R E M O V A B L E RPER M

O SOTVHA
OB L N
DO E T IPCRS O S T H O D O N T I C S

The Swing-Lock Denture: Its Use in

Conventional Removable Partial
Denture Prosthodontics
CHRISTOPHER D. LYNCH AND P. FINBARR ALLEN
natural teeth is such that there is poor
Abstract: This article describes the uses of the swing-lock retained removable partial
tooth support for the prosthesis;
denture in partially dentate patients where the potential for achievable retention with a
conventionally designed removable partial denture is less than adequate. The article
The remaining teeth are periodontally
presents two case reports detailing effective use of the swing-lock concept in removable compromised the swing-lock design
partial denture design and it is hoped that this article will increase the awareness of is thought to act as a splint,
practitioners to the use of this prosthesis type when planning removable partial dentures. distributing forces evenly among the
remaining teeth (the use of clasps on a
Dent Update 2004; 31: 506508 conventional prosthesis would
Clinical Relevance: The swing-lock removable partial denture is a useful subject periodontally compromised
treatment option for patients who lack clinical features for adequate retention of abutment teeth to damaging forces);
conventional removable partial denture therapy, or for those patients who, for a variety
Implant-retained prostheses are
of reasons, are not suitable for fixed prosthodontics or implant-retained prostheses. contra-indicated owing to financial or
clinical reasons.

Contra-indications for its use include

scenarios where:

I mprovements in dental health in

developed countries have led to an
increase in the prevalence of partially
dentate adults.1 Rehabilitation of partially
dentate patients place considerable
demands on the diagnostic, clinical and
technical skills of those involved in their
rehabilitation. The swing-lock denture is
useful in partially dentate patients where
the configuration of the remaining teeth is
such that either the retention or stability
available for a conventional removable
partial denture is less than ideal. Its
development can be credited to two
people; it was first documented by
Simmons in 1963,2 though previous work
by Ackerman3 in 1955 makes reference to a
prosthesis type that utilized a similar
mechanism for retention. While the use of
Christopher D. Lynch, BDS, MFD RCSI,
Registrar in Restorative Dentistry and
P. Finbarr Allen, BDS, MSc, FDS RCPS, PhD,
Senior Lecturer/Consultant, Department of
Restorative Dentistry, National University of
Ireland, Cork, Ireland.
a swing-lock component has been
documented in the retention of maxillo-
facial prostheses,4,5,6 the purpose of this

The patients manual dexterity is such
that they cannot correctly manipulate
article is to bring its use to the attention of the clasping mechanism of the swing-
dental practitioners for partially dentate lock portion;
patients where adequate retention is not
The patient has consistently
readily achievable. demonstrated poor oral hygiene, or
The design of this prosthesis inadequate dietary control, or
incorporates a conventional removable advanced unstabilized periodontal
partial denture design with a swing-lock disease (the prosthesis covers the
component consisting of a preformed gingival margins of many teeth);
metal hinge and locking precision
The patient has a shallow sulcus or
attachments in a single casting a hinge,
gate and clasp (Figure 1). This
additional component is usually placed in
the labial sulcus.
Indications for the use of a swing-lock
component include scenarios where:

Existing dental or alveolar undercuts
do not provide sufficient retention for
conventional removable partial
dentures;

The use of retentive clasps will lead to
compromised aesthetics; Figure 1. The swing-lock removable partial

The configuration of the remaining denture with the hinge, gate and clasp identified.

506 Dental Update November 2004


Figure 2. A mandibular swing-lock removable
partial denture. Note the use of metal struts on
the remaining teeth.
Figure 3. A maxillary swing-lock removable
partial denture with an acrylic flange added to
the labial bar.
large frenal attachment in the area
where the position of the bar is
planned;

For a maxillary prosthesis, the patient
has a high smile-line.
Original descriptions2 of the swing-lock
prosthesis used small metal struts
beneath undercut areas of abutment teeth
(similar to gingivally approaching clasps
on conventional prostheses) (Figure 2).
While this is feasible in mandibular
prostheses, it may compromise aesthetics
and limit patient acceptance of maxillary
prostheses, particularly if the patient has a
tendency towards a high smile-line. This
can be overcome by placing an acrylic
flange on the metal bar, which is also
useful in masking unaesthetic gingival
recession a common feature in such
aged dentitions (Figure 3). Struts also
have the potential to trap food, hence the
need for meticulous oral hygiene is clear.
The following case reports demonstrate
effective uses of swing-lock removable
partial dentures.
CASE REPORT 1
A 71-year-old partially dentate female was
referred to the Department of Restorative
Dental Update November 2004
R E M OVA B L E P R O S T H O D O N T I C S
Dentistry of the Cork University Dental
School and Hospital (Cork, Ireland) for
specialist treatment regarding her
prosthodontic rehabilitation. The patient
reported difficulty wearing several
maxillary removable partial dentures that
had been made for her in the past. The
patient was a retired dental assistant and
had extensive fixed prosthodontic work,
fitted during her lifetime, that was now
disintegrating. An intra-oral photograph of
this patient is shown in Figure 4. The
endodontically treated root of an upper
right canine was present, and the patients
referring practitioner suggested that this
tooth was suitable for restoration with a
dowel-retained crown. The patients
existing prosthesis was examined. It was
clear that the main difficulty with retention
of the prosthesis was in the upper left
quadrant, with no teeth present distal to
the upper left central incisor. Treatment
options discussed with the patient
included implant-retained prostheses
(fixed or removable), conventional
removable partial dentures, or a swing-
lock removable partial denture. As the
patient was elderly and limited by financial
constraints, an implant-retained prosthesis
was not suitable. As previous removable
prostheses had been unsuccessful, it was
decided to fabricate an upper swing-lock
removable partial denture, with a
prosthetic overdenture abutment tooth
to be placed over the root of the upper
right canine. Diagnostic casts were made
in the usual fashion and mounted on a
semi-adjustable articulator. The upper cast
was surveyed and a chrome-cobalt
framework designed. Following tooth
preparation, a master impression was made
in silicone. The impression was sent to the
technician with written instructions for the
fabrication of the designed prosthesis to
include a labial swing-lock component
with an acrylic flange to disguise the
appearance of the metal bar. The metal
framework was tried in the mouth and
found to fit accurately. The patients
dexterity in manipulating the clasp was
assessed at this stage and found to be
satisfactory. Following occlusal
registration and tooth selection, the
denture was completed in the normal
manner and delivered to the patient
(Figure 5). At subsequent review
Figure 4. Intra-oral photograph showing the
dental configuration of the patient described in
Case Report 1.
Figure 5. Intra-oral photograph showing the
swing-lock denture in situ for the patient in
Case Report 1.
appointments, the patient reported
satisfaction with the aesthetics, function
and retention of the prosthesis.
CASE REPORT 2
A 55-year-old female was referred to the
Department of Restorative Dentistry of the
Cork University Dental School and
Hospital (Cork, Ireland) for provision of an
implant-retained prosthesis. On
discussion with the patient, she reported
that she had several upper partial dentures
fabricated for her that she found difficult
to control. She was also concerned about
the cost of an implant-retained prosthesis.
On examination, the patient was found to
be partially dentate, with five teeth present
in her upper arch (3|, 2|, 1|, |1, |3) (Figure 6).
The upper left canine was over-erupted
and periodontally compromised (Grade III
mobility); however, the patient reported
that she wanted to retain this tooth.
When the upper cast was surveyed it
was found the labial surface of the
upper right canine was non-retentive.
In view of the patients clinical and
financial considerations, it was agreed
that an upper swing-lock removable
partial denture would be fabricated.
Following tooth preparation (which
included the addition of some adhesive
composite resin on the labial surface of
the upper right canine to enhance
retention), a master impression was
507
 R E M OVA B L E P R O S T H O D O N T I C S
Figure 6. Intra-oral photograph showing the
dental configuration of the patient described in
Case Report 2.
Figure 7. Intra-oral photograph showing the
swing-lock denture in situ for the patient in
Case Report 2.
Figure 8. View of the fitting surface of the swing-
lock denture for Case Report 2.
made in silicone. The prosthesis was
designed to include a labial swing-lock
component with an acrylic flange to mask
the gingival recession around the
remaining upper teeth, and fabrication
continued in the fashion described in the
previous case report. At the final try-in
stage, the patient reported that the upper
right canine had become quite
uncomfortable and requested its
extraction. It was decided to do this at the
delivery stage. The upper left canine was
removed from the master cast and added
to the final prosthesis prior to processing
of the acrylic component. At the denture
delivery stage, the upper right canine was
extracted and the prosthesis fitted
(Figures 7 and 8). At subsequent review
appointments the patient reported
satisfaction with the aesthetics, function
and retention of the prosthesis.
508
DISCUSSION
The swing-lock concept is a useful
method of improving retention of
removable prostheses where
conventional retention is absent. The
cases presented in this paper
demonstrate how to achieve a
satisfactory result for those dentitions
where the possibilities for clasp-retained
removable partial dentures are limited by
utilizing a concept which has been often
used in maxillofacial prosthodontics.4,5,6
Neither patient in the described case
reports was able to afford implant-
retained prostheses, and the chances of
success of a conventional removable
prosthesis were clearly limited. The
materials and techniques used are not
dissimilar from conventional removable
partial denture construction. It is critical
that the patients dexterity is assessed at
an early stage as poor manual dexterity
will clearly limit the success of the
prosthesis. Swing-lock dentures may also
be used in association with other
retentive factors such as implants.7
There is little scientific evidence in the
literature regarding patient satisfaction
with swing-lock prostheses or the effect
of swing-locks on the oral environment.
Most recommendations regarding its use
seem to be based on opinion rather than
scientific evidence for example, its use
as a splint for periodontally involved
teeth.8 The only evidence available is
published as case reports with varied
follow-up times9,10 and a study by Smith
and Schulte11 that examined a population
of swing-lock dentures provided in a
dental school. After an average follow-up
period of 2.5 years, they found this
prosthesis had no adverse effect on the
periodontium. It is noteworthy that, in
this study, subjects were exposed to a
rigorous oral hygiene programme. It is
worth remembering the potential risks to
the periodontal tissues caused by the
extensive coverage of gingival margins
by this prosthesis. There is a need for
further well-designed scientific
investigation of this area.
In terminal dentitions, the swing-lock
denture can be useful as a transitional
denture. Transitional dentures are
recommended for patients who are
progressing to an edentulous state,
enabling the patient to control and
become accustomed to removable
prostheses prior to being rendered
edentulous.
SUMMARY
The clinical scenarios described
demonstrate the usefulness of the swing-
lock concept in providing conventional
prostheses where retention is
compromised. The operational
techniques and materials utilized are
similar to those used in conventional
removable prosthodontics. Coupled with
the knowledge and skills of the dentist,
this technique can overcome this
particular clinical difficulty in a simple
fashion, while avoiding invasive and
expensive procedures.
ACKNOWLEDGEMENT
The authors are indebted to Mr Tim Clark and the staff
of the Dentacast of Exeter laboratory (PO Box 21,
18B Cowick Rd, Exeter, EX2 9BE, UK ) for technical
support in the cases described.
REFERENCES
1. OMullane D, Whelton H. Oral Health of Irish
Adults.The Stationery Office, Dublin, 1992.
2. Simmons JJ. Swing-lock stabilization and retention.
A preliminary clinical report. Tex Dent J 1963; 81:
1012.
3. Ackerman AJ. The prosthetic management of oral
and facial defects following cancer surgery.
J Prosthet Dent 1955; 5: 413432.
4. Sigurgeirsdottir E, Minsely GE, Rothenberger SL.
Incorporation of an ERA attachment for
obturator framework design: a clinical report.
J Prosthet Dent 2002; 87: 477480.
5. Javid NS, Dadmanesh J. Obturator design for
hemimaxillectomy patients. J Prosthet Dent 1976;
36: 7781.
6. Black WB. Surgical obturation using a gated
prosthesis. J Prosthet Dent 1992; 68: 339342.
7. McAndrew R. Prosthodontic rehabilitation with a
swing-lock removable partial denture and a single
osseointegrated implant: A clinical report. J Prosthet
Dent 2002; 88: 128131.
8. Bolender CL, Becker CM. Swinglock removable
partial dentures: where and when. J Prosthet Dent
1981; 45: 410.
9. Talbot TR. Review of the swinglock removable
partial denture. Int J Prosthodont 1991; 4: 8088.
10. Barclay CW, Russell MD, Murphy P. A three-part
bilateral swinglock design denture revisited. Br
Dent J 2001; 190: 538540.
11. Smith JK, Schulte DE. Clinical evaluation of
swinglock removable partial dentures. J Prosthet
Dent 1980; 44: 595603.
Dental Update November 2004