Framework Adjustment

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Framework Adjustment
2
RPD Framework Fabrication

• Prepare Master Cast
• Place blockout in undercuts
• Below heights of contour
• Minor connector lingual plate embrasures
• Soft tissue undercuts (if necessary)

3
RPD Framework Fabrication

• Prepare Master Cast
• Place relief
• Under gridwork
• Over FGM
• Under mandibular major connector

4
RPD Framework Fabrication

• Duplicate Master Cast
• Refractory material
• Withstand casting temperature
• Wax-up framework using design on secondary cast
  or paper equivalent
• Prefabricated patterns

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RPD Framework Fabrication

• Invest Refractory Cast
• Burnout wax
• Cast in a chrome cobalt or other alloy
• Finish polish
• Return to dentist

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Partial Denture Framework Adjustment

• Rudd Kuebker
• 75 of frameworks dont fit perfectly
• Active - orthodontic movement
• Adjust to make passive

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Partial Denture Framework Adjustment

• Adjust without denture base
• Adjust soon after fabrication
• Prevent tooth migration

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Preclinical Inspection

• Check accuracy of the framework as designed

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Preclinical Inspection

• Framework should fit master cast
• If it does not, probably will not fit intraorally

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Framework Evaluation

• Replace framework on master cast as little as
  possible
• Prevent abrasion (in case of remake)

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Pre-clinical Inspection

• Rest seats should be fully seated

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Pre-clinical Inspection

• Contacting Cast
• Retentive
• Reciprocal arms,
• Proximal plates
• Superior portion of lingual plates
• All maxillary major connectors

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Pre-clinical InspectionFramework Proportions

• Major minor connectors
• Adequate distance from abutments (hygiene)
• Proper proportions (rigidity, hygiene)
• Adjust or have lab adjust or remake framework

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Pre-clinical Inspection

• Minor Connectors
• Butt joint junction slightly undercut for acrylic
  resin
• 1mm gridwork relief

15
Direct Retainers

• Clasps have uniform taper

No Taper
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Finish and Polish

• Highly polished
• No pits, nodules, scratches
• No sharp edges - injure mucosa

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Framework Adjustment

• Reduction
• Heatless Stones
• Diamond burs
• Brasseler E-Cutter burs
• Coarse stones
• Shofu coral stones
• Carborundum disks

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Framework Adjustment

• Polish
• Carborundum points wheels
• Final polish - Shofu brown green points
• Use care!

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Clinical Adjustment

• Incomplete seating
• Usually binding on abutments
• Use an indicating medium

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Indicating Medium

• Aerosol Sprays (Occlude)
• Disclosing Wax
• Silicone

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Two DimensionalIndicating Medium

• Occlude
• Thin accurate
• Not easily displaced
• Can dissolve in saliva
• Difficult to remove
• Cant tell how far from seating

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Three DimensionalIndicating Medium

• Disclosing Wax
• Sets immediately
• Inexpensive
• Shows how far from seating
• Can stick to teeth
• Can be distorted

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Adjustment with Disclosing Wax

• Adjust areas of significant burn-through
• Completely remove wax with metal particles
• Repeat until full seating

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Adjustment with Silicone Indicating Medium

• Three dimensional
• Minimal distortion
• More expensive
• Sets relatively slowly ( 2 min)
• Can tear or pull off the framework

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Adjustment with Silicone Medium

• Use minimal amount (expense)
• Cover all components contacting the abutments
• Mark contacts with dampened red pencil
• Remove silicone material
• Adjust marked areas

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Framework Adjustment

• Initial Assessment
• How does the framework feel?
• No pulling or wedging
• Active engagement of abutment teeth
• Overall comfort of the framework

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Framework Adjustment

• Place indicating medium
• Align the framework
• Place pressure over rests
• No pressure over gridworks
• Check for burn-through
• Repeat

x
x
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Framework Adjustment

• Areas of abrasion on master cast may indicate
  areas of binding

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Cautious Adjustment

• Differentiate between normal abnormal contacts
• Guiding planes
• normal long vertical areas of contact
• broad areas of severe burn-through may indicate
  binding

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Cautious Adjustment

• Avoid excessive force - bending
• Heat generation could melt the acrylic
• Retentive tip of direct retainers
• normal burn-through
• eliminate active clasp retention

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Ensure complete seating

• Most common interferences
• Under rests
• Rigid portions of direct retainers
• Interproximal portions of lingual plates
• Interproximal minor connectors
• Shoulder areas of embrasure clasps

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Finalizing the adjustment

• Medium - thin even layer
• Greyish hue from underlying metal
• Seating
• No grating or snapping
• Gliding sensation
• Approximately 20 minutes

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Soft Tissue Impingements

• Pressure-indicating paste
• Thin layer with streaks
• Place with moderate pressure

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Soft Tissue Impingements

• Pressure-indicating paste
• Relieve areas of burn-through
• Remaining streaks indicates no contact
• Maxillary major connectors - broad even palatal
  contact

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Remake Poor Castings

• Determine if casting fits similarly on the cast
  and intraorally
• If not, final impression inaccurate
• Make new impression

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Framework Occlusal Adjustments

• Fabricated on unmounted casts
• Occlusal interferences usually present
• Occlusal vertical dimension should be unchanged
• Centric and eccentric contacts should be
  identical with or without the framework

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Framework Occlusal Adjustments

• Highly polished metal
• Articulating paper marks poorly
• Check opposing occlusal contacts
• Slightly roughen framework with air abrasive or
  rubber impregnated abrasive

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Opposing Frameworks

• Adjust individually
• Then adjust together
• Eliminate interferences between the frameworks

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Occlusal Rest Thickness

• If 1.5 mm after adjustment
• Subject to fatigue
• Possible fracture
• May require additional tooth preparation and
  remake
• Last resort - occlusal reduction of opposing teeth

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Interferences on Retentive Arms

• Minor interference
• Reduce opposing cusp - last resort
• Heavy contact
• Lower height of contour, remake
• Dont relieve
• Alters flexibility and fracture resistance

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Physiologic Relief

• Class I II w. long g.p
• Normally shorter guiding planes
• Triangular space below height of contour
• Allow for release
• Tipped teeth may only provide for long guiding
  planes (low h of c)

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Physiologic Relief

• Distal Extension Cases
• Guiding planes, minor connectors lingual plates
  coated with rouge
• Framework is placed under hyperfunction by
  pressing over the gridwork

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Physiologic Relief

• Relieve burn-through
• Until burn-through occurs only on the occlusal
  one third of the guiding planes

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Physiologic Relief Alternative

• Prescribe 1 relief
• OR
• Use physiologic relief, not both