--.

-~ - --~

s and strain rein

James T. White, D.D.S., M.S.*

University of North Carolina, School of Dentistry, Chapel Hill, N. C.

T he purpose of this article is to present a method

of observing strain patterns produced in the support-
the body. Stress has been defined as “the internal
force per unit of area which resistsa change in size or
ing structures of a removable partial denture. The shapeof a body,” and strain has been defined as“the
strain patterns produced by three different remov- internal deformation per unit of length.““’ An anal-
able partial dentures were compared by means of a ysis of internal strains should yield valuable criteria
photoelastic analysis technique. for successfuldesign.“’ These internal strains may be
visualized and recorded with the photoelastic analy-
REVIEW OF THE LITERATURE sistechnique.
The photoelastic analysis technique has been used “A photoelastic material is one which is capable of
to study the tooth and related stressesin the basic separating a polarized ray of light into two rays each
sciences.‘-” The visualization of stressesproduced polarized in a different direction.“‘” These materials
during orthodontic tooth movement has been stud- become double refractive when in a state of strain,
ied and a photoelastic-histopathologic correlation A circularly polarized transmission polariscope
carried out.s+ Analyses of the stress distribution was used to visualize the separation of the polarized
properties of endodontic postsand the stresstransfer light by the photoelastic material while in a st.rained
to the dental pulp by retention pins have also been state. The colored lines produced by the white light
reported.“, Ii’ Determining the effect of the cavity are known as isochromatic lines. They represent “one
preparation on the stressdistribution in the amal- of the frequencies being cancelled by interference at
gam restoration was one of the earliest applications each point of double refraction (coinciding with
of stressanalysis.l’-l’ The effects of the preparation maximum stresses),leaving a colored line that is
design on the stressinduced in a veneer crown have white light minus one frequency.““” The isochromat-
also been reported.‘i‘17 An extensive study of experi- ic lines are close together in regions of high stress
mental stressanalysis of dental restorations related to concentration and farther apart in regions of low
castings and fixed prosthodontics has been con- stressconcentration.
ducted.lx-” A photoelastic analysis of the internal Replica fabrication. Three photoelastic: materials
stressesin the periodontium created by occlusal were used in the fabrication of the replica. PI-1 ,* a
forces has led to far-reaching conclusions.‘“-3” The high-modulus epoxy resin, was used to simulate
stressesinduced through impression removal have tooth structure. Pl-2,* a medium-modulus epoxy
been visualized.‘“, ” The pressureson the teeth and resin, was used to simulate the bony architecture.
bone supporting removable partial dentures and PI-~,* a low-modulus urethane, was used to simulate
complete overdentures have been demonstrated,3”’ 3’ the periodontal ligament. Silastic 382f was molded
and stressanalysis of a maxillary complete denture to simulate the gingiva around the teeth. Rubber
during functional movements has been reported.“” base materialx equal to one thickness of baseplate
wax was adapted to the ridges to simulate the
METHODS AND MATERIALS mucosa.
Internal stresses due to the effects of forces applied The ability of the replica to simulate the actual
to a body are accompanied by internal strains within periodontium is a function of the replica’s design. Ii

Read before the Academy of Denture Prosthetics, San Antonio, “Photolastic. Inc., Malvern, Pa.
Texas. iDow Corning, Midland, Mich.
*Assistant Professor, Department of Fixed Prosthodontics. $Permlastic, Kerr Sybron Carp., Romulus. Mich

0022-3913/78/0240-0143$00.90/00 1978 The C. V. Moshy Co THE JOURNAL OF PROSTHETIC DENTISTRY 143


Fig. 1. The replica with the unilateral Dalbo removable
partial denture in place.
The geometric scaling was obtained by comparing
the ratios of the E values of the tooth, periodontium,
and bone to ratios of the E values of the simulated
structures. The geometric scaling obtained using
these materials was not as close as desired. This was
the best scaling that could be attained during this
project. The error should be taken into account when
comparing this study to others.
The replica was constructed to simulate a lower
jaw requiring a bilateral distal-extension removable
partial denture. The mandibular arch was intact
from the first premolar to the first premolar. The
second premolars and all molars were missing
(Fig. 1).
The first premolars and the canines were prepared
to receive full cast gold crowns. Care was taken to
not generate heat during the preparation of the
teeth. Excessive heat generation can result in the
formation of residual stressesin the replica, render-
ing it useless.Cast gold crowns were fabricated, and
one bilateral and two unilateral removable partial
dentures were constructed.
Testing prostheses. The Dalbo attachment* and
the May’s attachment? were usedin the construction
of three testing removable partial dentures.
The Dalbo attachment is a precision attachment
that can be used in the fabrication of both a
unilateral and bilateral distal-extension prosthesis.
*APM-Sterngold, San LMateo, Calif.
tDentalloy Dental Products Inc., Stanton, Calif.
144
WHlTE
The attachment is composed of a vertical T-rail
(male portion) with a ball-shaped retentive piece
projecting from the T-rail. The T-rail may be
inserted into the wax pattern of the abutment and
cast onto it. A slotted receptacle (female portion)
accurately fits over the T-rail and has an open-ended
cylinder that receives the retentive ball. A spring
may be placed into the cylinder to provide vertical
resilience to the attachment. The attachment
provides both vertical and hinge stressbreaking
features. A pin that is used to lock the attachment
into a rigid state is also provided. Jaw records are
made with the attachment locked.“”
The May’s attachment is a precision attachment
that can be used for the fabrication of a unilateral
distal-extension removable prosthesis.The manufac-
turer provides a plastic pattern (male portion) that is
luted to the wax pattern of the abutment tooth and
cast in the same metal as the retainer. A manufac-
tured slotted receptacle (female portion), with a
hinge piece opening to the lingual, closesto engage a
hole in the extension on the abutment crown, provid-
ing retention and a hinge movement to the remov-
able prosthesis. The manufacturer states that a
vertical action can be provided by altering the shape
of the hole in the extension.
The first removable partial denture was a bilateral
distal-extension design incorporating two Dalbo
attachments.* The principles described by Menso?
were followed in the construction of the prosthesis.
The ceramicor T-rails were incorporated into the
distal surfacesof the first premolar crowns. A lingual
plate was used as the major connector.
A plaster occlusal index was made of the cusps of
all the teeth. The index was used to position the
denture teeth during the construction of the other
two removable partial dentures. The occlusal plane
and the point of force application could be reasona-
bly duplicated by this procedure.
The second removable partial denture was a
unilateral prosthesis with a Dalbo attachment and
no cross-arch support. The mandibular left second
premolar and first molar were replaced with the
prosthesis.The same abutment crown was used.
The third removable partial denture was also a
unilateral prosthesis with a May’s attachment.
Retention was attained by engaging the hole in the
abutment attachment with the latch.
The castings were anchored to the photoelastic
*63.03.2 unilateral Dalho attachment.
AUGUST 1978 VOLUME 40 NUMBER 2
VIWAUZATtON IX STRAIN PATTERNS
replica by cementation and cross-pinning with regu-
lar TMS pins.* Each removable partial denture was
positioned, and a 3%pound force wa8 then applied to
the central fossa of the mandibular left first molar.
The straining frame used to apply the force was
constructed to fit into the circular transmission
polariscope. The resultant stress patterns were
photographed with a 35 mm camera and type A
fi1m.t
To visualize the effects of using two splinted
abutments, the crowns on the first premolars and
canines were soldered to form bilateral double abut-
ments. The splinted crowns were seated and cross-
pinned. The removable partial dentures were posi-
tioned, and a 35-pound force was then applied to the
mandibular left first molar.
Ali of the removable partial dentures were tested
with both single and double abutments. The unilat-
eral and the bilateral Dalbo partial dentures were
tested in a fully active, less active, and rigid state.
Fully active was defined as the attachment with no
spring or pin in place, permitting free movement of
the removable partial denture base. Less active was
defined as the attachment with the spring in place,
slightly restricting the vertical movement of the
removable partial denture base. Rigid was defined as
the attachment with the locking pin inserted,
making the attachment nonmovable and thereby
completely restricting the independent movement of
the removable partial denture base.
RESULTS
Single abutment
Repka before positioning prostheses. Slight
residual stresses were observed in the replica before
positioning the prostheses. A lightening of the
photoelastic material at the apices of the canine and
premolar teeth was apparent. The ridge was free of
residual stress.
Unilateral Dafbo attachment. The unilateral
Dalbo attachment was tested first in its most active
state, second in a less active state, and third in a rigid
nonactive state.
The most active state was achieved by removing
both the spring and the pin from the attachment. As
the 35-pound force was applied to the first molar,
activity was observed in the ridge beneath the point
of force application. The blue and red fringes repre-
*Whaledent, New York, N. Y.
?Eastman Kodak Co., Rochester, N. Y.
THE fOlJRNAL OF PROSTIiETIC DENTISTRY
sented a region of stress concentration. The
surrounding yellow fringe. represented a more dis-
tributed stress region. The first premolar had a
yellow fringe band at the distal aspect of the apex.
By placing the spring into the receptacle of the
attachment, some of the freedom in the Dalbo
attachment was removed. The stress pattern in the
ridge region increased in both quantity and quality.
The fringes penetrated deeper into the bone and
closer to the first premolar root. The yellow fringe
band associated with the distal aspect of the apex
increased in size. Activity was observed on the mesial
of the first premolar root at the midroot Jevel.
The Dalbo attachment was rendered rigid by
placing the locking pin into the attachment. This
procedure greatly reduced the stress in the ridge. The
stress pattern at the apex of the first premolar
showed increased concentration directly below the
apex. This represents a transfer of the force to the
long axis of the root as opposed to being directed
along the axis of the root configuration.
Bilateral D&o attachment. The bilateral Dalba
attachment prosthesis was tested in the same manner
as the unilateral Dalbo prosthesis: most active, less
active, and rigid.
The springs and pins were removed from the
attachments. The activity beneath the point of force
application on the ridge presented a concentrated
pattern. The yellow fringe band associated with the
first premolar was concentrated directly below the
root tip. Some activity was observed between the
canine and first premolar in the interdental bone.
The springs were placed into the receptacles of the
Dalbo attachments. The stress pattern associated
with the point of force application remained similar
to that of the fully active sample. The stress pattern
below the apex of the first premolar remained in the
same position but increased in magnitude. A sharp
yellow, red, and blue-green fringe was produced.
Again, some activity was observed between the
canine and first premolar in the interdental bone.
The Dalbo attachments were made rigid by inserr-
ing the locking pins. The stress associated with the
apex of the first premolar moved to the mesial side of
the root tip and increased in magnitude. A distinct
series of yellow, red, and blue fringes was observed.
Summary statement. In general, the bilateral
Dalbo prosthesis showed a more concentrated stress
pattern in the ridge that was, however, of a similar
magnitude as that produced with the unilateral
Dalbo prosthesis. The stress associated with the apex
145

Fig. 2. Stress pattern produced by the unilateral Dalbo
removablepartial denturewith no pinsor springsin place.
A, Singleabutment. B, Double abutment.
of the first premolar was greater in magnitude with
the bilateral Dalbo prosthesis.
With the May’s attachment, a stressdistribution
pattern similar to that resulting with the unilateral
Dalbo attachment with the locking pin inserted was
observed. The ridge showed a moderately distrib-
uted stresspattern of moderate magnitude. The apex
of the first premolar had a sharp yellow fringe band
directly below it.
Double abutment
Replica before positioning prosthesis. The solder-
ing and cross-pinning procedures resulted in a slight
increase in the level of residual stress around the
distal aspect of the apex of the first premolar.
Unilateral Dalbo attachment. The most active
state was achieved by removing both the spring and
the pin from the attachment. Activity was observed
beneath the point of force application. The resultant
stresspattern was not distributed along the edentu-
lous ridge. A yellow fringe band associatedwith the
apex of the first premolar was observed. Slight
changes in the character of the bone were also
observed adjacent to the canine root.
146
WHITE
Fig. 3. Stress pattern produced by the unilateral Dalbo
removable partial denture with the spring in place. .A
Single abutment. B, Double abutment.
The spring was placed into the receptacle to
reduce someof the freedom in the attachment. ‘I’he
stresspattern beneath the point of force application
remained very similar to that of the most active state.
The first premolar presented a definite increase in
fringe value in the apical region. At least one full
fringe order was observed. The stress distribution
was directly along the long axis of the root proper
and was not associatedwith the distal curve at the
root tip.
The Dalbo attachment was rendered rigid by
inserting the locking pin. The stresspattern beneath
the point of force application was greatly reduced.
With this reduction in stressthere was an increase in
the stresspattern apical to the first premolar. There
was a definite green band distal to the root in the
region representing the alveolar crest. A definite
fringe pattern was estabhshed in the interdental
bone between the canine and the first premolar.
Activity was also observed in the root of the canine
abutment.
Bilateral Dalbo attachment. With the springs and
pins removed, the active Dalbo attachments permit-
ted a poor distribution of stressalong the edentulous
AUGUST 1978 VOLUME 40 NUMBER 2
VISUALJZATION OF STRAIN PATTERNS

Fig. 4. Stress pattern produced by the unilateral Dalbo Fig. 5. Stress pattern produced by the bilateral Dalbo
removable partial denture with the locking pin in place. A, removable partial denture with no pins or springs in place.
Single abutment. B, Double abutment. A, Single abutment. B, Double abutment.

ridge. The distribution of the pattern was associated May’s attachment were similar to those with the
with the point of force application. There was a bilateral Dalbo attachments with no springs or pins
region of stress concentration below the apex of the in the receptacles; the values of the stresses were
first premolar. Very little if any change in the generally slightly greater. A lack of distribution of
appearance of the canine was observed. stress in the edentulous ridge was observed. Some
By placing the springs into the receptacles, the activity was observed in the canine abutment.
stress pattern in the edentulous ridge was markedly Cross-arch stress. Neither the single- nor the
reduced both in distribution and quantity. The stress double-abutment bilateral Dalbo removable partial
pattern below the apex of the first premolar dentures transmitted stresses that could be demon-
increased sharply. The location of the stress pattern strated to the opposite side of the arch. The replica
was along the long axis of the root. Very little showed no changes in the character of light transmis-
activity was associated with the canine abutment. sion on the side opposite the force application.
With the pins inserted, thus locking the Dalbo
attachments in a rigid state, the stress in the edentu-
Comparison of single to double abutments
lous ridge region was reduced and almost eliminated. The relationship between the alterations in the
The first premolar showed a marked increase of the attachments remained constant whether single or
stresses in the apical one third of the root. Two full double abutments were used to support the remov-
fringe orders were observed. The distribution of the able partial dentures. The changes that were
stress pattern was slightly mesial to the long axis of observed were relative to the change from single to
the root. Some activity was observed in the interden- double abutments.
tal bone between the. first premolar and canine Unilateral Dalbo attachment. In the unilateral
abutments. The canine revealed a low-order stress Dalbo attachment removable partial denture. the
pattern in the apical region to the distal aspect. stress pattern associated with the point of force
May’s attachment. The stress patterns with the application in the edentulous ridge was decreased in

THE JOURNAL OF PROSTHETIC DENTISTRY 147


Fig. 6. Stress pattern produced by the bilateral Dalbo
removable partial denture with the springs in place. A,
Single abutment. l3, Double abutment.
distribution and magnitude by the use of two abut-
ments. The stress patter11 below the apex of the first
premolar increased with the use of two abutments
(Fig. 2).
Unilateral Dalbo with the spring in the recepta-
cle. A decrease in the stress pattern in the edentulous
ridge was observed when two abutments were used
and the spring inserted into the receptacle. The stress
pattern at the apex of the first premolar became
more distinct (Fig. 3).
Unilateral Dalbo with locking pin. When the pin
was inserted in the unilatera1 Daibo removable
partial denture, the edentulous ridge showed some
decrease in the stress pattern when two abutments
were used. The decrease was not in proportion to the
increase in stress at the apex of the first premolar
(Fig. 4).
Bilateral Dalbo with no pins or springs. The
bilateral Dalbo with no pins or springs in the
receptacle showed a decrease in the stress pattern in
the edentulous ridge with the use of two abutments.
The stress pattern at the apex of the first premolar
148
WHITE
Fig. 7. Stress pattern produced by the bilateral Dalbo
removable partial denture with the locking pins in place.
A, Single abutment. 8, Double abutment.
increased in magnitude with the use of two abut-
ments (Fig. 5).
Bilateral Dalbo with the springs in the receptacle.
By placing the springs in the receptacles, the stress to
the edentulous ridge was greatly reduced when two
abutments were used. The stress at the apex of the
first premolar was greatly increased. The stress
pattern was located directly below the long axis of
the root and was not distributed mesiaily or distally
along the curve of the root tip (Fig. 6).
Bilateral Dalbo with locking pins. Of all the
samples tested, the bilateral Dalbo removable partial
denture with the pins in place showed the least stress
transfer to the edentulous ridge in the double-
abutment sample. Associated with this decrease in
stress was an increase in stress concentration at,the
apex of the first premolar. Two full fringe orders
were observed below the apex of the first premolar in
the double-abutment sample (Fig. 7).
May’s attachment. The patterns for the single and
double abutments in the May’s attachment sample
were similar to the previous findings (Fig. 8).
AUGUST 1978 VOLUME QO NUMBER 2
VISUALIZATION OF STRAIN PATTERNS

DISCUSSION
As the Dalbo attachment was rendered less free,
the stresses in the edentulous ridge supporting the
distal-extension base decreased in magnitude. Cec-
coni:‘” also found this to be true. He reported that the
ridge displacement was significantly decreased when
the Dalbo stressbreaker was made rigid.
The distribution of the stresses along the edentu-
lous ridge was related to the point of force applica-
tion, the central fossa of the first molar, and was not
directly related to the attachment employed. The
fully active Dalbo attachment resulted in the
greatest distribution of stresses along the supporting
edentulous ridge. Even with the ability of the
denture base to move vertically without restriction,
the stresses were not distributed along the full length
of the supporting tissues. By placing the spring into
the receptacle of the Dalbo attachment,‘the stresses
to the ridge were more concentrated at the point of
load application. The function of the spring is to
maintain the denture base at the passive rest position
when not in use.4” It is used to remove the “Class I
lever action of nonmovable partial dentures or the
shear and moment effect of the hinge-action or
vertical slot-type of partial dentures on the anchor
tooth and its underlying structures.“3R The increases
in the stress below the apex of the first premolar and Fig. 8. Stress pattern produced by the May’s attachment
the decrease in the stress distribution along the removable partial denture. A, Single abutment. B, Double
edentulous ridge do not support the function of the abutment.
spring. The attachment induces less stress when the
spring is eliminated. One explanation for this behav- ments tested varied mostly in magnitude and not in
ior is that the spring requires too great an applica- distribution of stressrelated to the apex of the first
tion of force to be compressed, thereby acting as a premolar, similar force systemsmust be generated.
point of rotation. The similarities between the stress By locking the Dalbo attachment with a pin, the
patterns of the May’s attachment and the Dalbo removable ‘partial denture becomes a slot attach-
attachment with the springs inserted substantiate ment partial denture behaving similarly to a rigid
this premise. cantilever fixed partial denture. Hentierson~” con-
The function of a stressbreaking system is to ducted an in-depth study of the cantiiever type of
reduce the torque to the abutment teeth induced by posterior fixed partial denture. The horizontal axis
the distal-extension removable partial denture.:‘” The of rotation for the fixed partial denture when two
vertical stressbreaking effect of the fully active Dalbo abutments were used was found to be in a region
attachment fulfilled this function. The forces were inferior to but almost midway between the two
transmitted through the long axis of the root of the abutments. The horizontal axis of rotation in the
first premolar. All of the samples tested transmitted replica when two abutments were used should have
the forces through the long axis of the first premolar. been in the root of the first premolar. ‘I’he high stress
Hayashi’ reported that the direction of force appli- concentration seen at the apex of the first premolar
cation to the teeth had a significant effect on the ruled this region out asa center of rotation. Hender-
distribution of force in the supporting structures. son also found that when two abutments were used
The stress distribution for a given movement was the distal abutment resisted more of the resultant
independent of the force magnitude but related to force than the other abutment. Also, the resultant
the direction of the force application and the config- force was found to be less for the single abutment
uration of the root structure. Since all the attach- than for the double abutment. The imrease of the

THE JOURNAL OF PR0STHEl-K DENTISTRY 149

 WHITE

resultant force over the applied force was explained 6. The use of two abutments (double abutments)
by the system of levers inherent to the cantilever resulted in greater stress concentrations in the distal
principle, The inactive Dalbo removable partial abutment than the use of single abutments.
denture behaved similarly to the cantilever fixed 7. Forces in the single abutment were resisted
partial denture studied by Henderson. Also, the along the long axis of the root.
resultant forces were less when a single abutment was 8. Forces in the double abutments were resisted
used. The explanation for the increased stresses seen along the long axis of the distal abutment.
when the double abutment was used with the The author would like to express his thanks to Dr. Matthew I‘
stressbreaking samples is not clear. The expected Wood, Professor of Removable Prosthodontics, t;niversity of
finding would have been more stress on the distal North Carolina, School of Dentistry, for his assistance in conduct-
aspect of the canine abutment. Very little activity ing this project.
was seen in this region. Possibly the center of rotation
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150 AUGUST1978 VOLUME40 NUMBER2

VISUALIZATION OF STRAIN PATTERNS

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