The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

Esthetica sectional denture with magnetic attachment: a case report
Shibata S1)，Matsumoto T2)，Ohkubo C1)
1

Department of Oral Rehabilitation and Prosthodontics, Tsurumi University School of DentalMedicine
2
Department of Dental Technician Training Institute, Tsurumi University School of Dental Medicine

I. Introduction
Currently, non-metal clasp denture are commonly used for esthetically demanding patients, to avoid
exposure the metal clasp on the labial side of the abutment teeth. However, the rigidity of conventional
non-metal clasp denture would be insufficient, it may have a negative impact the prognosis of theabutment teeth1).
Denture design based on the rigid support most be necessary to minimize the denture mobility 2).

II. Case report
1．Patient information
The patient was a 75 years old woman. She came to our hospital with a chief complaint of esthetic
defect due to detachment of anterior crown from the abutment tooth. Her #13 anterior resin crown andpost core were detached in December 2021. There was little structure of remaining tooth, and root
fractures was also observed. Fixed implant prostheses were placed at #23,#24 in 2005 and #47,#46,#45
in 2015, respectively.

Fig.1 Panoramic radiograph after teeth extraction #12and#13[Web Presentation] PS1-3-1

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

Fig.2 Intraoral views after teeth extraction #12 and #13
2．Treatment plans
After ＃12 and #13 were extracted, a non-metal clasp denture was placed as an immediate denture(Fig.3). Since the amount of remaining bone was insufficient, bone augmentation must be necessary
for implant placement, she did not accept implant treatment. Therefore, we proposed a metal baseremovable partial denture (RPD) without metal clasp xisting on the labial side for esthetic reasons.

Fig.3 Non-metal clasp denture as a immediate dentureIII. Denture fabrication
1．Denture design
Rests were placed on proximal occlusal surfaces of the #14,＃15,and #24 for the support. Guideplanes were prepared on the palatal side of #15,#14 and #21~#24 to obtain the bracing.Using theundercut below the adjacent surfaces of the #14 and #21, labial sectional part was fitted for theretention. Labial sectional part and main palatal framework were connected and fixed using magneticattachment on the sectional surface 3)(Fig.4).

Fig.4 Working cast

[Web Presentation] PS1-3-2

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

2．Fabrication of framework
Main palatal framework and movable part with Choix Swing Wedge Attachment (Fig5- a, b) werecast of Co-Cr alloy, and two castings were joined by laser welding (Fig.5-c). A rotational movable
plate was cast of sgold-silver-palladium alloy and then it was integrated to main framework withorthodontic 0.9 mm round wire (Fig.5-d).

Fig.5-aFig.5-b

Fig.5-cFig.5-dFig.5 Framework fabrication

3．Framework try in
The completed framework was tried in the oral cavity to check the fittness, movement of theswinging wedge attachment, and the retention was comfirmed. The occlusal contacts at centricocclusion and during eccentric movement were given on the metal up regions and rests of theframework to avoid stress to the swinging wedge attachment hinges.(Fig.6)

Fig.6 Intraoral views of framework
4．Placement of magnetic attachment
A keeper (Physiomagnet, Kedica??) was placed on the sectuonal surface of the movable plate using
adhensive resin cement (Panavia V5, Kurare?) (fig.7-a). The magnetic assemble (Physiomagnet,Kedica??) was fixed on the palatal side of the main frame. After artificial incisors were arranged andfixed using hybrid resin (????, GC?) (Fig7-b), and the denture base was characterised with stain(????, GC?) (Fig8).

Fig.7-a,b Fixation of magnetic assembly[Web Presentation] PS1-3-3

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

Fig.8 Completed sectional denture

IV. Denture delivery
1．Confirmation on the working cast
Before delivery, the adjacent surface of the denture base fitted to the undercut below the adjacentsurface was confirmed on the working cast by opening (Fig.9-a) and closing (Fig.9-b) the sectionalpart, .

Fig.9-a Opening the sectional partFig.9-b Closing the sectional part
2．Denture placement
The sectional denture was placed with great accuracy without pain on the abutment teeth and themucosa, including during placement and removal. The sectional part did not open or close during
mandibular movements. Patient highly satisfied of esthetics and function to the sectional denture(Fig.10).

Fig.10 Placement of sectional denture[Web Presentation] PS1-3-4

The 23rd International Conference on Magnetic Applications in Dentistry (Feb. 26 to Mar 15, 2024)
http://jsmad.jp/international/23/

3．Observation
Intraoral views of denture placement and subjective evaluartion to the new denture at one monthafter denture delivery were shown in Figs 11 and 12, repectively. The OHIP-J14 and the VAS showed
higher level of patient satisfaction. No problems were observed about the denture and the abutment
teeth for ten months after delivery.

Fig.11 Intraoral views of one month after denture delivery

OHIP-J14: 4 point
Fig.12 Visual Analogue Scale

V. Discussion/Conclusions
The application of magnetic attachments to fix the sectional compornets to obtaion the retention
during function.To avoid the stress on the swing wedge attachment hinge section, the occlusal contacts
during central occlusion and eccentric movement were given to the palatal metal up regions and restsof the framework. The sectional metal base denture indicated the highly esthetic without exposing themetal clasp on the labial side. These factors might contribute to the high level patient satisfaction. We
intend to continue to provide adequate maintenance including plaque control and force control.

References
1) Tsuzuki T et al, The trouble incidence in patients with non-metal clasp denture:Aretrospective
observational study, J Fukuoka Dent Coll.2019:44(4):129-134.
2) Ohkubo C et al, The current state of non-metal clasp dentures and prosthetic considerations, Practicein Prosthodontics 2012:45:504-514.
3) Watanabe I et al, Application of cast magnetic attachments to sectional complete dentures for apatient with microstomia: a clinical report, J Prosthet Dent 2002;88:573-7.

[Web Presentation] PS1-3-5