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DISCUSSION OF “INFLUENCE OF IMPRESSION PROCEDURES AND OCCLUSAL LOADING ON PARTIAL DENTURE MOVEMENT”

WILLIAM

L. MCCRACKEN,
of Alabama,

D.D.S.,MS."
School of Dentistry, Birmingham, Ala.

University

is to be complimented not only on an excellent article, but also on the original method used for testing partial denture base movement under simulated occlusal loading. The term “altered cast technique” used in this article is descriptive and might be adopted as accepted terminology to identify this type of secondary impression technique in partial denture construction. It is very important that everyone concerned with the problems of free-end partial dentures be ever mindful of the composite support inherent in all tooth-andtissue supported partial dentures. The objective of any treatment plan, design, and impression procedure should be to make compatible the support of the relatively rigid teeth, the resilient mucosa, and the underlying bone. It is also very important to emphasize the role of the retromolar pad in providing resilient support for the denture base, whether it be a complete or a partial denture. Even with a partial denture base having tooth support anteriorly, this area is almost completely tissue supported, and the combination of areolar and fibrous connective tissue in it provides for protective support which relieves the residual ridge anterior to it from trauma and resulting resorption. One recalls techniques in the past which called for “post damming” in the retromolar pad area to provide a posterior seal and, at the same time, make this area more compact in order to provide additional support for the denture. Perhaps the retromolar pad could be broadly compared to the heel of the foot which absorbs the initial force of walking and protects the adjacent areas from trauma. Steffel’ originally classified free-end partial denture design philosophies into three groups. “One group believes in the use of stress-breakers or stress equalizers . . . . A second group [believes that] . . . equalization of saddle and occlusal rest support can be accomplished by some form of physiologic basing . . . . A third group believ.es that excessive trauma to both ridges and teeth can be prevented by stress distribution over as many teeth as it may be advisable . . . .“t In the third group, the denture base is not mentioned. It is this group that utilizes multiple, frequently bilateral, splinted abutments in conjunction with internal attachments for distal extension partial dentures. Dr. Holmes’ investigation evaluated denture base movement in the first molar

D

R. HOLMES

Read before the Academy of Denture *Professor of Dentistry. +From Steffel: J.A.D.A. 32: 1093-1100,

Prosthetics, 1945. 482

Milwaukee,

Wis.

Partial Dentures Designed for Maximum Function.D. Clasp 1945. I believe that less movement could be demonstrated after a day or more of wear than occurs initially.region on relatively short distal extension denture bases. the quality of the residual ridge appeared to be quite good. because two or more test dentures cannot be worn concurrently. and the reaction of the tissues with one denture will influence the results with other dentures being tested. REFERENCE 1. Steffel. . V.: Simplified J. that is. 32:1093-1100. I believe that the results of investigation would be even more in favor of the functionally supported denture base had the length of the free-end base and the difference between anatomic and fmictional ridge form been greater than in the subjects used in this investigation.A. SOUTH RIRMINGHAM. This has always been one of the hindrances to clinical investigation in prosthetic dentistry. The length of time that the denture base was worn would also make a difference in the results. there was not a marked difference between the anatomic (static) form of the residual ridge and the functional (supporting) form as recorded with a fluid wax impression.ALA. L.. Many examples could be shown where the difference between the static and the supporting form of the residual ridge was more clearly evident. I would strongly urge that this investigation be continued with consideration given to these variables which may show greater differences between static and functionally formed partial denture bases.A. a minimum of indefinite unattached mucosa was present on the subjects selected. due to the adaptation of the tissues to the functionally formed base. 1919 SEVENTH AVE. Also. As a result.