Mystery of the second molar – solved!

Abstract

Precision attachments are a type of dental prosthesis that has been around for quite some time, but many dentists may not be familiar with their practical applications. In this article, we will delve into the topic of precision attachments and explore some of the valuable insights shared by Dr. Deepa Ravichandran in her recent webinar of the DR Clinical Series.

Dr. Zainulabideen’s Opinion

The term “precision attachments” had been lingering in the back of my mind for a while, but I had never really paid much attention to it. Although I had seen it mentioned in price-lists from labs, I had never bothered to inquire about its application. However, after doing some reading and clinical trial and error, I had come to the conclusion that it wasn’t quite a practical option for tooth replacement until I attended Dr. Deepa Ravidhcndran’s webinar.

I am grateful to Dental Reach for introducing me to Dr. Deepa through their DR Clinical Series virtual lectures, and allowing me to share my experience and appreciation for this invaluable learning opportunity. Kudos to Dental Reach team for being an amazing platform and for the consistent great work!

As a fan and follower of Dr. Deepa’s impressive work, I attend the webinar on time. The entire webinar was an exciting experience, with excellent documentation of clinical scenarios. The mentor has a remarkable talent for simplifying complex concepts, enabling viewers to apply these valuable skills in their practice and ultimately benefit their patients.

10 takeaways from the webinar on ‘precision attachments’

Here are a few things I learned from Dr. Deepa’s webinar on “precision attachments”.

1. Precision attachments are used for replacing missing teeth

Precision attachments are used to replace missing teeth or to support partial dentures. They consist of two parts, one that attaches to the abutment tooth and another that fits into the prosthesis. Precision attachments have been shown to solve problems related to replacing distal extensions, which can be particularly challenging when using conventional partial dentures. This is because conventional partial dentures rely on the remaining teeth for support, and when there are no teeth remaining to provide support, they can become unstable and uncomfortable for the patient.

2. They solve problems of replacing distal extensions

Before attending the webinar, I used to take the 2 premolars as abutments to give one molar. The second molar remained a mystery. But I learnt that you can replace the second molar too – with the use of precision attachments.

3. I learnt about monophase impression material

When Dr.Deepa shared the pros of monophase, it was an eye-opener.

One of the key takeaways from Dr. Deepa’s webinar was the use of monophase impression material in creating an accurate and precise fit for precision attachments. This material has several advantages over other impression materials, such as alginate, including improved accuracy, increased predictability, and a shorter working time. By using monophase impression material, dentists can ensure that the precision attachments fit snugly and comfortably in the patient’s mouth.

4. Learnt that relining is required for initial few years

Another important consideration when using precision attachments is the need for relining in the initial few years. As the residual ridge resorbs over time, the prosthesis may become loose and require adjustment. By understanding this, dentists can ensure that the patient receives the appropriate care and avoid complications down the road. Residual Ridge Resorption (RRR) goes unnoticed until several years later the patient comes back to you.

5. It is technique sensitive and having a good lab is necessary

Dr.Deepa also covered how precision attachments are technique-sensitive and require a good lab to create the components. Passive retention and pickup impression are the most important steps that must be taken care of during the fabrication of the precision attachment components. Therefore, dentists must choose a reputable lab that specializes in creating precision attachments.

6. Very useful where implants are difficult

Being the first dentist in my family and having several members with extracted upper molars, I’ve always wondered and postponed all these cases until now, wondering how I could go about replacing those molars without having to perform sinus lifts or without giving basal-implants. Fortunately, Dr.Deepa’s webinar came in at the right moment and I can’t wait to apply these learnings in my routine practice. Precision attachments are an excellent option for patients where implants are difficult or not feasible.

7. Less expensive

Cost factor is what majority of the patients consider and having the option of precision attachments not only goes easy on their finances but also gifts the dentist with a greater profit margin in less time. They are less expensive than other options, such as implants or cast partials, making them an accessible option for many patients.

8. Can prevent secondary caries as opposed to cast partials

Additionally, precision attachments have been shown to prevent secondary caries, as they do not require partial preparations as in cast partials.

9. Support from hard and soft tissue

One of the most significant advantages of precision attachments is that they provide support from both hard and soft tissues. This means that they can be used to replace single last molars or support partial dentures without the need for palatal extensions that many patients find uncomfortable or unsightly.

10. Can be used to replace standalone molar

I was surprised to learn from Dr. Deepa ma’am that precision attachments could be used for replacing standalone molars where no adjacent teeth are present, by means of a precision attachment FPD.

The valuable insights I gained on precision attachments during Dr. Deepa Ravichandran’s webinar made me reflect on why I hadn’t discovered this topic earlier. It has undoubtedly transformed the way I approach replacing posterior teeth. I am grateful to Dental Reach & Dr. Deepa for that. I hope that all dentists can benefit from this practical knowledge, which can enhance their clinical practice, increase revenue, and ultimately improve the smiles of their patients.