Stress analysis of disjunct removable partial dentures

J. W. Farah, D.D.S., Ph.D.,* A. R. MacGregor, Ph.D., F.D.S.R.C.S.,** and T. P. G. Miller***

University of Michigan, School of Dentistry, Ann Arbor. Mich., and Glasgow Dental Hospital and School.
Glasgow, Scotland

L ontinuous loss of residual ridge and the alveolar

support to abutment teeth in the partially edentu-
lous patient fitted with a removable prosthesis has
been of great concern to dentists. The basic treat-
ment objectives considered by most dentists are to
preserve, restore, and maintain the remaining teeth
and related oral structures within the limits of
physiologic tolerance. Once a decision has been
made to restore an edentulous space, the manner in
which the prosthesis will be supported against the
vertical and horizontal forces must be considered.
Preiskel’ wrote that “load falling on the prosthesis
should be vertically spread over as many natural
teeth as possible, and maximum support from the
mucosa should be obtained by wide mucosa cover-
age.” Baer,’ in a laboratory study, examined the
relationship between the supporting tooth and the
distal-extension removable partial denture. His find-
ing was that the kinematics of the supporting tooth
resulted from movements of the denture base which
were mainly from rotation. Hoffman i used 10 unilat-
eral distal-extension removable partial dentures in
the maxillary and mandibular arches to measure
movements of the supporting teeth when the
dentures were placed under load. The movement
seemed to be related to the removable partial
denture design and the extension of the denture
base. Fig. 1. The components of a disjunct removable partial
The magnitude and distribution of stresses caused denture.
by removable partial dentures is important for the
success or failure of the prosthesis and for the detecting and measuring the distribution of stress to
preservation of the health of the remaining tissues of simulated dental tissues is three-dimensional photo-
the mouth. The method used in this study for elasticity.’ The technique is especially useful for
structures which have a complicated shape or
complex loading conditions such as are found in
*Presently Associate Professor of Dental Biomaterials at the removable partial dentures. In three-dimensional
University of Florida, College of Dentistry, Gainesville, Fla.
photoelastic stress analysis. the magnitude and
**Professor, Department of Prosthodontics, Glasgow Dental
Hospital and School.
distribution of stresses can be determined at any
***Instructor in Dental Technology, Glasgow Dental Hospital point within the model being analyzed.
and School. The object of the present study was to make a

0022~3913/79/09027i + 05$00.50/00 1979 The C. V. Mosby Co. THE JOURNAL OF PROSTHETIC DENTISTRY 271
 FARAH, MACGREGOR, AND MILLER

Compressive
Stress (psi 1

0 -

IO *

l Tooth Supported RPD

20. n Ridge Supported RPD

Bilateral Loading (II.0 lb.1 At Site A.

Fig. 2. Compressive stresses of a tooth-supported removable partial denture compared to a
ridge-supported removable partial ‘denture under bilateral loading at site A.

number of disjunct removable partial dentures on denture, a ridge-supported removable partial den-
epoxy resin test models; to subject the dentures to ture, and a tooth- and ridge-supported removable
known loads under controlled laboratory conditions; partial denture-were examined. Each denture was
and to evaluate the stresses in the test models by loaded bilaterally at site 4 and unilaterally at sites B
means of three-dimensional photoelastic analysis. and C (Figs. 2 to 5). The edentulous ridges of the
testing model were covered with silicon rubber* to
METHODS AND MATERIALS simulate the mucosa.
The disjunct principle of removable partial For the tooth-borne prosthesis the pins were
denture design is a reasonably well-established meth- located at the top of the sleeves, and there was no
od of joining differently supported parts of a movement in the pin-sleeve junction. It was therefore
denture, and has been described by Geissler and assumed that a load applied to the posterior teeth
Watt’ and MacGregor and Miller.’ Thus, in the would be transferred by means of the buccal bars to
bilateral distal-extension edentulous ridges, the the framework on the teeth and that little load
mucosa-borne part is separate from the tooth-borne would be borne by the ridges under the base.
part. In a lower denture of this type the anterior For the ridge-supported prosthesis the pins moved
tooth-borne part is made. in cast alloy and a buccal freely within the sleeves, and therefore the, denture
bar extends distally from the last abutment tooth on base was assumed to be ridge-supported.
each side. The mucosa-borne part is attached to the For the tooth- and ridge-supported prosthesis, the
buccal bars by means of pins and sleeves which allow pin-sleeve movement was adjusted so that when load
vertical movement when load is applied to the was first applied to the posterior teeth, the denture
denture (Fig. 1). The movement of the sleeves on the base moved downward as the simulated mucosa was
pins can be adjusted so that when the mucosa is displaced and the top of the sleeve contacted the pin.
displaced, and therefore accepting load, any further This meant that as the load reached its maximum,
load may be directed forward by the buccal bars to some of the load would be transmitted to the
the tooth-borne part of the denture. simulated mucosa and some would be transferred by
The disjunct principle for distal-extension remov- the buccal bars to the tooth-borne component of the
able partial dentures is believed to have these advan- denture. Thus the load would be borne by the ridges
tages: (1) preventing harmful loads to the remaining and the remaining teeth. This third denture was
teeth, (2) reducing excessive load on the mucosa and termed tooth- and ridge-supported.
alveolar bone of the ridges, on which there is always
a deficit of supporting tissue,’ and (3) varying the RESULTS
pin-sleeve movement, allowing the overall load to be For each of the three models the fringe orders were
distributed proportionately between the ridge and identified and the stresses calculated in the ridges,
abutment teeth, thus optimizing the contributions the apical regions of the remaining teeth, and the
from the supporting structures.
Three prostheses-a tooth-borne removable partial *Citricon, Kerr Mfg. Co., Romulus, Mich.

272 SEPTEMBER 1979 VOLUME 42 NUMBER 3

STRESS IN DISJUNCT REMOVABLE PARTIAL DENTURES

l Tooth Supported RPD

11 Ridge Supported RFD

Unilateral Loading (5.5 Ibs) At Site B.

Fig. 3. Compressive stresses of a tooth-supported removable partial denture compared to a
ridge-supported removable partial denture under unilateral loading at site 5.

Compressive
Stress (psi)

0 -

IO -

20 - l Tooth Supported RPD

u Ridge Supported RPD

30.

Unilateral Loading (5.5 Ibs? At Site C.

Fig. 4. Compressive stresses of a tooth-supported removable partial denture compared to a
ridge-supported removable partial denture under unilateral loading at site C.

distal root surfaces of the first premolars. The stresses difference was found in the stress distribution when
are plotted in Figs. 2 to 4; each value represents a it was compared to the prosthesis supported by the
mean of four separate loadings. After each loading ridge alone. In general, Fig. 2 shows that the stresses
and subsequent determination of the stresses, the were lower when the prosthesis was supported by the
models were stress-relieved and then reloaded with ridge than when tooth-supported. The difference in
‘the same denture in place. stresses is indicated by the shaded area.
Similarly, in Fig. 3 the prosthesis was loaded
DISCUSSION unilaterally with 5.5 pounds at site B, located in the
In Fig. 2 the prosthesis was loaded bilaterally with central fossa of the second premolar. The stresses
11 pounds at site A, located in the central fossa of the were again lower when the prosthesis was ridge
first molar. Fig. 2 compares the compressive stresses -supported. Note that because of the nature of the
when the prosthesis was tooth-supported and when it loading (i.e., unilateral on the right side) the magni-
was ridge-supported. The third prosthesis, which was tude as well as the difference in the stress is larger on
tooth- and ridge-supported, is not plotted because no the right side than on the left, where the stresses

THE JOURNAL OF PROSTHETIC DENTISTRY 273

 FARAH, MACGREGOR, AND MILLER

ABC A

Compressive
Stress (psi)

200. RPD Supported by:

Fig. 5. Comparison
I Biloierol Looding
Loading Site: A

of the compressive
( I Ix) Ibd Uniloteral
B
Looding

stresses due to unilateral

(5.5 Ibr)
C

and bilateral loading at sites

A, B, and C.

converge toward a single value and approach zero in 26.3% higher for loading site B, and 17.9% higher for
the retromolar region. loading site C.
Finally, in Fig. 4, the prosthesis was again loaded It is interesting to note the evenness with which
unilaterally with 5.5 pounds at site C, located on the the stresses were distributed when the prosthesis was
rest near the distal marginal ridge of the first bilaterally loaded (Fig. 2). In fact if one were to
premolar. In this prosthesis too, the stresses were ignore the retromolar pads, where the stress was zero,
lower when the partial denture was ridge-supported. the stress varied only from a high 14.05 psi to a low
Also note the shift to the left in the location of the 11.07 psi for the ridge-supported denture. Even when
stresses. Because the load was directly on the frame- the prosthesis was tooth-supported the variation was
work of the prosthesis and indirectly on the first only from 13.2 to 16.3 psi. These values point to the
premolar, the stress was transferred through the importance of having a balanced occlusion, i.e.,
framework to the supporting structures. contacts of opposing teeth on both working and
The results are summarized in Fig. 5. For all three balancing sides. The variation in stress was much
loading sites, for bilateral as well as unilateral higher in the situations shown in Figs. 3 and 4, where
loading, the stresses were highest when the prosthesis the loads were unilaterally applied. In summary, this
was tooth-supported. No significant difference was study not only helped in determining the distribu-
recorded between the ridge-supported prosthesis and tion of the stresses within photoelastic test models,
the tooth- and ridge-supported prosthesis. This is not but also demonstrated the importance of knowing
to imply that no difference exists between a ridge- how this distribution can be changed and controlled
supported removable partial denture and a tooth- to better suit the requirements of each patient.
and ridge-supported removable partial denture, but
rather that further refinement of the pin-sleeve CONCLUSIONS
mechanism may be needed to provide better control 1. No significant difference was observed in the
of the manner of distribution of the stresses. In the level of stress between a prosthesis which was ridge-
disjunct design, load distribution is obviously supported and one which was tooth- and ridge-
influenced by the degree of direct retention offered supported.
by the clasps. In this sense the clasps act as indirect 2. The compressive stresses for the bilateral load-
supporting elements as they influence the overall ing at site A were 18.2% higher for the tooth-
support distribution when load is applied. supported prosthesis when compared to the ridge-
The stresses for the tooth-supported prosthesis supported or tooth- and ridge-supported prosthesis.
were 18.2% higher than the ridge-supported or tooth- 3. The compressive stresses for the tooth-
and ridge-supported prosthesis for loading site A, supported prosthesis, with unilateral loading at sites

274 SEPTEMBER 1979 VOLUME 42 NUMBER 3

STRESS IN DISJUNCT REMOVABLE PARTIAL DENTURES

A and B, were 26.3% and 17.9% higher than the 2. Baer, 0.: Die freind-sattel. Schiez Maselir Zahnheilh 73:197.
287, 1963.
ridge-supported and the tooth- and ridge-supported
3. Hoffman, M.: Pfeilerkinemalih and alcsrcltzung. Dtsch
prosthesis, respectively. Zahnheilh Z 22:1315. 1967.
4. Farah, J. W.: Stress Analysis of First Molar with Full Crown
SUMMARY Preparation using Three-dimensional Photoelasticity and
The (1) tooth-supported, (2) ridge-supported, and the Finite Llement Method. Thesis. University of Michigan,
(3) tooth- and ridge-supported variations of the 1972.
5. Geissler, P. R., and Watt, D. M.: Disjunct dentures for
disjunct removable partial denture were studied. patients with teeth of poor prognosis. Dent Pratt 15:421,
When testing loads were applied to three sites, 1965.
bilaterally and unilaterally, it was found that the 6. MacGregor, A. R.. and Miller, T. P. G.: Two modifications
stresses were highest when the removable partial of the disjunct lower partial denture. J Dent 2:211, 1974.
7. Watt, D. M., MacGregor, A. R., Geddes, hi . Cockburn, A.,
framework was tooth-supported. No significant
and Boyd, J. L.: Preliminary investigation ol the support of
difference was recorded between the ridge-supported partial dentures and its relationship to vertical loads. Dent
partial denture and the tooth- and ridge-supported Pratt 9:2. 1958.
partial framework. Further refinement of the pin-
Reprmt requests to:
sleeve mechanism may be necessary to effect better DR. J. W. FARAH
control over the distributions of the stresses. UNIVERSITY OF FLORIDA
COLLEGE of DENTISTRY, Box J-446
REFERENCES
GAINESVILLE. FLA. 32610
1. Preiskel, H. W.: Precision Attachments in Dentistry, ed 2. St.
Louis. 1973. The C. V. Mosby Co.

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