What is Cast Partial Denture?
A Denture is defined as a removable plate or frame holding one or more artificial teeth, which is used to replace missing teeth in the mouth. A Cast Partial Denture (CPD) is defined as a removable partial denture consisting of a cast metal framework that contains artificial teeth set in an acrylic resin.
As compared to conventional acrylic denture, Cast Partial Denture is stronger, more durable and retentive. However, the fabrication of cast partial denture is more costly, time-consuming and complex as compared to the conventional acrylic dentures. Each denture is specifically designed and fabricated to the individual patient.
What Are The Indications For A Cast Partial Denture?
- Partially edentulous (lose some of the teeth)
- No tooth is present behind to edentulous space
- Above the age of 17 years
- Periodontal (gum) condition of the remaining teeth is good
- Patient desires
- Trauma to the jaw bone
- When the remaining teeth have to be stabilized against lateral and anterior-posterior forces
What Are The Contraindication For A Cast Partial Denture?
- Poor oral hygiene
- Aesthetically not pleasant area (especially front teeth area)
- Weak teeth in the arch
- Remaining teeth are not able to retain the removable prosthesis (dentures)
- Rampant caries
- Poor periodontal/gum health
What Are The Clinical Procedures Of Fabricating A Cast Partial Denture?
Fabrication of Cast Partial Denture takes multiple dental visits. Each denture is uniquely designed and fabricated based on the individual dental conditions. Here are what you could expect during the dental appointments for cast partial dentures:
- During the first dental visit:
- Dental impressions will be taken for both upper and lower dental arches.
- Study models are fabricated. Cast Partial Dentures are uniquely designed on the study models.
- In the second dental visit:
- Dentist will perform a procedure called mouth preparation. Mouth preparation involves the modification of the shape of some teeth to retain and stabilise the final cast partial denture.
- Final dental impressions will be taken after mouth preparation.
- Master models are fabricated.
- Metal framework of cast partial denture is designed and fabricated by dental technician in dental laboratory.
- In the third dental visit:
- The metal framework of cast partial denture is tried in the patient’s mouth to check for the fitting and retention. Slight adjustment of the metal framework might be needed for better fitting and retention.
- Now, the dentist will record the patient’s bite/occlusion. This procedure is called as bite registration.
- Then, the dentist will be selecting the shade of the artificial teeth based on patient’s original teeth shade.
- According to the patient’s bite/occlusion, dental technician will be setting the artificial teeth on the trial dentures.
- In the fourth dental visit:
- Trial dentures are tried in the patient’s mouth.
- Fitting, stabilisation, retention, phonetics and aesthetic of the trial denture are checked and adjusted as needed.
- After the try-in, the trial dentures will be sent to dental laboratory for the fabrication of final cast partial dentures.
- In the fifth dental visit:
- Dentist inserts the final cast partial dentures into the patient’s mouth.
- Fitting, stabilisation, retention, phonetics and aesthetic of the final cast partial dentures are check and adjusted as needed.
- Occlusion/bite of the patient is checked and adjusted as needed.
- Instruction of proper denture care is given to the patient.
- In the sixth dental visit:
- After 1 week of denture insertion, the patient is called for a denture review.
- Patient will be asked if there is any problem (such as discomfort, pain or ulcers) caused by the dentures.
- Fitting, stabilisation, retention, phonetics and aesthetic of the cast partial dentures are again checked and adjusted accordingly.
- Occlusion/bite of the patient is checked and adjusted accordingly.
- In future dental visit:
What Are The Advantages Of A Cast Partial Denture?
- Minimises tissue change.
- Reduces the necessity of relining or rebasing the denture.
- Distribution of occlusal (biting stress) is good.
- Movement of the denture bases has a massaging effect on the underlying bone and soft tissue.
- Requires minimal direct retention as compared to the conventional acrylic denture.
- Balance the occlusion (bite).
- Provide support for lips and cheeks.
- Eliminates the tipping strain on the teeth.
- Prevent the teeth from shifting.
What Are The Disadvantages Of A Cast Partial Denture?
- Due to the incorporation of cast metal framework, cast partial denture becomes heavy and annoying to the patient.
- Impossible to repair..
- It is fragile.
- Fabrication process is complex.
- Takes more dental visits and longer time for the fabrication of cast partial denture.
- Lack of ability to prevent damaging lateral stresses.
- It requires constant maintenance.
- Aesthetically not pleasant.
Comparison Between Cast Partial Denture & Conventional Acrylic Denture
- Cast partial denture is more hygienic and tolerable as compared to the acrylic denture.
- Cast partial denture is more expensive to than the acrylic dentures.
- Cast partial dentures have superior strength as compared to the acrylic dentures.
- Acrylic dentures are easier to fabricate as compared to the cast partial denture.
- Cast partial denture may damage the gum tissue around the natural teeth if it is not designed & cleaned properly.
- Cast partial dentures are usually the better in the long run as compared to the acrylic denture.
What Are The Alternative Treatments To Cast Partial Denture?
- Dental Implant
- Dental Bridge
- Acrylic Denture
Each treatment option has its own indications and contraindications, thus, it is important to discuss with your dentist to figure out the best treatment option that is suitable for you.
Natural teeth always function better than the artificial teeth. Thus, it is very essential to prevent tooth loss in the first place through daily practise of good oral hygiene. Good oral health can be maintained through daily tooth brushing, flossing, use of mouthwash, tongue cleaning and regular dental visit. Always remember that good oral health care can result in good overall health.
Article written by,
Dr. Wong Kee Cheong (Tommy)
BDS (AIMST), MBA (SEGi), YCDP