Removable Partial Denture Framework Adjustment Rudd & Kuebker 75% of frameworks don’t fit perfectly Active - orthodontic movement Adjust to make passive

Framework Adjustment Adjust without denture base Adjust soon after fabrication Prevent tooth migration

Video: Framework Adjustment

Clinical Adjustment Incomplete seating Usually binding on abutments Use an indicating medium Incomplete seating

Indicating Medium Aerosol Sprays (Occlude) Disclosing Wax Silicone

Two-Dimensional Indicating Medium Occlude (aerosol) Thin & accurate Not easily displaced Can dissolve in saliva Difficult to remove Can’t tell how far from seating

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

Adjustment with Silicone Indicating Medium Three dimensional Minimal distortion More expensive Sets relatively slowly (~1-2 min) Can tear or pull off the framework

Framework Adjustment Initial Assessment ‘How does the framework feel?’ No pulling or wedging Active engagement of abutment teeth Overall comfort of the framework

Framework Adjustment Areas of abrasion on master cast may indicate areas of binding

Check Maxillary Beading Ensure not binding on bony midline Can cause entire framework not to seat Use PIP to check Will burn through if excessive height Beading

Cautious Adjustment Differentiate between normal & abnormal contacts Guiding planes normal: long vertical areas of contact broad areas of severe burn-through may indicate binding

Cautious Adjustment Avoid excessive force - bending Heat generation could melt acrylic Retentive tip of direct retainers normal: burn-through eliminate active clasp retention

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

Framework Occlusal Adjustments Fabricated on unmounted casts Occlusal interferences usually present Occlusal vertical dimension should be unchanged Centric & eccentric contacts should be identical with or without framework

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

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

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

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

Physiologic Relief Used for Class I & II w. long g.p. Normally shorter guiding planes Triangular space below height of contour Allow for release Tipped teeth may only provide for long guiding planes (low h of c)

Physiologic Relief Distal Extension Cases Guiding planes, minor connectors & lingual plates coated with indicator Framework is placed in hyperfunction by pressing over gridwork

Physiologic Relief Relieve burn-through Until burn-through occurs only on the occlusal one third of the guiding planes

Physiologic Relief Alternative Prescribe 1° relief OR Use physiologic relief, not both