Management of Loading Forces Distribution in Mandibular Distal-extension Prostheses
NCT ID: NCT02178384
Last Updated: 2015-10-05
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
30 participants
INTERVENTIONAL
2014-06-30
2015-10-31
Brief Summary
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Many methods have been used to control this movement, some of them:
1. Implant support on distal extension removable.
2. Stress breakers provide a mean of interposing a flexible connection between the tooth-borne retainer portion of removable partial denture and its distally extended tissue-borne segment.
3. Altered-cast technique.
4. Design development by using mesial indirect retainers rather than distal ones.
The purpose of this study is: (1) to compare bone absorption around abutment teeth nearby the free saddle; (2) denture displacement and pressure on the soft tissue under the denture base of distal extension RPD (Removable Partial Denture) (3) cellular changes in the soft tissue under the denture base of distal extension RPD.
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Detailed Description
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Rehabilitation with Distal-Extension Removable Partial Denture (DERPD) deserves special attention because of the difference in resilience between the remaining mucosa of the edentulous area and the periodontal ligament of the abutment tooth. When occlusal forces affect the bases, the difference in resilience between the mucosa of the edentulous area and the periodontal ligament of the abutment teeth creates a rotating movement whose axis is located on the occlusal rests on the abutment teeth. This may induce horizontal forces and mainly lateral forces upon them, causing inflammation, gingival retraction, increase in dental mobility and distal residual ridge resorption. This movement may cause a reduction in function, discomfort and trauma to the RPD supporting tissues.
MATERIAL AND METHODS:
Patients will be recruited from the Department of Prosthodontics at the University of Damascus Dental School. Thirty patients will be randomly divided into three groups (A, B, and C). A mandibular bilateral distal-extension removable partial denture will be used for patients in all groups. But every group will have its own specific method of distributing loading forces.
In Group A: A Removable partial dentures will be made by using altered-cast technique for free saddle.The investigators will make a primary impression using stock tray. This will be followed by a final impression by individual tray. After metal framework try-in, ridge regions are removed from uncorrected master cast with saw. Then, corrective impression of ridges will be obtained with soft ZOE impression paste. Therefore, a metal framework with associated corrective impression will be repositioned on tooth portion of master cast prior to altering distal-extension bases.
In Group B: Removable partial dentures will be made by using precision attachments which will be located on the last abutment tooth. At first, crowns will be prepared to receive the precision attachment, then these are cemented to their respective abutment teeth. So that a mean of interposing a flexible connection between the tooth-borne retainer portion of a removable partial denture and its distally extended tissue-borne base will be provided.
In Group C: Removable partial dentures will be made by using resilient-layer in the distal extension of the removable partial denture.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Altered-cast technique
Removable partial dentures will be made using altered-cast technique for free saddles.
Altered cast technique
This techniques deals with the procedures that are employed when constructing the removable partial denture on working casts.
Precision attachments
Removable partial dentures will be made using precision attachments which will be located on the distal abutment teeth.
Precision Attachments
These are minor attachments used to split the loading forces during appliance wear
Resilient layer
Removable partial dentures will be made using a resilient-layer on the distal extension of each appliance.
Resilient layer
This is a layer beneath the appliance which helps in reducing the transmission of loading forces to the underlying soft tissues
Interventions
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Altered cast technique
This techniques deals with the procedures that are employed when constructing the removable partial denture on working casts.
Precision Attachments
These are minor attachments used to split the loading forces during appliance wear
Resilient layer
This is a layer beneath the appliance which helps in reducing the transmission of loading forces to the underlying soft tissues
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Stable systemic health, including absence of a history of cardiovascular disease.
* No evidence of infection or trauma in the oral region.
* Negative history of syndromes or temporomandibular disorders and parafunction.
Exclusion Criteria
* Patients with ages beyond the accepted age range.
35 Years
75 Years
ALL
No
Sponsors
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Damascus University
OTHER
Responsible Party
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Principal Investigators
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Fadi Alhaji Jnaid, DDS MSc
Role: PRINCIPAL_INVESTIGATOR
PhD student, Department of Removable Prosthodontics, University of Damascus Dental School, Damascus
Alaa' Salloum, DDS MSc PhD
Role: STUDY_DIRECTOR
Senior Lecturer, Removable Prosthodontics Department, University of Damascus Dental School, Damascus
Locations
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Department of Removable Prosthodontics, University of Damascus Dental School
Damascus, Rif-dimashq Governorate, Syria
Countries
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References
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Pellizzer EP, Ferraco R, Tonella BP, Oliveira BJ, Souza FL, Falcon-Antenucci RM. Influence of ridge type on mandibular distal extension removable partial denture. Acta Odontol Latinoam. 2010;23(1):68-73.
Aydinlik E, Akay HU. Effect of a resilient layer in a removable partial denture base on stress distribution to the mandible. J Prosthet Dent. 1980 Jul;44(1):17-20. doi: 10.1016/0022-3913(80)90039-6.
Kratochvil FJ, Thompson WD, Caputo AA. Photoelastic analysis of stress patterns on teeth and bone with attachment retainers for removable partial dentures. J Prosthet Dent. 1981 Jul;46(1):21-8. doi: 10.1016/0022-3913(81)90129-3.
Holmes JB. Influence of impression procedures and occlusal loading on partial denture movement. 1965. J Prosthet Dent. 2001 Oct;86(4):335-41. doi: 10.1067/mpr.2001.119826. No abstract available.
Igarashi Y, Ogata A, Kuroiwa A, Wang CH. Stress distribution and abutment tooth mobility of distal-extension removable partial dentures with different retainers: an in vivo study. J Oral Rehabil. 1999 Feb;26(2):111-6. doi: 10.1046/j.1365-2842.1999.00345.x.
Leupold RJ, Flinton RJ, Pfeifer DL. Comparison of vertical movement occurring during loading of distal-extension removable partial denture bases made by three impression techniques. J Prosthet Dent. 1992 Aug;68(2):290-3. doi: 10.1016/0022-3913(92)90332-5.
Vahidi F. Vertical displacement of distal-extension ridges by different impression techniques. J Prosthet Dent. 1978 Oct;40(4):374-7. doi: 10.1016/0022-3913(78)90115-4.
Saito M, Miura Y, Notani K, Kawasaki T. Stress distribution of abutments and base displacement with precision attachment- and telescopic crown-retained removable partial dentures. J Oral Rehabil. 2003 May;30(5):482-7. doi: 10.1046/j.1365-2842.2003.01092.x.
Tebrock OC, Rohen RM, Fenster RK, Pelleu GB Jr. The effect of various clasping systems on the mobility of abutment teeth for distal-extension removable partial dentures. J Prosthet Dent. 1979 May;41(5):511-6. doi: 10.1016/0022-3913(79)90082-9.
Other Identifiers
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UDDS-RemPro-01-2014
Identifier Type: -
Identifier Source: org_study_id
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