CLINICAL RESULTS OF THE USAGE OF THE PROPOSED ELASTIC REMOVABLE PARTIAL DENTURE WITH A FLIP-OVER CLASP

Abstract

Partial removable dentures remain one of the main methods of prosthetic treatment in patients with medium and large defects of the dental arches. Modern elastic removable partial dentures made of thermoplastic polymers provide better aesthetics and comfort compared to conventional acrylic and metal-based constructions. Objective. To clinically substantiate the proposed design of an elastic removable partial denture with a flip-over clasp, and to evaluate the effectiveness of its retention and its influence on the abutment teeth. Materials and methods. Prosthetic treatment was performed in 25 patients with bounded or free-end edentulous spaces in the dental arches, for whom elastic removable partial dentures were fabricated according to the proposed design and technological protocols. The effectiveness of prosthetic treatment was assessed on the basis of clinical examination, including evaluation of the retention of the removable partial dentures and the periodontal status of the abutment teeth. The follow-up periods were 3, 6, 12 and 24 months. Results. An elastic removable partial denture is proposed, consisting of a base made of elastic resin, acrylic teeth, and clasps manufactured as extensions of the denture base with bilateral arrangement. It is characterized by the fact that in the clasp system with bilaterally positioned clasps, at least one clasp is made as a flip-over clasp in the form of a continuous elongated extension of the base, fabricated from the elastic base resin with an inner surface configuration reproducing the contour of the veneer and crown of the abutment tooth, and with isolation during fabrication taking into account the resiliency of the oral mucosa by 0.5–1.0–1.5 mm, allowing it to flip over the intermediate segment or cantilever (veneer) onto the abutment teeth. At all patients, there were no complaints of insufficient retention of the elastic denture, no episodes of spontaneous dislodgement, rotation or displacement of the prosthesis; there was no pain during mastication and no trauma to the oral mucosa. Patients noted the aesthetic appearance of the construction due to the translucent elastic resin imitating the colour and contour of the gingiva and the absence of visible metal clasps. Conclusions. The elastic removable partial denture with a flip-over clasp provides reliable retention and a more uniform distribution of masticatory load on the abutment teeth without excessive overloading of the periodontium, while maintaining high aesthetics. This design can be considered a promising alternative to standard flexible and acrylic removable partial dentures in patients with medium and large defects of the dental arches.