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Equipoise Denture Design System

Thursday, August 2, 2018 10:14 AM

ZHI YEN

Reason for Equipoise Denture


• Currently there's no standardized design
• Showing of metal clasp arm
• Conventional design flaw of Class I lever design, Equipoise denture utilizes Class II lever

Rules to Follow:
• All interproximal Plates with rests are always on the side of abutment tooth, away from
edentulous area

• All retentive units are placed next to the edentulous areas


• All rests used to stabilize an edentulous area where extra retention is not necessary, are placed
next to edentulous area

• All Final Master casts should be surveyed in the true horizontal. No tilting of surveyor needed.
○ If there's no undercut on the abutment tooth at horizontal position, there wont be undercut
in the mouth
○ An undercut found on a tilted cast will be frictionally and not passively retained in the
mouth
○ All final impressions should be taken in stock trays using either alginate/hydrocolloid
○ Custom trays are only needed when stock trays cannot be properly placed over the
dentition
○ Edentulous tissue should be at rest position when the impression is taken
• Lower denture base : Shy of muccobuccal fold , as thin as possible, includes the retro molar pad

• Upper denture base : Shy of muccobuccal fold, includes tuberosity for free end saddles

Four Basic Design :


• Single or Double Free End Saddle
○ If anterior and posterior edentulous area present, the major retentive unit places next to
the edentulous area that gets the greatest amount of function
○ Stabilizing rest are used to prevent anterior/ posterior tooth movement
• Free end saddle on one side, tooth borne on the other side

• One or Two Edentulous area , all tooth borne


○ Free end tip always face the edentulous area

• Three Edentulous area or more, all tooth borne


○ Free end tip always face the same direction

Tooth Preparations
• Utilize Equipoise Analyzer for parallel interproximal plate preparations
• Rest seat : conventional manner : 1-1.5mm deep
• All rests seated on the mesial or distal abutment away from edentulous area
• Interproximal plate : 1mm thick
○ Offers stabilization and reciprocates free end bar of retention
○ Not necessary to plate all way to buccal. 3/4 may be enough provided a 1mm thickness -->
only for all tooth borne design

Retentive Device
• Never placed well below the survey line.
• Placed on the bottom of survey line
• Thickness of clasp is placed below survey line

Planning and Designing with Equipoise


• Occlusion
○ Occlusion must be balanced and corrected
○ Extruded teeth should be adjusted as much as possible
• Retromolar pad and tuberosity
○ All free end RPD must include these areas
○ For collapsed bite : Restore vertical dimension by RPD so that these areas can be included
• Tori
○ Major connector by passing the tori may be larger and bulkier
• Abutment teeth
○ Molar teeth tilted lingually may necessitate a labial bar
○ Molar teeth tilted mesially : Mesial rest and mesial plates with buccal and lingual arm
• Poor prognosis tooth
○ Likely to beextracted in the near future
○ Plan as if these teeth are already extracted and design accordingly
○ If the tooth in doubt is a terminal abutment tooth, no interproximal plate rest or retentive
clasp needed but the tooth can still be used for retention

• Tooth movement after tooth prep


○ Likely within 7 days the opened up interproximal space will start to close up
○ Keep space open by LC composite without acid etch and bonding

Little or No undercut
• Make an Equipoise crown on abutment tooth with a rest 1mm deep at the side away from
edentulous area and a flattened area and a 1mm space between abutment crown and adjacent
tooth
• Recontour abutment tooth and provide undercut
• Use Equipoise clasp with an I bar