Dentistry - Equipoise Clasping

Author

Equipoise Clasping

Joel344

2006-05-09, 1:09 am

1: Aust Prosthodont J. 1990;4:53-7. Related Articles, Links

Clinical study of the modified Equipoise clasp.

de Kok M, Thomas CJ.

Department of Dental Prosthetics, university of Stellenbosch, South
Africa.

The modified Equipoise clasp has been developed to overcome the
negative aesthetics of anterior clasping. Fifteen patients involving
twenty-two Equipoise clasps were followed up for retention, aesthetics
and oral health. Examiners found that 36.4% of the clasps gave poor
retention, 18.1% were reasonable and 45.5% were good. Aesthetics were
23.6% poor, 36.4% reasonable and 50% good. Oral health was 9.1% poor,
50% reasonable and 40.9% good. The patients reported that retention was
13.3% reasonable and 86.7% good. Twenty percent of the patients felt
aesthetics were reasonable and 80% felt it was good. The clasps were
reasonably comfortable in 13.3% and most comfortable in 86.7%. The
Equipoise clasp can be used with success for, among others, the Kennedy
Class IV case if the correct clinical and laboratory procedures are
followed. However, it is unsuitable in, for example, a Class I
dentition where posterior stability is poor. Its lingual window can
adversely affect oral hygiene and careful patient selection is
necessary.

PMID: 2096896 [PubMed - indexed for MEDLINE]

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http://www.equipoisedental.com/rdp.html

The Equipoise® Complete R.P.D. System

"For most Dentists and patients, Removable Partial Denture restorations
are failures."1 This statement is as true today as it was then. Dental
Schools in general have treated R.P.D.’s with little or no
consideration for scientific evidence. Without uniform design
principles, most dentists are ill prepared in properly diagnosing
abutment teeth in R.P.D. design.

Removable Partial Dentures in Dentistry are now at the advent of a new
age. Several factors indicate the need for an increase in RPDs:

People are living longer and saving more of their remaining teeth.
Baby Boomers, the largest segment of the population (Approximately 76
million), are now reaching the age of prosthetic needs.
Implants and crown and bridge, although preferred treatment plans, are
not always indicated and are far more expensive for the patient.
Dentistry is more accessible for more people than ever before.
Immigration has increased and many of these people have not had the
benefit of proper dental care in others parts of the world.
Managed Care is on the rise. Most insurers are very particular about
paying out for "fixed" restorations (i.e. Implants and Crown and
Bridge), limiting treatment plans.

--
Joel344
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Bill

2006-05-10, 1:07 pm

Joel, thanks for posting this information.

I take issue with the author's claim that dental schools treat partial
dentures with little consideration for scientific evidence. Even though
it was nearly 40 years ago, my school was already focusing on the
engineering principles of clasp and rest design for cast partials. The
chairman of the prosthetics department was himself instrumental in the
development of the I-bar and guiding-planes concepts.

It's interesting that the article you quoted shows, "Examiners found
that 36.4% of the clasps gave poor retention." I can't imagine any
dental school program that would accept 36% of its clasps being
designed with poor retention. Why not actually apply basic principles
and design the clasps with GOOD retention from the beginning?

Although it can be said that many patients "need" a removable partial
denture, it is also a fact that many patients don't do very well with
them. Most often this is due to poor oral health habits and substandard
hygiene, which is often what caused the original tooth loss, creating
the "need" for a partial denture in the first place.

If people won't bother to take care of themselves, they can't expect
that some magic appliance will suddenly take care of them.

It is also worth noting that the article classifies "oral health" of
the patients into three categories: "poor," "reasonable," and "good."
How can a level of oral health, that does not even reach the level of
"good," be termed "reasonable?"

If it doesn't reach the level of "good," perhaps it would be more
accurate to describe it as "NOT good!"

And if it is NOT good, then perhaps the plan of treatment should be
modified in order to obtain a better level of oral health.

A final word on the closing lines of the article: "Managed Care is on
the rise. Most insurers are very particular about paying out for
"fixed" restorations (i.e. Implants and Crown and Bridge), limiting
treatment plans."

It is illegal for an insurer to "limit" treatment plans. It is
perfectly legal for an insurer to follow the exact terms of its
insurance contract and to pay only for treatment included in the
contract, as the patient still retains the right to have any care he
wishes to pay for. The law on this matter is very clear.

The distinction is very important. Too many dental patients act as
though their dental choices are limited to what some inadequate,
non-comprehensive "dental plan" may happen to cover. Yet those same
patients go out and buy $25,000 automobiles without expecting some
"auto plan" to buy the car for them.

It's a free country and people can buy what they wish -- whether it's a
car, beer and cigarettes, or (preferably) first-class dental care. The
choices are theirs. They are NOT limited to what some rich insurance
company executive wants to dole out for them.

- dentaldoc