Flexibility is our Strength

1. Flexibility is our Strength

2. Purpose • Background and Theory of Valplast Flexible Partials • Case Histories and Special Applications • Planning Successful Valplast Restorations

3. Why Valplast Flexible Partials? • In late 1940’s, people became more conscious of appearance. • Patients demanded more aesthetic dental restorations

4. Prevailing Dental Materials • Metal and Acrylic became standard but only for about 10 years. • Metal frame design became more scientific and standardized.

5. Limitations of Materials • Metal Frames display the clasps • The partial requires routine patient maintenance and modification to remain stable.

6. Where the Research Ends • Throughout the 1910’s, 20’s and 30’s, researchers acknowledged the damaging effects of rigid partials. • The research in removable prosthetics is replaced by research in new, more aesthetic, and more stable fixed prosthetic techniques. • New direction still leaves gap in economical and simple solutions.

7. Some Functional Issues The Distal Extension partial is our greatest challenge, so we will focus on this

8. Free-End Design • The Distal Extension or Free-End Saddle restoration poses a greater challenge because it is partly supported by the tooth and partly by the residual ridge

9. The Forces

10. Fulcrum Line Axis

11. Longitudinal Axis

12. Lateral Force

13. The Goals of Partial Design • The goal of framework design is: • Retain the Partial • Support the partial • The challenge of Conventional RPD design is to balance the requirements of retention and support while minimizing damage to natural dentition and the supporting ridge.

14. One of our Better Options

15. Mesial Driving Force with RPI Clasp

16. Drawbacks • Requires precise guideplane prep • Very accurate surveying required • Modified or Altered Cast Impression recommended • Requires routine maintenance and reline • Fails easily with improper preparation

17. Where Valplast Comes In • Valplast came into development during this time • Improvements are intended to address process, functional and aesthetic limitations • Simple, safe and effective.

18. Thinking Beyond Design • The Valplast approach is to address the requirement of retention and support by leveraging flexible base properties with simple designs.

19. Advantages of Valplast • Aesthetics are obvious. The metal clasp is eliminated entirely • The natural translucency blends in with the gum tissue.

20. Functional Solution Flexibility acts a stress-breaker to disengage forces on individual saddles. • Balanced distribution of forces over the edentulous areas • Elimination of unnecessary stresses on remaining natural teeth

21. Long Term Function • Tissue Conditioning: The Flexibility of the resin allows the partial to create a gentle stimulation of the gum improving circulation and tissue vitality. • Stress Relief: The Flexibility of the resin eliminates the fulcrum effects that produces a network of damaging stresses throughout a conventional rigid partial. • Wolff’s Law: Under normal physiological stress, bone mass stabilizes at normal levels. Under excessive stress, mass increases, and under low stress, bone resorbs.

22. Why no Vertical Stops? • The stop or rest is useful only in a rigid or semi-rigid frame as part of the support and balance structure. • The flexibility of the Valplast eliminates the need to balance stresses against tooth surfaces. • The flexible base is self-balancing.

24. Case Histories All theories mean something only if they really work in practice. The following case histories illustrate a small sample of the practical results.

25. Case 1: 12 Year Partial

26. Photos provided byDr. J.F. Warriner, Oklahoma City • Patient received Valplast Maxillary partial in December, 1985. • Partial last adjusted in March, 1986. • Photos taken May, 1997. Note the healthy mucosa over the tuberosities

27. Case 2: 7 Year Partial • Mandibular Valplast Partial inserted in 1990.

28. Note gingival health and excellent color.

29. 1989, Immediately prior to extraction 1997, After partial worn 7 years Dense horizontal bone is apparent at same level as before extraction

30. Case 3: 4 Year Partial • Partial inserted in 1992.

31. These flanges are very comfortable and esthetic Note gingival health on labial and palatal sides of abutment tooth.

32. Typical Cases

33. Mandibular Partial Denture Excellent esthetics Teeth #21-25 are retained Note the flanges are almost invisible

34. Maxillary Partial Denture

35. Mandibular Partial Denture Instead of a metal clasp, Valplast partial dentures utilize a flexible nylon extension.

36. Special Applications

38. Oral Carcinoma These thin Valplast flanges are less bulky and more comfortable than conventional acrylic.

39. Full Denture for Boney Tuberosity The flexible flanges are excellent in cases which have inoperable or large undercuts.

40. Aesthetic Correction Flange provides gingival architecture, restores speech and improves mastication efficiency.

41. Special NeedsValplast Partials are ideal for people in high-risk situations • Athletes • Police and Firefighters • Military Personnel • Prisoners and Prison Officers • Any person who might be exposed to harm or injury

42. Perfection? Does Valplast solve all the problems of partial restoration? We believe that no product can solve all the problems of partial restoration. The key is to solve as many as possible in a simple way that is affordable for the patient. We have focussed on improvements over conventional partials in Aesthetics, Function, Durability, and Longevity.

43. How Long Do They Last…(Really)? • For real…as long as the mouth undergoes slow, healthy, gradual change, the partial will remain functional. • Patient comfort is a good guide of function. • Only drastic or abnormal changes in the mouth require addition, rebase, or a new partial. • Valplast resin is created so that material failure does not become a factor in causing appliance failure

44. Indications • Valplast partials can be offered whenever a conventional partial is considered. • Additionally, Valplast can be used in most cases where metal and/or acrylic is not usable or preferable. • We have not encountered any limits to restoration with Valplast not solved by an experienced technician.

45. Indications Exceptions Valplast Partials Conventional RPD

46. Numbers that Mean Something • Valplast has a flexural modulus of 475 MPa at Body Temperature • This is the appropriate degree of flexibility for the partial to function in a predictable way WHEN DESIGNED AND FABRICATED CORRECTLY • Other flexible type resins have drastically different flexural properties and may not be usable in this application

47. Recap of Advantages • Aesthetics • Confidence • Durability • Simplicity • Reliable Lab Processes • Clinically non-invasive • Lab-Manufacturer Cooperation

48. Clinical ProceduresSubmission Guidelines • Perfect Alginate Impression • Bite Registration • Try-In • Insertion • Adjustment • Patient Care Instructions

49. Impression Technique • Alginate impression material minimizes compression of alveolar mucosa and muscle formations • Mucostatic Impression Required

50. Insertion Procedure • Partial must be immersed in hot water prior to insertion • Slight increase in flexibility minimizes the patient’s reaction to the first unfamiliar sensation