This position paper proposes a definition and naming standard for removable partial dentures (RPDs) using thermoplastic resin, and presents a guideline for clinical application. A panel of 14 experts having broad experience with clinical application of RPDs using thermoplastic resin was selected from members of the Japan Prosthodontic Society. At a meeting of the panel, "non-metal clasp denture" was referred as the generic name of RPDs with retentive elements (resin clasps) made of thermoplastic resin. The panel classified non-metal clasp dentures into two types: one with a flexible structure that lacks a metal framework and the other having a rigid structure that includes a metal framework. According to current prosthetic principles, flexible non-metal clasp dentures are not recommended as definitive dentures, except for limited cases such as patients with a metal allergy. Rigid non-metal clasp dentures are recommended in cases where patients will not accept metal clasps for esthetic reasons. Non-metal clasp dentures should follow the same design principles as conventional RPDs using metal clasps.

This position paper reviews physical and mechanical properties of thermoplastic resin used for non-metal clasp dentures, and describes feature of each thermoplastic resin in clinical application of non-metal clasp dentures and complications based on clinical experience of expert panels. Since products of thermoplastic resin have great variability in physical and mechanical properties, clinicians should utilize them with careful consideration of the specific properties of each product. In general, thermoplastic resin has lower color-stability and higher risk for fracture than polymethyl methacrylate. Additionally, the surface of thermoplastic resin becomes roughened more easily than polymethyl methacrylate. Studies related to material properties of thermoplastic resin, treatment efficacy and follow-up are insufficient to provide definitive conclusions at this time. Therefore, this position paper should be revised based on future studies and a clinical guideline should be provided.

The kinematic center of the temporomandibular condyle is that condylar point which follows as much as possible the same movement path during different types of mandibular movements. In this study, the location of the kinematic center with respect to the palpated lateral pole of the condyle was investigated. Also, the lengths of the condylar movement path reconstructed by means of the kinematic center and the palpated condyle were compared. Mandibular movements were recorded with 6 degrees of freedom in 20 healthy subjects. A software procedure calculated the location of the kinematic center as that mandibular point for which the protrusive and opening movement path showed a minimal difference. For each subject, its average location was calculated on the basis of 16 pairs of protrusive and opening movements. The kinematic center was located posteriorly and superiorly with respect to the palpated condylar point (p < 0.0001). The standard deviation in the anterior-posterior coordinate of the average kinematic center was smaller than that in the superior-inferior coordinate (p < 0.0001). During opening, the path length of the kinematic center is longer than that of the palpated lateral pole of the condyle (p < 0.0001). In contrast to left-right differences found in the path lengths of the lateral pole of the condyle, no left-right differences were found for the kinematic center.

Little is known about the detailed kinematics of the human temporomandibular condyle during jaw opening and closing. According to the rotate and swing model by Osborn (1989), the condyle is kept in close contact with the articular eminence during opening. Whether the condyle is in closer contact with the articular eminence during opening than during closing is unknown. Another consequence of the model is that the opening condylar movements are less variable than the closing movements. In this study, the hypothesis that the opening condylar path is closer to the articular eminence and also less variable than the closing condylar path is tested. Twenty subjects (10 males and 10 females with a mean age of 22) without signs or symptoms of a craniomandibular disorder performed 2 series of 4 protrusive movements and 2 series of 4 empty opening-closing movements. The movements were recorded by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D). The kinematic center of the condyle was used as a reference point for the reconstruction of condylar movement paths. Characteristics of the opening and closing paths were investigated by means of a displacement index (DI). This index is the quotient between the three-dimensional path length and the three-dimensional path distance between the start and the end point of an opening or closing movement of the kinematic center. The DI was smaller (p < 0.0001) and also less variable (p < 0.0001) during opening than during closing. The smaller DI value, in combination with the concave nature of the movement path, indicates that the opening path of the kinematic center lies above the closing path and thus closer to the articular eminence.

The purpose of this study was to clarify the effect of the reducing agent on the oxygen-inhibited layer of the cross-linked reline material. A commercial autopolymerizing reline resin containing 1,6-hexanediol dimethacrylate as cross-linking agent and 1 wt.% sodium sulphite solution as a reducing agent was prepared. The inhibited layer was observed using an optical transmission microscope under the conditions of the application of sodium sulphite for 0, 1, 5 and 15 min after curing for 10 min in air. As a control, the reline material was cured on sealing from air. Moreover, the three-point flexural strength test was performed under the same conditions. The fracture was then observed using scanning electron microscopy (SEM). Although hardness of the inhibited layer was enhanced after the application of the reducing agent, the layer was still observed. The flexural strength of the control and the groups after application of the reducing agent was significantly higher than the group without reducing agent. SEM examination revealed many polymer beads on the group without reducing agent, whereas polymer beads could not be observed on the groups applying the reducing agent. These results indicated that the application of sodium sulphite was effective in hardening the surface unpolymerized zone.

The results suggested that ES, ES-B and LF have adequate fitting accuracy for incorporating metal framework into dentures and that annealing effectively improved the fitting accuracy of ES-B, LF and RN.

The purpose of this study was to investigate the influence of some demographic and clinical variables on psychosomatic traits of the patients who visited the prosthodontic section of the Dental Hospital at Tokyo Medical and Dental University for replacement of their removable partial dentures (RPDs). Sixty-six patients with 50 maxillary and 44 mandibular RPDs completed the psychological measurements concerning their dentures using visual analogue scales (VAS). Female patients rated significantly lower satisfaction with the comfort of their dentures than males. Younger patients expressed less satisfaction with the aesthetics of their dentures than the older patients. The period of wearing the present denture significantly correlated with psychological measures of pain, comfort, and general satisfaction, suggesting that this clinical variable may be an important factor. There was no significant correlation between the patients' general satisfaction with dentures and the retention/stability scores assessed by the examiner.

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