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Removable Partial Denture Framework Adjustment

This guide emphasizes the significance of properly adjusting removable partial denture frameworks. Research shows that 75% of frameworks do not fit perfectly, necessitating adjustments soon after fabrication to prevent issues like tooth migration and incomplete seating. Various indicating mediums, such as aerosol sprays and disclosing wax, are discussed for identifying areas of binding. The adjustment process includes careful assessments, occlusal adjustments, and ensuring no excessive force is used. This resource is essential for dental professionals seeking to improve patient comfort and denture fit.

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Removable Partial Denture Framework Adjustment

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  1. Removable Partial Denture Framework Adjustment • Rudd & Kuebker • 75% of frameworks don’t fit perfectly • Active - orthodontic movement • Adjust to make passive

  2. Framework Adjustment • Adjust without denture base • Adjust soon after fabrication • Prevent tooth migration

  3. Video: Framework Adjustment

  4. Clinical Adjustment • Incomplete seating • Usually binding on abutments • Use an indicating medium Incomplete seating

  5. Indicating Medium • Aerosol Sprays (Occlude) • Disclosing Wax • Silicone

  6. Two-Dimensional Indicating Medium • Occlude (aerosol) • Thin & accurate • Not easily displaced • Can dissolve in saliva • Difficult to remove • Can’t tell how far from seating

  7. Three-Dimensional Indicating Medium • Disclosing Wax • Sets immediately • Inexpensive • Shows how far from seating • Can stick to teeth • Can be distorted

  8. Adjustment withSilicone Indicating Medium • Three dimensional • Minimal distortion • More expensive • Sets relatively slowly (~1-2 min) • Can tear or pull off the framework

  9. Framework Adjustment • Initial Assessment • ‘How does the framework feel?’ • No pulling or wedging • Active engagement of abutment teeth • Overall comfort of the framework

  10. Framework Adjustment • Areas of abrasion on master cast may indicate areas of binding

  11. Check Maxillary Beading • Ensure not binding on bony midline • Can cause entire framework not to seat • Use PIP to check • Will burn through if excessive height Beading

  12. Cautious Adjustment • Differentiate between normal & abnormal contacts • Guiding planes • normal: long vertical areas of contact • broad areas of severe burn-through may indicate binding

  13. Cautious Adjustment • Avoid excessive force - bending • Heat generation could melt acrylic • Retentive tip of direct retainers • normal: burn-through • eliminate active clasp retention

  14. Remake Poor Castings • Determine if casting fits similarly on the cast and intraorally • If not, final impression inaccurate • Make new impression

  15. Framework Occlusal Adjustments • Fabricated on unmounted casts • Occlusal interferences usually present • Occlusal vertical dimension should be unchanged • Centric & eccentric contacts should be identical with or without framework

  16. Framework Occlusal Adjustments • Highly polished metal • Articulating paper marks poorly • Check opposing occlusal contacts • Slightly roughen framework with air abrasive or rubber impregnated abrasive

  17. Opposing Frameworks • Adjust individually • Then adjust together • Eliminate interferences between the frameworks

  18. Occlusal Rest Thickness • If ≤ 1.5 mm after adjustment • Subject to fatigue • Possible fracture • May require additional tooth preparation & remake • Last resort - occlusal reduction of opposing teeth

  19. Interferences on Retentive Arms • Minor interference • Reduce opposing cusp - last resort • Heavy contact • Lower height of contour, remake • Don’t relieve • Alters flexibility & fracture resistance

  20. Physiologic Relief • Used for Class I & II w. long g.p. • Normally shorter guiding planes • Triangular space below height of contour • Allow for release • Tipped teeth may only provide for long guiding planes (low h of c)

  21. Physiologic Relief • Distal Extension Cases • Guiding planes, minor connectors & lingual plates coated with indicator • Framework is placed in hyperfunction by pressing over gridwork

  22. Physiologic Relief • Relieve burn-through • Until burn-through occurs only on the occlusal one third of the guiding planes

  23. Physiologic Relief Alternative • Prescribe 1° relief OR • Use physiologic relief, not both

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