J. Dent.
J. Dent
1988;
16: 264-268
ABSTRACT
Using a laboratory model for the distal extension removable partial denture situation, the
effect of resilient and rigid precision attachment retainers on abutment tooth and denture
base movement was studied. It was found that both abutment tooth and denture base
movement was least with the rigid and semi-precision attachments used compared to the
resilient attachments. Abutment tooth movement was generally towards the mesial,
except for the C and L attachment which produced distal movement.
INTRODUCTION
One of the accepted philosophies concerning the planning
and construction of the distal extension removable partial
denture is the use of stress-breaking devices as a means of
distributing the load between the abutment teeth and the
tissues underlying the base (Steffel, 195 1). The need for
stress breakers has been suggested because the vertical
displacement of the abutment tooth in its socket is
approximately 0.1 mm whereas that of the mucosa
underlying the base ranges between O-4 mm and 2 mm
(Steiger and Boitel, 1959). This tissue resilience differential of between 4 and 20 times the axial displacement of
the abutment tooth is generally regarded as indicating the
need for some form of stress breaking (Mensor, 1968)
in order to minimize damage to the tissues during
function.
The purpose of this study was to compare, using a
photographic method, the effect of resilient and rigid
precision and semi-precision attachment retainers on
abutment tooth and denture base movement in the distal
extension removable partial denture situation.
In experiments with various types of retainers using
models and strain gauges, Shohet (1969) compared the
stress they produced on the abutment teeth. He found that
precision attachments produced the greatest degree of
distal stress on single abutments and that a semi-precision
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265
MATERIALS
AND METHODS
method. This involved double exposure of a film frameone exposure being obtained before loading and one
afterwards, as described in a previous communication
(Feingold et al., 1986). Two single lens reflex cameras
were used, one to observe movement as seen from the
anterior aspect of the model representing buccolingual
movement, and another to observe the model from the
lateral aspect to determine anteroposterior movement
(Fig. 2).
266
J. Dent. 1988;
16: No. 6
Table I. Movement of abutment tooth and denture base when using a Dalbo attachment in different modes
Type of attachment
to abutment tooth
Direction of
base movement
2.52
(0.04)
Mesial
2.96
(O-08)
Lingual
Lingual
Dalbo without
spring
3.14
(O-06)
Mesial
3.64
(0.081)
Lingual
Lingual
3.23
(O-05 1)
Mesial
3.1 1
(0.04)
Lingual
Lingual
Tab/e I/. Movement of abutment tooth and denture base using Crismani attachments in rigid and resilient modes
Type of attachment
to abutment tooth
Crismani slide
(rigid)
1.02
(0.06)
Mesial
Crismani slide
(resilient)
3.78
(0.05 1)
Mesial
2.31
(O-09)
3.76
(O-1 3)
Direction of
base movement
Lingual
Lingual
Lingual
Lingual
using
RESULTS
The results obtained using the Dalbo attachments (Tubk
I) show that least tooth movement occurred with the
DISCUSSION
In this study, using the Dalbo and Crismani attachments
in a rigid state, the magnitude of abutment tooth
movement was significantly reduced when compared to
the precision attachments in a resilient state. This is in
agreement with the study of Cecconi et al. (1975), but is
contrary to the results of the studies carried out by Shohet
(1969), Nally (1973) and Takanshi (1972) who found
that rigid precision attachments produce greater abutment
tooth movement than resilient attachments.
Using the resilient precision attachments, Nally (1973)
267
Table /IL Movement of abutment tooth and denture base when using the C and L attachment
Type of attachment
to abutment tooth
C and L
Figures in
parentheses
are standard
Distal
2.39
(O-09)
Direction of
base movement
Lingual
Lingual
deviations.
attachment
produced
a mesial abutment
tooth
movement.
If the hypothesis of Christadou et al. (1973) derived
from the result of in vivo observations is correct, &e
resultant of a vertical force applied to an angular ridge
produces a mesially directed force to the denture base and
to the abutment tooth. Then, if the abutment tooth moves
even a small distance distally, it would imply that the
distal force of the C and L attachment must have cancelled
out the mesially directed force.
If it is considered that the best retainer design is one that
produces the least abutment tooth and denture base
movement, then the C and L attachment and the rigid
Crismani attachment are the retainers of choice of those
tested. This is shown graphically in Fig. 3 where denture
base and abutment tooth movement are related for various
retainer systems.
Duncans new multiple range test on the order of
ranking of the five retainer systems shown indicates least
denture base movement for the Crismani rigid and the C
and L attachments. The same test for abutment tooth
movement indicates least effect from the rigid Crismani
attachment.
.
00
.
:?
0
4
4
2
t
01
0
Abutment
tooth
..T*
I
3
movement
i.:
(mm)
268
J. Dent. 1988;
16: No. 6
CONCLUSIONS
1. In general, the use of rigid precision attachments
as
retainers
for the distal extension
removable
partial
denture reduces both abutment
tooth movement
and
denture base movement compared to that resulting from
the use of resilient attachments.
2. The Crismani slide attachment
and the C and L
semi-precision
attachment
produced the least abutment
tooth and denture base movement.
3. The direction of abutment
tooth movement
was
generally mesially except for the C and L attachment
which produces distal abutment tooth movement.
Acknowledgement
The apparatus
used in this study was produced
by
Mr H. Todd, dental instructor, to whom grateful acknowledgement is made.
References
Cecconi B. T. (1974) Effect of rest design on transmission of
forces to abutment teeth. J. Prosthet. Dent. 32, 14 l-l 5 1.
Cecconi B. T., Kaiser G. and Rahe A. (1975) Stressbreakers
and the removable denture. J. Prosthet. Dent. 34,
145-151.
Correspondence should be addressed to: Professor A. A. Grant, University Dental Hospital of Manchester, Department of Prosthetic
Dentistry, Higher Cambridge Street, Manchester Ml5 6FH, UK.
Book Review
Oral Radiology: Principles and Interpretation,
2nd
edition.
Paul W. Goaz and Stuart C. White. Pp. 791. 1987.
St Louis, C. V. Mosby. Hardback, f38.00.
In the 5 years since its initial publication, this has become
the most frequently recommended dental radiology
textbook in US dental schools. Its popularity is well
justified and says much about its excellence and
suitability as a teaching aid. The new edition consists of
30 chapters, 20 of which have been revised, four others
re-written and a new chapter on endodontic radiology
added: as a result it now has 87 more pages and 162
additional illustrations.
The book is divided into seven sections, the first of
which is a highly interesting historical account of the
development of dental radiology and radiography,
illustrated with examples of some of the early dental
X-ray machines and equipment. Sections 2. 3 and 4 give
accounts of the physics, the biological effects, and the
safety and protection aspects of radiation. These have
been updated and it is to be welcomed that
measurements of radiation are now given in SI units.