Clinical Case Report Of RPD Repairing Dentition Defect With Different Clasp Design On Isolated Abutment

Background:Dentition defect refers to the absence of a different number of teeth in dentition,while there are still different numbers of natural teeth,often caused by severe dental caries,periapical disease and periodontal disease,which is one of the common oral diseases in the elderly.With the improvement of medical standards and quality of life,the aging of China's population is becoming more and more serious.According to the results of the fourth National Oral Health Epidemiological Survey,the incidence of dentition defects in the elderly population is still not optimistic,of which nearly 40%of the patients failed to repair in time,seriously affecting the oral function and quality of life of the patients.Therefore,in order to restore patients' normal oral function and improve their unpleasant condition caused by dentition defects,on the premise of detailed examination and full understanding of different patients' oral conditions,it is of great clinical significance to make full use of the remaining isolated teeth as abutments,set different types of clasps and use removable partial dentures(RPD)to repair different types of dentition defects.In the design of denture,how to make effective use of the remaining teeth,reasonably set the extension range of the support,retainer and base,and disperse the force,in order to reduce the burden of abutment teeth,maintain the long-term periodontal health of abutment teeth and prolong the service life of dentures has always been an important content of attention and research for oral clinical restorersObjective:To evaluate the clinical effect of repairing dentition defects with RPD designed with isolated teeth as abutments and the changes of health status of isolated abutments after restorationMaterials and Methods:Patients with dentition defects who were admitted to the Department of Prosthodontics of the affiliated Hospital of Stomatology,College of Stomatology of Dalian Medical University from June 2018 to June 2019 were selected for this study.All the cases of dentition defects in the study were finally repaired by RPD,and there were 10 cases with isolated teeth as abutment teeth,including 3 cases of maxilla and 9 cases of mandible,with a total of 18 isolated abutments,4 males and 6 females,the oldest was 84 years old,the youngest was 45 years old,the average age was 68 years old Through detailed specialist examination and adequate communication between doctors and patients,formulate a reasonable and feasible treatment plan for RPD restoration,design different clasps according to the specific conditions of isolated abutments,and finally complete the repair according to the clinical standard treatment process,teach patients to wear dentures and give oral health guidance to patients.The patients were followed up for 3 to 12 months.By examining and understanding the mobility and periodontal status of isolated abutments,and inquiring about the use of dentures after wearing,the clinical restoration effect of dentures with isolated teeth as abutments and the changes of health status of isolated abutments after restoration were evaluatedResults:When wearing the final denture,all the 10 patients could be placed smoothly,the base fitted well with the mucous membrane,the clasp retention was appropriate,the patients took off and wore it freely without pain,and the satisfaction was high.Three patients felt local tenderness and occlusal pain in the subbase mucosa after using the final denture for 1or 2 weeks,which was relieved after proper modification.After wearing the denture for 3 to 12 months,all the 10 patients had no subbase mucosal tenderness,good masticatory function,no loss during eating and speaking,no increase in the mobility of isolated abutment compared with that before restoration,and the periodontal condition was good.Conclusion:When designing removable partial dentures with isolated teeth as abutments,different types of clasps are designed for isolated abutments under different conditions and regions.Good retention and stability can be obtained after denture restoration,and the masticatory efficiency of patients can be improved.And the periodontal health of isolated abutments can be maintained.