Over the years, we have had the opportunity to discuss the patient presentation of cast partials with many clinicians and dental practitioners. They all seem to agree that it is important to understand the patient’s perceptions regarding removable restorations. In short, patients simply do not understand them. They doubt that the prosthesis will function. They fear their removable restoration will destroy their abutment teeth because of stress and decay. And, with esthetics becoming a prerequisite for all patients, they refuse to accept any restoration that shows unsightly metal on the abutment teeth.

Here are some “key points” we have heard suggested for the initial and insertion cast partial presentations to patients:

Initial Patient Presentation

“Replacing your missing teeth will not only improve your appearance and the way you feel, it can prevent many other problems from occurring.”

“The space left from a missing tooth affects the rest of the teeth in your mouth. The surrounding teeth try to fill the space by drifting, tipping or rotating while the teeth in the opposite jaw gradually move up or down into the spaces left by the missing teeth.”

“When your healthy teeth move because of missing teeth, they may cause you to bite in an unnatural way. This creates stress on your healthy teeth and surrounding bone. Left untreated, this condition may lead to the loss of bone or additional teeth.”

“These problems can be prevented with a custom-designed Partial Denture which will replace your missing teeth.”

Insertion Presentation

1. Put patient at ease.
2. Explain the function of partial.
3. Prepare the patient for the fact that it will take them a while to adjust to wearing a cast partial.
4. Demonstrate cast partial insertion and removal to patient. Patient must be able to perform this properly before leaving office.
5. Instruct patient on cast partial management and care.

Computerized Cast Partial Design

Technology has supplied us with another new key vehicle for clear, concise communication: an interactive computerized design system available free of charge to all of our clients. Unlike “catalogue” programs that merely list completed designs, Aurum Ceramic/Classic’s exclusive system maintains a library of all the various components (i.e., teeth, clasps, rests, connectors, etc.) needed to complete a custom prosthesis. You can also specify tooth condition, clasp type, various courses of action and materials. In fact, the system provides for up to 15,000 different partial designs per arch. Automatically applying one of Stress Broken, Semi-Rigid or Mixed Technique methodologies, it automatically creates a recommended design taking every possible configuration of the teeth into account.

A detailed full-colour plot is generated for each custom prosthesis design. The system’s flexibility allows a variety of different plots clearly outlining different treatment possibilities to be sent to you for consideration and approval before the final impression is taken. All final designs are stored on the system. Any design can be quickly re-accessed and modified as needed. And, these same plots make excellent patient education tools to explain the proposed treatment.

All that we require to create a customized design is a regular prescription form specifying:

• The morphology of existing teeth.
• Whether a regular or hidden clasp framework is desired.
• Any factor that is out of the ordinary with the case.
• Any personal preferences (e.g., a particular type of palatal connectors).

Conclusion

By utilizing clear communication with patients, supported by graphic representations of proposed treatment plans, it is possible to put them more at ease about their cast partial both prior to case acceptance and upon insertion and long-term care.