Introduction of MUCODYNAMIC RPD Design - - ...

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Dentsply

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The literature below has been authorized by Dr John G. Knapp. Get more information from Dr Knapp's website: http://www.postdds.com

Introduction of MUCODYNAMIC

RPD Design

Dr. Knapp is a licensed prosthodontist with a broad background in research in biomech anics and bioengineering. He earned his DDS from the University of Detroit and his MS degree in Prosthodontics from the University of Michigan. He holds several patents in th e fields of dental and orthopedic implants and prosthetics. He has wide ranging experie nce in private and public health care, teaching graduate and under-graduate dentistry a t the University of Michigan and University of Detroit/Mercy. He has also engaged in sig nificant research in materials, prosthetic design and in application techniques. These ex periences have allowed him to both innovate and apply prosthetic and surgical methods and instruments to improve every day practice for the general dentist and specialist. Dr. Knapp lectures nationally and internationally and is a widely published author. He p ractices his specialty in Livonia, Michigan. He is the CEO of Interphase Implants, Inc. a nd Post Doctoral Dental Studies Institute LLC. He is committed to the improvement of p atient health and to the education of those who provide it. Benefits of a MUCODYNAMIC 1. 2. 3. 4. Spares teeth Feels comfortable, Looks aesthetic, Lasts long

Removable Partial Denture (RPD):

Attached mucosa, unattached mucosa and teeth have different physical property. If you load teeth and mucosa equally: 1. The resistance to the load is not equal

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2.

The biological response is not equal

Introduction Vitallium removable partial denture frameworks act as intermediaries transmitting fun ctional biting loads to the teeth, to the edentulous ridges or both. Traditional concepts of frameworks have simultaneously loaded the teeth and the ridges.

Traditional RPD Simple major connectors act as levers to torque clasped abutment teeth In the traditional design: 1. 2. 3. 4. Framework is rigid Clasping of teeth defines rotation Base support depends on tissue rebound Occlusal load is shared simultaneously but unequally by teeth and mucosa

Traditional free end RPD concerns: 1. sis 2. Biting forces applied to RPD supply teeth cause rotation to the free end prosthe Torque causes repetitive micro rotation of abutment teeth

3. The micro movement of tipped teeth causes mobility and accelerates periodonta l disease

Components of Typical Removable Partial Denture includes: occlusal rest, reciprocating arm, retentive arm, connector, base and teeth. Lever Arms are not long and Rotation often happens against the fulcrum line.

The paradox: Physical properties of tissues differ: Periodontium is intended to support teeth Ridge mucosa is intended to resist abrasion Over time, it will result in: 1. 2. Residual ridges reabsorb Abutment teeth become loose and are lost

The traditional paradigm doesnt work 1. Teeth are still at risk

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2. Compliance to recommended recall and maintenance is ults in: Increased mobility Increased periodontal disease Lost teeth New Paradigm!

unpredictable and res

Separate the dual forces. Use teeth for guiding the position of the bases but n ot for support of the bases 1. 2. Let teeth carry biting forces Let ridges carry biting forces

MUCODYNAMIC

- RPD DESIGN

Goal of Mucodynamic 1. 2.

design:

Reduce torque to abutment teeth Use existing technology

Method 1. 2. 3. 4. Deemphasize retentive clasp flexibility Increase the length of the lever arm Employ flexibility of the major connectors Select an alloy with suitable elongation, hardness and yield strength.

Result 1. 2. 3. 4. Improved prognosis for abutment teeth Improved esthetics Improved comfort Extend the utility for the prosthesis

Compare Removable Partial Dentures (RPD) Traditional RPD Designs: Support the prosthesis on teeth as much as possible

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Reduce rotation forces to the teeth Make the framework rigid

MUCODYNAMIC

RPD:

Separate the two different dynamic capacities ridge support periodontal support Use teeth to stabilize and retain the position of the bases on the ridges (not for support ) Separate and mitigate the forces applied to both teeth and ridge Use the physical capabilities of Vitallium

This is a typical maxilla Mucodynamic RPD framework design: This is a typical mandibular Mucodynamic RPD design:

Design Variables of Flexible Major Connector 1. 2. 3. Length Geometry Mucosal Support Area

Experimental test

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Test the load distribution before splitting the framework Test the load distribution after splitting the framework Test : Experimental model Typodont Load applied Strain on anterior (rigid) major connector Strain on posterior (bending) major connector Paired Comparison of Designs

Graph of Test results: The deflection of rigid framework is little and mainly because of the deflection of Typod ont itself. Load applied to the flexible framework has straight line relationship with deflection of t he flexible framework.

Mucodynamic design apply the beam bending theory: 1. 2. 3. 4. Split the frame Change the axis of rotation Lengthen the lever arms Maximize the potential of the metal

Major Connector of MUCODYNAMIC 1. 2. 3.

framework has special attributes:

Long lever arms reduce rotation Controlled connector geometry related to resiliency of mucosa Retentive clasp arm attached to flexible base

Major Connector Characteristics 1. 2. Geometry dependent :Increased complexity increases rigidity Support dependent: Increased base support area resists displacement

Important Alloy Properties of Vitallium 1. 2. 3. Bending control Deformation rebound Fracture resistance

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MUCODYNAMIC 1. 2. 3. 4.

RPD Applications

Maxilla or mandible Unilateral or bilateral free end RPD Especially useful with teeth of periodontally compromised patients No special attachments

Mucodynamics

and Vitallium

follow biomechanics in RPD design

Selectively distribute the biting load to the teeth and to the supporting tissues of the ri dges 1. 2. Avoid torque to the teeth Reduce the potential for tooth mobility and tooth loss

Further Research Further Laboratory Studies Dynamics Beam Bending Human Subject Studies with Sensors and Instrumentation Longitudinal and Cross Sectional Studies

Conclusion 1.Mucodynamic a 2.Vitallium 3.Vitallium

design meets the variable properties of the teeth and mucos

has the properties to comply with the design has 60 years of reliability

Vitallium Satisfies all quality assurance protocols USFDA ASTMI ISO Traceable certificates of tests to the USNBS It is a complete system including investment and instrumentation. Since 1932 it has be en trusted by dentists and laboratories to create world class function, fit and beauty in their partial dentures. Dentsply International provides: Completeness, Quality, Support, Service for the Customer

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