Framework Adjustment. RPD Framework Fabrication Prepare Master Cast –Place blockout in undercuts -Below heights of contour -Minor connector & lingual

Framework AdjustmentFramework AdjustmentFramework AdjustmentFramework Adjustment

RPD Framework RPD Framework FabricationFabrication


Prepare Master Prepare Master CastCast–Place blockout Place blockout in undercutsin undercuts-Below heights of Below heights of contourcontour

-Minor connector Minor connector & lingual plate & lingual plate embrasuresembrasures

-Soft tissue Soft tissue undercuts (if undercuts (if necessary)necessary)

Prepare Master Prepare Master CastCast–Place blockout Place blockout in undercutsin undercuts-Below heights of Below heights of contourcontour

-Minor connector Minor connector & lingual plate & lingual plate embrasuresembrasures

-Soft tissue Soft tissue undercuts (if undercuts (if necessary)necessary)



Prepare Master Prepare Master CastCast–Place reliefPlace relief

-Under gridworkUnder gridwork-Over FGMOver FGM-Under mandibular Under mandibular major connectormajor connector

Prepare Master Prepare Master CastCast–Place reliefPlace relief

-Under gridworkUnder gridwork-Over FGMOver FGM-Under mandibular Under mandibular major connectormajor connector



•Duplicate Master CastDuplicate Master Cast–Refractory materialRefractory material

- Withstand casting temperatureWithstand casting temperature- Wax-up framework using design Wax-up framework using design on secondary cast or paper on secondary cast or paper equivalentequivalent

- Prefabricated patternsPrefabricated patterns

•Duplicate Master CastDuplicate Master Cast–Refractory materialRefractory material

- Withstand casting temperatureWithstand casting temperature- Wax-up framework using design Wax-up framework using design on secondary cast or paper on secondary cast or paper equivalentequivalent

- Prefabricated patternsPrefabricated patterns

RPD Framework RPD Framework Fabrication Fabrication RPD Framework RPD Framework Fabrication Fabrication

•Invest Refractory CastInvest Refractory Cast–Burnout waxBurnout wax–Cast in a chrome cobalt Cast in a chrome cobalt or other alloyor other alloy

–Finish & polishFinish & polish–Return to dentistReturn to dentist

•Invest Refractory CastInvest Refractory Cast–Burnout waxBurnout wax–Cast in a chrome cobalt Cast in a chrome cobalt or other alloyor other alloy

–Finish & polishFinish & polish–Return to dentistReturn to dentist

Partial Denture Framework Partial Denture Framework AdjustmentAdjustment


•Rudd & KuebkerRudd & Kuebker–75% of frameworks don’t 75% of frameworks don’t fit perfectlyfit perfectly

–Active - orthodontic Active - orthodontic movementmovement

–Adjust to make passiveAdjust to make passive

•Rudd & KuebkerRudd & Kuebker–75% of frameworks don’t 75% of frameworks don’t fit perfectlyfit perfectly

–Active - orthodontic Active - orthodontic movementmovement

–Adjust to make passiveAdjust to make passive



•Adjust without denture Adjust without denture basebase

•Adjust soon after Adjust soon after fabricationfabrication–Prevent tooth migrationPrevent tooth migration

•Adjust without denture Adjust without denture basebase

•Adjust soon after Adjust soon after fabricationfabrication–Prevent tooth migrationPrevent tooth migration

Preclinical InspectionPreclinical InspectionPreclinical InspectionPreclinical Inspection

•Check accuracy of the Check accuracy of the framework as designedframework as designed

•Check accuracy of the Check accuracy of the framework as designedframework as designed

Preclinical InspectionPreclinical InspectionPreclinical InspectionPreclinical Inspection

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

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

Framework EvaluationFramework EvaluationFramework EvaluationFramework Evaluation

•Replace Replace framework on framework on master cast as master cast as little as little as possiblepossible

•Prevent Prevent abrasion (in abrasion (in case of remake)case of remake)

•Replace Replace framework on framework on master cast as master cast as little as little as possiblepossible

•Prevent Prevent abrasion (in abrasion (in case of remake)case of remake)

Pre-clinical Pre-clinical InspectionInspection


Rest seats should be fully seated Rest seats should be fully seated Rest seats should be fully seated Rest seats should be fully seated



Contacting Cast:Contacting Cast:–RetentiveRetentive–Reciprocal arms, Reciprocal arms, –Proximal platesProximal plates–Superior portion of lingual Superior portion of lingual plates plates

–All maxillary major All maxillary major connectors connectors

Contacting Cast:Contacting Cast:–RetentiveRetentive–Reciprocal arms, Reciprocal arms, –Proximal platesProximal plates–Superior portion of lingual Superior portion of lingual plates plates

–All maxillary major All maxillary major connectors connectors

Pre-clinical InspectionPre-clinical InspectionFramework ProportionsFramework Proportions

Pre-clinical InspectionPre-clinical InspectionFramework ProportionsFramework Proportions

• Major & minor Major & minor connectorsconnectors–Adequate distance Adequate distance from abutments from abutments (hygiene) (hygiene)

–Proper proportions Proper proportions (rigidity, hygiene)(rigidity, hygiene)

–Adjust or have lab Adjust or have lab adjust or remake adjust or remake frameworkframework

• Major & minor Major & minor connectorsconnectors–Adequate distance Adequate distance from abutments from abutments (hygiene) (hygiene)

–Proper proportions Proper proportions (rigidity, hygiene)(rigidity, hygiene)

–Adjust or have lab Adjust or have lab adjust or remake adjust or remake frameworkframework



•Minor ConnectorsMinor Connectors–Butt joint junction Butt joint junction slightly undercut slightly undercut for acrylic resinfor acrylic resin

–1mm gridwork relief 1mm gridwork relief

•Minor ConnectorsMinor Connectors–Butt joint junction Butt joint junction slightly undercut slightly undercut for acrylic resinfor acrylic resin

–1mm gridwork relief 1mm gridwork relief

Direct RetainersDirect RetainersDirect RetainersDirect Retainers

•Clasps have uniform Clasps have uniform tapertaper

•Clasps have uniform Clasps have uniform tapertaper

No TaperNo Taper

Finish and PolishFinish and PolishFinish and PolishFinish and Polish

•Highly polished Highly polished •No pits, No pits, nodules, nodules, scratchesscratches

•No sharp edges No sharp edges - injure mucosa- injure mucosa

•Highly polished Highly polished •No pits, No pits, nodules, nodules, scratchesscratches

•No sharp edges No sharp edges - injure mucosa- injure mucosa


•ReductionReduction–Heatless StonesHeatless Stones–Diamond bursDiamond burs–Brasseler E-Brasseler E-Cutter bursCutter burs

–Coarse stonesCoarse stones- Shofu coral Shofu coral stonesstones

- Carborundum Carborundum disksdisks

•ReductionReduction–Heatless StonesHeatless Stones–Diamond bursDiamond burs–Brasseler E-Brasseler E-Cutter bursCutter burs

–Coarse stonesCoarse stones- Shofu coral Shofu coral stonesstones

- Carborundum Carborundum disksdisks


•PolishPolish–Carborundum Carborundum points & points & wheelswheels

–Final polish - Final polish - Shofu brown & Shofu brown & green pointsgreen points

–Use care!Use care!

•PolishPolish–Carborundum Carborundum points & points & wheelswheels

–Final polish - Final polish - Shofu brown & Shofu brown & green pointsgreen points

–Use care!Use care!

Clinical AdjustmentClinical AdjustmentClinical AdjustmentClinical Adjustment

•Incomplete seatingIncomplete seating•Usually binding on Usually binding on abutmentsabutments

•Use an indicating Use an indicating medium medium

•Incomplete seatingIncomplete seating•Usually binding on Usually binding on abutmentsabutments

•Use an indicating Use an indicating medium medium

Indicating MediumIndicating MediumIndicating MediumIndicating Medium

• Aerosol Sprays (Occlude)Aerosol Sprays (Occlude)• Disclosing WaxDisclosing Wax• Silicone Silicone

• Aerosol Sprays (Occlude)Aerosol Sprays (Occlude)• Disclosing WaxDisclosing Wax• Silicone Silicone

Two DimensionalTwo DimensionalIndicating MediumIndicating MediumTwo DimensionalTwo Dimensional

Indicating MediumIndicating Medium

•OccludeOcclude–Thin & accurate Thin & accurate –Not easily displacedNot easily displaced–Can dissolve in Can dissolve in salivasaliva

–Difficult to removeDifficult to remove–Can’t tell how far Can’t tell how far from seatingfrom seating

•OccludeOcclude–Thin & accurate Thin & accurate –Not easily displacedNot easily displaced–Can dissolve in Can dissolve in salivasaliva

–Difficult to removeDifficult to remove–Can’t tell how far Can’t tell how far from seatingfrom seating

Three DimensionalThree DimensionalIndicating MediumIndicating MediumThree DimensionalThree DimensionalIndicating MediumIndicating Medium

•Disclosing WaxDisclosing Wax–Sets immediatelySets immediately–InexpensiveInexpensive–Shows how far Shows how far from seatingfrom seating

–Can stick to Can stick to teeth teeth

–Can be distortedCan be distorted

•Disclosing WaxDisclosing Wax–Sets immediatelySets immediately–InexpensiveInexpensive–Shows how far Shows how far from seatingfrom seating

–Can stick to Can stick to teeth teeth

–Can be distortedCan be distorted

Adjustment with Adjustment with Disclosing Wax Disclosing Wax Adjustment with Adjustment with Disclosing Wax Disclosing Wax

•Adjust areas of Adjust areas of significant burn-significant burn-throughthrough

•Completely remove Completely remove wax with metal wax with metal particlesparticles

•Repeat until full Repeat until full seatingseating

•Adjust areas of Adjust areas of significant burn-significant burn-throughthrough

•Completely remove Completely remove wax with metal wax with metal particlesparticles

•Repeat until full Repeat until full seatingseating

Adjustment withAdjustment with Silicone Indicating MediumSilicone Indicating Medium

Adjustment withAdjustment with Silicone Indicating MediumSilicone Indicating Medium

• Three dimensionalThree dimensional• Minimal distortionMinimal distortion• More expensiveMore expensive• Sets relatively slowly (~ Sets relatively slowly (~ 2 min)2 min)

• Can tear or pull off the Can tear or pull off the frameworkframework

• Three dimensionalThree dimensional• Minimal distortionMinimal distortion• More expensiveMore expensive• Sets relatively slowly (~ Sets relatively slowly (~ 2 min)2 min)

• Can tear or pull off the Can tear or pull off the frameworkframework

Adjustment with Silicone Adjustment with Silicone MediumMedium

Adjustment with Silicone Adjustment with Silicone MediumMedium

–Use minimal amount Use minimal amount (expense)(expense)

–Cover all components Cover all components contacting the abutments contacting the abutments

–Mark contacts with Mark contacts with dampened red pencildampened red pencil

–Remove silicone materialRemove silicone material–Adjust marked areasAdjust marked areas

–Use minimal amount Use minimal amount (expense)(expense)

–Cover all components Cover all components contacting the abutments contacting the abutments

–Mark contacts with Mark contacts with dampened red pencildampened red pencil

–Remove silicone materialRemove silicone material–Adjust marked areasAdjust marked areas


•Initial AssessmentInitial Assessment•‘‘How does the framework feel?’How does the framework feel?’•No pulling or wedgingNo pulling or wedging

–Active engagement of abutment Active engagement of abutment teethteeth

•Overall comfort of the Overall comfort of the frameworkframework

•Initial AssessmentInitial Assessment•‘‘How does the framework feel?’How does the framework feel?’•No pulling or wedgingNo pulling or wedging

–Active engagement of abutment Active engagement of abutment teethteeth

•Overall comfort of the Overall comfort of the frameworkframework


Place indicating mediumPlace indicating medium–Align the frameworkAlign the framework–Place pressure over restsPlace pressure over rests–No pressure over No pressure over gridworksgridworks

–Check for ‘burn-through’Check for ‘burn-through’–RepeatRepeat

Place indicating mediumPlace indicating medium–Align the frameworkAlign the framework–Place pressure over restsPlace pressure over rests–No pressure over No pressure over gridworksgridworks

–Check for ‘burn-through’Check for ‘burn-through’–RepeatRepeat xx xx


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

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

Cautious AdjustmentCautious AdjustmentCautious AdjustmentCautious Adjustment

• Differentiate between Differentiate between normal & abnormal normal & abnormal contactscontacts

• Guiding planesGuiding planes– normal: long vertical normal: long vertical areas of contactareas of contact

– broad areas of severe broad areas of severe burn-through may burn-through may indicate bindingindicate binding

• Differentiate between Differentiate between normal & abnormal normal & abnormal contactscontacts

• Guiding planesGuiding planes– normal: long vertical normal: long vertical areas of contactareas of contact

– broad areas of severe broad areas of severe burn-through may burn-through may indicate bindingindicate binding

Cautious AdjustmentCautious AdjustmentCautious AdjustmentCautious Adjustment

•Avoid excessive force - bendingAvoid excessive force - bending•Heat generation could melt the Heat generation could melt the acrylicacrylic

•Retentive tip of direct Retentive tip of direct retainersretainers–normal: burn-throughnormal: burn-through–eliminate active clasp retentioneliminate active clasp retention

•Avoid excessive force - bendingAvoid excessive force - bending•Heat generation could melt the Heat generation could melt the acrylicacrylic

•Retentive tip of direct Retentive tip of direct retainersretainers–normal: burn-throughnormal: burn-through–eliminate active clasp retentioneliminate active clasp retention

Ensure complete Ensure complete seatingseating

Ensure complete Ensure complete seatingseating

Most common interferences:Most common interferences:–Under Under restsrests–Rigid portions of direct retainersRigid portions of direct retainers–Interproximal portions of Interproximal portions of lingual lingual platesplates

–Interproximal minor connectorsInterproximal minor connectors–Shoulder areas of embrasure claspsShoulder areas of embrasure clasps

Most common interferences:Most common interferences:–Under Under restsrests–Rigid portions of direct retainersRigid portions of direct retainers–Interproximal portions of Interproximal portions of lingual lingual platesplates

–Interproximal minor connectorsInterproximal minor connectors–Shoulder areas of embrasure claspsShoulder areas of embrasure clasps

Finalizing the Finalizing the adjustmentadjustment

Finalizing the Finalizing the adjustmentadjustment

• Medium - thin even layerMedium - thin even layer• Greyish hue from underlying metalGreyish hue from underlying metal• Seating Seating

– No grating or snappingNo grating or snapping– Gliding sensationGliding sensation

• Approximately 20 minutesApproximately 20 minutes

• Medium - thin even layerMedium - thin even layer• Greyish hue from underlying metalGreyish hue from underlying metal• Seating Seating

– No grating or snappingNo grating or snapping– Gliding sensationGliding sensation

• Approximately 20 minutesApproximately 20 minutes

Soft Tissue Soft Tissue ImpingementsImpingementsSoft Tissue Soft Tissue ImpingementsImpingements

•Pressure-Pressure-indicating pasteindicating paste–Thin layer with Thin layer with streaksstreaks

–Place with moderate Place with moderate pressurepressure

•Pressure-Pressure-indicating pasteindicating paste–Thin layer with Thin layer with streaksstreaks

–Place with moderate Place with moderate pressurepressure

Soft Tissue Soft Tissue ImpingementsImpingementsSoft Tissue Soft Tissue ImpingementsImpingements

•Pressure-indicating Pressure-indicating pastepaste–Relieve areas of Relieve areas of burn-throughburn-through

–Remaining streaks Remaining streaks indicates no contactindicates no contact

–Maxillary major Maxillary major connectors - broad connectors - broad even palatal contacteven palatal contact

•Pressure-indicating Pressure-indicating pastepaste–Relieve areas of Relieve areas of burn-throughburn-through

–Remaining streaks Remaining streaks indicates no contactindicates no contact

–Maxillary major Maxillary major connectors - broad connectors - broad even palatal contacteven palatal contact

Remake Poor CastingsRemake Poor CastingsRemake Poor CastingsRemake Poor Castings

•Determine if casting fits Determine if casting fits similarly on the cast and similarly on the cast and intraorallyintraorally

•If not, final impression If not, final impression inaccurate inaccurate

•Make new impressionMake new impression

•Determine if casting fits Determine if casting fits similarly on the cast and similarly on the cast and intraorallyintraorally

•If not, final impression If not, final impression inaccurate inaccurate

•Make new impressionMake new impression

Framework Occlusal Framework Occlusal Adjustments Adjustments

Framework Occlusal Framework Occlusal Adjustments Adjustments

•Fabricated on unmounted castsFabricated on unmounted casts•Occlusal interferences usually Occlusal interferences usually presentpresent

•Occlusal vertical dimension Occlusal vertical dimension should be unchangedshould be unchanged

•Centric and eccentric contacts Centric and eccentric contacts should be identical with or should be identical with or without the frameworkwithout the framework

•Fabricated on unmounted castsFabricated on unmounted casts•Occlusal interferences usually Occlusal interferences usually presentpresent

•Occlusal vertical dimension Occlusal vertical dimension should be unchangedshould be unchanged

•Centric and eccentric contacts Centric and eccentric contacts should be identical with or should be identical with or without the frameworkwithout the framework

Framework Occlusal Framework Occlusal AdjustmentsAdjustments

Framework Occlusal Framework Occlusal AdjustmentsAdjustments

•Highly polished metalHighly polished metal– Articulating paper marks poorly Articulating paper marks poorly

– Check opposing occlusal Check opposing occlusal

contactscontacts– Slightly roughen framework with Slightly roughen framework with

air abrasive or rubber air abrasive or rubber impregnated abrasiveimpregnated abrasive

•Highly polished metalHighly polished metal– Articulating paper marks poorly Articulating paper marks poorly

– Check opposing occlusal Check opposing occlusal

contactscontacts– Slightly roughen framework with Slightly roughen framework with

air abrasive or rubber air abrasive or rubber impregnated abrasiveimpregnated abrasive

Opposing FrameworksOpposing FrameworksOpposing FrameworksOpposing Frameworks

•Adjust individuallyAdjust individually•Then adjust Then adjust together together

•Eliminate Eliminate interferences interferences between the between the frameworksframeworks

•Adjust individuallyAdjust individually•Then adjust Then adjust together together

•Eliminate Eliminate interferences interferences between the between the frameworksframeworks

Occlusal Rest Occlusal Rest ThicknessThickness

Occlusal Rest Occlusal Rest ThicknessThickness

•If ≤ 1.5 mm after adjustment If ≤ 1.5 mm after adjustment – Subject to fatigueSubject to fatigue– Possible fracturePossible fracture

•May require additional tooth May require additional tooth preparation and remakepreparation and remake

•Last resort - occlusal Last resort - occlusal reduction of opposing teethreduction of opposing teeth

•If ≤ 1.5 mm after adjustment If ≤ 1.5 mm after adjustment – Subject to fatigueSubject to fatigue– Possible fracturePossible fracture

•May require additional tooth May require additional tooth preparation and remakepreparation and remake

•Last resort - occlusal Last resort - occlusal reduction of opposing teethreduction of opposing teeth

Interferences on Interferences on Retentive ArmsRetentive Arms

Interferences on Interferences on Retentive ArmsRetentive Arms

•Minor interference Minor interference –Reduce opposing cusp - last resortReduce opposing cusp - last resort

•Heavy contactHeavy contact–Lower height of contour, Lower height of contour, remakeremake

•Don’t relieve Don’t relieve –Alters flexibility and fracture Alters flexibility and fracture resistance resistance

•Minor interference Minor interference –Reduce opposing cusp - last resortReduce opposing cusp - last resort

•Heavy contactHeavy contact–Lower height of contour, Lower height of contour, remakeremake

•Don’t relieve Don’t relieve –Alters flexibility and fracture Alters flexibility and fracture resistance resistance

Physiologic Relief Physiologic Relief Physiologic Relief Physiologic Relief

•Class I & II w. long g.pClass I & II w. long g.p•Normally shorter guiding planesNormally shorter guiding planes

–Triangular space below height of Triangular space below height of contourcontour

–Allow for release Allow for release

•Tipped teeth may only provide Tipped teeth may only provide for long guiding planes (low h for long guiding planes (low h of c)of c)

•Class I & II w. long g.pClass I & II w. long g.p•Normally shorter guiding planesNormally shorter guiding planes

–Triangular space below height of Triangular space below height of contourcontour

–Allow for release Allow for release

•Tipped teeth may only provide Tipped teeth may only provide for long guiding planes (low h for long guiding planes (low h of c)of c)


•Distal Extension CasesDistal Extension Cases–Guiding planes, minor Guiding planes, minor connectors & lingual connectors & lingual plates coated with rougeplates coated with rouge

–Framework is placed Framework is placed under hyperfunction by under hyperfunction by pressing over the pressing over the gridworkgridwork

•Distal Extension CasesDistal Extension Cases–Guiding planes, minor Guiding planes, minor connectors & lingual connectors & lingual plates coated with rougeplates coated with rouge

–Framework is placed Framework is placed under hyperfunction by under hyperfunction by pressing over the pressing over the gridworkgridwork


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

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

Physiologic Relief Physiologic Relief AlternativeAlternative

Physiologic Relief Physiologic Relief AlternativeAlternative

•Prescribe 1° relief Prescribe 1° relief

OROR •Use physiologic relief, Use physiologic relief, not bothnot both

•Prescribe 1° relief Prescribe 1° relief

OROR •Use physiologic relief, Use physiologic relief, not bothnot both

Documents

Framework Adjustment. RPD Framework Fabrication Prepare Master Cast –Place blockout in undercuts -Below heights of contour -Minor connector & lingual