CLASSIC ARTICLE
Evaluation of photoelastic stress patterns produced by various designs of
bilateral distal-extension removable partial dentures
Wayne D. Thompson, DDS,a F. James Kratochvil, DDS,b and Angelo A. Caputo, PhDc
Veterans Administration Hospital, Long Beach, Calif, and University of California, School of
Dentistry, Los Angeles, Calif
T he extent and direction of movement of removable
partial dentures during function are influenced by the
nature of the supporting structures and the design of the
prosthesis.1 Since forces are transmitted to abutment
teeth by rests, guide planes, and direct retainers during
functional movements, optimum design based on the
best available research data will preserve the health of
abutment teeth and their supporting structures.
The purpose of this study was to compare the forces
exerted on the supporting structures of abutment teeth
by seven removable partial denture designs using a pho-
toelastic model. The designs consisted of combinations
of four direct retainer designs and two occlusal rest po-
sitions. The bilateral distal-extension or Kennedy Class I
removable partial denture was used, since it frequently
occurs in clinical situations.
LITERATURE REVIEW
The World Workshop in Periodontics (1966)2 dis-
cussed several clinical studies that showed that gingival
inflammation, tooth mobility, and bone resorption in-
creased drastically in teeth adjacent to removable partial
dentures.3-5 One of these studies was summarized in
another article,6 and other clinical studies concurred
with these conclusions.7-9 The World Workshop also
noted and discussed articles showing that it is advanta-
geous to obtain loading in the long axis of the abutment
tooth.10 The periodontal ligament is arranged to best
withstand occlusal forces in this long axis.11-13
Applegate14 wrote that the combination retainer (a
wrought-wire buccal arm and a cast lingual arm) is indi-
cated for distal-extension removable partial dentures.
McCracken15 suggested four types of direct retainers
with distal occlusal rests that can be used for a distal-
Read before the Pacific Coast Society of Prosthodontists, Portland,
Ore., and the American Prosthodontic Society, Chicago, Ill.
a
Chief, Restorative Section, Veterans Administration Hospital.
b
Professor and Director of Postgraduate Prosthodontics, Univer-
sity of California, School of Denistry.
c
Professor and Chairman, Dental Materials Section, University of
California, School of Dentistry.
Reprinted with permission from J Prosthet Dent 1997;38:261-73.
J Prosthet Dent 2004;91:105-13.
FEBRUARY 2004
extension removable partial denture. He stated that in
his experience, the combination retainer is superior to
other designs. He also stated that the bar and circum-
ferential direct retainer designs should be used only
when the undercut is present on the distal surface of the
abutment tooth.
Kratochvil16 has stated that when placed at the point
of greatest circumference of the buccal surface of the
abutment tooth and used in conjunction with a me-
sioocclusal rest, the I-bar direct retainer will control
torquing force on the tooth. However, the metal-to-
tooth contact of the framework in the distal gingival
regions must be physiologically adjusted in the patient’s
mouth to prevent tooth and tissue impingement. In
another laboratory study, Kratochvil and Caputo17
tested this design concept with the adjustment proce-
dure using photoelastic analysis. The results showed that
this design along with the adjustment of the framework
keeps the force within the long axis of the abutment
tooth.
In two current studies, a positive correlation was
demonstrated between stress analysis of photoelastic
models and histologic specimens.18,19
More recently, Henderson and Steffel20 described
five types of direct retainer designs that can be used for
distal-extension removable partial dentures. They sug-
gested using double mesial occlusal rests with these de-
signs.
In many studies, attempts have been made to mea-
sure the movements of the abutment teeth of distal-
extension removable partial dentures. Clayton and
Jaslow,21 Cecconi and associates,22 Shohet,23 and
Nally24 have studied the forces on abutment teeth in
laboratory experiments by mechanical methods using
measurement gauges. Clayton and Jaslow21 found
that the wrought-wire direct retainer design exerted
greater forces against the abutment tooth than the
cast bar clasp. Results of the study by Cecconi and
associates22 showed that the direction of abutment
tooth movement was not significantly altered by di-
rect retainer design and did not indicate a ‘“best”
clasp design. They found greater movement of the
abutment tooth with the I-bar design. However, their
THE JOURNAL OF PROSTHETIC DENTISTRY 105
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Fig. 1. Plastics used to form test model are: type A, pho-
toelastic plastic for entire tooth; type B, photoelastic plastic
for periodontal ligament; and type C, photoelastic plastic for
bone.
Fig. 3. Design No. 2— distal rests and cast circumferential
arms.
procedures did not indicate relieving the distal guid-
ing planes of the frameworks, as described by
Kratochvil,16,17 which is essential to this concept. A
study by Shohet23 confirmed that a more destructive
distal force was exerted on an abutment tooth with
the circumferential direct retainer and the internal
precision attachment. The study by Nally24 showed
that less distal displacement of the abutment tooth
resulted with a mesial occlusal rest and that the two
designs that stressed the abutment teeth most were
the circumferential and T-bar designs with distal rests.
MATERIALS AND METHODS
A photoelastic model was used to observe and evalu-
ate the effects of different direct retainer designs and
occlusal rest positions on the apical movement of the
abutment teeth after occlusal loading with a standard-
ized force. This provided a basis for analyzing the forces
by observing the stress concentration lines produced by
the seven test designs.
A model was fabricated that included the anterior
teeth and the first premolars on both sides. The teeth,
including the roots, were formed with one type of
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THOMPSON ET AL
Fig. 2. Design No. 1—mesial rests, buccal I-bars, and distal
guiding planes.
Fig. 4. Design No. 3—mesial rests and cast circumferential
arms.
plastic (type A), (PLM-1Z, Photoelastic, Inc.,
Malvern, Pa.) the periodontal ligaments were formed
by coating the root surfaces with a second plastic (type
B), (Solithane, Thiokol Chemical Corporation, Tren-
ton, N. J.) and the remainder of the model which
simulates bone was of a third plastic (type C) (PL-2,
Photoelastic, Inc., Malvern, Pa.) (Fig. 1). The teeth,
roots, and tissue contours of the model were of aver-
age size and shape. The periodontal ligament was
formed to an approximate 0.2 mm. thickness, based
on data reported in the literature.11,12 The clinical
crowns were contoured with undercuts of no more
than 0.010 inch. This eliminated the possibility of
excessive undercut engagement. (It is realized that
some of the designs call for greater undercuts.)
Seven removable partial denture frameworks were
fabricated of chrome-cobalt metal (Vitallium, How-
medica, Inc., Chicago, III.) for the master model and
incorporated basic designs. All frameworks were pro-
duced by one laboratory using standardized conditions
and methods.
Design No. 1 (Fig. 2) had mesial rests, buccal I-bars,
and distal guiding planes. This framework was properly
adjusted with chloroform and rouge16,17 to prevent im-
VOLUME 91 NUMBER 2
THOMPSON ET AL
Fig. 5. Design No. 4 — distal rests, 18 gauge wrought-wire
buccal arms, and cast lingual circumferential arms.
Fig. 7. Design No. 6 — distal rests, buccal one-half T-bar
arms, and cast lingual circumferential arms.
Fig. 9. Removable partial denture design on the photoelastic
cast with silicone simulating the mucosa.
pingement of guiding planes and lingual minor connec-
tors during movement. The undercuts engaged by the
retentive arms were limited to 0.010 inch.
Design No. 2 (Fig. 3) had distal rests with cast cir-
cumferential arms on both buccal and lingual surfaces.15
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THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 6. Design No. 5—mesial rests, 18 gauge wrought-wire
buccal arms, and cast lingual circumferential arms.
Fig. 8. Design No. 7—mesial rests, buccal one-half T-bar
arms, and cast lingual circumferential arms.
Fig. 10. Test design with a connecting bar for force
distribution.
Undercuts of 0.010 inch were engaged on the mesial
buccal surfaces only.
Design No. 3 (Fig. 4) had mesial rests with cast cir-
cumferential arms on the buccal and lingual surfaces.
They originated at the mesial occlusal surfaces of the
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THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 11. Testing apparatus with the photoelastic model in test position.
Fig. 12. Arrangement of light, lens, and camera is depicted schematically.
teeth and extended distally.20 Undercuts of 0.010 inch
were engaged only by the buccal arms.
Design No. 4 (Fig. 5) had distal rests, cast lingual
circumferential arms, and 18 gauge wrought-wire buc-
cal arms (Ney PGP Wire, The J. M. Ney Company,
Hartford, Conn.) that originated at the distal occlusal
rests and extended mesially to engage 0.010 inch under-
cuts.14,15
Design No. 5 (Fig. 6) had mesial rests, cast lingual
circumferential arms, and 18 gauge wrought-wire buc-
cal circumferential arms. (Ney PGP Wire, The J. M. Ney
Company, Hartford, Conn.)20 They originated at the
mesial tests and extended posteriorly to engage 0.010
inch undercuts on the buccodistal surfaces.
Design No. 6 (Fig. 7) had distal rests, cast lingual
circumferential arms, and buccal one-half T-bar retainer
108
THOMPSON ET AL
arms.14,15 The bar clasp arms engaged 0.010 inch un-
dercuts distally.
Design No. 7 (Fig. 8) had mesial rests, cast lingual
circumferential arms, and buccal one-half T-bar retainer
arms.20 The bar clasp arms engaged 0.010 inch under-
cuts distally.
Each framework was carefully fitted to the master
model for proper seating of the rests and proper position
and contact of the retainers. Plastic denture bases were
attached to the frameworks with a uniform 2-mm space
between the denture bases and the ridges of the master
model. This 2-mm space was lined with silicone impres-
sion material (“Sir,” silicone rubber base, Stern Dental
Company, Mount Vernon, N.Y.) to simulate mucosa
resiliency (Fig. 9). A metal bar was positioned between
the right and left denture bases at the level of the occlu-
VOLUME 91 NUMBER 2
THOMPSON ET AL
Fig. 13. Test design with the load cell delivering force and
the fiberoptic light source in center of cast.
sal plane in the region of the mesial cusp of the first
molar (Fig. 10). A matrix was used to uniformly place
the bar on all frameworks. The load was directed against
the center of this bar.
A rotating platform was constructed in the center of a
straining frame; this platform would accept the pho-
toelastic model on the center of rotation. This permitted
movement around a fixed axis which presented all parts
of the model to a fixed camera source (Fig. 11).
A light source was derived from a fixed fiberoptic
system positioned in the center of the rotating platform.
The camera and light source were fixed in relation to
each other while the model rotated between them. Re-
sults were photographed with 35 mm. color and 4 ⫻ 5
black-and-white film (Fig. 12).
A load cell was positioned by means of a straining
frame mounted on the rotating platform. This load cell
delivered a vertical force which was calibrated and re-
corded by an x-y recorder. A load of 66 pounds was
delivered to the center of the crossbar connecting the
denture bases, resulting in approximately 33 pounds of
force to each side (Fig. 13). Each partial denture design
was tested by loading three times. The first was for ori-
entation and visual evaluation, the second for recording
results with black-and-white film, and the third for re-
cording results on color film.
RESULTS
Examination of the model before placing any partial
denture framework on it revealed no significant stress.
Observations of both sides of the arch revealed that the
left side received a greater part of the applied load for all
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THE JOURNAL OF PROSTHETIC DENTISTRY
frameworks tested. Since the nature of the response was
similar for both sides, the presentation of the data will be
facilitated by considering the left side of the arch.
Sketches which define regions and extent of substruc-
ture involvement are presented as an aid in describing
and interpreting the stress distributions observed. The
sketches are not drawings of individual fringe lines and
must be considered in conjunction with the isochro-
matic fringe patterns (Figs. 14 to 20, A). Selected
sketches of isochromatic patterns are presented to dem-
onstrate the comparative intensity among designs. In
these sketches, higher fringe numbers indicate higher
stresses (Figs. 14 to 20, B). For all the frameworks
tested, no clear photoelastic information was recorded
in the coronal portions of the model teeth or the residual
ridges because of the presence of the lingual bar and
denture bases which prohibited the passage of light in
these regions.
Design No. 1—Mesial rest, I-bar retainer
(Fig. 2)
The occlusal load concentrated stresses near the crest
of the ridge (Fig. 14). The internal stresses that devel-
oped in the root of the premolar were fairly uniform
with a tendency to concentrate mesially near the crest
and down the mesial surface. The supporting structure
near the premolar revealed a primarily apical stress re-
sponse, with a mesial drift interacting with the apex of
the canine. Only minor involvement of the canine can be
noted.
Design No. 2—Distal rest, cast circumferential
retainer (Fig. 3)
Stress observed in the edentulous region was fairly
uniform and extended posteriorly (Fig. 15). Stress was
concentrated at the mesial and distal surfaces of the root
of the premolar, indicative of some bending within the
root. Stress was localized apical to the root in the sup-
porting structure, with a tendency for a distal drift. Some
interaction was noted between the canine and the pre-
molar and near the apex. Stress developed at the apical
third of the canine.
Design No. 3—Mesial rest, cast
circumferential retainer (Fig. 4)
The pressure that developed in the edentulous region
was uniform in distribution, with an increase in intensity
near the distal part of the root of the premolar (Fig. 16).
A reduction of stress intensity within the root was noted
in comparison with design No. 2. The stresses apical to
the premolar were less than those observed with the
same retainer design using a distal rest.
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THE JOURNAL OF PROSTHETIC DENTISTRY THOMPSON ET AL

Fig. 14. A, Diagrammatic sketch of forces resulting from design No. 1. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 1. Ascending numbers indicate increased stresses.

Fig. 15. A, Diagrammatic sketch of forces resulting from design No. 2. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 2. Ascending numbers indicate greater stresses.

Fig. 16. A, Diagrammatic sketch of forces resulting from design No. 3. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 3. Ascending numbers indicate greater stresses.

Design No. 4 —Distal rest, 18 gauge wrought-
wire buccal arm and cast lingual arm retainer
(Fig. 5)
More intense pressure was developed in the edentulous
region with this design (Fig. 17). High concentrations of
stress were observed within the premolar root near the
distal rest, and there was a reduced intensity near the mesial
edentulous crest. This indicates a tendency to bend and
rotate the tooth distally. The stresses apical to the premolar
lean mesially and interact with the canine. This tooth re-
ceived no significant stresses under loading.

110 VOLUME 91 NUMBER 2

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Fig. 17. A, Diagrammatic sketch of forces resulting from design No. 4. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 4. Ascending numbers indicate greater stresses.

Fig. 18. A, Diagrammatic sketch of forces resulting from design No. 5. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 5. Ascending numbers indicate greater stresses.

Fig. 19. A, Diagrammatic sketch of forces resulting from design No. 6. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 6. Ascending numbers indicate greater stresses.

Design No. 5—Mesial rest, 18 gauge
wrought-wire buccal arm and cast lingual arm
retainer (Fig. 6)
A situation existed in the edentulous region that was
similar to that existing with design No. 4, but of a little
higher intensity (Fig. 18). However, within the premo-
lar, the mesial rest caused a much reduced and more
uniform stress distribution. The stresses around the pre-
molar were mainly apical with some interaction with the
canine.

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Fig. 20. A, Diagrammatic sketch of forces resulting from design No. 7. B, Isochromatic stress lines indicating intensity of forces
resulting from design No. 7. Ascending numbers indicate greater stresses.
Design No. 6 —Distal rest, one-half T-bar and
cast lingual arm retainer (Fig. 7)
Low-level, uniformly distributed stresses were gener-
ated in the edentulous region by this design (Fig. 19).
Some stress concentration was observed distal to the
premolar near the crest of the ridge. Stresses were trans-
mitted apically, with a tendency for a mesial drift and an
interaction with the apex of the canine. Intense concen-
trations of stress developed within the root of the pre-
molar especially along the distal surface, along with a
concentration mesially near the gingival crest.
Design No. 7—Mesial rest, one-half T-bar and
cast lingual arm retainer (Fig. 8)
Minor uniform stresses were observed in the distal
edentulous region (Fig. 20) A uniform stress distribu-
tion was evident within the tooth, with some concentra-
tion within the apical third. Stresses within the support-
ing structure were primarily apical near the premolar,
with a slight distal drift and some interaction with the
canine. Low-level stress was developed within the canine
in the apical third.
DISCUSSION
These experiments indicate that anterior positioning
of rests provides a better mechanism for vertical load
transfer. This was observed with all tested designs.
Comparison of the data for the designs tested further
revealed that the most severe stresses were produced by
design No. 2 (distal rest, cast circumferential retainer,
Fig. 3); design No. 4 (distal rest, wrought-wire buccal
arm and cast lingual arm retainer, Fig. 5); and design
No. 6 (distal rest, one-half T-bar and cast lingual arm
retainer, Fig. 7). This may be caused by the retainer
engaging the mesial undercuts on the buccal surfaces
and the distal rest exerting a posterior force.
The most favorable internal force distribution re-
sulted with design No. 1 (mesial rest, I-bar retainer, Fig.
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THOMPSON ET AL
2) and design No. 5 (mesial rest, wrought-wire buccal
arm and cast lingual arm retainer, Fig. 6). The mesial rest
with I-bar retainer is preferred because of less tooth
contact, greater esthetic acceptability, and less interfer-
ence with natural tooth contours.
It is important to note that all undercuts engaged
were only 0.010 inch. It may be theorized that engaging
deeper undercuts might cause stress patterns of greater
magnitude and of different size and location. It is also
likely that bulkier cast clasp arms, which result from
variations of dental laboratory wax-ups, may result in
greater stress because of reduced flexibility.
The thickness of the tissues covering ridges will un-
doubtedly affect the amount of denture movement and
will be an important factor in the direction of forces
transmitted to the supporting structures. Studies have
indicated that use of the altered-cast impression tech-
nique provides better support for the prosthesis and
helps reduce its movement in function.25,26 Each clinical
situation presents a specific set of circumstances which
cannot be reproduced in laboratory experiments. How-
ever, this study can assist in developing basic concepts
for the design of removable partial dentures. An example
is using mesial rests in the design of distal-extension
removable partial dentures.
It is important to note that the forces evaluated were
direct vertical forces. If lateral forces had been incorpo-
rated in the experiment, different or additional stress
patterns could have been demonstrated.
CONCLUSIONS
The results of this study showed that:
1. The design of a retainer with a mesial rest in con-
junction with a buccal I-bar or a wrought-wire and cast
lingual arm exhibited the most favorable distribution of
vertically applied forces.
VOLUME 91 NUMBER 2
THOMPSON ET AL
2. Retainer designs with a distal rest tend to move
the clinical crown distally and the root mesially at the
apex, resulting in horizontal forces in the bone.
3. Placing rests of distal-extension removable partial
dentures more anteriorly provides an axis of rotation
that directs applied forces in a more vertical direction.
4. The distal rest in conjunction with circumferential
retainers developed greater horizontal forces within the
supporting structures.
The authors thank Mr Mark Koenig for assistance in fabricating
the photoelastic models and performing the tests; Dr Krishan K.
Kapur, Chief, Dental Service, Veterans Administration Hospital,
Sepulveda, Calif., for use of optical testing facilities; and Dr Hubert
O. Minick, Chief, Central Dental Laboratory, Veterans Administra-
tion Wadsworth Hospital Center, Los Angeles, Calif., and the Pro-
fessional Laboratory, U.C.L.A. School of Dentistry, for fabrication of
the test partial denture frameworks.
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0022-3913/$30.00
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