Abutment Analysis of Metallic Denture Frameworks in Mandibular Kenedy Class III Cases

Abutment Health and Occlusal Analysis of CAD-CAM and Conventional Metallic Partial Denture Framework in Mandibular Kenedy Class III Cases: A Randomized Cross Over Clinical Trial

This study is aimed to compare CAD/CAM (digitally fabricated) metallic partial denture frameworks to conventionally fabricated metallic partial denture frameworks in mandibular Kennedy class-III arches in terms of abutment health and occlusal analysis

Traditional metallic partial dentures with cobalt-chromium frameworks and clasps considered a reliable choice because they're affordable, durable and have a resistance to distortion. However, the fabrication of traditional metallic partial dentures involves several manual steps, like pouring of the stone casts, surveying the hard tissue and soft tissue undercuts to choose the best path of insertion, and meticulously waxing each component (major and minor connectors, rests, clasps, and denture base retainers) directly onto the cast. This hands-on process can result in some fabrication errors, which by in turn can increase the stresses on the teeth supporting the denture (abutments) and even other non-abutment teeth.

CAD/CAM technology is increasingly being used for the fabrication of metallic partial denture frameworks; it has been highlighting in several investigations. The workflow starts with an intra oral digital scan of the oral cavity, to generate a 3D digital model, that allows for electronic surveying. The metallic partial denture frameworks are then designed virtually using specialized software, after which a wax pattern is created by milling or rapid prototyping. Then the wax pattern would be casted conventionally into metallic partial denture frameworks. The key advantages are simplifying the fabrication process, enhance the accuracy of fit, and reduce the stresses on abutment teeth, significant time savings, and reduction of the potential errors inherent in traditional multi-step lab procedures

Inclusion Criteria:

• Patients with unilateral bounded saddles in the mandible (Kennedy class III).
• Opposing dentition is fully intact or restored.
• Sufficient inter-arch space.
• Angle's class I maxilla-mandibular relationship.

Exclusion Criteria:

• Periodontal affection of the abutment teeth.
• Skeletal mal-relation.
• Unmotivated patients to maintain adequate oral hygiene to follow up.
• Patients with neuromuscular and Psychiatric disorders.
• Systematic disease affecting bone and periodontal health.
• Insufficient inter-arch space.
• Patients with physical disabilities that could affect follow up.