Using Removable Partial Denture Framework as Matrix for Pin-Retained Restoration

To introduce a method of digital modeling and fabricating removable partial denture (RPD) frameworks using self-developed software for RPD design and rapid manufacturing system. The three-dimensional data of two partially dentate dental casts were obtained using a three-dimensional crossing section scanner. Self-developed software package for RPD design was used to decide the path of insertion and to design different components of RPD frameworks. The components included occlusal rest, clasp, lingual bar, polymeric retention framework and maxillary major connector. The design procedure for the components was as following: first, determine the outline of the component. Second, build the tissue surface of the component using the scanned data within the outline. Third, preset cross section was used to produce the polished surface. Finally, different RPD components were modeled respectively and connected by minor connectors to form an integrated RPD framework. The finished data were imported into a self-developed selective laser melting (SLM) machine and metal frameworks were fabricated directly. RPD frameworks for the two scanned dental casts were modeled with this self-developed program and metal RPD frameworks were successfully fabricated using SLM method. The finished metal frameworks fit well on the plaster models. The self-developed computer aided design and computer aided manufacture (CAD-CAM) system for RPD design and fabrication has completely independent intellectual property rights. It provides a new method of manufacturing metal RPD frameworks.

IntroductionThe conventional method for teaching removable partial denture (RPD) design using a pencil drawing on a solid cast has always been the basis for teaching RPD design in most dental schools at both the undergraduate and graduate levels. This does not apply to RPD fabrication technology, as more laboratories have recently adopted more efficient and versatile digital techniques to design and fabricate RPD frameworks.MethodsAt the University of Iowa College of Dentistry, we created a pilot workshop to assess the efficiency of a new approach to teaching RPD design utilizing this new digital RPD technology as a teaching tool for graduate prosthodontics residents. Three first-year prosthodontics residents were enrolled in the workshop, which involved learning the new digital workflow of designing RPD.ResultsThis new teaching approach very successfully achieved its educational goals. The residents reported that the digital RPD teaching approach enriched their knowledge and deepened their understanding of RPD design.DiscussionThe technique garnered significant interest from the students and seemed to also increase their understanding of the steps involved in RPD fabrication as well as the different components of the RPD.

Process parameter optimization for removable partial denture frameworks manufactured by selective laser melting

Additive manufacturing (AM) often referred to as 3D printing (3DP) has shown promise of being significantly viable in the construction of cobalt-chromium removable partial denture (RPD) frameworks. The current paper seeks to discuss AM technologies (photopolymerization processes and selective laser melting) and review their scope. The review also discusses the clinical relevance of cobalt-chromium RPD frameworks. All relevant publications in English over the last 10 years, when the first 3D-printed RPD framework was reported, are examined. The review notes that AM offers significant benefits in terms of speed of the manufacturing processes however cost and other aspects of current technologies remain a hindrance.

To evaluate the overall adaptation and retention of class I cobalt-chromium (Co-Cr) removable partial denture (RPD) frameworks using three different computer-aided design and computer-aided manufacturing (CAD-CAM) technologies: Indirect wax milling with lost wax technique (LWT), direct milling, and selective laser melting (SLM) technique. An educational maxillary stone model (Kennedy class I) was scanned after preparing rest seats to create a resin model. The resin model was scanned, and the RPD framework was digitally designed and saved as a standard tessellation language (STL) file. Twenty-four Co-Cr RPD frameworks were then constructed and divided into three groups (n = 8) based on fabrication technique: Group A (indirect wax milling with LWT), Group B (direct milling), and Group C (selective laser melting). In Group A, the STL file was used to mill the design from castable resin blanks which were then cast by the LWT. In Group B, the STL file was used to mill the design from the Co-Cr blank directly. Finally in Group C, the STL file was used to print the design from Co-Cr powder using SLM 3D printed technique. Geomagic Control X software was used to measure the overall adaptation of the fabricated RPD frameworks, Retention was also tested using a universal testing machine. One-way Analysis of Variance (ANOVA) test was used to compare the three groups then the Tukey HSD post-hoc test was used for pair-wise comparisons. The significance level was set at p ≤ 0.05. Regarding the overall adaptation, Group B (0.71±0.02mm) showed significantly higher adaptation than Group A (0.96±0.06mm) and Group C (1.05±0.16mm). Regarding retention, Group B (2.03±0.34 N) showed significantly higher retention than Group A (1.00±0.13 N) and Group C (0.78 ±0.17 N). Based on the findings of this in vitro study, Co-Cr RPD frameworks fabricated by direct milling technique revealed the best adaptation and retention.

PurposeThis in vitro study aims to explore the effects of selective laser melting (SLM) process parameters on the accuracy of the intaglio surface of cobalt–chromium alloy (Co–Cr), commercially pure titanium (CP Ti) and titanium alloy (Ti–6Al–4V) maxillary removable partial denture (RPD) frameworks and optimize these process parameters.Design/methodology/approachMaxillary RPD framework specimens designed on a benchmark model were built. The process parameters, including contour scan speed and laser power, infill scan speed and laser power, hatch space, build orientation and metallic powder type, were arranged through the Taguchi design. Three-dimensional deviations of the clasps area, connector area and overall area of maxillary RPD frameworks were analyzed by using root mean square (RMS) as a metric. One-way analyses of variance with the above RMSs as the dependent variable were carried out (α = 0.05).FindingsMaxillary RPD frameworks built horizontally had a more accurate intaglio surface than those built at other orientation angles; CP Ti or Ti–6Al–4V maxillary RPD frameworks had a more accurate intaglio surface than Co–Cr ones; the Maxillary RPD framework built with a higher infill scan speed and lower infill laser power had the more accurate intaglio surface than the one built with other levels of these two process parameters.Originality/valueA novel benchmark model for evaluating the accuracy of the intaglio surface of maxillary RPD frameworks manufactured by SLM is proposed. The accuracy of the intaglio surface of maxillary RPD frameworks can be improved by adjusting SLM process parameters. The optimal setting of process parameters concerning the accuracy of the intaglio surface of maxillary RPD frameworks was given.

Trueness of 3D printed removable partial denture frameworks: Investigation of printing parameters and storage conditions.

Although porcelain and zirconium oxide might be used for fixed partial dental prostheses instead of conventional dental metals in the near future, removable partial denture (RPD) frameworks will probably continue to be cast with biocompatible metals. Commercially pure (CP) titanium has appropriate mechanical properties, it is lightweight (low density) compared with conventional dental alloys, and has outstanding biocompatibility that prevents metal allergic reactions. This literature review describes the laboratory conditions needed for fabricating titanium frameworks and the present status of titanium removable prostheses. The use of titanium for the production of cast RPD frameworks has gradually increased. There are no reports about metallic allergy apparently caused by CP titanium dentures. The laboratory drawbacks still remain, such as the lengthy burn-out, inferior castability and machinability, reaction layer formed on the cast surface, difficulty of polishing, and high initial costs. However, the clinical problems, such as discoloration of the titanium surfaces, unpleasant metal taste, decrease of clasp retention, tendency for plaque to adhere to the surface, detachment of the denture base resin, and severe wear of titanium teeth, have gradually been resolved. Titanium RPD frameworks have never been reported to fail catastrophically. Thus, titanium is recommended as protection against metal allergy, particularly for large-sized prostheses such as RPDs or complete dentures.

Retention and support are needed for removable partial denture stability. The stability can be achieved by clasps, occlusal and cingulum rests on healthy abutment teeth. However, implants or crowns can be used to support the removable partial denture instated on unhealthy abutment teeth. This study was conducted to investigate the fracture strength of two types of all-ceramic restorations used as abutments for the removable partial denture framework. The crowns were manufactured with two types of ceramic materials: zirconia and IPS e.max Press ceramics. The metal alloy (cobalt-chrome) was cast to form the removable partial denture framework. A universal testing machine was used to evaluate the fracture strength of both ceramic crown materials. The results presented no fractures in all-ceramic crowns, but deformation of the partial denture frameworks occurred. With the limitation of this study, it can be concluded that zirconia and IPS e.max Press ceramic can be used as abutments to provide adequate support to the removable partial denture.

Effects of the type and rigidity of the retainer and the number of abutting teeth on stress distribution of telescopic-retained removable partial dentures

The introduction of computer-aided design and computer-aided manufacturing in rehabilitation with removable partial denture, enabled the emergence of new methods of fabrication of the framework and materials. In view of this, polyether-ether-ketone appears as an alternative to Cobalt-Chromium, due to its aesthetic properties, high resistance and for being non-allergic. In this sense, the present study aimed to report a clinical case where the framework of a removable partial denture was manufactured from a digital workflow, using polyether-ether-ketone as the material of choice, compared to a removable partial denture made with a cobalt-chromium framework. In this case, it was possible to perceive that the use of computer-aided design and computer-aided manufacturing technology for the construction of a removable partial denture framework of polyether-ether-ketone resulted in a denture with adequate adaptation and good aesthetics. Patient satisfaction, comfort, retention, number of follow-up sessions, masticatory performance and quality of life were evaluated. Compared with the conventional denture, the polyether-ether-ketone framework denture provided better satisfaction and comfort. Both prostheses showed similar results in terms of masticatory performance and in terms of quality of life, however the polyether-ether-ketone framework denture showed better results. In conclusion, polyether-ether-ketone proved to be a viable material for making removable partial denture framework. However, controlled and randomized clinical trials are needed to demonstrate the benefits of this treatment as an alternative in relation to the conventional denture.

Effect of layer thickness setting on the adaptation of stereolithography apparatus–fabricated metal frameworks for removable partial dentures: An in vitro study

Comparing the trueness of 3D printing and conventional casting for removable partial denture metal framework fabrication in different mandibular major connectors designs: An in vitro study.

Fabrication of a removable partial denture combining conventional and digital techniques

Objective: To evaluate the fitness of bilateral free-end dentition defect removable partial denture framework fabricated by selective laser melting (SLM) technique with different support angles. Methods: After the control group has been set to eliminate the system error, and according to the standard model of bilateral mandibular posterior teeth loss, eighteen titanium alloy removable partial denture frameworks fabricated by SLM technology were divided into 3 groups with support angles of 0° (horizontal group), 45°(45° group) and 90° (vertical group). Plaster cast with duplicated structure of tissue surface of the removable partial denture (RPD) framework was obtained. A three-dimensional scanner was used to scan original and duplicated plaster casts. The gaps between framework and the model in different parts were analyzed using Geomagic Qualify software to evaluate the fitness of the framework with visual method. Results: The framework fits on the plaster model completely, and its tissue surface fitted on the plaster model well. The deviation between frameworks and plaster casts was calculated as follow: the total deviations of the horizontal, 45°, and vertical group were (0.146±0.017), (0.182±0.015) and (0.185±0.022) mm respectively. The mean deviation of the horizontal group was significantly less than those of the 45° group and the vertical group (P<0.05). Moreover, there was no significant difference in the total deviation between the 45° group and the vertical group. The total deviation of occlusal rest of the horizontal group was significantly less than that of the 45° group (P<0.05). However, no significant difference was detected in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group (P>0.05). There was no significant difference in the deviation of occlusal rest among the vertical group, the horizontal group, and the 45° group. The deviation of clasp of the horizontal group was significantly smaller than those of the 45° group and the vertical group (P<0.05). Whereas, there was no significant difference in the deviation of clasp between the 45° group and the 90° group (P>0.05). No significant difference was found in the deviation of lingual bar among the three groups (P>0.05). Conclusions: Among the three kinds of bilateral free-end dentition defect RPD framework fabricated by SLM in different support angles, horizontal printing was proved to reach the minimal deviation, even though the fitness of all three kinds of frameworks can fullfil clinical requirements according to previous studies.