Partial Denture - Cast vs Flexible

I asked Dr. Dray to talk about his ideas on cast partials vs flexible partial dentures. Dr. Dray has almost 1/2 a century of prosthodontics under his belt and it's interesting to see his shift in philosophy. www.allthingsdentistry.com www.dentsitrylearningnetwork.com

Comments

1. I am a retired dental hygienist and i can vouch for the fact that both Valplast (ihave had a one tooth flipper made of Valplast #3 for 9 years and also have a 2 tooth Duraflex partial on the opposite side #12 and #14. They work very well because i had
   Excellent impressions taken by my dentist and a lab who knows how to work with these materials. They are extremely comfortable and are not harming the teeth that they are resting on. I do not chew gum or eat gooey food. I take excellent care
   Of my teeth. I know this is very necessary for good results.
2. what is the metal used framework? cobalt chrome, palladium? i have metal allergies and was wondering what route to go. prefer the rigid metal frame as opposed to all acrylic.
3. Missing the four back teeth on the bottom right and left both, can I get a partial, flexible or otherwise, that will be functional for eating? I need it for six to nine months while healing after implants. Can I get it as soon as two weeks after the extractions and implants are placed or will I be in trouble because of the gums shrinking as swelling goes down over a few months?
4. I have a metal denture for 3 front teeth would it be more comfortable with the rubber or nylon one and is it more expensive?
5. I have been making flexible partials for approx. 13 years now.  I have to agree that, for whatever the reason may be(possibly tissue response to nylon vs acrylic?), tissue responds excellently to flexible partial dentures.  I also routinely see less resorption of the bone with flexible partials in comparison to traditional partial dentures, full metal bases excluded.  As well, almost every patient I've ever had who had previously worn a cast partial and switched to a flexible partial has said that the flexible partial is far more comfortable.
   
   Teeth can be added to flexible partials.  You simply need to wax in the new tooth and rebase the partial.  I routinely add teeth temporarily(without rebasing) to flexible partial dentures with excellent results.  Many of the temporary additions last for several months to 1+ year.  I tell my patients that teeth can be added to a flexible partial, however, tooth additions incur a much higher cost(a rebase vs. repair) in comparison to cast or acrylic partials.  I tell them it's the price they'll have to pay in these instances if they want the comfort and aesthetic outcomes of a flexible partial.
    
   There are only two downfalls I see to a flexible partial denture.  They stain much faster and they can occasionally lead to gingival recession on the lingual and inter proximal aspects of the teeth over time.  Otherwise they are fabulous.
6. I am needing a partial denture made for one front tooth. I have lots of allergies, and was wondering if you tell me the composition so I can be tested, I do know I am allergic to Sodium Benzoate. Please I really need help, my dentist is unable to tell me.
7. Here's something to consider with flexible.  They are nylon.  There is no mechanical bond. When the patient wears the teeth down to the diatoric holes. The denture teeth fall out and there's no good way to put them back in.  Also. it's a bad choice if the patient will be losing more teeth as Nylon does not bond to Nylon and acrylic does not bond to Nylon.  They also turn brown after a while..Other than that, they are great. 
8. I am just getting setup with partials. I don't know if they are plastic or I guess 1/2 medal and half plastic. I was wondering am I limited on what I can eat so I won't damage my new partials? I am getting tops and bottoms and missing most of my teeth I use to chew.
9. i wish you were MY dentist! you tend to approach issues from all angles and weigh the pros/cons of each. you THINK! how very refreshing that is.
10. I would not you to be my dentist....
11. i like the major connector
12. es imposible de agregar una pieza mas al aparato ya procesado. La unica forma es reinyectandolo este proceso es como hacer un de nuevo. Tengo 13 años de trabajar con este tipo de materiales y he utilizado todo les materiales que existen y es lo mismo ya que solo el nombre cambia.
13. Thankyou for the info, my dentist tells a different story, but im suspicious of his information as it sometimes seems like hes just making things up, or being lazy.
14. This is untrue you can add to any flex material if it is a semi crystalline material or a amorphus nylon material. One requires using a liquid to soften the current material before injecting the new material and the other requires raising the melting temp up by ten degrees prior to injecting the addition. If you need the info contact your supplier! Thanks
15. I think one of the biggest things to consider is that with a cast partial you can add teeth down the road, you cannot with a flexible partial, to add teeth you have to start all over with a whole new flexible partial.
16. thanks a lot for the video ! I try to use most of the times the combination of metal framework and maybe metal stops with the resin (nylon) in the esthetic zone. cheers from mx