Özet

Günümüzde kısmı dişsizliğin fonksiyonel ve estetik olarak rehabilite edilmesinde en çok kullanılan tedavi yöntemlerinden biri hareketli bölümlü protezlerdir. Ancak içerdikleri ana bağlayıcı sebebiyle kapladıkları alanın çok büyük oluşu bu protezlerin hastalar tarafından kabul edilmesini zorlaştırmaktadır. Unilateral hareketli bölümlü protezler, tek taraflı kısmi dişsizliğin varlığında bilateral hareketli bölümlü protezler yerine kullanılabilecek önemli bir tedavi alternatifidir. Ancak, özellikle retansiyon ve stabilize açısından bu protezlere duyulan güven oldukça azdır. Bu protezler; kroşeli, hassas bağlantılı ve implant destekli olarak dizayn edilebilir. Hassas bağlantıların kullanılması, unilateral hareketli bölümlü protezlerde karşılaşılan sorunları önlemede yardımcıdır. Özellikle doğru ataşman ve sistem seçiminin tedavinin prognozuna direkt olarak katkısı mevcuttur. Unilateral hareketli bölümlü protezlerde başarıyı artırmak için dental implantlardan da yararlanılabilmektedir. Doğru pozisyonda implant yerleşimi ile bu protezlerin tutuculuk sorunları en aza indirilmekte ve hastaların konforu artmaktadır.

Anahtar Kelimeler

Unilateral Hareketli Bölümlü Protez, Kısmi Dişsizlik, Hassas Bağlantı, İmplant Destekli Protezler.

---

Abstract

​​​​​​Removable partial dentures are one of the most common treatment methods for rehabilitation of partial edentulism. However, due to their design with major connector, they cover a vast area in the mouth and this makes the denture difficult to be accepted by patients. Unilateral removable dentures are an important treatment alternative in the presence of unilateral edentulism. However, confidence in these denture are very low, especially in terms of retention and stability. These dentures can be designed with clasps, precision attachment or they can be supported by dental implant. The use of precision attachment is helpful in avoiding problems. In particular, selection of the right attachment and the system has a direct effect on the prognosis of the treatment. Dental implants can also be used to increase the success of unilateral removable partial dentures. With the placement of implant in the correct position the success of these dentures increase.

Keywords

Unilateral Removable Partial Dentures, Partial Edentulism, Precission Attachment, İmplant Supported Denture

---

Referanslar | References

1. Fuller E, Steele J, Watt R, Nuttall N. a report from the Adult Dental Health Survey 2009. The Health and Social Care Information Centre, Oral health and function 2011.
2. Karir N, Hindocha V, Walmsley A D. Sectional dentures revisited. Dent Update 201; 39: 204–210.
3. Walton J N, MacEntee M I. Choosing or refusing oral implants: a prospective study of edentulous volunteers for a clinical trial. Int J Prosthodont 2005; 18: 483–488.
4. Carr Alan B, Brown David T, McCracken’s Removable Partial Prosthodontics, 13th edition, St. Louis, Missouri, Elsevier, 2016
5. McCord F, Smales R. Oral diagnosis and treatment planning: part 7. Treatment planning for missing teeth. Br Dent J 2012; 213: 341–351.
6. Lynch C D. Successful removable partial dentures. Dent Update 2012; 39: 118–126.
7. Sakar O, Major and Minor Connectors, Sakar O, Removable Partial Dentures, 1st edition, Switzerland, Springer, 2016, 85-94
8. Goodall WA, Greer AC, Martin N. Unilateral removable partial dentures. Br Dent J. 2017 Jan 27;222(2):79-84.
9. Luk K, Tsai T, Hsu S, Wang FL. Unilateral rotational path removable partial dentures for tilted mandibular molars: design and clinical applications. J Prosthet Dent. 1997 Jul;78(1):102-5.
10. Stratton RJ, Wiebelt Fj. An atlas of removable partial denture design. 1st edition, Chicago: Quintessence Publications, 1988
11. Jacobson TE, Krol Aj, Rotational path removable partial denture design. J. Prosthet Dent 1982;48:370-6
12. Jin X, Sato M, Nishiyama A, Ohyama T. Influence of loading positions of mandibular unilateral distal extension removable partial dentures on movements of abutment tooth and denture base. J Med Dent Sci. 2004 Sep;51(3):155-63.
13. Zarb GA, Bergman B, Clayton JA, MacKay HF, Prosthodontic treatment for partially edentulous patients. 13th edition, St Louis,  Mosby, 2013
14. Gallas M, Blanco M, Martinez-Ares D, Rivo E, García-Fontán E, Cañizares M. Unnoticed swallowing of a unilateral removable partial denture. Gerodontology. 2012 Jun;29(2):e1198-200.
15. Goodacre CJ. A dislodged and swallowed unilateral removable partial denture. J Prosthet Dent. 1987;58:124–125.
16. King E, Jagger R. Swallowed and inhaled dentures – what’s the problem?. Dent Update 2014; 41: 882–890.
17. Toshima T, Morita M, Sadanaga N, et al. Surgical removal of a denture with sharp clasps impacted in the cervicothoracic esophagus: report of three cases. Surg Today. 2011;41:1275-1279.
18. Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz PO ve ark, Prosthetics: Bracing and reciprocation. Br Dent J 2001; 190: 10–14.
19. Nakai N, Kurogi T, Murata H. Oral health-related quality of life of conventional removable partial dentures, unilateral nonmetal clasp dentures, and shortened dental arch with 2- or 3-tooth unilateral distal extension tooth loss in the mandible: A randomized, crossover, clinical trial. J Prosthet Dent. 2022 Jun 10:S0022-3913(21)00407-8. 
20. Stafford GD, Huggett R, MacGregor AR, Graham J, The use of nylon as a denture-base material, Journal of Dentistry, 1986;14:18-22
21. Anusavice KJ. Phillips’ Science Of Dental Materials. Tenth edition. Philadelphia: WB Saunders; 1996.
22. Vojdani M, Giti R. Polyamide as a Denture Base Material: A Literature Review. J Dent (Shiraz). 2015 Mar;16(1 Suppl):1-9.
23. Singh K, Aeran H, Kumar N, Gupta N. Flexible thermo- plastic denture base materials for aesthetical removable partial denture framework. J Clin Diagn Res 2013; 7: 2372–2373.
24. Ucar Y, Akova T, Aysan I. Mechanical properties of polyamide versus different PMMA denture base materials. J. Prosthodont, 2012, 21:173-176
25. Yunus N, Rashid AA, Azmi LL, Abu Hassan MI. Some Flexural Properties of a Nylon Denture Base Polymer. J Oral Rehabil 2005;32:65-71
26. Singh JP, Dhiman RK, Bedi PS, Girish SH. Flexible denture base material: a viable alternative to conventional acrylic denture base material. Contemp Clin Dent 2011;2;313-7
27. Horie N, Ouchi T, Nishiyama R, Usuda S, Morikawa S, Asoda S, ve ark. Vertical Displacement in Unilateral Extension Base Flexible Removable Dentures. Bull Tokyo Dent Coll. 2019 Dec 10;60(4):233-239.
28. Muhsin SA, Wood DJ, Hatton PV, Johnson A, Sereno N. The Effect of Processing Conditions on the Flexural Strength of Polyetheretherketone (PEEK) Used as Innovative Denture Base Material. The 2nd International PEEK Meeting, USA-Washington DC, 23-24th April, 2015.
29. Stawarczyk B, Beuer F, Wimmer T, Jahn D, Sener B, ve ark, Polyetheretherketone-a suitable material for fixed dental prostheses? J Biomed Mater Res B Appl Biomater. 2013; 101:1209-16.
30. Sadek SA. Comparative Study Clarifying the Usage of PEEK as Suitable Material to Be Used as Partial Denture Attachment and Framework. Open Access Maced J Med Sci. 2019;7(7):1193-1197.
31. Radović K, Čairović A, Todorović A, Stančić I, Grbović A. Comparative analysis of unilateral removable partial denture and classical removable partial denture by using finite element method. Srp Arh Celok Lek. 2010 Nov-Dec;138(11-12):706-13. 
32. Krol Aj, Jacobson TE, Finzen FC. Removable partial denture design, an outline syllabus. 4th ed. San Rafael (CA): Indent, 1990
33. Sato Y, Abe Y, Yuasa Y, Akagawa Y. Effect of friction coefficient on Akers clasp retention. J Prosthet Dent. 1997 Jul;78(1):22-7.
34. Leung KF, Liu HJ, Yeh KY, Removable partial denture psorthodontics. 1st edition, Taipei, Taiwan: Ho Chi Publication, 1984
35. Stewart KL, Rudd KD, Kuebker WA. Clinical removable partial prosthodontics. 2nd ed. St. Louis: Ishiyaku EuroAmercia Inc, 1992
36. Rubel B et ark, Unilateral semi-precision removable partial denture utilizing Bredent VKS-SG attachment system. N Y State Dent J. 2009 Jun-Jul;75(4):36-8.
37. Moldovan O, Rudolph H, Luthardt RG. Clinical performance of removable dental prostheses in the moderately reduced dentition: a systematic literature review. Clin Oral Investig. 2016 Sep;20(7):1435-47.
38. Radi IA, Taha K. No clear evidence on the clinical performance of different removable prosthetic options in partially edentulous patients. Evid Based Dent. 2017 Dec 22;18(4):117-118.
39. Schmitt J, Wichmann M, Eitner S, Hamel J, Holst S. Five-year clinical follow-up of prefabricated precision attachments: a comparison of uni- and bilateral removable dental prostheses. Quintessence Int. 2011 May;42(5):413-8. 
40. Patrnogić V, Todorović A, Sćepanović M, Radović K, Vesnić J. ve ark. Free-end saddle length influence on stress level in unilateral complex partial denture abutment teeth and retention elements. Vojnosanit Pregl. 2013 Nov;70(11):1015-22.
41. Afify M, Helmy M, Abbas N. Evaluation of Biting Force of New Design of Extracoronal Castable Precision Attachment versus Conventional Partial Denture for Treatment of Unilateral Mandibular Distal Extension Area: A Randomized Controlled Trial. Open-Access Maced J Med Sci. 2020 Apr 05; 8(D):23-28.
42. Cilingir AA, Atachments and Double Crown Systems for Removable Partial Dentures, Sakar O, Removable Partial Dentures, 1st edition, Switzerland, Springer, 2016, 171-194
43. Owall B. Precision attachment retained removable partial dentures: 1. Technical long-term study. Int J Prosthodont. 1991;4:249–57.
44. Preiskel HW. Precision attachments in prosthodontics vol 1: The applications of intracoronal and extracoronal attachments, 1st edition Chicago: Quintessence Publishing Co.; 1984.
45. Tang MW, Aristidou G, Djemal S. Unilateral bounded saddles: a clinical case report on the use of a two part sectional removable partial denture. Eur J Prosthodont Restor Dent. 2013 Mar;21(1):16-23.
46. Wu ZH, Zhang XJ, Zhao J. The reasons why 13 MK1 attachment were re-fabricated and some methods for improvement. Shanghai Kou Qiang Yi Xue. 2013 Dec;22(6):715-7. 
47. Pullen-Warner E, L’estrange PR. Sectional dentures - a clinical and technical manual. Bristol, 1978, John Wright & sons Ltd.
48. L’Estrange PR, Warner EP. Sectional dentures – a simplified method of attachment. Dent Pract Dent Rec 1969; 19: 379-81
49. Watson Rm, Treacher FG. Two part dentures with precision attachments. Dent J 1972; 132: 287-8
50. Kurtzman GM et ark, Treatment of the partially edentulous maxilla in the presence of tori: a prosthetic approach. Dent Today. 2005 Aug;24(8):48, 50-3;
51. Dbrowa T., Panek H., Napadek P. 8 Year Clinical Observation of Telescopic Anchors Applied in Removable Dentures – Case Report, Dent. Med. Probl. 2007, 44, 4, 521-525.
52. Langer Y., Langer A. Tooth-supported telescopic prostheses in compromised dentitions: A clinical report. J. Prosthet. Dent. 2000, 84, 2, 129–132
53. Coca I. Lotzmann U. Poggeler R. Long term experience with telescopically retained overdentures, double crown technique. Eur. J. Prosthodont. Restor. Dent. 2000, 8, 33–43.
54. Sherestha P. Sherestha K. Telescopic crowns used as retainers for Kennedy class II removable partial dentures: A case report, Journal of Nepal Dent. Assoc., 2010:11(2),159-161
55. Ulm CW, Solar P, Gsellmann B, Malejka M, Watzek G. The edentulous maxillary alveolar process in the region of the maxillary sinus—a study of physical dimension. Int J Oral Maxillofac Surg. 1995;24:279–282.
56. Bortolini S, Natali A, Franchi M, Coggiola A, Consolo U. Implant-retained removable partial dentures: an 8-year retrospective study. J Prosthodont 2011;20:168–72.
57. Carpenter JF. Implant-assisted unilateral removable partial dentures. Dent Today. 2014 Jan;33(1):106, 108-11.
58. Fahmy A, Abuelroos EM, Nada MM. Effect of using attachment on implant supported distal extension lower partial over- dentures. Cairo Dent J 2008;24(1):1.
59. Mitrani R, Brudvik JS, Phillips KM. Posterior implants for distal extension removable prostheses: a retrospective study. Int J Periodontics Restorative Dent. 2003;23:353–359.
60. Giffin KM. Solving the distal extension removable partial denture base movement dilemma: a clinical report. J Prosthet Dent. 1996;76:347–349.
61. Uludag B, Celik G. Technical tips for improved retention and stabilization of a unilateral removable partial denture. J Oral Implantol. 2007;33(6):344-6.
62. de Freitas RF, de Carvalho Dias K, da Fonte Porto Carreiro A, Barbosa GA, Ferreira MA. Mandibular implant-supported removable partial denture with distal extension: a systematic review. J Oral Rehabil 2012;39:791–8.
63. Eckert SE, Wollan PC: Retrospective review of 1170 endosseous implants placed in partially edentulous jaws. J Prosthet Dent 79:415, 1998
64. Matsudate Y, Yoda N, Nanba M, Ogawa T, Sasaki K. Load distribution on abutment tooth, implant and residual ridge with distal-extension implant-supported removable partial denture. J Prosthodont Res. 2016 Oct;60(4):282-288.
65. Grossmann Y, Nissan J, Levin L. Clinical effectiveness of implant-supported removable partial dentures: a review of the literature and retrospective case evaluation. J Oral Maxillofac Surg. 2009 Sep;67(9):1941-6.
66. Ahmed Mohamed A.E et ark, Comparative study of two different designs of partial over denture supported with distal implant for the treatment of mandibular Kennedy class II cases, Tanta Dental Journal;2013,10:2,39-47
67. Nawar NH, Asfahani A-El. The effect of using different designs on distal  implant for treatment of mandibular Kennedy class 2 cases, Egyptian dental journal:65, April,2019,
68. Abu Elross E. Proposed solution for Kennedy class I partially edentulous cases using osseointegrated implant. Doctor thesis in Prosthodontics. Cairo University; 2003.
69. Gerber JA, Tan WC, Balmer TE, Salvi GE, Lang NP. Bleeding on probing and pocket probing depth in relation to probing pressure and mucosal health around oral implants. Clin Oral Implant Res 2009;20(1):75.