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유리단 국소의치에서 Suprabulge Clasp와 Infrabulge Clasp가 지대치 동요에 미치는 영향에 관한 연구

Effect of Suprabulge Clasp and Infrabulge Clasp on the Mobility of Abutment Teeth for Distal Extension Removable Partial Dentures

Abstract

Distal-extension removable partial dentures have long been implicated in the increase in mobility and the destruction of the supporting structures of the primary abutment teeth. Various clasping systems have traditionally been used to retain distal extension removable partial dentures, and other designs have been proposed to minimize torquing forces on the abutment teeth. Most recent studies investigating the effects of removable partial dentures on abutment teeth have been performed in it laboratory setting. Results obtained from in vitro research have given dentists insight into removable partial denture design, but laboratory test model cannot be constructed that simulates actual functional or parafunctiona1 movements and forces. The purpose of this study was to clinically evaluate the degree of tooth mobility produced by two clasping systems (suprabulge type and infrabulge type) used for distal extension removable partial dentures. Akers clasp and R.P.I. system were selected for the evaluation, and four patients required a distal extension removable partial denture on the mandibular arch were selected for participation in the study. Two partial dentures were constructed in the same condition expect the design of clasp. All abutments in the study were mandibular first or second premolars. Measurements of mobility were made with a research tool designed by $M\"{u}hlemann$. This instrument, periodontometer, measures tooth mobility in the mouth by means of a dial gauge accurated to 0.01mm when the tooth is stressed with a force meter. Lingual and buccal deflection of abutment tooth was measured using buccal and lingual pressure. The amount of force applied was 500gm. Tooth mobility tests were made at four key stages; 1. Before insertion of the first removable partial denture, baseline mobility was establsihed. 2. After wearing of the first prosthesis, measurement was made at weekly intervals for 4 weeks. 3. The removable partial denture was then taken from the patient, and tooth mobility was measured again at weekly intervals until the patient's established baseline mobility had returned. 4. The second prosthesis of different clasp design was worn for a month and evaluated in the same manner as the first. The sequence of placement of clasping system was alternated between patients. The following results were obtained from this study; 1. The mobility of abutment tooth increased during the initial stage of wear and returned to baseline mobility after removal of removable partial dentures. 2. The mobility of abutment tooth showed no difference between Akers clasp and I-bar clasp during the 4-week test period. 3. All teeth tested showed greater mobility toward the buccal than the lingual direction.

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