CLINICAL DENTISTRY AND RESEARCH 2012; 36(2): 41-44

TEMPORARY FLEXIBLE REMOVABLE PARTIAL DENTURE: A

CLINICAL REPORT

Tevfik Yavuz, DDS ABSTRACT

Research Assistant, Department of Prosthodontics,
Faculty of Dentistry, Seluk University
Konya, Turkey
Filiz Aykent, DDS, PhD
Professor, Department of Prosthodontics,
Faculty of Dentistry, Seluk University,
Konya, Turkey
Missing tooth, replacement a must and it becomes best
if a denture patient wearing is comfortable. Innovation of
flexible dentures, flexibility combined with strength and light
weight provides total comfort and great looks. Features of
these prostheses are good retention, aesthetically superb
and virtually invisible, excellent strength, easy in handling, no
involvement of metal, noninvasive procedures, comfort. All of
these factors become important when producing long-term
provisional prostheses during implant or complex restorative
cases, or when used for permanent removable appliances.
This case study presents that the patient with long missing
dentition in upper anterior region can be temporary treated
esthetically and comfortably with flexible removable partial
dentures.

Correspondence

Tevfik Yavuz, DDS

Department of Prosthodontics,
Faculty of Dentistry,
Seluk University,
42079, Konya, Turkey Key words: Flexible Denture, Provisional Prostheses,
Phone : +90 332 2231190 Removable Partial Denture.
Fax: +90 332 2231190
Submitted for Publication: 09.13.2011
E-mail: drtevfikyavuz@gmail.com
Accepted for Publication : 02.02.2012

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INTRODUCTION
When tooth extraction is unavoidable the resulting
mutilation causes patients a great deal of anxiety that
tends to be even more intense when esthetic appearance
is compromised. This problem can be solved with making
temporary denture. After the surgical area has healed this
temporary denture is replaced by permanent denture. If
the missing area requires long span fixed partial bridge, the
edentulous patient can treated with a removable partial
denture (RPD). There are several types of RPDs.1,2 All of
them use standard denture teeth as replacements for the
missing natural teeth.1 The differences between them are
the materials used to support the denture teeth and retain
the RPD in the mouth.1,3
The application of nylon-like materials to the fabrication of
dental appliances has been seen as an advance in dentistry.1
This material generally replaces the metal, and the pink
acrylic denture material used to build the framework for
standard RPDs.1,4
Thermoplastic materials for dental prostheses, Valplast
(Valplast Int. Corp.-USA) and Flexiplast (Bredent - Germay),
were first introduced to dentistry in the 1950s.1Both
materials were similar grades of polyamides (nylon plastics).
Since their introduction, there has been a continued
interest in thermoplastic dental materials.1,5,6 Acetal was
first proposed as an unbreakable thermoplastic resin RPD
material in 1971. It was during this period that Rapid
InjectionSystems developed the first tooth-colored clasps
with a thermoplastic fluoropolymer.7 In 1992 The Flexite
Company developed and patented the first pre-formed
tooth-color claps known as Clasps-Eze. This product, made
of a nylon material, is available in pink and clear color shades
and currently sold worldwide.1
Thermoplastic resins are used for a broad variety of
applications from removable flexible partial dentures
preformed partial denture clasps, fiber reinforced fixed
partial dentures, provisional crowns and bridges, obturators
and speech therapy appliances, orthodontic retainers and
brackets, impression tray8 and border molding materials9,
occlusal splints, sleep apnea appliances, and implant
abutments.
Thermoplastic resins and co-polymers have many
advantages over conventional resin systems.1
Some of these advantages include:
1. Cosmetically elegant; no metal clasps and can also
be combined with natural colour clasps.
42
2. Metal ,monomer and acrylic free
3. Can be used for patients allergic to conventional
acrylic restorations.
4. Lightweight, strong and durable
5. Flexible dentures are almost unbreakable and can be
made thinner than traditional acrylic dentures, providing
more comfort and confidence for the patient.
6. Flexible dentures have just the right degree of
flexibility and will not warp or become brittle.
7. The material used can provide translucency that
blends with the natural tone of tissue for a more natural
appearance.
All of these factors become important when producing
long-term provisional prostheses during implant or complex
restorative cases, or when used for permanent removable
appliances.1
This clinical report describes an esthetic flexible RPD
(deflex) used for the temporary treatment of a patient with
long missing dentition in upper anterior region.
CASE REPORT
A 24-year-old woman was referred to the Dentistry Faculty
(Department of Prosthodontics) for the replacement of the
missing maxillary anterior teeth (Figure 1). The patients main
complaint was the high level of embarrassment caused by
congenitally missing anterior teeth. A panoramic radiograph
revealed no development of primary or secondary teeth/
tooth germs (Figure 2). Clinical and radiographic examination
was revealed that there were no restorations, caries with
abutment teeth so implant supported fixed prosthesis were
planned for the edentulous spaces.
The patient underwent implant operation and four dental
implants were placed in both sides of maxillary canine and
lateral incisor regions. Twenty one days after the operation,
the soft tissues appeared healthy without any sign of
inflammation. Initial impressions of mandible and maxilla
were made with an alginate for the construction of study
casts. Interim RPDs were fabricated to provide immediate
esthetic results, re-establish the occlusion by replacing
missing teeth, and allow the patient to become familiar
with removable dentures before delivery of the long interim
provisional prostheses. To mount the maxillary master
cast, an acrylic template was built up with the immediate
provisional removable dentures in position.

Figure 1. Missing maxillary anterior teeth.
Figure 2. Panaromic radiography before the implant treatment.
Fabrication of long term temporary thermoplastic resin
RPD:
The first impression of the maxilla and mandible were made
with a rreversible hydrocolloid (Kromopan, Sesto Fiorentino,
Firenze, Italy) to acquire the anatomic molds in common
plaster. The maxillary mold was outlined, and there movable
temporary partial denture was planned on this maxillary
cast. Rests were made on the maxillary teeth to support the
denture. Radiographic examination of abutments revealed
that these teeth had good root formation and enough root
lengths to set clasps. After obtaining the working models,
the retentive regions were relieved. The bases were made
with a wax roll, and a mold of the facial arch was taken.
The maxillary model was mounted in an articulator then
the mandibular model was mounted in the articulator the
maxillary-mandibular relationship was checked.
The prosthetic teeth shade was selected, and then the
teeth were mounted in the laboratory. After mounting
teeth, the denture was checked intraorally. The temporary
flexible maxillary prosthesis was included in a differential
metal muffle to be adapted to the injection machine. The
Temporary Flexible Removable Denture
muffle has a hole in its structure, adapted to the nozzle of
a cylinder in which the aluminum capsule containing the
flexible resin is melted.
After the prosthesis was fabricated, the flexible temporary
maxillary RPD was checked intraorally. The occlusal and
other adjustments were made and then the prosthesis was
send to the laboratory for finishing and polishing (Figure
3). Patient really appreciates the tooth colored esthetics.
An acetal single cast partial denture that is color matched
for the patient is both esthetic and the flexibility aids in
retention and comfort (Figure 4).
DISCUSSION
Thermoplastic resins have been used in dentistry for over
50 years. During that time the applications have continued
to grow, and the interest in these materials of both the
profession and the public has increased. Patient success is
high since these appliances can be extremely aesthetic.1
Flexible resins are mainly indicated for the construction
of RPD in anterior region for esthetic requirements like
translucency and natural appearance.10 One must remember
that careful attention must be paid to the basic concepts
of diagnosis and design, and a different approach to clasp
design is essential.
Acetal as a homo-polymer has good short thermo-
mechanical properties, but as a co-polymer has better
long-term stability. Acetal resin is very strong, resists wear
and fracturing, and is quite flexible. It is rigid enough for
a long time clinical service.11 An important characteristic
of this material is its flexibility, enabling the denture to
have an excellent and more comfortable insertion.12 These
characteristics make it an ideal material for pre-formed
clasps for partial dentures, single pressed unilateral partial
dentures, partial denture frameworks, provisional bridges,
occlusal splints, and even implant abutments. Acetal resin
resists occlusal wear and is well suited for maintaining
vertical dimension during provisional restorative therapy.6
However thermoplastic acetal resin is very expensive as a
provisional restorative material.
Ritterbeck13 relates that the absence of porosity as a result
of monomer release is reflected in improved hygiene, since
biofilm adherence and bacterial calculus formation are
hindered. The denture made with flexible resin is lighter
than the denture made of conventional acrylic resin, which
means more comfortable for the patient.12,13
Resin bonded fixed partial denture can be used for
temporary treatment before replacement the definitive
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 CLINICAL DENTISTRY AND RESEARCH
Figure 3. Finishing and polishing of prosthesis.
Figure 4. Final prosthesis.
implant supported prosthesis. The resin bonded fixed partial
denture is not new, but there is still some concern about the
longevity of this type of prosthesis and totally untested. A
review of about 60 on the clinical survival of resin bonded
fixed partial dentures put the 4-year survival rate at 74%.
The patient in this case report had a long edentulous space
in anterior region to make temporary fixed resin bonded
partial denture. Because of the risk of cementation failure,
we did not use the adhesive bridge. Also a conventional RPD
was not preferred as a temporary prosthesis because of
the metal clasps which cause esthetics problem in anterior
region.
CONCLUSION
In the present case, flexible framework RPD has served
as a successful until the permanent fixed prosthesis have
restorated in anterior esthetic region and increased patients
the quality of life in this interim. With the development of
new properties, elastomers and copolymer alloys, there are
certain to be additional new applications for thermoplastic
44
resins in the future, to help patients with damaged or
missing teeth.
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