
- •Ministry of Public Health of Ukraine Higher State Educational Establishment of Ukraine
- •Actuality of the theme:
- •2. Specific objectives:
- •3.Basic knowledge, skills, skills needed for the study subjects (interdisciplinary integration)
- •4. Tasks for independent work during preparation to practical classes.
- •4.1. Recommendations for students’ independent work and album for independent work of students.
- •4.2 Theoretical questions to the lesson:
- •4.3. Practical work (task) that are fulfilled in class:
- •2. Biomechanical retention
- •Physical
- •4. Biophysical (functional suction in complete dentures).
- •Indirect retainers
- •7. Recommended literature.
Physical
The denture is retained by the forces of adhesion, cohesion,viscosity, gravity, as well as the plastic molding of the soft tissue around the polished surfaces of the dentures. Atmospheric pressure is effective primarily as a rescue force when extreme dislodging forces are applied to the denture.
Adhesion: the physical attraction of unlike molecules. Adhesion of saliva to the mucous membrane and the denture base is achieved through ionic forces between charged salivary glycoprotein and surface epithelium or acrylic resin.
Cohesion: the physical attraction between like molecules. Physical attraction of like molecules for each other creates retentive force and usually occurs with saliva that is present between the denture base and the mucosa. Normal saliva is not very cohesive
Interfacial surface tension: resistance to separation by the film of liquid between
the denture base and the supporting tissues (combines cohesion and adhesion).
Viscosity
This is the rate of separation of two surfaces under an applied force, best described in the context of surface tension and interfacial viscous tension. The force holding two wet glass planes together against a straight pull, or the force holding two parallel plates together are due to the viscosity of interposed liquid.
Stefan’s law (24) describes that the viscous force increases proportionally to increases in the viscosity of the interposed fluid. When the equation is applied to denture retention, it demonstrates the need for a good base adaptation to the tissues and the importance of taking full advantage of the surface area covered by the denture. This may be relevant to the maxillary denture. However, if the two plates with interposed fluid are immersed in the same fluid, there will be no resistance to pulling them apart. Since the borders of the mandibular denture are bathed in saliva, surface tension, viscosity and film thickness may not play a role in lower denture retention
Gravity
The weight of a lower prosthesis constitutes a negligible gravitational force and is insignificant in comparison with the other forces acting on a denture.
Oral and facial musculature.
Muscular control is an important aspect of successful complete denture therapy. Although this may supply additional retentive forces, provided that the polished surfaces are properly shaped, the teeth are positioned in the neutral zone and the denture bases are properly extended to cover the maximum area possible, retention is a quality of the denture rather than that of the patient. Therefore, musculature is relevant only in the context of ‘manipulative skill’ of the patient, rather than in retention in the strictest sense.
4. Biophysical (functional suction in complete dentures).
Atmospheric pressure - Vacuum
Atmospheric pressure has been claimed to be an important factor in complete denture retention. For atmospheric pressure to be effective, it must operate under condition of a pressure difference - (de) pressure. There must be a lower pressure beneath the dentures and only if vacuum were there the full effect could be felt.
Atmospheric pressure can act to resist dislodging forces, if the dentures have an effective seal around their borders. This is called ‘suction’ because it is the resistance to removal in a direction opposite to that of insertion. But there is no suction or negative pressure, except when another force is applied.
Under the assumption that vacuum could be generated by exerting a pull that tended to increase the volume beneath the base of the denture and the tissue, the lower pressure would have to be generated by external means and a perfect seal created and maintained around their entire borders for the lower pressure to be sustained.
Denture stability is a quality of a denture that permits it to maintain a state of equilibrium in relation to its tissue foundation and/or abutment teeth. Denture stability is the denture’s ability to remain securely in place when it is subjected to horizontal movements. This occurs during the functional force of chewing, talking, singing, whistling, etc.
-to be stable, the denture requires the following:
-good retention
-non-interfering occlusion
-proper tooth arrangement
-proper form and contour of the polished surfaces
-good control and coordination of the patient’s musculature
Retainers - prevent displacement of the denture during function
Direct Retainer (clasps). Clasp was introduced by Mouton in 1764.
Requirements of a Clasp
1. Retention
- Resistance to dislodgment in an occlusal direction .Provided by the clasp tip engaging the undercut when a dislodging force is Bracing (Stabilize)
2. Resistance to forces from a lateral (sideways) and anterior posterior direction. Provided by the arms and occlusal rest
3. Passivity
When a clasp is in place on a tooth, it should be at rest. Its retentive function is activated only when dislodging forces are applied
Clasp types
a. Cast metal - Fabricated using wax or plastic patterns
b. Wrought wire
- commercially supplied wire of various gauges
- adapted to cast by bending with pliers
Parts of a Wrought wire clasp (Fig.1)
a.Clasp arm
b.Shoulder
c.Tale