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Involvement of TMD in prosthodontics is oftentimes ignored. Denture treatment and other dental management usually concentrate on dentition and the surrounding structure setting aside the importance of temporo mandibular joint. We can not get away from the fact that the dental structure is at the interior segment of the mandible and the joint is at the posterior. Any manipulation or correction of the dentition is automatically reflects a certain degree of change at the joint area. Any kind of treatment approach without awareness of the joint’s existence may put the dentist at legal risk.

Fixed Partial Denture Treatment

Single Tooth Removable Partial Denture in a Flexible Framework

Single Tooth Removable Partial Denture, also known as Nesbit, is a type of RPD to replace a missing tooth. It is composed of a single denture tooth and a flexible framework. Its clasps, rests and framework are all made of flexible plastic material.

Removable Partial Dentures allow versatility but when used to restore small spans they have the following drawbacks:

1. Problems of retention may take the denture unnecessarily complicated and bulky.
2. A removable denture does not always give the patient the confidence of one that is fixed.
3. There is a risk of accidental swallowing of a small removable partial denture.

According to a photoelastic study of support structures in RPD [1]: The distribution of of tension was influenced by the type of retainer, the length of the saddle and by the form of load application. In relation to the retainer, a more equal distribution of forces between the support structures was seen in the RPI retainer, followed by the T-bar and by the circumferential reatiners. As for the saddle length a more equal distribution of forces between the support structures was observed on the long saddles as the dentures with short saddles induced a greater concentration of tensions on the residual ridge. The best distribution of tensions occurred when the load was uniformly distributed, while the load localized on the last artificial tooth induced greater concentration of tensions on the residual ridges.

Reference
1. Costa MM, da Silva MAMR, Oliviera SAGO, Gomes VL, Carvalho PM Lucas BL: Photoelastic study of the support structures of distal-extension removable partial dentureJ Prosthodontics 2009;18:589-595