Removable Partial Denture Framework Adjustment Rudd & Kuebker 75% of frameworks dont fit perfectly Active - orthodontic movement Adjust to make passive Framework Adjustment
Adjust without denture base Adjust soon after fabrication Prevent tooth migration Video: Framework Adjustment Clinical Adjustment Incomplete seating
Usually binding on abutments Use an indicating medium Incomplete seating Indicating Medium Aerosol Sprays (Occlude) Disclosing Wax
Silicone Two-Dimensional Indicating Medium Occlude (aerosol) Thin & accurate Not easily displaced Can dissolve in saliva Difficult to remove
Cant tell how far from seating Three-Dimensional Indicating Medium Disclosing Wax Sets immediately Inexpensive Shows how far from seating Can stick to teeth
Can be distorted Adjustment with Silicone Indicating Medium Three dimensional Minimal distortion More expensive Sets relatively slowly (~1-2 min)
Can tear or pull off the framework Framework Adjustment Initial Assessment How does the framework feel? No pulling or wedging Active engagement of abutment teeth
Overall comfort of the framework Framework Adjustment Areas of abrasion on master cast may indicate areas of binding 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 Cautious Adjustment Differentiate between normal & abnormal contacts Guiding planes
normal: long vertical areas of contact broad areas of severe burnthrough may indicate binding Cautious Adjustment Avoid excessive force - bending Heat generation could melt acrylic Retentive tip of direct retainers
normal: burn-through eliminate active clasp retention Remake Poor Castings Determine if casting fits similarly on the cast and intraorally If not, final impression inaccurate Make new impression
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
Framework Occlusal Adjustments Highly polished metal Articulating paper marks poorly
Check opposing occlusal contacts Slightly roughen framework with air abrasive or rubber impregnated abrasive Opposing Frameworks
Adjust individually Then adjust together Eliminate interferences between the frameworks 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
Interferences on Retentive Arms Minor interference Reduce opposing cusp - last resort Heavy contact Lower height of contour, remake Dont relieve
Alters flexibility & fracture resistance 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) Physiologic Relief Distal Extension Cases Guiding planes, minor connectors & lingual plates coated with indicator
Framework is placed in hyperfunction by pressing over gridwork Physiologic Relief Relieve burn-through Until burn-through occurs only on the occlusal one third of the guiding planes
Physiologic Relief Alternative Prescribe 1 relief OR Use physiologic relief, not both
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