When is reinforcement of a removable denture justified?

The popularity of dentures with a fine structure among patients is determined by their aesthetic and functional characteristics. However, such structures do not always have a sufficient margin of strength and resistance to mechanical loads that occur during meals. The formation of even small, at first glance, damage often becomes the cause of discomfort, imbalance and configuration of the replacement system. To strengthen prostheses, internal reinforcement technology is used, which involves integrating a strong mesh into the frame of the product.

General overview

Reinforcement technology is recommended for prosthetic systems made from polymer materials and is aimed at strengthening the base, which has a fine structure. The occurrence of structural defects is caused not only by excessive physical impact, but also by the natural wear and tear of the prostheses. Strength can be increased using mesh inserts made from metal or fiberglass blanks.

Placing a reinforcing frame at the base of the prosthesis provides resistance to mechanical damage. This is an optional procedure, but many experts recommend performing it at the first sign of deterioration in the properties of the prosthetic system. The presence of mesh not only strengthens the prosthesis, but also increases the comfort of wearing it.

Alternative or addition to a prosthesis

If the dentist diagnoses poor enamel quality or serious consequences of tooth decay that need to be corrected immediately, reinforcement often comes to the rescue.
This is a dental procedure that can be used to completely restore a tooth or strengthen a denture. The method is used in conjunction with the following orthodontic structures:

• temporary crowns;
• bridges;
• prostheses with multiple supports and large intermediate parts.

Reinforcement can be either an addition to prosthetics or an alternative. Depending on the situation, different parts can be used for strengthening:

• metal pins;
• grids;
• tabs;
• steel threads;
• fiberglass.

Fiberglass is the most popular, because thanks to this technology it is possible to restore a missing tooth without installing dentures. At the same time, the operation takes little time, and the price is not very expensive. True, there are certain risks. It is not recommended to heavily load a tooth restored with fiberglass, because regular chewing of hard food can lead to a change in the original appearance of the structure. In addition, this technology is only suitable for restoring one tooth (by attaching to two adjacent support elements).

Material

When choosing the material used to reinforce dentures, the following factors are taken into account:

• Biological compatibility;
• Resistance to acids and mechanical stress;
• Maximum duration of operation;
• Interaction with pathogenic microflora of the oral cavity.

In modern dentistry, aramid threads, metal-based meshes, cast alloy gaskets, and bases made of precious metals are used. Until recently, the most popular option was high-strength fiber fabric, but today preference is increasingly given to carbon fiber or aramid threads.

Causes of structural fractures

Under normal operating conditions, acrylic dentures rarely break. Factors that create an increased risk of fracture can be divided into 3 groups:

• related to the properties of the material used - both the base and the reinforcement;
• due to the nature of the load on the prosthesis;
• associated with a violation of manufacturing technology or some objective conditions existing in the denture workshop.

Reasons related to the quality of acrylic polymer

• Insufficient tensile, impact and bending strength of the base material.
• Polymer aging.
• Reduction in the strength of the base due to water absorption during polymerization.

Reasons due to the nature of the load

1. High values ​​and multiple loads on the prosthesis.
2. Clinical and anatomical features of the jaw and oral cavity – torus, exostoses, flat palate, narrowed jaw, single teeth.
3. Complex jaw prosthetics. These are cases when the manufacture of a prosthesis is carried out after surgery due to any defect in the teeth or jaws.

Causes of breakdowns due to the manufacturing process

1. Entry of foreign bodies into the polymer mass.
2. Pieces of wax remaining on the surface of the teeth, leading to disruption of the surface of the mold.
3. Uneven thickness of the base plate.
4. Defects in dental alignment.
5. Violations during installation of reinforcement.
6. Error in determining the central relationship of the jaws.
7. Failure to comply with the polymerization regime, leading to internal stress. For example, cooling the structure too quickly after polymerization.
8. Uncorrected bony protrusions.
9. Errors of the technician or doctor in ensuring correct occlusion (contact of the upper and lower teeth).

Factors that increase the risk of failure

• Bruxism (night grinding of teeth).
• The presence of a complete removable denture in the opposite row.
• Rough handling, such as falling, plunging into too hot water.

In general, to summarize, the service life of an acrylic prosthesis is based on three components: the presence of reinforcement, workmanship and proper operation.

Indications and contraindications

When deciding to reinforce the prosthesis, you do not have to worry about possible discomfort after making changes to the structure of the structure. All reinforcing elements are located inside the base, do not come into direct contact with mucous tissues, and do not have a negative effect on the condition of the oral cavity. The indications, the presence of which is the reason for reinforcing the prosthetic system, include:

• Narrowing of the oral cavity - in such situations, the service life of the prosthesis increases many times, and its likelihood of damage is minimized;
• Prevention of possible fracture of the base of a worn prosthesis;
• Specific design of the bed, requiring reinforcement of the structure;
• The need for fixation of units of the dentition, characterized by increased mobility;
• Restoration of shrinkage density, eliminating chafing of the mucous membrane.

Limitations to the procedure are determined individually, during an examination in a clinical setting, as well as based on an analysis of the patient’s medical history.

Manufacturing and general requirements

The installation of the reinforcing mesh is carried out by a qualified dental technician, which is due to the complexity of the procedure. The whole process is divided into the following stages:

• Examination of the condition of the oral cavity and calculation of the potential load on supporting units;
• Preparation of a reinforcing mesh based on a plaster model of the jaw apparatus;
• Adjustment and installation of position limiters of the reinforcing element;
• Preliminary application of a fixing polymer composition;
• Installation of the base in the cuvette on one side of the grid;
• Applying the final layer of polymer, followed by sanding and polishing.

Installation of the reinforcing mesh is carried out only in the base, since placement in the beam part of the prosthesis does not increase the strength of the structure. It is recommended to reinforce deep areas with a pronounced relief texture. The duration of the procedure is from 7 to 10 days.

Before deciding to install a reinforced prosthetic structure, it is imperative to determine the presence of a possible allergy to acrylic or metal materials that are planned to be used to create an orthopedic product. Identifying limitations is an important condition, since otherwise the production of the system may not bring the desired result, since the patient will not be able to use the prosthesis for its intended purpose.

Advantages and disadvantages

The positive aspects of using reinforced prostheses are obvious:

• Strength and durability;
• Comfort and reliability;
• Convenient hygienic care;
• Aesthetics and functionality.

Strengthened models allow you to increase the load on the dentition without fear or negative consequences, which is important for patients in the older age group.

Among the disadvantages characteristic of the technology, there is an increase in the mass of prostheses reinforced with metal meshes, as well as the need to go through an adaptation period.

Service life

The service life of structures without reinforcement varies between 3-5 years. It can be less than these values ​​(for fractures of the base) and higher (up to 7-8 years) if the product is used correctly in compliance with hygienic standards.

Note. When talking about the service life of a structure, most often we mean the service life, which, in addition to the quality of the product itself, also depends on the rate of atrophy of the jaw bone tissue.

In the event that the system does not break down, most often it is bone atrophy that determines the service life.

Considering that the acrylic base under favorable conditions (no atrophy and fractures) can last up to 8-10 years, the service life of a reinforced acrylic prosthesis can be considered just that - 8-10 years.

How long do acrylic dentures last?

Dentures without reinforcement last approximately 3 – 5 years. If you properly care for it and handle it with care, its service life increases to 7–8 years.

If used incorrectly and poorly maintained, the product may not last even the required 3 years.

However, the service life of the product depends not only on its quality, but also on the rate at which the jaw bone decreases. Even if the structure does not break, it has to be replaced due to the fact that the bone tissue decreases in volume.

Acrylic plates on which artificial teeth are attached can last a very long time (8 – 10 years) under favorable conditions.

In what cases is tooth reinforcement performed?

Doctors perform reinforcement of pulpless teeth that have been severely destroyed as a result of deep caries, pulpitis, periodontitis or due to trauma. The roots and coronal area can be subjected to this manipulation. Next, a composite material is built up or artificial crowns are installed, which accurately recreate the anatomical shape, color and functionality of a natural tooth.

On a note! The procedure can be performed in cases where the patient is diagnosed with inflammation of the periodontal tissues, leading to loosening of the roots. Teeth that are loose due to periodontitis or periodontal disease are strengthened with fiberglass threads, which keep them from falling out and correctly distribute the chewing load, but here it is more correct to talk not about reinforcement, but about splinting.

If one tooth is missing, the specialist can also offer you a reinforcement procedure with special materials in order to quickly restore the defect and restore the integrity of your smile. For example, with direct restorations, doctors build up the crown with a composite on fiberglass threads fixed between two supporting adjacent teeth. This will allow the patient to solve the problem of partial adentia in one visit to the clinic.

Reviews

People experiencing a particular health problem are always interested in knowing how others cope with it.

We invite you to read reviews from patients at dental clinics who have installed reinforced acrylic dentures.

If you have your own experience using such products, share it with others and leave your review at the bottom of the page. For some, your advice may be a lifesaving option.

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Factors that increase the risk of denture failure

Even if a product is made of high-quality materials using the latest technology, it may break under the influence of certain factors. These factors include:

• The patient suffers from bruxism (involuntary grinding of teeth during sleep)
• A complete removable denture is installed on the opposite jaw
• The patient handles the product carelessly (drops it or washes it with too hot water)

In order for the prosthesis to serve for a long time and not break, three conditions must be met: the presence of reinforcement inside the structure, the high quality of the structure itself, and compliance with all operating rules.

When is denture reinforcement necessary?

Reinforcement can be carried out at the laboratory stage of manufacturing prosthetic structures. For example, if a patient has long bridges with large intermediate parts installed. During operation, they will bear a large load, and if they are not strengthened, they will cause discomfort and quickly fail.

Doctors can also strengthen removable dentures. This is done to give them greater strength and extend their service life. To strengthen the structure, experts place a metal mesh or fiberglass into the plastic base.

The presence of reinforcing materials does not cause any discomfort to the patient, because they are located at the base of the product, but the strength characteristics of the prosthesis increase by an order of magnitude.

Prices

The prices listed below should be viewed as approximate nominal values, since the cost of prosthetics depends not only on the type of base material and the presence or absence of reinforcement, but also on the material of the teeth (imported ones are more expensive, domestic ones are cheaper).

And also the price depends on other features, for example, elements of fastening the prosthesis. The cost of a separate reinforcement operation starts from 5,000 rubles.

Approximate prices of reinforced and non-reinforced acrylic and nylon prostheses

What are the dentures reinforced with?

The denture base is made of polymethyl methacrylate (acrylic plastic). It is made by injection molding with cold or hot polymerization. Hot polymerization increases the performance properties of the product.

Previously, plate structures were reinforced with metal. Today, polymers or other materials are also used for this purpose. This variety allows you to choose the best option for each patient.

The fittings for the prosthesis are made from the following materials:

• Metal alloys
• Cellulose fiber
• Fiberglass
• Aramid threads. Durable, wear-resistant material that is not afraid of exposure to organic solvents
• Heavy duty polyethylene. In order for polyethylene fibers to better adhere to the base of the structure, they are treated with gas-discharge plasma. After this treatment, polyethylene adheres well to resins and plastics
• Carbon fibers. Thin filaments (5-15 microns), in which carbon crystals are located parallel to each other. Because of this, they do not break even under strong tension. The advantage of carbon fibers is their chemical inertness, lightness, low coefficient of thermal expansion
• Quartz fibers. This is silicon oxide, which is characterized by elasticity, strength, good resistance to high temperatures and aggressive substances

Strengthening dentures with metals has long been used in denture practice. The most commonly used design is a mesh of thin wire, as well as perforated and cast plates. Manufacturers produce standard reinforcing elements (metal mesh and perforated plates). There are products made specifically for the sky (a plate with a hole in the middle).

The reinforcement is made of plastic fine mesh with a continuous metal edging.

Reinforcement elements are sometimes coated with gold and installed in areas of stress concentration

Some metal meshes are coated with gold plating. It increases the strength and aesthetics of the product. Gold-plated elements are well attached to the plaster model, firmly adhere to acrylic and match its color.