There are two types of partial dentures: fixed and removable. Fixed partial dentures (FPDs) look natural and are more comfortable than removable partial dentures (RPDs). However, FPDs are more expensive and therefore are recommended to replace one or two missing teeth.
All FPDs and RPDs have pros and cons. Some are expensive but attractive, while others are inexpensive but require more time to get used to. Still others are comfortable and cheaper but less stable or require more maintenance.
FPDs are also called bridges. Bridges are artificial teeth affixed to the jaw or permanently attached under the gum tissue. There are two types of bridges: conventional and bonded fixed bridges.
Bridges don't work very well if you're missing three or more teeth in a row. It is difficult to clean bridges; therefore, bad breath or other oral problems may arise. Flossing must be part of your dental hygiene routine for their care.
Due to their permanent nature, bridges make you susceptible to inflammation. They are also more expensive than RPDs.
Disadvantages of Conventional and Bonded Fixed Bridges
A conventional fixed bridge requires more tooth reduction than does a bonded fixed bridge. In a case of excessive bone or gum loss, a conventional bridge may not look as natural as a bonded fixed bridge.
A bonded fixed bridge may not last as long as a conventional bridge and is less reliable, as the gum tissue around the teeth might shrink and leave empty spaces that can cause additional dental problems. Also, in some cases, the metal backing of a bonded fixed bridge may show off.
RPDs consist of a resin base, artificial teeth, and a metal clasp fixed on a metal frame. Types of RPDs include flippers, cast metal, flexible framework, Nesbit, and Cusil.
Disadvantages of RPDs
Flippers have a brittle acrylic base and tend to break frequently. To prevent breakage, the flipper construction is thickened, which makes them fairly uncomfortable. Flippers are not as stable as bridges and must be relined frequently, because, with time, they descend from their original level.
RPDs with a cast-metal frame are the most stable; however, the metal framework adds more pressure to the teeth and can be uncomfortable.
Flexible-framework RPDs are made from a synthetic nylonlike material. As the name suggests, they are extremely flexible and therefore easy to install. However, adjusting their polymer framework takes effort and can be problematic. Sore spots develop easily, and excessive time can be spent giving flexible-framework RPDs a comfortable fit.
The Nesbit RPD consists of a single tooth. Made from the flexible-framework material, it has metal clasps that fit around the teeth next to the gap. It is not supported by any teeth on either side of the mouth and therefore puts extreme stress on the clasped teeth, which is uncomfortable. Nesbit RPDs are prone to the danger of accidental swallowing, but the flexible material is safe for the digestive tract's lining.
Cusil RPDs are like full dentures. They sit in the location of the missing teeth and have spaces to accommodate the residual natural teeth. They are more expensive than any other RPD and require good oral hygiene for maintenance.
All RPDs must be removed for cleaning and can get lost or damaged during or after removal. To some wearers, they feel less stable.