Professional Documents
Culture Documents
D.D.S.,*
Wayne D. Thompson,
School of Dentistry,
Los Angeles,
D. D.S.,**
Calif.,
and Veterans
Administration
Medical
q A
fm#
q IC
REVIEW
Descriptions and discussions of attachment retainers have been reported in the literature by many.*-*I
Chayes12devised the first internal attachment. It was
basically the same as attachments currently manufactured, such as Stemgold (APM-Stemgold,
San
Mateo, Calif.), McCollum (APM-Stemgold), Ney (J.
M. Ney Co., Bloomfield, Conn.), and Baker (Engelhard Industries, Baker Dental Division, Newark,
NJ.).*-. 13.* In this study, the Stemgold type 7
precision attachment was tested.
Another design is a European concept developed
by Hans Dalla Bona in Switzerland, and n&keted
as the Dalbo attachment (APM-Stemgold).. lo. I. I5
It has been described and classified as an extracoronal stressbreaker by Mensor15 and others.O
Thompson*B described an attachment retainer
which is intracoronal, semiprecision, and has been
Read hefore the Pacific Coast Society of Prosthodontists, Orcas
Island, Wash.
*Professor and Director of Postgraduate Prosthodontics, University of California, School of Dentistry, Los Angeks, Calif.
**Chief, Restorative Section, Veterans Administration
Medical
Center, Long Beach, CaIif.
***Professor and Chairman, Biomaterials Science Section, University of California, School of Dentistry, Los Angeles, Calif.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
Center,
---
type
7 is basic H-shaped
21
KRATOCHVIL.
sol-
22
CAPUTO
Fig. 6. Relation to fulcrum line of receptacle and retention dimple of Thompson dowel. A, Distal view. B,
Occlusal view.
MATERIAL
distal-extension
removable partial dentures. Many
authors through the years have suggested splinting
two abutments for each extension base.8. y. 23 Dykeis used to
ma et a1.24 wrote, . . . if an attachment
retain a partial denture with a free-end extension
base (Class I or II), fixed splinting of the abutment
AND
Fulcrum Line
-__________________________________
THOMPSON,
AND METHODS
JULY 1981
VOLUME
46
NUMBER
PHOTOELASTIC
ANALYSIS
OF STRESS PATTERNS
Design I-Sterngold
MK attachment (Fig. 3)
THE JOURNAL
POLARIZATION
QUARTER
A
M
ANALYZER
POLARIZED
LIGHT
- PGLARUER
MODEL - BIREFRINGENT
PLASTIC
position of light,
Design 2-Dalbo
OF PROSTHETIC
DENTISTRY
model and
Design 3-Thompson
23
KRATOCHVIL,
THOMPSON,
AND
CAPUTO
2A
IA
4A
%A
511
Fig. Ilk
Photoelastic stress distribution
with single abutment.
Fig. 1ZA. Photoeleastic stress distribution
with abutments splinted.
Fig. 13A. Photoelastic stress distribution
single abutment.
Fig. 14A. Photoelastic stress distribution
abutments splinted.
Fig. 15A. Photoelastic stress distribution
with single abutment.
Fig. 16A. Photoelastic stress distribution
with abutments splinted.
24
JULY 1981
VOLUME
46
NUMBER
... .. ...__....._....._._............ .J
118
12B
.......... .
..........................
%..........
....................................
............................................
148
......... i
.......................................
...........................................
15B
Fig. 1lB. Diagrammatic
with single abutment.
Fig. 12B. Diagrammatic
with abutments splinted.
Fig 136. Diagrammatic
single abutment,
Fig. 14B. Diagrammatic
abutments splinted.
Fig. 13B. Diagrammatic
with single abutment.
Fig. 168. Diagrammatic
with abutments splinted.
25
KRATOCHVIL,
framework
receptacles
torquing.
Assembly procedures
The gold crowns were secured to their respective
abutment teeth with threaded screws (Fig. 8). This
arrangement
allowed for ease of placement
and
removal of the crowns when testing the three types of
removable
partial
denture
attachment
retainers,
while assuring fixation
comparable
to a crown
cemented in place clinically.
Acrylic resin denture
bases were attached to each prosthesis. A uniform
thickness of 2 mm silicone material
(Sir, Stern
Dental
Co., Mt. Vernon,
N.Y.) was positioned
between the denture base and the model. This
resilient silicone layer simulated oral mucosa.
A metal bar was positioned between the right and
left denture bases at the level of the occlusal plane in
the region of the mesial cusp of the first molars (Fig.
8). A matrix was used to duplicate the bar position
on all frameworks. The load was directed against the
center of this bar. The removable partial denture on
the photoelastic model was positioned in the center
of a straining frame. The frame could be turned to
present all parts of the model to a fixed camera (Fig.
9). A fiber optic light source was positioned at the
rotational center of the photoelastic model, in a fixed
relation to the camera. Results were recorded photographically.
The load cell was positioned over the
center of the bar between the right and left edentulous regions. A vertical
force of 33 pounds was
applied
and
monitored
by an XY recorder
(Fig. 10).
The first premolar abutments were then splinted
to the canines with solder to form a double abutment. The entire sequence of testing was repeated to
evaluate differences between single and double abutments.
RESULTS
Examination
of the model before and after the
placement of the removable partial denture frameworks on the photoelastic model revealed no significant stresses. Similar responses to the applied force
were observed on both sides of the arch. Therefore, to
simplify
data presentation,
only results from the
right side will be analyzed. To facilitate presentation
and interpretation
of the photoelastic data, schematic representations
of stress intensity were prepared.
Areas of darker shading represent higher stress. It is
26
THOMPSON,
Design I-Sterngold
AND
CAPUTO
do not include
type 7 attachment
MK attachment
dowel attachment
JULY 1981
VOLUME
&
NUMBER
Comparing
the attachments
ments. It is important
to note that the forces evaluated were direct vertical forces. If lateral forces had
been incorporated
in the experiment,
different stress
patterns could have been demonstrated.
Further
investigation
in this area is indicated.
SUMMARY
This investigation
was designed to evaluate the
forces developed in supporting structures by removable partial dentures with attachment retainers. The
attachments tested were the (1) Sterngold type 7, (2)
Dalbo MK, and (3) Thompson
dowel. The study
utilized a photoelastic model with stress areas recorded photographically.
The results showed that:
1. Splinted abutments are indicated when using
the tested attachment
retainers.
2. With single abutments, the attachment
retainers induced distal force on the teeth which resulted in
unfavorable
horizontal
bone forces.
3. The Dalbo MK attachments
produced
the
most force on the edentulous regions and the least
force on the abutment teeth.
4. The Thompson
dowel and Sterngold type 7
attachment
retainers induced similar stress patterns
on single abutments and both produced distal abutment forces.
5. The Thompson dowel induced more favorable
stress patterns when the abutments were splinted.
We would like to thank APM-Sterngold
project.
REFERENCES
1. The Academy of Denture Prosthetics: Principles, Concepts,
and Practices in Prosthodontics-1976. J PROSTHETDENT
373211, 1977.
2. Kratochvil, F. J., and Caputo, A. A.: Photoelastic analysis of
pressure on teeth and bone supporting removable partial
dentures. J PROSTHETDENT 32:52, 1974.
3. Thompson, W. D., Kratochvil, F. J., and Caputo, A. A.:
Evaluation of photoelastic stress patterns produced by various designs of bilateral distal-extension removable partial
dentures. J PROSTHETDENT 38~261, 1977.
4. Cutiingham,
D. M.: Indications and contraindications for
precision attachments. Dent Clin North Am 14:595, 1970.
5. Preiskel, H. W.: Precision Attachments in Dentistry, ed 2. St.
Louis, 1973, The C. V. Mosby Co.
6. Prciskel, H. W.: Intracoronal attachments. Dent Clin North
Am 17:691, 1979.
7. Miller, E. L.: Removable Partial Prosthodontics. Baltimore,
1972, The Williams and Wilkins Co., pp 291-294.
8. Henderson, D., and Steffel, V. L.: McCrackens Removable
Partial Prosthodontics, ed 5. St. Louis, 1977, The C. V.
Mosby Co.
27
KRATOCHVIL,
9.
Appelate,
0. C.: Essentials
of Removable
Partial
28
Thompson
dowel semiprecision
PROSTHET DENT 37:19, 1977.
Denture
Prosthesis, ed 3. Philadelphia,
1965, W. B. Saunders Co.
10. APM-Stemgold
Procedure
Manual.
San Mateo,
Calif.,
1975, APM-Sterngold.
11. Tylman,
S. D., and Malone, W. F. P.: Tylmans
Theory and
Practice of Fixed Prosthodontics,
ed 7. St. Louis, 1978, The
C. V. Mosby Co.
conducive
to health and the
12. Chayes, H. E. S.: Bridgework
instruments
for constructing
it. Dent Items Int 37:267,
1939.
13. Ney Attachment
Manual.
Hartford,
Corm., 1970, J. M. Ney
co.
14. Shohet, H.: Relative magnitudes
of stress on abutment
teeth
with different retainers. J PROSTHET DENT 21:267, 1969.
15. Mensor,
M. C.: Resilient
hinge-action
stressbreaken.
J
PROSTHET DENT 20~204, 1968.
16. Thompson,
M. J.: Reversible hydrocolloid
impression material: Its treatment
and use in operative
and prosthetic
dentistry. J Am Dent Assoc 39~708, 1949.
17. Harris,
F. N.: The precision
dowel rest attachment.
J
PROSTHET DENT 5:43, 1955.
18. Morrison, M. L.: Internal precision attachment
retainers for
partial dentures. J Am Dent Assoc 64:209, 1962.
19. Knowles,
L. E.: A dowel attachment
removable
partial
denture. J PROSTHET DENT 13:679, 1963.
20. McLeod, N. S.: A theoretical analysis of the mechanics of the
21.
22.
23.
24.
25.
26.
THOMPSON,
AND CAPUTO
intracoronal
retainer.
Reprint requeststo:
DR. F. JAMES KRATOCHVIL
UNIVERSITY OF CALIFORNIA
SCHOOL OF DENTISTRY
Los ANGELES, CA 90024
JULY 1981
VOLUME
46
NUMBER