FRS vs. Valplast

[Frank Stephen]

Being a thermo-plastic material that has great adjustment characteristics, and can have clear clasp, provides your patients with strong, adjustable, flexible and aesthetics partials.

Cosmetic dentist in Southampton

 

[Denturist]

Which are completely tissue supported and inadequate for all but temporary aplications.........

 

[Clear Precision Dental]

Which are completely tissue supported and inadequate for all but temporary aplications.........

Amen. They're also a pain to polish, reline, repair or adjust, even when you know what you are doing.

 

[TheLabGuy]

Okay, I'm not trying to play devil advocate here, but I've got quite a few FRS's in the mouth and never had a problem. Had to make a couple adjustments after a couple days due to a sore spot or two, but nothing more than you would if it was a denture. Maybe it's only a matter of time before the ball drops and my opinion is changed like yours, should I be scared?

 

[DDDental]

No, not at all Rob, if it does what it is supposed to, you are just fine. We all have to understand basic principles of dental prosthetics, and they are biocompatibility, stability, retention, aesthetics, dentoalveolar support as much as possible, easy maintenance, good hygienic control, durability, and above all costumer satisfaction. If you have 75% of all of this, you are in good shape.

 

[kcdt]

No, not at all Rob, if it does what it is supposed to, you are just fine. We all have to understand basic principles of dental prosthetics, and they are biocompatibility, stability, retention, aesthetics, dentoalveolar support as much as possible, easy maintenance, good hygienic control, durability, and above all costumer satisfaction. If you have 75% of all of this, you are in good shape.

While I don't disagree with your points at all, i think what denturist was getting at is a valid statement. The three basic principles of RPD prosthetic stability are three R's: Retention, Reciprocation, and Rest. If any of these are missing, as they are in tissue borne appliances, then the long term risks of orthodontic movement are higher. Remember that for a RPD to qualify as a definitive prosthesis as opposed to a treatment or temporary measure is the design considerations given to stabilizing the dentition over the long term.
While many patients like them, the flexibles tend to be tissue borne and thus really only suited to interim use. Should elements be incorporated in their design the take the three R's into account, then they could indeed qualify... I've just never seen any.That goes more into the market that the labs who use them are shooting for. One could build an acrylic RPD with soldered clasp assemblies incorporating the 3R's and it would be suited for long term use. But what lab cranking out flippers is going to take the time to survey, much less what insurance based practice will pay the extra fee for a properly designed appliance? So in terms of strict definition a temporary design should not be considered anything but.

 

[JohnWilson]

I wasn't going to jump in on this thread but I have a minute or two to point out facts as it relates to VALPLAST. I am not here to sway the nay sayers but to point out what I have learned about the product over the years

The 3 R's as it relates to conventional CAST Rpd design are completely different from the criteria needed for VALPLAST. I have been fabricating VALPLAST as a certified VALPLAST tech for more than 10 years. I went to New York and took the course and have been satisfying many patients with this specific restoration. A properly made Valplast appliance does not utilize rest seats in the conventional way that a cast RPD does. It relies on reciprocation over every remaining ling tooth structure above the height of contour. Retention is achieved differently than a metal clasp that rides the H. O. C. only to allow the tip of the clasp to engage an undercut. A proper Valplast clasp gains most of the retention from tissue undercut than tooth undercut.

Proper case selection and design is what makes Valplast a success or failure. The problem is with so many copycat products that require little to no training there are techs trying to fabricate Flexible style partials after RPD design which is a huge mistake. This of course leads to discomfort and potential tooth loss based on these dissimilar design principals.

Do flexible partial fall into the interim or definitive restoration category? I really don't care to "Label" the product one way or the other. I care to fabricate and sell a quality restoration based on the needs of my prescribing clients. If what they ask for fits the qualifications of the material than I feel it's a successful restoration.

 

[TheLabGuy]

John, very nicely stated.........

 

[kcdt]

Guys don't get me wrong here... I am not denigrating any one product or market. All I'm saying is from an evidenced based, textbook rational these are tissue borne. Should someone ever care to cough up a research article or a textbook that will equate the valplast "design" as valid as RPD theorum, I'll be glad to listen. These are a valid product serving a need in the market place, but I prefer to keep my technospeak correct within what is currently defined. Sorry if that ruffles anyone's feathers.

 

[kcdt]

In the interest of fairness (and the desire not to come off like a complete ass),I found reference to a study in RPD design the indicated that perhaps as many as 75% of rest don't fit intimately enough to do what they intend. Mention is made of Brudvik's Advanced Removable Partial Dentures wherein he discusses using suprabulge encirclement to provide noninvasive resting. I quote: "The effect of a positive rest can be obtained with minor connectors (guide plates) alone, but only if they touch the tooth on opposing sides and above the height of contour, since the tooth is not able to move away from the partial. This situation is rare and usually limited to the management of existing crowns with porcelain occlusal surfaces in cases where preparing an adequate rest may damage a crown that need not otherwise be replaced."p9. The JPD 2006:95:323-6 mentioned this and said it may be relevant to new rest designs. However the uses only cover a small number of the Kennedy classifications.
John is correct in that a properly designed suprabulge contact can, in some instances act as resting.

 

[CYNOSURER]

Guys don't get me wrong here... I am not denigrating any one product or market. All I'm saying is from an evidenced based, textbook rational these are tissue borne. Should someone ever care to cough up a research article or a textbook that will equate the valplast "design" as valid as RPD theorum, I'll be glad to listen. These are a valid product serving a need in the market place, but I prefer to keep my technospeak correct within what is currently defined. Sorry if that ruffles anyone's feathers.

Here's one:

View attachment Dr.Lingen.pdf

Well, at least it's printed or printable. Valplast has plenty of antidotal stories. Their favorite is that the VA was in the process of a much more detailed study of their flexible concept when a little thing called 'Vietnam" interrupted it. It really is a shame there hasn't been better studies on something that's been around for 55 years. There are a lot of things I don't like about this 'study' but the thing that Valplast likes to point out is that the prescribing doc tended to prescribe Valplast to those patients he thought would be least likely to keep their abutments. What sold him on was the success rate of these patients. Again, some really good documentation would be nice.

 

[kcdt]

Here's one:

View attachment 364
It really is a shame there hasn't been better studies on something that's been around for 55 years.

I totally agree. I tend to take anything a mfr says with a huge grain of salt, I look to the textbooks and evidence based literature to help guide my choices. I just wish they'd get around to looking at products whose market share is growing and whose popularity is evident. There may be something to the product, but all we get for now are anecdotes from those who either love or hate it. A real study seems to be in order.

 

[DDDental]

OK, lets say we have a case with #s 4,5,6,11,12,13 missing.Easy you think, we will crown 7,8,9,10 and place distal attachments on 7 and 10 and done story. Yep but patient can't afford it.( affordability is another thing I forgot to mention when I put down basic principles of dentistry). We go ahead , we are ignorant and put acers on #3 and 14, and I bars on 7 and 10. We have everything all your 3 R s. But patient says What is this, I have metal showing all over, I don't like this, I can not smile, I can not go in the public I am desperate. So we lost aesthetics and customer satisfaction. OK we say, we will just cut the I bars off . Oops, we lost retention, one of the big 3. Patient says what is this , this partial is falling of when I eat, I can not go to the public places. So we lost retention and patient satisfaction. OK we say, just put some adhesive on and you should be fine. Patient comes back, and says, this thing is nightmare, giving me allergies, it is so hard to clean, I am desperate.( So we lost biocompatibility and good hygienic control, and costumer satisfaction). Ok, we say, we are smart, we will put some tooth colored clasps on 7 and 10 and that's it. Patient come back after 3 months says, this thing stained. ( Lost aesthetics). OK you say, I will repolish it. But patient comes back with clasps broken in 6 months. ( Now we talk about durability, and again costumer satisfaction). We were so ignorant all this time and did not pay attention to the all basic principles of dentistry because we think only about big R-s. And what if we just had designed nice valplast partial in the first place?

 

[kcdt]

I am not saying that would not be a good service, but let's be fair, the scenerio you painted is a way stop on the road to a complete denture no matter how you cut it. First of all lateral incisors have a very poor prognosis as terminal abutments on a bridge because of poor crown to root ratios and bone support. Add an attachment system to the distal of that and you might as well extract them now and save time. I would feel the same if this were your cast Rpd with the I-bars. If this patient still has any natural dentition on the mandible, especially the anteriors, then the support for the whole of the patients occlusion rests with just the four incisors, eventually that will collapse. The valplast is probably the best SHORT term solution, but real planning would be to start with a root form overdenture to save the bone loss; if you just let the upper anterior segment go you'll loose the teeth AND the bone that surrounds them.
The fact that the patients finances put limits on the treatment means the treatment is limited. Nothing wrong with that- its reality. But let's not redefine this into more than a holding action.

 

[CYNOSURER]

The valplast is probably the best SHORT term solution, ...

Valplast is probably the better long term solution as the clasps wouldn't use the anterior teeth as an abutment as much as it would use the soft tissue undercut and even then in a retentive capacity and not supportive.

Because of the flexibility of the base, anterior/posterior and cross arch stresses are reduced or eliminated. Most tooth/abutment stress is created when the patient bites down. There is much less stress from the displacement forces. Valplast is soft tissue/bone supported and soft tissue/tooth retained. Cast partials are tooth supported and tooth retained, so you are correct in saying that the laterals would be ill equipped to handle the stresses a cast design would deliver.

As with all removables, occlusion plays a major role, but with Valplast it plays a more critical role to the success, comfort, and longevity of the appliance as well as the overall impact on the oral health of the supportive structures.

 

[DDDental]

I am not saying that would not be a good service, but let's be fair, the scenerio you painted is a way stop on the road to a complete denture no matter how you cut it. First of all lateral incisors have a very poor prognosis as terminal abutments on a bridge because of poor crown to root ratios and bone support. Add an attachment system to the distal of that and you might as well extract them now and save time. I would feel the same if this were your cast Rpd with the I-bars. If this patient still has any natural dentition on the mandible, especially the anteriors, then the support for the whole of the patients occlusion rests with just the four incisors, eventually that will collapse. The valplast is probably the best SHORT term solution, but real planning would be to start with a root form overdenture to save the bone loss; if you just let the upper anterior segment go you'll loose the teeth AND the bone that surrounds them.
The fact that the patients finances put limits on the treatment means the treatment is limited. Nothing wrong with that- its reality. But let's not redefine this into more than a holding action.

Thank you for mentioning that, as I did not even go into the matter concerning stress to the remaining teeth produced by cast RPD. Another reason why in this situation, Valplast is given the patient budget, the best possible solution. Of course If we have unlimited source of money, we could play with design, and make it the best RPD for long term solution. We could make copings for 7,8,9,10, with telescoping, we could devitalize teeth, cut them and place ball attachments, we could go with Hader bar ,and clips, we could crown 7,8,9,10 place PD locks between 7,8 and 9,10 and so on and so forth. Yes, but if patient can't afford it, we have to find the best possible solution. Of course when I said in previous post crown 7,8,9,10 they would be connected, and rest seats would be placed on 8 and 9 with cast partial lingual plating resting on linguals reliving stress on 7 and 10.

 

[kcdt]

I dunno, patients lost more than 60% of the dentition in the arch, even if you get that hygene problem under control (and thats a BIG if),the anteriors remaining aren't going to resist the forces pushing them labially. Mutually protected occlusion is gone and the VDO is going to collapse. The type of partial isn't going to keep that from occuring unless the trend the whole mouth is taking is stopped and stabilized.

 

[adamjhuathan]

Valplast is a latest technology used by dentists worldwide. I am experimenting it for the past 2 years with more than 90% success.

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[Ian414]

Valplast

I'm new to this forum. Does anyone know the material composition of Valplast dentures? I have been searching for compatible materials for a possible denture or bridge. I understand that it is possibly a nylon base but so far am unable to get a list of the materials used in this product.

 

[kcdt]

If you go to a supplier web site, such as Henry Schein and pull up the product, you'll often find a PDF download of the MSDS. That'll answer your question about composition.