Journal Club Presentation on Overlay Removable Partial Denture
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This clinical report details the rehabilitation of a patient with a posterior open bite relationship and skeletal Class III malocclusion using overlay removable partial dentures (ORPDs). The study indicates that ORPDs offer an affordable and effective method for restoring occlusal vertical dimension and improving patient satisfaction. The approach is recommended for patients needing conservative treatment options to preserve their dental structures while addressing esthetic and functional concerns.
Journal Club Presentation on Overlay Removable Partial Denture
- 1. Journal Club Presentation NEERAJA M MENON װ MDS
- 2. Posterior open occlusion management by registration of overlay removable partial denture: A clinical report Nosouhian S, Davoudi A, Derhami M. The Journal of the Indian Prosthodontic Society. 2015 Oct;15(4):386.
- 3. Content Aim Introduction Case report Discussion Conclusion Related Articles
- 4. Aim This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion.
- 5. Introduction Posterior open bite is defined as the lack of occlusal contact in posterior teeth in any occluding position of the anterior teeth.
- 6. In spite of many remarkable achievements and success rates in implant science, preservation of natural teeth or their roots are recommended to postpone future edentulism of a patient. Brewer AA, Morrow RM. Overdentures. 2nd ed. St. Louis: CV Mosby; 1980.
- 7. Overlay removable partial dentures (ORPDs), a subset of overdentures, are often referred to as an RPD that has part of their components covering the occlusal surface of the abutment teeth to restore them into a functional occlusion Farmer JB, Connelly ME. Treatment of open occlusions with onlay and overlay removable partial dentures. J Prosthet Dent 1984; 51: 300-3.
- 8. Interim ORPD Defenitive ORPD Medical/financial limitation Patel MB, Bencharit S. A treatment protocol for restoring occlusal vertical dimension using an overlay removable partial denture as an alternative to extensive fixed restorations: A clinical report. Open Dent J 2009;3:213-8
- 9. Case Report Diagnostic cast Determining vertical dimension loss Mounting the cast to semi adjustable articulator Oral prophylaxis, endodontic therapy and restorative filling. Preliminary treatments
- 10. Casting posts and copings for maxillary right lateral and both central incisors A post core crown for the first right lower premolar Ball attachments for both mandibular second premolars and maxillary left canine Metal-ceramic crowns for the maxillary left second molar and left mandibular canine: Interim ORPDs were fabricated on the casts by using autopolymerized acrylic resins on mandibular left first premolar and right canine plus maxillary second molars. Special treatments
- 11. Maxilla A-P palatal strap Aker’s clasp for 17,27,15 Patrix Housing Preparing final overlay removable partial dentures Cementation of posts and crowns Making impression and pouring cast Try-in of the framework Recording maxillo- mandibular relationship Denture try-in Final Insertion Mandible Lingual plate Mesial rest for 33,34,44 Patrix housing
- 12. Final finished and polished overlay removable partial dentures (a) and during latrusive movements (b and c) a c b
- 13. Discussion Depending on the patient’s adaptation ability, the interim ORPD period can be modified. Furthermore, a careful monitoring may shorten the overall treatment duration. Six months follow-up after ORPD delivery, patient’s satisfaction was noticed. The retention was provided as much as possible by using clasps, predicting ball attachment and using post copings in the anterior region.
- 14. Conclusion The vertical dimension rehabilitation by using ORPD is affordable for many patients, specially those who need orthognathic surgeries because of intraoral complications. Furthermore, designating attachment systems or other methods for increasing esthetic and retention is impressively recommended.
- 15. RELATED ARTICLES
- 16. Reestablishment of occlusion through overlay removable partial dentures: a case report. Bataglion C, Hotta TH, Matsumoto W, Ruellas CV.. Brazilian dental journal. 2012 Apr;23(2):172-4. Aim: The article reports a clinical situation in which an ORPD was used to treat teeth with severe wear and absence posterior occlusal support.
- 17. Clinical Report Intraoral frontal view of maxillary and mandibular dentitions
- 18. Impressions made and cast poured Mounting to semi-adjustable articulator Determining VD Construction of ORPD Follow-up VDR = 10mm VDO = 7mm
- 19. Intraoral frontal view of restored dentition.
- 20. Discussion ORPD have been suggested to be efficient and cost effective with the final outcome pleasing to the patient. Considering that restorative procedures for the elderly patient should be conservative and should maintain the dental structures intact, functional, comfortable, and aesthetically pleasant, the ORPD were the best choice of treatment.
- 21. Disadvantage: Esthetic issues, caries or periodontal disease if poor oral hygiene is present. Cast metal denture base may be an additional difficulty in future relining.
- 22. Several therapies could be used in this case but a conservative treatment approach was agreed as the best choice. In conclusion, the treatment was effective because it solved the patient’s esthetic concerns and improved the masticatory functions.
- 23. Restoration of the Occlusal Vertical Dimension with an Overlay Removable Partial Denture: A Clinical Report. Zanardi PR, Santos MS, Stegun RC, Sesma N, Costa B, Laganá DC. Journal of Prosthodontics. 2016 Oct;25(7):585-8. Aim This clinical report reviews restoration of a severely resorbed dentition with overlay removable partial denture.
- 24. Classical situations involving tooth wear: (A) initial conditions of tooth wear and OVD loss; (B) restorative solution for case A; (C) initial condition of tooth wear without OVD loss; and (D) periodontal surgical procedures and restorative treatment for correction.
- 25. Case Report Intraoral view of the patient’s initial condition.
- 26. Impression made and diagnostic cast Mounted in semi- adjustable articulator Intraoral photographs; digital smile design concept Virtual planning performed to assist in the predictability of the restorative procedure
- 27. Impression made Surveryed Try-in 27 Incisal restoration of the anterior teeth and the occlusal rest seat.
- 28. 28 Framework wax-up with a simple occlusal retention for the acrylic resin. ORPD final aspect.
- 29. (A) Right lateral view; (B) frontal view; (C) left lateral view; (D) occlusal plane view; (E) final esthetic result
- 30. Concluion 30 The overlay RPD treatment seems to be satisfactory, restoring the OVD and esthetics and providing greater muscle comfort for the patient with low cost and shorter working time. Further randomized clinical trials are suggested to compare the longterm effectiveness of different treatment options for the worn teeth associated with OVD loss.
- 31. Overlay removable partial dentures for a patient with ectodermal dysplasia: A clinical report. Pavarina AC, Machado AL, Vergani CE, Giampaolo ET. The Journal of prosthetic dentistry. 2001 Dec 1;86(6):574-7 Aim: This clinical report describes the fabrication of an overlay RPD for a patient with ectodermal dysplasia.
- 32. Clinical Report Preoperative anterior view.
- 33. Impression made and diagnostic cast Maxillo-mandibular relationship recorded and cast mounted on semi-adjustable articulator Interim RPD fabricated
- 34. New diagnostic cast Surveying of cast Rest seat were prepared on 11,12,53,63,73
- 35. Maxillo- mandibular relation (a) Clinical try-in (b) Final prosthesis inserted (c) and (d) Central Incisors were build-up using composite Follow-up d ca b
- 36. Conclusion For the patient described, the treatment improved esthetics and oral function and established a more favorable plane of occlusion. The patient’s social confidence also improved significantly as a result of the dental treatment.
- 37. A Treatment Protocol for Restoring Occlusal Vertical Dimension Using an Overlay Removable Partial Denture as an Alternative to Extensive Fixed Restorations: A Clinical Report. Patel MB, Bencharit S. A. The open dentistry journal. 2009;3:213. Aim: The following case report describes the rehabilitation of a patient with severe worn dentition with interim ORPDs and later permanent ORPDs.
- 38. Clinical Report
- 41. Final Prosthesis
- 42. Conclusion Acrylic resin and composite resin were selected for the interim and the permanent ORPDs, respectively; with the reason that both of these materials are relatively inexpensive and easy to fix if wear or fracture occurs. Regular recall and maintenance visits are therefore essential to ensure the long term success of ORPDs. In addition, the patient should be instructed and reinforced oral hygiene and denture hygiene with occlusal overlay prosthesis
- 43. Maxillary and mandibular overlay removable partial dentures for the treatment of posterior open-occlusal relationship: A clinical report. Del Castillo R, LaMar Jr F, Ercoli C. The Journal of prosthetic dentistry. 2002 Jun 1;87(6):587-92. Aim: This clinical report describes the use of maxillary and mandibular overlay removable partial dentures to treat a patient with class III skeletal malocclusion and a posterior open-occlusal relationship.
- 44. Clinical Report Pretreatment oral view
- 45. Right and left sides of diagnostic casts mounted in articulator. Pencil lines on teeth indicate projected clasp position on mandibular right and left canines and left second molar and planned incisal edge position as determined by esthetic analysis.
- 46. Final ORPD patterns waxed on refractory casts and mounted in articulator; (a) retention beads Occlusal views of mandibular (A) and maxillary (B) overlay wax-ups on refractory cast.
- 47. Anterior view of definitive maxillary and mandibular ORPDs in occlusion; (a) junction between maxillary overlay denture and posterior natural teeth Tissue surface of definitive maxillary overlay denture.
- 48. Discussion Given the existing tooth position, the VDO established during the prosthodontic evaluation phase, and the uncertain prognosis and financial burden of combined orthodontic/oral surgery procedures, the proposed treatment plan included prosthodontic rehabilitation with maxillary and mandibular ORPDs. This reversible, conservative, and cost-effective treatment solution allowed esthetic and functional rehabilitation
- 49. “Be home, be safe”
Editor's Notes
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