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SUMMARY The advantages of removable partial dentures with cobaltchromium frameworks over those
made entirely of acrylic resin, in oral health and
hygiene, are well documented. However, in cases
where teeth are to be extracted for fitting the
removable partial denture, a difficulty arises
because of the need to test the fit of the removable
partial denture framework. The advent of two
modern technologies laser welding and metal
bonding agents make it possible to test the fit of
the major part of the framework prior to adding
additional metal components to support artificial
teeth. A case is described in which the four lower
Introduction
Removable partial dentures have been shown to have
the potential to damage the remaining oral structures
(13). However, this damage can be minimized if the
standard of oral hygiene is enhanced (4) and if the
removable partial denture is well supported and covers
as little of the gingival tissues as possible (5). These
requirements can best be met if the removable partial
denture has a cast metal framework.
Patients who require immediate replacement of untreatable teeth and who would benefit from an immediate replacement denture with a cast metal framework
present a particular problem. Although the technology
involved in making cast metal removable partial denture
frameworks is tried and tested, it is still considered
necessary to test the fit of a metal framework before
adding the artificial teeth and completing the denture. In
the case of a denture that will replace teeth that are
extracted when the denture is fitted, there are additional
difficulties regarding the attachment of the artificial teeth
2005 Blackwell Publishing Ltd
incisors were extracted. The main part of the framework was constructed and its fit tested. A second
casting was laser-welded to the lingual plate of the
first casting to support the artificial incisor teeth.
This technique avoids the need to make an acrylic
resin temporary denture but incurs the cost of the
additional technical work and so the advantages
may be considered to be economically neutral.
KEYWORDS: removable partial dentures, immediate
replacement dentures, cobaltchromium, laser
welding, bonding agents
Accepted for publication 5 December 2004
772
Case report
A 42-year-old female patient presented at the Department of Prosthodontics at Guys Hospital. She was
concurrently receiving periodontal treatment but the
lower incisor teeth showed grade III mobility and were
considered to be unsavable. Conventional treatment
would have been to extract the incisors and insert a
transitional acrylic resin immediate replacement
removable partial denture. The periodontal condition
of her remaining teeth although unsatisfactory, was
improving under treatment. It was thought that the
hygiene benefits of a denture with a cobaltchromium
framework would supplement the periodontal therapy.
Diagnostic casts were made and mounted on a
Dentatus semi-adjustable articulator using a face bow
transfer record. The lower cast was surveyed and a
Fig. 1. Testing the fit of the first part of the cobalt chromium
framework in the patients mouth before extraction of the lower
incisor teeth. A second casting will be added to the lingual plate to
support artificial incisor teeth.
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Fig. 4. The denture has been completed, the incisor teeth have
been extracted and the denture fitted.
Fig. 3. The incisor teeth have been removed from the cast, the
second casting has been laser-welded to the first casting.
Discussion
Occasionally, it is desirable to make immediate
replacement removable partial dentures with metal
frameworks. Traditionally, this has been difficult because
of the need to test the fit of the framework prior to
extracting the teeth. Recent technological advances in
laser welding and bonding of acrylic resin to metal have
References
1. Carlsson GE, Hedegard B, Koivumaa KK. Studies in partial
dental prosthesis II. Acta Odontol Scand. 1961;19:215.
2. Carlsson GE, Hedegard B, Koivumaa KK. Studies in partial
dental prosthesis III. Acta Odontol Scand. 1962;20:95.
3. Carlsson GE, Hedegard B, Koivumaa KK. Studies in partial
dental prosthesis IV. Acta Odontol Scand. 1963;23:443.
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