TECHNICAL REPORT: PROSTHETIC MANUFACTURE
Assignment Sample

Abstract

This study has been conducted on the subject of prosthetics. The dental prosthetics or denture and various aspects about it have been selected. In the introductory section, the basic concepts and types of dentures have been stated. After that, the different aspects and the over view of partial denture have been discussed. The types of the partial denture along with the concept of bridge have also been included within this section. In the next part of the report, the indication and contraindications along with the use of different types of flanges have been discussed. The type of flange suitable for partial, complete and single tooth denture has been separately stated. The chromium cobalt denture has been discussed along with its advantage and disadvantages. The structure of the complete denture and the factors influencing g the structure has widely discussed. On the other hand, the different factors like physical, mechanical, physiological which are affecting the stability and retention of the denture has been discussed. Lastly all the findings have been represented shortly in the conclusion.

Table of content

Introduction	4
1. Designs to show understanding of a complete denture	4
2. Relies on different methods of retention	17
3. Compare and contrast two major connector types for a removable chrome partial denture 22	22
4. Legal and ethical factors and their impact	24
Conclusion	25
Reference list	27
Appendix 1: Special tray of complete denture	38

Introduction

Prosthesis is one of the most important inventions of science which provides supplement to the different human body parts which have got damaged or lost due to congenital defects, trauma, and accidents or due to disease. In medical science the wide use of prosthesis is noticed in order to enable the patient to lead a usual life style with both surgical and non-surgical application. Among different types of prosthesis, different types of dental prosthesis and its use in the medical context is most common. Additionally in the context of dental prosthesis, the use of different types of dentures is identified which includes full or complete dentures, partial, immediate, custom dentures and more. Denture is the type of prosthetic implant which is used as the best replacement for the missing teeth of the patient.

1. Designs to show understanding of a complete denture

Different aspects about partial denture and the structures have vividly been discussed. Now, this section is all about the complete denture. This is the oral prosthetics that provides the full artificial dentition of a complete arch. As informed by Shimodaira et al. (2018), the full or complete denture creates its primary impression over the residual ridge of mandible and maxilla, buccal sulcus, frena, functional labia, retromolar pad, hamular notch and more. Hence, the structure of a complete denture should be designed with care in order to keep the oral and extra oral parts unaffected.

The task of the complete denture is not only to provide a best substitute to the normal dentition of a patient but qalos have some other factors like providing support. As per the view of Kutkut et al. (2018), the main approach of a complete denture is to provide support, maintain stability and retention as well. This can also be considered as the major function of the complete denture. The structure of the full denture has a close relationship with that of aesthetics and facial impression of the patient. As per the idea of Alqattan, Alalawi & Khan (2016), the special tray of the complete denture have the role over the impression of the patient and this should be customized as the facial expression differs from person to person. In modern orthodontics, the special tray have been further classified into closed fitting and windowed special tray. (Refer to Appendix 1)

The windowed special tray is the dental impression of the patent is taken in the plaster and this type of special tray is specifically applied for the patient who has the issue of flabby ridge. On the other hand, as per the view of Hein et al. (2015), in the context of closed fitting one, the use of wax has not been included in the spacers to block the undercuts. The impression has been taken in the closed fitting type of special tray with the help of silicon.

On the other hand, in the structure of the complete denture, occlusal rim takes a major part. As stated by McLaughlin (2015), the occluding fabricated surface on the complete denture base which has the function in the retention of teeth and providence of support to the maxillomandibular region is represented as the occlusal rim. Moreover, this has the major task in the arrangement of the artificial teeth of the oral prosthetics. In many cases it acts as the denture base and gives support to the prosthetics.

The selection of the position of the occlusal rim is a main task of the dentists in the process of preparation of a suitable complete denture. As opined by Janeva, Kovacevska & Janev (2017), the dentist should select the RCP (retruded contact position), the patient having no teeth and intercuspal position should be selected in this context. The relation between rim and ridge is a major factor in the providence of comfort and proper impression to the patient who demands the support of the complete denture. A time span of one year is generally considered for the proper placement of the ocular rim with the ridge of the patient and the height of the rim is also managed with this time. In many cases the replacement or re-modification of the denture after a year is needed.

The relationship between the alignment of the teeth between the upper and lower arch of an individual influences the structure of the complete denture. This factor has been represented as occlusion. As commented by Manfredini, Lombardo & Siciliani (2017), occlusion is the contact between the teeth of the upper and lower arch, in dentistry. The normal alignment and the relationship of the dentition of the two archesare stated as occlusion but the abnormal alignment is represented as malocclusion. As per the idea of Zou et al. (2018), the malocclusion has been differentiated into three sub-categories which influence the structure of a full denture. As per the occlusion of the patient the denture is to be prepared. On the other hand, the correction of the malocclusion can also be done prior to the preparation of the denture. Type I malocclusion, the incisor teeth are involved which have created some misalignment in the dentition of the patient. As per the view of Bamba et al. (2016), in traditional type I malocclusion 2 mm overjet for the incisor is identified along with 2 mm overbite. However, there is no underbite observed at the posterior position of the dental arch. This is majorly identified as the hereditary factor and this modulates the jaw size and indirectly has a role in the determination of the facial impression of the patient. As opined by de Carli et al. (2016), the profile turns straight to convex and according to this factor the full denture is to be prepared. The lip competence of the patient is focused on the time of designing the full denture for the type I malocclusion patients.

In the context of the class II division II malocclusion, least overjet is noticed. As per the view of Souto et al. (2018), the central and lateral incisor of the maxilla is retroclinedfor this type. A vertical overbite is noticed for them along with sealed upper lip and perfect chin size. A squire appearance of the face is noticed with a prominent mental groove.All these factors should be kept unaltered in the structuring of the full dental prosthetics for these patients.

Type III malocclusion have an edge to edge alignment of the incisor tooth of the patient which provides the chance of crowding and crossbite. As per the view of He et al. (2017), a smaller maxilla is noticed which provides little space for denture bearing in this case. On the contrary, as per the idea of Liu et al. (2018), another type of skeletal structure is identified in type III malocclusion which provides very small frankfort-mandibular angle. This provides some opportunity in the retention of the upper denture due to large mandible and helps in prognosis. In the structuring of the full denture, the factor of neutral zone in the oral cavity should be kept in mind. As per the view of Longhini et al. (2017), the combined force of tongue and cheek is necessary for the management of the stability of the full denture. In the absence of the said force the denture can be displaced due to the other force created by the musculateral system. Muscles have greater influence in the maintenance of stability of the full dental prosthetics within the mouth of the patient.

Figure 1: Full denture and the muscles associated with it

The muscular position like intercuspal position controls theretention and activity of the denture in the mouth. As per the view of Santos et al. (2016), the horizontal as well as vertical position of the mandible within which the major occlusion contact takes place is represented as the intercuspal position. This vertical and horizontal position helps in the upliftment of the mandible from rest and this takes place with a balanced muscular activity. Hence, it is stated for the user of the full denture that, the intercuspal and muscular position should coincide. On the other hand, Komagamine et al. (2019), informs that the muscles like capsule, elevator and depressor muscles helps active and passively in the maintenance of the denture in its proper position. The air pressure also has passive role for the full denture user, to keep then denture retended.

In the design of the complete denture, the fact of free air space should be managed. As stated by Abdullah, Cui & Hendaheva (2017), in the case of a denture which does not allow the free air space, creates fatigue to the elevator muscles and creates pain for the patient. The muscle should feel an excessive load and the normal resting length of the elevator muscle get hampered. Hence, the orthodontist should manage this issue with care to provide comfort to the patient. In the providence of the major free airspace the appearance of the patient along with the masticator effectiveness get adversely affected. Hence, OVD (Occlusal vertical dimension) and RVD (Rest vertical dimension) should not be modified in the structuring of the full denture.

Overview of partial denture designs

The basic idea and introduction has already been provided in the upper section about denture. Moreover, the types of denture have been stated. Now, this section of the study has its prior focus on the division of partial denture. As opined by Sailer et al. (2019), the basic concept of partial denture is a plate of gum like structure over which the false teeth are fixed. Further asinformed by Mühlemann et al. (2019), the partial denture may be removable and have clasps to keep the entire structure in proper position within the mouth of the patient. This has been considered as one of the simplest processes to utilise dental prosthetics andcan be operated by the patient. As per the comments of Heintze et al. (2018), in the case of the removable partial denture, no surgical program is needed for the use and has been identified as least invasive for the patient.

Partial denture has some other functions than that of only providing an effective substitute to the missing teeth. Sailer et al. (2019) informs that in major cases, a shift of the dental position has been noticed for patient due to several reasons like pressure over the dental set in regular manner, any dental surgery, infection and tooth breakage or loss and more. Now, partial denture provides support to this orthodontic issue. As per the idea of Brandt et al. (2019), both in the upper and lower jaw, the partial denture may be used and it provides support to the other natural teeth of the patient from changing position. This is the major advantage of the use of partial denture

The application of FPD (Fixed Partial Denture) is also noticed in the context of orthodontic treatment. As opined by Mühlemann et al. (2019), FPD is the kind of artificially secured restoration of teeth along with the natural teeth of the patient which is not ready to remove. In this case, an advantage about the path of insertion has been noticed. As per the view of Heintze et al. (2018), FPD uses a single path of insertion for more than one tooth which is not possible for the individual fixation of teeth as they do not prefer the same path for the insertion.

As informed by Suzuki et al. (2016), hamular notch is the junction of the maxilla and the denture is designed on the basis of that notch. Additionally, the use of cast clasp has been noticed for the patients whose dental condition demands extra support to the coronal zone. The partial denture can be used as an immediate denture or in the context of temporary denture where the patient is unable to take the permanent denture.

The application of the bridge concept has been applied in the context of partial denture. As per the suggestion of Reich et al. (2017), fixed bridge is the best solution for the patients who have lost two or more consecutive teeth having natural teeth at both the ends. As commented by Kang & Lee (2016), Maryland bridge is the better option than that of the fixed bridge to maintain the oral health. However, this has also been sometimes rejected in the aesthetics ground.

Explanation

The discussion till now has addressed the overview and different attributes about the designs of partial denture. In the same context the different issues related to the flange design have been stated. Hence, now it is clear that the flange design have greater relationship with that of the comfort of the patient.

The immediate denture has been further differentiated into socket fit and flanged denture. As per the view of Tôrres et al (2019), socket fit denture is generally flangeless which and in many cases it provides looser fit to the patient. Hence, the application of this type of immediate denture is related with that of patient’s comfort. However, the application of the socket fit denture is notices in the case of any swelling at the site of denture for the patient. The socket fit denture should continuously be worn by the patient before denture refitting for first time. The gingival tissue replacement is not needed for the socket fit denture which is a better option for the patient. On the other hand, it has been noticed that, socket fit is not suitable for the patients who have been edentulous for a prolonged time period like multiple years. However, for extraction patients, the application of socket fit is quite acceptable.

The contraindications and indications of flange design

Flange is the base of the denture which holds the artificial teeth. Hence, it is quite important to design a firm flange keeping the factor of comfort at the back of the mind for every type of denture. As per the views of Elmorsy et al. (2015), the different types of flanges are used which includes, labial flange, flangeless denture and partial flange. All these classes of flange have their specific indications and contraindications, which are generally analysed by orthodontists prior to use in the practical context.

Labial flange or completeflange

This is a specific type of flange design utilised for the dental prosthetics designing. As per the view of Bidra, Manzotti & Wu (2018), the application of the labial flange has been noticed for the maxillary denture in the context of partial denture. This type of flange has both indication and contraindication. As per the suggestion of Bidra et al. (2018), the labial flange sometimes causes irritation and cut which invokes discomfort to the patient. Additionally, in many cases, the complaint in the aesthetics ground have beenidentified for labial flange. Hence, these can be taken under the contraindications of this flange.

On the other hand, the indication of labial flange has been identified as it provides a firm support to the denture. Hence, the stability of the detruire gets enhanced with the application of this type of flange.As per the view of Joseph et al. (2015), the healing of the tissue is possible as labial flange provides covering over the same. Additionally, the lip activity remains unaltered due to the thin flange structure which is very much essential to maintain the normal activity of the mouth.

Partial flange

The use of partial flange is also identified in the context of immediate dentures. As per the idea of Bukhari & Jambi (2018), the partial flange extended with acrylic can be placed directly within the patient’s mouth and have the capacity to maintain the aesthetics value and healing as well. Hence, from this viewpoint, this is a major indication of the partial flange. Additionally, no alveolectomy are needed to modify the structure of alveolar bone. As opined by Nallaswamy (2017), in the case of undercut at the buccal and labial portion of the residual ridge the partial flange design can be used and it acts as a surgical splint. Hence, this is another indication of partial flange.

Figure 2: partial flange

On the other hand, certain contraindications are also pointed out. As per the idea of Çilingir (2016), the multiple corrective processesare needed for a suitable denture formation with partial flange structure which is not at all suitable from the economic point of view. This is the contraindication of this flange type. Additionally, the activity of the lip-line sometimes gets unusual which creates discomfort for the users.

In such kind of situation four anterior teeth are replaced in a bounded saddle where the patient requires both laterals and centrals. According to Doolittle (2017), flange design plays an important role for the success of removable partial dentures. Undercuts, aesthetics, residual ridges influence the design. These factors are basically interrelated to treat the situation because there is a probability that the remaining supporting tissues can be affected by partial denture.

Flangeless or open denture

The flangeless denture is also known as open denture which has been identified as the most easy to construct and use as well. As per the suggestion of Stephen, Sudeep & Dinesh (2017), no surgical programme is needed to use prepare the patient for the use of open denture. Moreover, in case of undercuts in the buccal zone, dentists generally use the flangeless dentures. It is also recommended as the least invasive process of denture use asalveoplasty is not demanded. The normal activity of the lip line may be managed with the use of flangeless open denture.

On the other hand, certain contraindications have been noticed among which the use of adhesive is prior to be mentioned. The use of adhesive is done in order to manage the problem of retention. Additionally, due to lack of a firm flange, the contour of residual ridge (anterior) may appear uneven. This should also be considered by the partitioning orthodontist before using for a patient.

Design most suitable for complete, partial anterior and single tooth denture

A complete denture is most widely used prosthetics in the practical field of dentistry. This provides the ultimate substitute for the total dentition of an individual. As opined by Özkan (2018), the complete denture also determines the oral and extra oral contour of the patient which includes vermilion border, philtrum, nasolabial angle, Sulcus and more. On the other hand, the structure of flange has contribution in the maintenance of the facial and oral contour. Hence, from this point, the utilisation of the complete flange will be the best suitable. More number of teeth is associated with the complete denture which can invoke an issue of retention. From this point of retention, complete flange is best choice.

On the other hand, the partial denture is focused over a part of the entire dentition of the patient. As per the idea of Özkan (2018), less number of false teeth is associated with partial denture for both anterior and posterior part of both maxilla and mandible which has effectively been represented by Kennedy classes. Hence, in this case, partial flange is the best option to provide the patient comfort and manage the aesthetic level.

The loss of single tooth is one of the common cases in dentistry. The substitution of the single tooth with the application of denture is also another common practice. As opined by Çilingir (2016), denture is the most viable solution for the replacement of one or more than one tooth. The loss of single tooth is generally managed with the application of immediate partial denture. A partial denture which is removable is used in this context. Osseo-integrated tooth is the best option for the use in long term but, it takes time for preparation and the fixation as well. Hence, the application of immediate partial denture is the quicker solution in case of loss of single or two to three teeth. Bukhari & Jambi (2018) suggested that, partial flange provides better support in the context of retention of artificial tooth than that of flangeless denture. In case of the single tooth, the retention may be an issue which can be managed with the application of the partial flange structure.

Cobalt chromium denture

The use of metal denture is also another practice in the field of dental prosthesis which helps the patient to get an alternative for the acrylic or glass denture. As opined by Kümbüloğlu et al. (2018), the alloy of the metals like cobalt and chromium is used to produce this type of dentures and due to this reason, these dentures are commonly represented as chrome or cast metal denture. The patients having problem or allergy to the plastic or acrylic denture, moves to the best alternative of chrome denture. The clasps are stronger than that of the dentures made out of other materials. As opined by Abd-Elrahman et al. (2016) the combination of cobalt and chromium offers the perfect balance of strength and flexibility for the patients. Hence, from this point, the use of chrome denture is worthy enough.

On the other hand, this type of dentures has certain disadvantages which can create an issue for the users. As opined by Campbell et al. (2017), the revival of the prior form is quite impossible for the chrome denture in the issue of bent. Hence, from this point the management and maintenance of this type of denture is problematic. Moreover, it creates a cost issue for the issue for its expensive process of structuring. Hence, chrome denture is not affordable for all.

On the opposite view, a number of advantages have also been noticed for the metal dentures. As per the view of Mercieca et al. (2018), thin and lightness of the cobalt chromium alloy along with optimal strength turns the denture perfectly suitable for the use. Moreover, this type of denture keeps the palate open which offers the users to get a taste of the food better, than that of acrylic denture. The retention capacity of this prosthetic is also better than that of other dental prosthetics and no issue related to aesthetics hinders the normal look of the patient.

The cobalt-chrome is used in two ways in the dental prosthetics. Firstly, metal is used in the baser over which the artificial teeth are fixed. Secondly metal is used in the minor connector of a denture.

2. Relies on different methods of retention

The retention of dental prosthetics of the patient is modulated by certain factors which include physical, anatomical, mechanical and physiological factors as well. All these factors should be managed in order to maintain the stability of the denture within the mouth of the patient.

Minor connector

Minor connector has an important role in the case of retention. As per the idea of (), minor connector takes the linking role between the major connector and the base of the removable partial denture. Actually, in a partial denture (removable), all the other parts of the denture is connected with the major connector by means of the minor connector. Hence, the retention and maintenance of the denture is dependent over the minor connector. The minor connectors have been differentiated into different types like surface, base retention mechanism, embrasure and proximal as well. The clasp and the major connector are attached with minor connector along with the saddle area. Additionally, it helps to locate the clasp position more accurately.

Figure 3: Minor connector

Extra coronal retention

Direct retainers can be classified into two forms intracoronal and extracoronal. As per the views of Mohamed (2017), it is observed that the precision and semi-precision phase under intracoronal are of different nature than extracoronal attachments and clasps. Clasps are mainly segmented into types such as occlusal and gingival. Likewise, the circumferential clasp acts as the retention arm whereas the reciprocating arm acts as the bracer that is usually followed by a proximal plate. Moreover, the functional requirements of clasp lie in the form of retention, support, stability, passivity, encirclement and reciprocation. In addition to that, support can be denoted as the quality of clasp that suggests the way the teeth are in rested position. In specific terms, the the extra coronal retainers are classified across supra bulge clasps, infrabulge clasps and combination clasps.

Anatomical

The anatomical factors have a close relationship with that of the retention of the denture. In the context of the complete denture, this factor is maintained with more consciousness. As per the idea of Tôrres et al. (2019), the shape, size and bearing area of the denture is mostly related with the anatomical factor of denture retention. The inappropriate shape always creates major discomfort within the oral cavity of the patient which further hampers the stability of the denture. On the other hand, the area of retention of the denture is very much essential for both the arch which also determines the stability of the denture.

Physical

The physical factors for the maintenance of the stability of denture are also very important. As per the idea of Gill et al. (2017), the adhesive and cohesive force within the human oral cavity along with the action of normal surface tensionhelps the denture to be placed at its proper position. The attraction between the mplecul;es which are dissimilar to each other is expressed as adhesive force. As per Fallahi et al. (2018), the adhesion between the salivary molecule and acrylics of the denture flange is noticed which provides a witting effect to the denture and the mucous membrane. In the case of the patient with the complications of Xerostomia, the lack of salivary flow in the mouth is noticed. This may create an ulceration and tissue aberration within the mouth due the use of denture.

Figure 4: Adhesive and cohesive force in Pressure

On the other hand, cohesion is the attraction between the similar molecules which has been noticed in the salivary filmcreated due to the use of the denture.Additionally, the cohesive force creates a meniscus with saliva and invokes the factor of surface tension. It has been noticed that low meniscus provides better retention. As per Joseph et al. (2016), wax denture creates larger meniscus. This invokes a retention issue which should be replaced with other material like acrylic. The salivary viscosity is another factor which supports during eating. The greater viscosity and narrow flow of saliva creates better retention of the denture.

Figure 5: Surface tension in denture

Mechanical

The mechanical factor encompasses certain sub-factors like rotation insertion, undercut, and parallel path and more. The complete denture sometimes creates mechanical force over the undercut, which turns to afact of discomfort for the endentoulus patients.As per Janeva, Kovacevska & Janev (2017), with a single insertion, a number of teeth can be placed in case of both the partial and full denture which helps the patient. The rotational insertion path of the denture always provides a better retention and support to the gum of the patient.

Physiological

The physiological factors are something most important for the retention of the oral prosthetics. As opined by Luthra et al. (2015), the control of the muscle and get the pressure over the nerve points is the major factor which determines the physiological comfort of the patient. The neutralization of the muscle force along with the concave shape of the denture helps in the retention. The border seal helps to keep the prosthetics in its proper position. In many cases tissue prevents the vertical displacement of the denture which also helps in the time of oral functions.

3. Compare and contrast two major connector types for a removable chrome partial denture

In the partial denture, the connection between the two removable prostheses is highly important and this job is conducted by the major connectors of denture. All the parts of partial dentures are connected with either indirectly or directly by means of the major connector. The functions like unification, cross arc stabilization are performed by the major connectors. In the case of partial chrome denture, the connector varies from one another. This types includes

• Single palatal bar
• Single palatal strap
• U-shaped palatal connector
• Anterior-posterior palatal bar
• Combination anterior and posterior palatal strap-type connector.
• Palatal plate-type connector.
• Lingual bar, sublingual bar, lingual plate, labial bar

The lingual bar is mainly utilized in case of the dentures for mandible position. The shape is flat for the tissue side and confect for the side which is in the contact with the tongue. As per the idea of Camacho et al. (2018), the size depends upon the occluso-gingival shape and width of an individual. However, it has been noticed that approximately 4 to 6 mm in width is noticed for lingual bar On the contrary, this cannot be used for the patient with high lingual freanum but otherwise it is widely accepted in the denture.

Figure 6: Lingual bar

The indication of lingual bar suggests that this type of connector is suitable for the patients with sufficient space between gingival tissue (lingual) and the alveolar lingual sulcus. However, the crisis gets created in the time of elevation of mouth’s floor during oral function. Moreover, the normal anterior dentition gets tilted lingulaly. However, cingulm bar can be used as a major connector for mandible denture

On the other hand, in the maxillary denture, u-shaped pallet connector is a notable one. It is known as horse shoe connector and is less frequently used without utter necessity but it has higher flexibility. In spite of being a poor connector, in the case of the patients who have resistance towards the hard palate of denture, this type of connector can be utilized. In case of maxillary denture, palatal bar is used as a major connecter which can be made up of metal. This has also been used in the interim of partial denture. However, it has a limitation in the providence of artificial tooth for 2 to 3 teeth loss. This has been managed with the application of palate strap as a major connector. In this case also large palatal coverage is a major disadvantage. Horse shoe palate strap may be used in this context.

4. Legal and ethical factors and their impact

Legal and ethical factors largely contribute to the treatment of dental issues that requires denture implantation. Legal factors limit the application of the denture practice in a severe manner. On the other hand, the ethical issues lie in disagreement with treatment modalities as well as clustering of various dental clinics. In relation to that, the five elements that are ethically and legally associated with the construction of both complete and partial denture are addressed below:

Clustering of dental clinics

It is observed that the clustering of the dental clinic has played a major role in limiting the denture practices in an effective manner. Likewise, the dental clinics saturated have plagued the practices in a significant way that has ensured strict law in the application of providing the construction of complete and partial denture.

Required consent from patients

Patient consent has been poor in terms of dental checkups that have lead to negative impact over the association of the application of denture treatment.

Poor managed consent process

Hospitals as well as private clinics have failed to manage the way in which denture treatment should be done. In relation the legal documentation has lacked valid inputs from the side of doctors.

Increased cost

Cost has played a major role in manipulating the treatment across various demographics. Similarly the variation across cost for the same treatment has generated ethical issues with no legal bindings.

Competence and illegitimate operations

Operating in a legitimate manner has been a major issue as some of the medical associates have just focused on implementing single denture or complete denture without any legal documentation. Collectively, stricter rules would ensure that legal and ethical factors are not able to limit the denture treatment.

Conclusion

At the final section of this report, it can be inferred that, denture is one of the most effective solutions invented by the study of prosthetics for the patients whose normal dentition has got disrupted. The substitute of artificial dentition is provided by denture which helps the patient to maintain the aesthetic appearance of the face along with chewing and eating. Both fixed and movable dentures are used in the context of orthodontics which have further been classified in various subdivisions like partial, complete, bridge denture and more. The partial denture has been classified in Kennedy class I, II, III and IV due to the structure and the number of the false teeth as well. On the other hand, flange is one of the most important factors for the structuring of the denture. The complete, partial and flangeless denture is available which have respective indication and contraindication as well. The complete flange always provides better retention and support but in many cases it creates pain for undercuts and creates aesthetics issue from the point of appearance. This factor is not associated with the flangeless denture but it may create in the issue of firmness and retention as well. The metal denture is also quite popular in the practical field of orthodontics and this is made out of the alloy of chromium and cobalt. In the case of the complete denture the special plate and malocclusion plays major role in the determination of the structure of the denture for the individual patient. On the other hand, the fact of free air space and muscular movement should be kept unaltered in order to provide better comfort for the user of the complete denture. The difference between the chrome denture and non metallic denture has been identified in this study. The application of cast metal in prosthetics is done due to its light weight along with better strength. However, in the case of partial flange the application of metal denture is noticed than that of full denture.

Reference list

Abd-Elrahman, I. A., Helal, M. A., Saqar, H. M., & Abas, M. (2016). Evaluation of fatigue resistance of acetal resin and cobalt–chromium removable partial denture clasps. An in-vitro study: Part 1. J Dent Oral Care Med, 2(3), 304. Retrieved on 25 October 2019, from: https://pdfs.semanticscholar.org/5f14/d36bce729845b4524ca8c7e1463e41b59d06.pdf

Abdullah, M., Cui, J., & Hendaheva, R. (2017). Sigmoid perforation caused by dentures—A rare case report. International journal of surgery case reports, 41, 280-282. Retrieved on 25 October 2019, from: https://www.sciencedirect.com/science/article/pii/S2210261217305382

Alqattan, W. A., Alalawi, H. A., & Khan, Z. A. (2016). Impression techniques and materials for complete denture construction. Dent Health Curr Res 2, 1, 13-17. Retrieved on 25 October 2019, from: https://www.researchgate.net/profile/Zahid_Khan20/publication/304914862_Impression_Techniques_and_Materials_for_Complete_Denture_Construction/links/58426b1a08ae2d217561d9a0/Impression-Techniques-and-Materials-for-Complete-Denture-Construction.pdf

Bidra, A. S., Manzotti, A., & Wu, R. (2018). Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 2: Blinded Subjective Analysis. Journal of Prosthodontics, 27(1), 17-21. Retrieved on 25 October 2019, from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jopr.12621

Bidra, A. S., Zapata, G., Agar, J. R., Taylor, T. D., & Grady, J. (2018). Differences in lip support with and without labial flanges in a maxillary edentulous population. Part 1: Objective analysis. Journal of Prosthodontics, 27(1), 10-16. Retrieved on 25 October 2019, from: https://onlinelibrary.wiley.com/doi/abs/10.1111/jopr.12614

Appendix 1: Special tray of complete denture