Tooth preparation for rest seats for cobalt-chromium removable partial dentures completed by general dental practitioners

The aim of this project was to examine tooth preparations made by general dental practitioners (GDPs) for occlusal and cingulum rest seats for cobalt-chromium removable partial dentures (RPDs). Master casts and prescribed denture designs for cobalt-chromium RPDs produced by a commercial dental laboratory from impressions made by 45 GDPs across Wales were evaluated over a period of 5 months. Rest seats and associated interocclusal clearances were assessed using pre-determined criteria. A total of 68 casts were examined. Of these, 33 did not have rest seats included in their prescription. Of the remaining 35 casts, 81 rests had been prescribed of which only 24 (30%) had signs of tooth preparations for these rest seats. Using pre-determined criteria, 60% of rest seats were under-prepared in the mesio-distal plane and 30% were over-prepared in the bucco-lingual plane. In 17 cases where natural teeth opposed the rest seat, the mean interocclusal clearance was 1.5 mm (range 0.6-3.5 mm) with 6 of the 17 rests (35%) being less than the recommended thickness. In total, 18 of the 24 rests prepared did not meet the criteria, and 11 of the 21 rests prescribed had no obvious preparation and insufficient occlusal clearance. Where prescribed, the majority of rests did not meet the identified criteria. The rest seat preparations varied greatly in all planes including the interocclusal clearance. Further emphasis should be given to aspects of denture design in undergraduate and continuing education programmes for dentists.