METAL FRAMEWORK

TRY-IN IN RDP
Contents
• Introduction
• Steps to fabricate the CPD metal framework
• Fitting the framwork in the working model
• Examination of the framework after receiving from the lab
• Fitting the framework in the patients mouth
• Pitfalls
• What to do after metal frame work try in?
Introduction
• No matter how much care is taken during the clinical and
laboratory phases of removable partial denture service,
some discrepancies in the fit of the framework will occur.
• It has been estimated that as many as 75% of removable
partial dentures do not fit the mouth on the day of
insertion.
• Improper fit may contribute to movement of the associated
teeth arid may result in discomfort.
• Improper fit also may be the primary reason that many
removable partial dentures are not worn.
• The practitioner must ensure that each framework fits
extremely well. This requires patience, careful
examination, and precise adjustment.
• Each completed removable partial denture must be
completely passive in the mouth.
• When the prosthesis is fully seated, it should not exert
forces on the teeth or the soft tissues.
• Uncontrolled forces can produce movement of the
remaining teeth and cause damage to the soft tissues and
supporting bone.
Complete steps for RPD construction
(Clinical + Laboratory)
1. Diagnosis and treatment planning
2. Primary impression using alginate
3. Preliminary cast (LAB)
4. Jaw relation
5. Surveying and design
6. Tooth preparation
7. One stage selected pressure, McLean’s, Hindle’s
tecniques for final impression*
Complete steps for RPD construction
(Clinical + Laboratory)
8. Framework construction (LAB)
• Transfer the design to the master cast
• Beading of the master cast
• Wax block-out and relief procedure
• Duplication of the master cast (+ pouring the refractory
cast)
• Wax-up of refractory cast
• Spruing
• Investing
• Burn out
• Casting
• Finishing and polishing
Complete steps for RPD construction
(Clinical + Laboratory)
9. Framework try-in in master cast (LAB)
11. Framework try-in on patient
12. Altered cast technique for secondary impression~
13. Wax try-in
14. Delivery
Recap…..
Design Transfer Blockout
Silicone Duplicating Materials
 Duplication ..Agar Agar

(From left) Duplicating materials (agar), Automated Machine Agar Dispenser,

Duplicating Flasks
Refractory cast hardening
Refractory Cast and Master Cast
Completed Wax Pattern

A
Investing
Finishing
Electropolishing
Completed framework and denture
Fitting the framework (Laboratory)

• At this stage of the procedure, the technician carefully

seats the metal framework on a duplicate master cast.
• The t e c h n i c i a n tries to identify areas that prevent
seating of the framework.
• Special powdered sprays and liquid disclosing media are
commercially available to aid in this process.
Fitting the framework (Laboratory)

• An appropriate disclosing medium is selected and applied

to the cast.
• The framework is then seated and subsequently removed.
• Areas that interfere w i t h seating are identified and
relieved using s p o t - g r i n d i n g techniques.
• This process of seating and spot grinding is repeated until
the rests are completely seated on the cast.
Examination of Framework
• The metal framework should be carefully examined upon
its return from the dental laboratory.
• The practitioner should ensure that all directions have
been followed and that the metal framework accurately
fits the master cast.
• The metal framework should be fitted to the mouth shortly
after it is returned from the dental laboratory.
• This will decrease the likelihood of tooth movement and
simplify the fitting process.
The following questions should be
addressed.
Was the proposed design closely followed?
• Dental laboratory personnel should never alter a design
without consulting the dentist who submitted the work
authorization order. If any discrepancy exists between the
prescribed design and the framework returned by the
laboratory, the reason for the difference should be
determined.
Does the framework fit the master cast
accurately?
• A properly constructed framework should fit tightly against
the cast
• If a framework does not fit the master cast, it is highly
unlikely that it will fit the mouth.
• Are the rests fully seated in their preparations?
• Are reciprocal clasp arms and/or lingual plating in intimate
contact with tooth surfaces?
• Have finishing and polishing procedures been carried out
correctly?
NODULE
• The external surface of the framework should be finished
and subsequently polished to a high shine.
• The highly polished external surface provides increased
comfort and is less likely to retain plaque and debris.
• Both the internal and the external surfaces of the
framework should be examined for nodules and other
artifacts that may prevent complete seating and produce
patient discomfort
• Internal and external finish lines should be sharply defined
and slightly undercut to provide firm mechanical locks for
acrylic resin denture bases
Is the major connector sufficiently rigid?
• Rigidity is the first and most important requirement of a
major connector.
• Lack of rigidity can result in the localization of destructive
forces and may cause traumatic injury to the teeth, soft
tissues, and underlying bone.
• Finger pressure should be applied to both sides of the
frame work simultaneously to check the rigidity of the
framework.
• The framework should be rigid enough to resist flexure
Clinical Procedures
• This appointment has two separate objectives.
• The first is to fit the framework to the teeth and soft
tissues of the supporting arch.
• The second is to adjust the framework to the opposing
occlusion.
• The framework must be fitted to the supporting arch
before occlusal adjustments are made.
Fitting the framework to supporting
teeth and soft tissues
• It is almost always possible to improve the fit of a
framework by judicious grinding of the metal.
• A partial denture that is not quite seated can produce
discomfort and destruction beyond what might be
expected.
• Therefore, the practitioner must always remember that
"near fit" is not sufficient.
• An accurate fit is essential for prosthodontic success.
Disclosing media

• To properly adjust a removable partial denture framework,

the practitioner must identify areas of interference and
binding.
• This may be accomplished using a number of
commercially available disclosing media
• Spray-type disclosing media are often used during fitting
procedures.
• Consequently, spray-type disclosing media should not be
used for intraoral fitting procedures.
• Disclosing wax is easy to use and will provide excellent
results if it is properly read
• The greatest advantage of disclosing wax over other
disclosing agents is its three-dimensional nature.
• Because the wax is translucent, it provides clear visual
evidence regarding framework adaptation.
• In thin films, disclosing wax takes on the grayish
appearance of the removable partial denture framework.
In thicker films, the wax appears white.
• When the framework is in place, firm vertical pressure is applied to
rests.
• In the case of a distal extension framework, no pressure should be
applied over the distal extension area.
• This would cause the framework to rock and would produce
misleading results in the disclosing wax.
Correcting discrepancies

• The framework is carefully removed from the mouth to

avoid damaging the surface of the disclosing wax.
• The surface of the wax is examined for areas of metal
show-through.
• Areas of show-through represent interferences that
prevent complete seating of the framework.
• Areas that have been defined as true interferences must
be carefully machined. This is accomplished using a
multifluted carbide bur in a high-speed handpiece
Final check after removing interferences
Fitting the framework to the opposing
occlusion
• After the framework has been fitted to the teeth, it must be
adjusted to the opposing occlusion. The framework must
not keep the natural teeth from making normal occlusal
contacts in centric or eccentric closures.
• Undesirable contacts are eliminated by grinding the
offending area or areas of the metal framework.
• To promote patient comfort, all adjustments should be
accomplished with the framework out of the mouth.
Fitting the framework to the opposing
occlusion
• If maxillary and mandibular frameworks have been
constructed, the frameworks should be fitted individually.
• After each framework has been corrected individually,
maxillary and mandibular frameworks should be placed
simultaneously
• Reduction of the framework is best accomplished using a
multifluted carbide bur in a high-speed handpiece
• In rare instances, the practitioner may choose to reshape
the opposing tooth rather than perform additional
adjustments on a removable partial denture framework.
 Important considerations
• Corrective grinding procedures should always be performed
with great care.
• The practitioner must avoid overcutting the metal surfaces,
since this process weakens the important elements of the
removable partial denture framework.
• If an occlusal rest is removed as result of overcutting, support
will be compromised
Finishing and polishing ground
surfaces
• After the framework has been fitted to the supporting teeth
and opposing occlusal surfaces, the corrected surfaces
must be finished and polished.
• This is accomplished using mounted stones, as well as
carborundum impregnated wheels and points
What to do after framework try in?
• Before dismissing the patient, the practitioner should
determine what treatment will be provided at the next
appointment.
• Treatment may follow several courses, including the
following:
1. Corrected cast impression procedures.
• This appointment is necessary for patients requiring
mandibular distal extension removable partial dentures,
those requiring long-span maxillary distal extension
removable partial dentures, and those requiring long-span
anterior replacements.
2. Jaw relation records.
• This appointment is required for patients who do not need
corrected cast impression procedures, yet do not have a
sufficient number and distribution of teeth to permit
accurate hand articulation of casts.
• Jaw relation records may be made at the framework try-in
appointment if sufficient time is available.
3. Esthetic try-in.
This appointment is required for patients who do not need
corrected cast impression procedures or j aw relation
records, but who will have anterior teeth replaced with
denture teeth on a denture base.
4. Denture delivery
References