JMN
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Got a situation with a super duper severe bruxer which I'll outline, but overall I'm wondering what materials, steps, or methods have been found that were most beneficial to the longevity of the prosthetic.
Pt presents with the most severe bruxism I've ever seen. Prescription medication has exacerbated what was a prior issue, it now happens day/night awake/asleep.
Constantly, unless talking or eating. Pt has de-cemented a crown!!
Current RPD is TCS over cast frame, has a saddle at/for 3-4 with cast clasps on palatal of 2 & 5 and TCS clasps on buccal of 2 & 5. That entire saddle has been broken off 2x and both buccal TCS clasps have been replaced with wrought wire after failing.
Just wondering if a fully flexible RPD, having some give, would provide a more robust solution or staying with a cast frame is considered best practice. I'm being asked for advice from the DDS for the next go-round coming earlly next year.
My thoughts are mixed:
With cast framework again and a PMMA base that it can be easily repaired as often as it is broken.
A fully Flexible RPD would be harder to destroy, but any repair would be much more likely to fail rapidly unless I sent it somewhere else to get reshot at that area. And with the diatorics, the teeth may fail sooner than if on a cast frame.
Any observations, thoughts, known studies, even just wild conjecture which is all I'm doing, would be very welcome. Really don't want to be married to this one again.
Pt presents with the most severe bruxism I've ever seen. Prescription medication has exacerbated what was a prior issue, it now happens day/night awake/asleep.
Constantly, unless talking or eating. Pt has de-cemented a crown!!
Current RPD is TCS over cast frame, has a saddle at/for 3-4 with cast clasps on palatal of 2 & 5 and TCS clasps on buccal of 2 & 5. That entire saddle has been broken off 2x and both buccal TCS clasps have been replaced with wrought wire after failing.
Just wondering if a fully flexible RPD, having some give, would provide a more robust solution or staying with a cast frame is considered best practice. I'm being asked for advice from the DDS for the next go-round coming earlly next year.
My thoughts are mixed:
With cast framework again and a PMMA base that it can be easily repaired as often as it is broken.
A fully Flexible RPD would be harder to destroy, but any repair would be much more likely to fail rapidly unless I sent it somewhere else to get reshot at that area. And with the diatorics, the teeth may fail sooner than if on a cast frame.
Any observations, thoughts, known studies, even just wild conjecture which is all I'm doing, would be very welcome. Really don't want to be married to this one again.