Indications:

Contraindications and Concerns:

Clasps have been crafted in exact proportion for proper function. DO NOT reduce clasp thickness at chairside. This could jeopardize strength and/or retention.

Conduct a complete clinical examination including Periapical and Panoramic x-rays.
Take a high quality alginate impression (e.g., Accu-Dent System 2 from Cerum Dental Supplies Ltd.) for both maxillary and mandibular arches. Pour completed impressions in high strength laboratory stone to create accurate Study Models within 5 minutes of impression-taking. Take a bite registration.
Provide a complete prescription including usual information pertaining to patient and treatment plan. Send prescription, study models and bite registration to laboratory. The laboratory will return mounted study models and bite rims (if bite registration wafers are not sufficient) for next appointment.

Restore the dentition where necessary. Prepare the teeth for rests, guide planes, occlusal room, retention, etc. as indicated by the design.
Using high quality alginate (e.g., Accu-Dent System 2 from Cerum Dental Supplies Ltd.), take a final impression (NOTE: If the opposing model is damaged, take a new impression of this as well). Pour completed impression(s) in high strength laboratory stone within five minutes of impression-taking to create final Master Model.
Send complete prescription, master model, opposing model, bite registration, articulator and final design to laboratory. Laboratory will return a framework for try-in.

Examine laboratory-supplied framework on master model mounted, along with opposing model, on articulator supplied by laboratory. Also examine framework by itself.
Insert the framework into the mouth and evaluate it for rest and clasp fit, adaptation to abutment teeth, occlusal interference, relief areas and overall stability.
Place disclosing agent on framework. If necessary, adjust framework with carbide burs while in the mouth to relieve areas where the framework binds. Repeat process if necessary. Adjust opposing dentition with diamonds, burs and polishing points. Polish relieved areas with rubber points and wheels. Confirm occlusal relationship with wax bite rim or wafer.
Select tooth shade and mould according to patient needs and established guidelines.
Send laboratory prescription, tooth selection information, framework on master model and articulator with opposing model. Laboratory will return teeth set up on framework for next appointment.

Examine framework (with teeth now in place) on master model, on articulator with opposing model and in the mouth.
Evaluate functional aspects of framework intraorally. Check rest and clasp fit, adaptation to teeth, occlusal interference, relief areas and overall stability. Adjust as necessary.
Evaluate esthetic aspects of framework intraorally. Check esthetics of teeth, shade match and occlusion. Adjust teeth if necessary.
Discuss acceptance of framework design, placement and shade of teeth and overall esthetics with patient. Have patient sign acceptance form for completion.
Return prescription, patient approved framework with teeth and articulator to laboratory. Laboratory will return finished NaturalFlex II partial for insertion.

Examine complete finished partial.
Find an easy path of insertion and insert partial into mouth. Evaluate occlusion, function and esthetics. Check lateral and protrusive excursions. Adjust as necessary.
Apply pressure indicating paste to tissue side of acrylic saddles. Reinsert partial into mouth, check for pressure spots and adjust.
Demonstrate appliance insertion and removal to patient. Patient MUST be able to perform these before leaving office. Instruct patient in appliance management and care.