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RPD SUPPORT
RPD SUPPORT
RPD SUPPORT
RPD SUPPORT
RPD SUPPORT: Every RPD (Dyer 1972): Utilize design principles of Spoon denture: - a space maintainer & RPD in children: - replacing missing upper anterior teeth. Best example of mucosa-supported RPD. Design features: Denture base well-away from FGMs. Denture base on displaceable palatal mucosa: - pin-damming / food-lines carved (seal). - Base sealed on lateral NV bundles. Posterior border extended upto Ah line.
RPD SUPPORT
RPD SUPPORT
RPD SUPPORT: Lower FES RPDs: Differential support problem. Mesially teeth provide support for DEB of RPD. Distally DEB of RPD supported on mucosa. Mucosa more displaceable than PDL of teeth. Such RPD if made on cast made of impression: - recorded in muco-static imp. material will: - be unstable during function b/c of mucosa: - yielding under load & causing sinking of RPD. Tilting forces & torque on premolar abutments. Damage their PDL and lead to their loss.
RPD SUPPORT
RPD SUPPORT: Lower FES RPDs: 3-ways to solve problem of differential support: 1. Chair-side / Intra-oral Reline of RPD: - Done at the RPD insertion stage using: - close mouth impression technique &: - Hi Mol. Wt intraoral self-cure resin. 2. Flexible / Stress-breaker connection in RPD: - allows independent movements of: - tooth-borne & tissue-borne parts of RPD. Technically difficult approach. Skills not available universally. RPD distortion & Tissue impingement.
RPD SUPPORT
RPD SUPPORT: Lower FES RPDs: Solving problem of differential support (Contd):
3. Recording Controlled displaced state of tissues by: - Altered Cast Impression Procedure (ACIP) to: - fabricate a Stable, Well-fit & Rigid RPD. ACIP (Applegate 1959): 2-Step Procedure: 1. Impression Step: Fabricate metal FWK & Try in mouth. Add temporary acrylic bases with its fitting surface: - relieved from ridges by 0.25mm relief spacer. Controlled displaced state of mucosa obtained by: - painting molten wax (Kerr. Correcta wax No.4): - using a camel hair brush. (Contd)...
RPD SUPPORT
RPD SUPPORT: Lower FES RPDs (Contd): Solving problem of differential support (Contd): Upon each layer of wax, FWK is inserted in mouth. FWK held stationary & pressed in place by; - firmly holding it thru lingual major connector. No pressure on temporary bases. Continue painting molten fluid wax on fit surface until: - even, smooth & glossy fitting surface obtained. 2. Cast-altering step: Done on master cast on which FWK was tried / fitted. FES areas of cast cut with frit-saw (wire saw). Fit Trayed FWK to altered cast (No FES parts). Add new FES areas to cast by pouring stone mix.
RPD SUPPORT
RPD SUPPORT: Lower FES RPDs (Contd): Solving problem of differential support (Contd): When set, remove temporary bases from cast. Add wax bases & occlusal rims to FWK. Register MMR & face-bow transfer records. Establish occlusion on articulator. Prepare waxed-up RPD for trial. On Trial, accomplish final wax-up & seal RPD on: - new altered cast. Invest, de-wax, pack mould and process / finish RPD. Fit RPD in mouth. Review & Recall visits.