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Background/aims: Speech impairment during the initial phase of removable partial denture (RPD) treatment can prevent patient adaptation to RPDs. This study was undertaken to investigate the influence of oral morphology on speech production in subjects wearing RPDs with major connectors., Methods: Two types of connectors were fabricated for 17 subjects with normal dentitions: covering the middle palate (M-bar) and the anterior/posterior palate (AP-bar). Four target sounds ([∫i], [t∫i], [çi], and [ki]) were evaluated under 3 recording conditions: no connector, M-bar, and AP-bar. The mean appearance ratios of correct labels (MARCs) were calculated as parameters representing speech production accuracy with the speech evaluation system. Subgroup analysis was conducted based on palate height, dental arch width, and front space volume of the oral cavity., Results: Based on the multiple linear regression test, a significant association was found between the MARCs of [∫i] with M-bar and front space (p = 0.036). In the subgroup analysis, the AP-bar had a significant effect on the MARCs of [∫i] among subjects with high palate (p = 0.026), narrow arch (p = 0.004), and small front space (p = 0.014)., Conclusion: RPDs with major connectors could disturb speech production among patients with high palates, narrow arches, and small front spaces., (© 2018 S. Karger AG, Basel.)

Statement of Problem: The optimum selection of denture teeth for patients with a reduced interarch distance has not been established., Purpose: The purpose of this in vitro study was to investigate the influence of denture tooth material and thickness on the fracture resistance of thin acrylic resin denture bases., Material and Methods: Acrylic resin (AC), composite resin (CO), or ceramic (CE) molar denture teeth were embedded in denture base blocks (2.0 mm thick). The distance from the central fossa to the tooth base was 0.5, 1.0, 2.0, or 2.5 mm for AC and CO, and 1.0 mm for CE (n=7), with a total thickness of 2.5 mm for all specimens. Each specimen was placed on a 3-point flexural setup with a shorter (8 mm) or longer (12 mm) support span than the tooth width and vertically loaded. A finite element analysis was performed to assess the stress distributions. The effects of tooth thickness and support span were statistically tested with ANOVA, followed by the Tukey honestly significant difference post hoc test (α= .05)., Results: With the shorter support, the mean fracture load was higher in CO than AC, regardless of the tooth thickness. Under the longer support, the mean fracture load with the CO decreased significantly as the tooth thickness increased, with increased maximum stress. Some CO tooth specimens of 2.0 mm or 2.5 mm thickness failed at the tooth-denture base interface at significantly lower loads than those exhibited by tooth fractures. CE showed minor cracks before bulk fracture., Conclusions: Higher fracture resistance was indicated with CO; however, the resistance decreased as the thickness of the CO tooth increased., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: To incorporate a metal framework into removable partial dentures, the dimensional accuracy of thermoplastic resins requires precision equivalent to conventional acrylic resins. This study aimed to evaluate the fitting accuracy of thermoplastic resins compared to heat-cured acrylic resin., Materials and Methods: Four thermoplastic resins (polyethylene terephthalate [EstheShot, ES; EstheShot Bright, ES-B], polyamide [Lucitone FRS, LF], polycarbonate [Reigning Resin N, RN] and a heat-curing acrylic resin [Acron, AC]) were used. The specimens were created on master casts constructed of high-strength stone that simulated a maxillary edentulous ridge. Additionally, high-expansion stone was used as the master cast for RN specimens. The ES-B, LF and RN specimens were prepared with and without annealing after injection molding. The gaps between the molded resin and the cast were measured., Results: ES had the smallest gap and was significantly smaller than AC (p < 0.05). The gap sizes of ES-B, LF and RN (high-expansion stone) without annealing were similar to AC (p > 0.05), while the gap size of RN (high-strength stone) with and without annealing was significantly greater than AC (p < 0.001). The gap sizes of ES-B and LF with annealing were significantly less than AC (p < 0.05). Further, the gap sizes of ES-B, LF and RN with annealing were significantly smaller than the gaps without annealing (p < 0.05)., Conclusions: The results suggested that ES, ES-B and LF have adequate fitting accuracy for incorporating metal framework into dentures and that annealing effectively improved the fitting accuracy of ES-B, LF and RN.

Objective: To investigate the effects of the width and cross-sectional shape of the major connectors of maxillary dentures located in the middle area of the palate on the accuracy of phonetic output of consonants using an originally developed speech recognition system., Patients and Methods: Nine adults (4 males and 5 females, aged 24-26 years) with sound dentition were recruited. The following six sounds were considered: [∫i], [t∫i], [ɾi], [ni], [çi], and [ki]. The experimental connectors were fabricated to simulate bars (narrow, 8-mm width) and plates (wide, 20-mm width). Two types of cross-sectional shapes in the sagittal plane were specified: flat and plump edge. The appearance ratio of phonetic segment labels was calculated with the speech recognition system to indicate the accuracy of phonetic output. Statistical analysis was conducted using one-way ANOVA and Tukey's test., Results: The mean appearance ratio of correct labels (MARC) significantly decreased for [ni] with the plump edge (narrow connector) and for [ki] with both the flat and plump edge (wide connectors). For [çi], the MARCs tended to be lower with flat plates. There were no significant differences for the other consonants., Conclusion: The width and cross-sectional shape of the connectors had limited effects on the articulation of consonants at the palate., (© 2015 S. Karger AG, Basel.)

The purpose of this study was to evaluate the fracture resistance of computer-aided design/computer-assisted manufacture (CAD/CAM)-fabricated fiber-reinforced composite (FRC) denture retainers. Distal extension dentures incorporating two telescopic retainers and two molar pontics, with or without fiberglass, were fabricated by CAD/CAM or by the conventional polymerization method. The dentures were subjected to a vertical load on the second molar pontic until fracture. Within each manufacturing method, embedment of the FRC increased the mean final fracture load, suggesting the reinforcing effect of fiberglass. The polymerized dentures with FRC showed greater mean final fracture load than the CAD/CAM dentures with FRC.

Purpose: The effect of gingival coverage by removable partial dentures (RPDs) on bacterial accumulation has not been sufficiently established. The aim of this study was to evaluate the periodontal and microbiologic reactions to mandibular major connectors. It was hypothesized that the use of a lingual plate increases the risk of periodontal disease., Materials and Methods: Fourteen subjects (mean age: 69.0 years) received oral hygiene instructions and ultrasonic debridement prior to examination. Each subject received an experimental RPD incorporating either a lingual bar or lingual plate for the first 8 weeks and was then switched to the other option for the next 8 weeks. Clinical parameters (Plaque Index, Gingival Index, probing depth, and tooth mobility) were recorded. Subgingival plaque samples were collected from the periodontal pocket in the test site to measure the colonization of periodontal pathogens after the use of each denture., Results: The mean probing depth was significantly greater after use of the lingual plate compared to the lingual bar (P < .05), whereas the type of connector did not affect the levels of any of the microbial species. All subjects that exhibited at least one bacterial species showed smaller numbers of microorganisms at the second examination than at the first., Conclusions: The lingual cervical coverage did not precipitate the accumulation of anaerobic microorganisms, although it could potentially induce gingival inflammation. The results suggest that a lingual plate can be used as safely as a lingual bar if oral and denture hygiene are carefully monitored.

The purpose of this study was to evaluate the reinforcing effect of fiberglass on composite resin retainers of the telescopic dentures. A finite element method was used to assess the effect of the abutment height and the embedment of the fiberglass on the stress distributions of the retainers. The experimental retainers of Poly(methylmethacrylate), composite resin (CR) and the fiber-reinforced composite resin (FRC) were used in the fracture test. The fracture load of the FRC retainers were significantly greater than those of the other retainers. The embedment of the fiberglass reduced the stress at the upper surface of the CR retainers. The fracture origin in the CR retainers was seen on the upper surface, while that of the FRC was at the cervical region near the abutment. These results suggest that the change in the fracture pass by the fiberglass increased the fracture resistance of the CR retainer.

Purpose: The aim was to assess the influence of connection of the canine teeth to implant-retained long-span fixed dentures on stress in mandibular bone using finite element analysis., Materials and Methods: Each 3-dimensional model included bone, 6 implants, both natural canines, and superstructures. Each model simulated 1 of 4 prosthetic designs: a tooth/implant-retained 1-piece superstructure (One-piece), 3-piece superstructures with an anterior and 2 posterior segments with unconnected teeth (UnConnect), 3-piece superstructures with the teeth connected to the posterior segments (PostConnect), and 3-piece superstructures with the teeth connected to the anterior segment (AntConnect). A nonlinear elastic modulus was applied to the periodontal ligament (PDL). Maximum intercuspal (IP), canine-protected (CP), and group-function (GF) occlusions were simulated., Results: The maximum stresses in the peri-implant regions of the bone were lower for the One-piece than for the other superstructures. In PostConnect and AntConnect, the maximum stress in the PDL was lower than that in UnConnect, but the stress in the peri-implant bone was comparable in those 3 models. The stresses were lower in the GF model than in the CP model. The stress created in the peri-implant bone was insensitive to the modes of the teeth/implant connection in long-span fixed dentures., Conclusion: Within the limitation of the mechanical analysis, it is suggested that the connection of the canine tooth to the implant-retained long-span superstructures is an acceptable option in partially edentulous patients.

Purpose: The aim was to study the influence of abutment selection on elastic stress distribution in oral mucosa in a maxillary removable partial denture (RPD) by means of 3-dimensional finite element models., Materials and Methods: Four RPD framework models of an equal size (by area) and underlying oral mucosa were produced for a Kennedy Class II arch. Each framework included an occlusal rest as part of a clasp assembly on one of four abutments (canine, first, and second premolars, and first molar) on the side contralateral to the edentulous ridge (tooth-supported side). Movement of the alveolar surface of the mucosa and the occlusal rest on the abutment adjacent to the ridge were fixed in a vertical direction. Movement of the rest on the tooth-supported side was restricted in all directions. Vertical or buccally oblique biting force was applied simultaneously on each of the locations representing three missing teeth., Results: The frameworks with the contralateral side rest on the canine or the first premolar were less resistant to lateral forces than other framework designs, showing greater saddle displacements under the oblique force than the vertical force. The framework with the rest on the second premolar demonstrated relatively good resistance to deflection; however, both vertical saddle intrusion and the maximum equivalent stress in mucosa shown in all the models were within small ranges., Conclusion: The saddle movement was influenced by the abutment selection on the tooth-supported side, although resultant stress in the mucosa was insensitive to the abutment location., (Copyright 2006 by The American College of Prosthodontists.)

Ti-6Al-7Nb alloy was cast into three differently designed, removable partial denture frameworks: Palatal strap (PS), Anterior-posterior bar (AP), and Horseshoe-shaped bar (HS). The vertical displacement and local strain of Ti-6Al-7Nb alloy frameworks were investigated to compare against those of Co-Cr alloy frameworks. Vertical loading force of 19.6 N was applied at two locations, 10 and 20 mm, from the distal end of the framework. Although higher vertical displacement and local strain were observed for Ti-6Al-7Nb alloy frameworks than those for Co-Cr alloy frameworks, the PS framework appeared to show the least deformation. In addition, the strain at 10-mm location was higher than that at 20-mm location for AP and HS frameworks. This study thus proved that design had a significant influence on the deformation properties of denture frameworks. The PS design was evaluated to be a suitable design for the removable denture framework with Ti-6Al-7Nb alloy.

Objectives: The purpose of this study was to determine the influence of the occlusal rest position in removable partial dentures on the displacement of the abutment tooth and the stress distribution in the periodontal ligament (PL)., Methods: We constructed three-dimensional finite element models of the mandibular first and second premolars. A layer of the PL and a mesial or distal occlusal rest were produced on the second premolar as an abutment. A zero displacement was prescribed on the outer surface of the PL and the first premolar. In each simulation, the rest was moved 0.05 mm vertically to the apical direction, with or without restriction of horizontal movements. We simulated the contact phenomena on the abutment surfaces, and calculated the movements of the abutment and stress distributions in the PL., Results: We observed a maximum distal displacement of 42 microm at the buccal cusp of the abutment and a principal compressive stress of 0.35 MPa in the PL when the abutment was vertically loaded by a distal rest that was allowed to move horizontally. However, the displacements and stresses were relatively small, and were all within the physiological limitations of the tissues. The restriction of the horizontal movement of the rests was effective in reducing the horizontal displacements of the abutment, regardless of the rest position., Conclusions: The single vertical load exerted from either the mesial or distal rest on the abutment was unlikely to cause any mechanical damage to its supporting tissues.

Purpose: The purpose of this study was to investigate the dynamic retentive force of a mandibular unilateral distal-extension partial denture framework with a back-action clasp that was designed in a buccally tilted cast on a dental surveyor. The retention mechanism of this framework was analyzed in comparison with other typical unilateral and bilateral frameworks for the mandibular Kennedy class II case., Materials and Methods: Experimental gold alloy frameworks of three designs were repositioned to the master cast, and lifted upward to the vertical direction to the occlusal plane. The load required to dislodge each framework was recorded. The retentive force of each framework was determined by the maximum load in a dislodgment cycle. The bending strength of a plain clasp pattern of the same length as the clasp arm used in each framework was also measured by cantilever beam test., Results: The mean retentive force of the unilateral framework with a back-action clasp of relatively low bending strength was significantly higher (P < 0.01) than that of the unilateral framework with two Akers clasps of relatively high bending strength, and 70 to 80% of the bilateral framework with two Akers clasps on the edentulous side and a double Akers clasp on the contralateral side. The unilateral framework with a back-action clasp showed the greatest early load resistance in the dislodgment cycle among the three designs., Conclusion: The reasonable retention mechanism was demonstrated by the unilateral framework with a back-action clasp.

Purpose: This study investigated the area size of the flow of a gold braze alloy on commercially pure titanium and Ti-6Al-4V alloy plates, and elemental composition at the interface was determined. In the second part of this study, the tensile strengths of titanium plates brazed using a gold alloy were investigated., Materials and Methods: Chips of Type IV gold alloy and silver braze alloys were melted onto commercially pure titanium and Ti-6Al-4V surfaces in a dental infrared radiation unit. Flow area of each braze alloy was measured using a digital image analyzer. Tensile specimens (n = 5) were also prepared by infrared brazing using the braze alloys. Five specimens for each combination of the two titanium plates and the two braze alloys were subjected to tensile loading using a Universal testing machine. Electronprobe microanalysis of x-rays at cross-section of the brazed joints to determine elemental composition across the interface, as well as scanning electron microscopic observation at the fracture surfaces, were also conducted., Results: The braze alloys flowed well and spread over the Ti and Ti-6Al-4V plates. Braze alloy type significantly influenced flow, and the gold alloy flowed less on the titanium materials. The mean tensile strengths of Ti and Ti-6Al-4V plates brazed using the gold braze alloy were 219 MPa and 417 MPa, respectively. The fracture surfaces of Ti-6Al-4V specimens with the gold braze alloy exhibited typical ductile behavior. Ti with the same braze alloy showed brittle surfaces. A greater concentration of Cu was found at the Ti with gold braze interface., Conclusion: The flow and the tensile strength of the gold alloy coating on titanium surface by means of an infrared brazing is adequate for dental use.

Statement of Problem: Superplastic forming of Ti-6A1-4V alloy has been used in the fabrication of a removable denture framework. The method provides the titanium alloy denture framework with excellent physical properties not seen in cast titanium prostheses., Purpose: This study describes the technical procedure for fabricating removable dentures with this type of framework and evaluates clinical applications of the dentures in short-term follow-up periods from 6 months to 3 years., Results: Results of this study demonstrated that the dentures functioned well and did not cause any major clinical difficulties. The patients have expressed satisfaction with the dentures at regular recall appointments., Conclusion: The clinical observations suggest that this method is suitable for fabricating titanium alloy removable dentures.

The thickness and adaptation of superplastic forming Ti-6Al-4V alloy denture frameworks were investigated using cross-sectional measurements. The frameworks for maxillary complete dentures were fabricated form Ti-6Al-4V disks of thickness ranging from 0.75 to 1.30 mm. Although the thickness of each disk was reduced by superplastic forming, the complete framework had more than 78% of the original disk thickness. Differences in the thickness did not significantly affect either the thickness ratio of the framework to the disk or the gap discrepancy between the framework and the working cast. The accuracy of fit of the framework would satisfy ordinary clinical requirements.