Clinical Removable Prosthodontics Forth Year

1. TRIAL INSERTION OF
METAL FRAME WORK

2. PARTIAL DENTURE
FRAMEWORK ADJUSTMENT

Rudd & Kuebker
 75%
of frameworks don’t fit
perfectly
 Active - orthodontic movement
 Adjust to make passive

3. INTRODUCTION

EXAMINATION OF FRAME WORK

FITTING FRAME WORK TO TEETH

CORRECTING DISCREPENCIES

FITTING FRAME WORK TO OPPOSING
OCCLUSSION

4. EXAMINATION OF THE FRAME WORK


Examine frame work carefully upon its return from the
lab.
Check whether the design has been closely followed.
1.
2.
3.
4.
5.
6.
Has the major connector been positioned as requested?
Are the finish lines for acrylic denture bases properly
postioned?
Have the required rests been included?
Are the designated clasp assemblies present and complete?
Do the retentive arm clasps display the appropriate
sizes,shapes &positions?
Have soft tissue undercuts handeled as directed?

5. DOES THE FRAME WORK FIT THE MASTER
CAST ACCURATELY?
2

A properly constructed
framework should fit
tightly against the cast
Framework should fit master cast
If it does not, probably will not fit
intra orally

6. 
Check accuracy of the framework as
designed

7. 3
3.Rests must be
completely seated in the
corresponding rest seats

8. 4. LINGUAL PLATING SHOULD BE CLOSELY
ADAPTED TO THE SURFACE OF THE CAST
4
4

9. 5.THE TISSUE SURFACE OF THE FRAMEWORK SHOULD
EXHIBIT A FINE MATTE TEXTURE.THIS SURFACE
SHOULD NOT BE HIGHLY POLISHED
5

10. 6. THE EXTERNAL SURFACE OF THE FRAMEWORK
SHOULD BE EXTEMELY SMOOTH AND SHOULD BE
POLISHED TO A HIGH SHINE
6

11. 7
7. ALL SURFACES SHOULD BE
CHECKED FOR NODULES,WHICH MAY
PRODUCE DISCOMFORT AND
PREVEVENT COMPLETE SEATING OF
THE FRAMEWORK
8
8. INTERNAL FINISH LINES
SHOULD BE SHARPLY
DEFINED

12. 9
9. EXTERNAL FINISH LINES SHOULD BE
SHARPLY DEFINED AND SLIGHTLY
UNDER CUTTO PERMIT IMPROVED
RETENTION OF ACRYLIC RESIN
DENTURE BASES
10
10. FINGER PRESSURE SHOULD BE
APPLIED TO BOTH SIDES OF THE
FRAMEWORK SIMULTANEOULY.THE
FRAMEWORK SHOULD BE RIGID
ENOUGH TO RESIST FLEXURE.

13. CORRECTING DISCREPENCIES
11
11. DISCLOSING MEDIA
Supplied as
a. Waxes
b. sprays
12
12. ARMAMANTARIUM
a. Wax
b. Heat source
c. Waxing instrument

14. Indicating Medium



Aerosol Sprays (Occlude)
Disclosing Wax
Silicone

15. Two Dimensional
Indicating Medium

Occlude
 Thin
& accurate
 Not easily displaced
 Can dissolve in saliva
 Difficult to remove
 Can’t tell how far from
seating

16. Three Dimensional
Indicating Medium

Disclosing Wax
 Sets immediately
 Inexpensive
 Shows how far from
seating
 Can stick to teeth
 Can be distorted

17. 13
13. To prevent contamination of the
remaining material, disclosing wax is
removed from its container using a clean
tongue depressor
14
14 .A NO. 7 WAX SPATULA OR
ROACH CARVER IS HEATED OVR
LAB BURNR

18. 16
15
15
15. HEATED INSTRUMENT IS USED TO
GATHER DISCLOSING WAX
16. DISCLOSING WAX IS APPLIED TO THE
INTAGLIO OF THE FRAMEWORK

19. 17
17. THE FRAMEWORK IS PROPERLY
ALIGNED AND GENTLE FINGER
PRESSURE IS APPLIED
18
18. 1 WELL-FITTING FRAME
WORK SHOULD GO INTO PLACE
WITH RELATIVE EASE

20. 19
19. IN THIS INSTANCE,CINGULUM RESTS
WERE EMPLOYED.THERE,PRESSURE WAS
APPLIED OVER THE LINGUAL SURFACES
OF THE CANINES.
20
20. PRESSURE SHOULD NEVER BE
APPLIED TO THE EXTENSION BASE
AREAS OF THE FRAMEWORK.

21. 21
21. UPON REMOVAL OF THE
FRAMEWORK,THE DISCLOSING WAX IS
CAREFULLY EXAMINED.AREAS OF
SHOW-THROUGH ARE IDENTIFIED.
22
22.AREAS THAT HAVE BEEN IDENTIFIED AS
TRUE INTERFERENCES ARE CAREFULLY
MODIFIED USING AMULTIFLUTED FINISHING
BUR IN AHIGH SPEED HANDPIECE.

22. 23
23.METAL SHAVINGS OFTEN BECOME
EMBEDDED IN THE DISCLOSING WAX
AS A RESULT OF GRINDING
PROCEDURES.IF THE CONTAMINTED
WAX IS NOT REMMOVED,THESE
PARTICLES WIL INTERFERE WITH
SEATING OF THE FRAMEWORK.

23. 24
25
24. THE FRAMEWORK IS HEATED OVER
A LABORATORY BURNER TO FECILITATE
REMMOVAL OF CONTAMINATED
DISCLOSING WAX
25.MELTED WAX IS ELIMINATED FROM THE
FRAMEWORK USING AN AIR SYRINGE.

24. 26
26.WHEN THE FRAMEWORK HAS BEEN
PROPERLY ADJUSTED,THE DISCLOSING
WAX DISPLAYS A GREYISH HUE
27
27.INSPECTION OF APROPERLY
ADJUSTED FRAMEWORK REVEALS
ATHIN ,EVEN LAYEROF DISCLOSING
WAX ON THE INTAGLIO SURRFACE

25. Soft Tissue Impingements

Pressure-indicating paste
 Thin
layer with streaks
 Place with moderate
pressure

26. Soft Tissue Impingements

Pressure-indicating paste
 Relieve
areas of burn-
through
 Remaining streaks
indicates no contact
 Maxillary major connectors
- broad even palatal
contact

27. FITTING FRAMEWORK TO
OPPOSING OCCLUSION
28
28. SHIM STOCK IS TO USED TO IDENTFY THE
PATIENTS EXISTING OCCLUSSALS
CONTACTS.THIS PATTERN OF OCCLUSSAL
CONTACTS ALSO MUST BE PRESENT
FOLLOWING INSERTION & ADJUSTMENT OF
REMOVABLE PARTIAL DENTURE
FRAMEWORK.
29
29.THIN ARTICULATING PAPER IS USED
TO EVALUATE CENTRIC CONTACTS AS
THE PATIENT TAPS THE TEETH
TOGETHER IN VERTYICAL MOTION

28. 30
30.CONTACTS THAT INTERFERE
WITH NORMAL CLOSURE ARE
ELIMINATED USING A MULTIFLUTED CARBIDE BUR IN A HIGH
SPEED HAND PEICE
31
31. ARTICULATING PAPER IS USED TO
EVALUATE ECCENTRIC CONTACTS.THISS
IS ACCOMPLISHED BY HAVING THE
PATIENT MAKE RIGHT LATERRAL,LEFT
LATERAL,&PROTRUSSIVE MOVEMEMNTS
WITH THE ARTICULATING PAPER BETWEEN
THE TEETH

29. Opposing Frameworks



Adjust individually
Then adjust together
Eliminate interferences
between the frameworks

30. Framework Occlusal
Adjustments

Highly polished metal



Articulating paper marks poorly
Check opposing occlusal contacts
Slightly roughen framework with air
abrasive or rubber impregnated
abrasive

31. Occlusal Rest Thickness

If ≤ 1.5 mm after adjustment




Subject to fatigue
Possible fracture
May require additional tooth preparation
and remake
Last resort - occlusal reduction of
opposing teeth

32. WHEN BOTH MAXILLARY AND MANDIBULAR
FRAMEWORKS ARE MADE
32

33. 34
33
33.A METAL THICKNESS
`GAUGE IS USED TO ENSURE
THAT THE FRAMEWORK IS
THINNED NOT EXCESSIVELY
34. UPON COMPLETION OF THE
ADJUSTMENT PROCESS,THE
FRAMEWORKK IS FINISHED &
POLISHED WITH AN ARRAY OF
RUBBER POINTS,FELT WHEELS, &
BRUSHES

34. Finish and Polish
Highly polished
 No pits, nodules,
scratches
 No sharp edges injure mucosa


35. Framework Adjustment

Reduction
 Heatless
Stones
 Diamond burs
 Brasseler E-Cutter
burs
 Coarse stones


Shofu coral stones
Carborundum disks

36. Framework Adjustment

Polish
 Carborundum
points & wheels
 Final polish Shofu brown &
green points
 Use care!

37. Adjustment with
Silicone Indicating Medium





Three dimensional
Minimal distortion
More expensive
Sets relatively slowly (~ 2 min)
Can tear or pull off the
framework

38. Adjustment with Silicone
Medium
 Use
minimal amount (expense)
 Cover all components
contacting the abutments
 Mark contacts with dampened
red pencil
 Remove silicone material
 Adjust marked areas

39. Remake Poor Castings
Determine if casting fits similarly
on the cast and intraorally
 If not, final impression inaccurate
 Make new impression


40. Interferences on Retentive Arms

Minor interference
 Reduce

Heavy contact
 Lower

opposing cusp - last resort
height of contour, remake
Don’t relieve
 Alters
flexibility and fracture resistance

41.  THANK
YOU