Discuss the contra-indications andundesirable effects of metal partialdenture provision.

• The supporting teeth should be physiologically sound. Abutment teeth are used to support the denture and prevent it from dislodging
1. If the teeth are compromised the metal denture will apply pressure causing it to weaken the structure and possibly cause removal of the tooth.
• Periodontal breakdown- Clasped teeth suffer periodontal breakdown when excessive functional forces in excess of their physiological limits are placed on them. This danger is most often witnessed in the abutment teeth of free end saddle cases.
1. The bony structure and soft tissues covering edentulous ridges and hard palate breakdown under excess pressure, leading to resorbed ridges. Therefore itll lead to tooth mobility, possible aggravation of existing periodontal diseases or inflammation of mucous membrane.
• Oral Hygiene- Any component placed in the oral environment covers part of the tissue, this has an undoubted affect on oral hygiene. The component should either be self-cleansing (have space beneath, around it) or be easily removed to enable access for cleaning.
1. If the patient is unlikely or unable to regularly clean bacteria can grow under the denture baring area which can lead to inflammation of tissue that could progress to the underlying tissue and diseases such as teeth decalcification and caries
• Allergies- Some (although it is less than 3%) have an allergic reaction to Co/Cr alloy used in denture construction. Other alloys or designs should be a consideration in these cases. Stainless steel, Gold etc.
• Unnecessary- If there is no movement of surrounding teeth predicted, no increase in masticatory efficiency can be achieved, or no improvement of aesthetics then a partial denture is deemed unnecessary and will not provide any benefit to the patient
• If the denture has a design error within the occlusal area this can cause problems creating tooth mobility or possible muscle dysfunction damaging the TMJ. More still trauma induced by components of the metal denture can cause abrasion to the tissue, inflaming the soft tissue and possible the underlying tissue or in the worst case denture induced hyperplasia, where excess folds of connective tissue form as a protection against continuous rubbing.

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Discuss the contra-indications andundesirable effects of metal partialdenture provision.

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