the early days clasp dental prostheses can lead to nausea, vomiting, enhanced salivation, speech impaired and disorder of taste sensations, polluted nibble and food  chewing . All of this suggests that the prosthesis causes local and general tissue and nerve endings irritation.

Adaptation of the patient to clasp dental prosthesis occurs gradually. Note the three phases of adaptation to the denture. The first phase - irritation. It is observed on a fixing day of clasp dental prosthesis in the patient mouth. Phase II - partial inhibition: salivation comes to standards, the purity of the language is restored, the nausea disappears, increasing of chewing efficiency. The second period is short and takes 2-3 days. The third phase -full braking phase, it comes from the time when the patient ceases to feel the prosthesis as foreign body. Chewing efficiency is at maximum. This period, depending on the type of nervous activity continues 1-2 weeks.

For faster patients adaptation to clasp dental prostheses is advised not to take off them at night for 3-4 days, limiting only to hygienic care.

Adaptation period when using the clasp dental prostheses twenty-four-hour is shorter. Good adaptation promotes rapid restoration of masticatory efficiency.

 

 

 

  Adhesion is the use of two identical surfaces when there is a thin sublayer of fluid between them.

      The adhesion fixation force is 100g/cm2, the denture of the upper jaw with an area of 20 cm2 is fixed with force of 2 kg. During the masticatory function the denture withstands pressure of 15-20 kg in force. Therefore, adhesion for fixation of the partial plate denture is insufficient.

      Anatomical retention points

      The so-called clasp-free dentures are fixed with the aid of the anatomical retention points. This kind of dentures is satisfactory as to the cosmetic appearance. Although denture fixation becomes weaker in some period of time as the base loosens the abutment teeth. Clasp-free dentures are justifiable in using elastic plastic.

     Plastic dentoalveolar clasps by Kemeni.

     The Hungarian dentist I.Kemeni proposed to use dentoalveolar clasps made of plastic for fixation of the partial plate dentures. These dentures are called retention ones. The dentoalveolar clasps may be constructed in case when the vestibular surface of the alveolar process has a straight or sloping structure and the teeth are positioned in conformity with the alveolar crest. When the vestibular surface of the alveolar process is thread-like or the teeth are inclined vestibularly, retention dentures cannot be constructed.

     Fixation of the removable plate dentures with the help of telescopic crowns

     This kind of dentures is widely applied in the Western countries. The singly standing or separate groups of the teeth are constructed metal crowns-caps that are fixed on the teeth by phosphate cement. Other crowns are constructed to be placed on these crowns that are, in their turn, fixed in the denture. While placing the denture the external crowns are applied on the internal ones, thus achieving satisfactory fixation of the dentures. But the masticatory load falling on the whole denture is transferred to a small number of the teeth resulting in overload of the parodont of these teeth with different consequences.

     Fixation of the dentures by Rumpel

      The singly standing teeth or separate groups of the teeth are covered with crowns with soldered metal bar that passes in the middle of the alveolar process. A long slot is made in the denture base where the bar fit. The masticatory load is transferred on the bar via the denture, and in this way on the abutment teeth resulting in the fast loosening due to overload.

     Fixation of the partial plate dentures with the help of vestibularly-directed clasps

      To strengthen the single teeth or separate groups of the teeth and to fix plate dentures V.I.Kulazhenko proposed a construction of the continuous vestibular clasp in 1962. The vestibular clasp is a metal bar that connects natural teeth from the vestibular side at the neck. Such construction of dentures contributes to strengthening of the loosen teeth and provides good fixation of the plate dentures.

      Clasp fixation

      A clasp is a hook that fixes the denture. Natural teeth where the clasps are placed are called the abutment teeth.

      To obtain the best fixation of the denture the following should be taken into consideration: mobility of the abutment teeth, their number, choice and solution of the problem of the kind of the clasp strengthening.

      There are three kinds of clasp fixation:

- Point fixation – only one tooth is used for abutment. In such fixation the abutment tooth becomes loosen rapidly because of lever-like force of the clasp and denture base on the abutment tooth.

- Linear fixation – two teeth are used for abutment. The clasp line may be sagittal, diagonal and transversal. When there is a free choice, it is better to construct a diagonal one on the upper jaw and transversal clasp fixation – on the lower jaw. The sagittal fixation is the least fitting for both jaws.

- Plane strengthening is the most rational strengthening as 3-4 teeth are used as abutment teeth.

 Clasps are divided into:

1. By the method of making – wire (labile) and cast (stable).

2. By the shape: circular, semicircular and strip.

3. By the degree of coverage – one-chain, multichain and continuous

4. By the number of arms – one-arm and two- arm.

5. By the fixation – retaining, tooth-supported, molar clasper

      The retainer is composed of the arm, body and process (anchor part). The arm covers the abutment tooth from the vestibular side between the equator and the tooth neck. The body is located on the equator with approximal surface of the tooth; and the process connects the clasp with the denture base.

      Even the clasp of the most rational construction is not safe for the abutment teeth. The more flexible the clasp, the less it loosens the abutment teeth. Clasp flexibility depends on the method of its making and the arm of length. Cast clasps do not have flexibility, which is characteristic of the flexible ones.

Indications and constructive features of crown construction for clasps of the plate dentures

     As it was said, the crown construction in prosthesis with partial denture is not obligatory.

     The crowns are indicated 1) in defects of the hard tissues of the tooth; 2) in devitalization of the teeth; 3) for strengthening of the loosen teeth by soldering several crowns; 4) for leveling of the occlusion plane.

      The abutment teeth, on which the crowns are constructed, are prepared in such a way that their sides are equilateral. In restoration of the anatomical shape of the prepared teeth on the model, the equator is formed only on the vestibular side that has an adjacent tooth. The lateral sides are modeled as equilateral ones.

How do you wear a removable partial denture?

  Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps. Consult with your dentist to find out which type is right for you.

How long will it take to get used to wearing a partial denture?

  For the first few weeks, your new partial denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Never force the partial denture into position by biting down. This could bend or break the clasps.

How long should I wear the partial denture?

  You may be asked to wear your partial denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your dentist will adjust the denture to fit more comfortably. After making adjustments, the dentist will probably recommend that you take the denture out of your mouth before going to bed and replace it in the morning.

Will it be difficult to eat with a partial denture?

  Having a partial denture should make eating a more pleasant experience. Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid foods that are extremely sticky or hard. When having partial dentures you may want to avoid chewing gum while you adjust to the denture.

Will the partial denture change how I speak?

  It can be difficult to speak clearly when you are missing teeth but wearing a partial denture may help. With time, you will become accustomed to speaking properly with your denture.

How do I take care of my partial denture?

  Handling a partial denture requires care. It's a good idea to stand over a folded towel or a sink of water just in case you accidentally drop the denture. Brush the denture each day to remove food deposits and plaque. Brushing your denture helps prevent the appliance from becoming permanently stained. It's best to use a brush that is designed for cleaning dentures. A denture brush has bristles that are arranged to fit the shape of the denture. A regular, soft-bristled toothbrush is also ok to use. Avoid using a brush with hard bristles, which can damage the denture.
  We recommend any denture cleaner with the American Dental Association (ADA) Seal of Acceptance.
  Some people use hand soap or mild dishwashing liquid to clean their dentures, which are both acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.
  Clean your dentures by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Brush all denture surfaces gently to avoid damaging the plastic or bending the attachments.
  A denture could lose its shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution. The dentist will recommend the proper method for keeping your dentures in good shape.
  Brushing twice a day and cleaning between your teeth daily help prevent tooth decay and gum disease that can lead to tooth loss. Pay special attention to cleaning teeth that fit under the denture's metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Will my partial denture need adjusting?

  Over time, adjusting the partial denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Partial Dentures that do not fit properly should be adjusted by the dentist. Loose partial dentures can cause various problems, including sores or infections. Contact the dentist if your denture becomes loose.

Can I make minor adjustments or repairs to my partial denture?

  You can do serious harm to your partial denture and to your health by trying to adjust or repair your denture. We recommend that you do not try to attempt to fix dentures yourself and instead go see you dentist.

Removable partial or full dentures require proper denture care to keep them clean, free from stains and looking their best. For good denture care:

What's the best way to care for removable dentures?