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Introduction To Removable Partial Dentures

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0% found this document useful (0 votes)
9 views67 pages

Introduction To Removable Partial Dentures

Uploaded by

blackbook982
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Introduction to Removable

Partial Dentures
Prosthodontics
Treatment Options for Partially Edentulous
Types of RPD’s
RPD Classification
Clinical Anatomy Tour
Prosthodontics
Restoration or replacement
of missing teeth & contiguous tissues

Maxillofacial
Fixed Removable
Congenital Conditions
Complete Dentures Cleft palate
Crowns, Onlays
Removable Partial Acquired Conditions
Fixed Partial Dentures Dentures - Injuries
(Bridges) - Conventional - Cancer
- Attachment
Facial & Intraoral
Prostheses

Implants
Treatment Objectives
Oral Health
Restore and/or improve mastication
Restore health and comfort
Improve Quality of Life
Treatment Options
Partial Edentulism
• No Replacement
• Fixed Partial Denture (FPD)
• Removable Partial Denture (RPD)
• Implant crowns/FPD
• Extractions & Complete Denture
Treatment Option: No
Replacement
Shortened Dental Arch (SDA)
• Patients can function
with as few as 20
occluding teeth
• No significant
difference in
• chewing
• discomfort
• This concept suggests that the minimum number of
occluding pairs of teeth required to provide satisfactory
levels of oral function may vary according to age and
other factors:

• Kayser and Witter suggested that the anterior and


premolar teeth are the strategic part of the dental arch
and are essential for satisfactory oral function and oral
comfort.
No Replacement
Shortened Dental Arch
(SDA)
• Require Anterior teeth + 4-6
occlusal units
• Opposing PM’s = 1 occlusal
unit
• Opposing PM’s = 2 occlusal
units
• Symmetric loss need 4 units
• Assymetric loss need 6 units
• Kayser estimated the minimum number of teeth needed to
satisfy functional demands of modern man:

• biting→ 12 anteriors + 4 premolars


• mastication→ 8 premolars + 4 molars
• speech→ 12 anteriors
• esthetics→ 12 anteriors + 4 premolars in the maxilla
• mandibular stability→ 12 anteriors + 8 premolars + (4
molars in some cases)
Treatment
Options Partial
Dentures
• Prosthesis replacing one
or more, but not all teeth Fixed Partial Denture (FPD)
• Supported by teeth
(abutments) and/or
mucosa
• May be fixed or
removable

Removable Partial Denture (RPD)


Treatment Option: FPD

. Patients prefer cemented


porcelain fused to metal over
RPD
. Need tooth (abutment) at either
ends
Treatment Option:
FPD

Must be prepared (grind down abutments)


If too long, flexes, loosens or breaks
More expensive
Treatment Option: RPD
• Can be removed &
replaced by patient
• Less expensive
• Won’t necessarily
improve function if
patient has ≥ 4
occlusal units
Indications for
RPD's
Edentulous area too
long for fixed
prosthesis
Longer than 4 units
is more complex
Indications for RPD's

No posterior abutment
for a fixed prosthesis
Indications for RPD's

Excessive alveolar bone


loss (esthetic problem)
Indications for RPD's

Poor prognosis for


complete dentures due to
residual ridge morphology
Indications
for RPD's
Reduced periodontal
support of remaining teeth

Won't support a fixed


prosthesis)
Other Indications for
RPD's
Need for immediate replacement
of extracted teeth
Cost/patient desire
considerations
Cross-arch stabilization of teeth
needed
Treatment Option: Complete
Dentures

Remaining teeth are


hopeless
Other options are too
complex/expensive
Treatment
Option: Implant
Prostheses
Implant Crowns
Implant Bridges
Implant Dentures
Partially Edentulous Treatment
Options?
Types of
RPD’s

Interim Definitive (permanent?)


Interim Denture
(Provisional; Temporary)
Used for short time to
provide:

•Esthetics
•Mastication
•Occlusal support
Interim Denture

Partial denture made while


crowns are being
fabricated for a definitive
RPD)
Transitional Denture
Prosthesis to which teeth
will be added
Replaced after post-
extraction tissue changes
Made with intention of
subsequently altering it
Components of an RPD

Major Connector
Connects parts together
Principal functions:
Unification
Rigidity
Components of a RPD
Minor Connector
Connects other components to
the major connector
Principle functions:
Unification
Rigidity
Components of an RPD

Direct Retainer
Provides retention
against dislodging
forces.
Components of RPD
Direct Retainer

'Clasp' or 'clasp unit' composed


of:
Rest
Retentive arm
Reciprocal arm
Minor connector
Components of an RPD

Denture Base
Covers the residual
ridges
Supports the denture
teeth
Partially Edentulous Arch
Classification
May be over 65,000
possible combinations of
teeth and edentulous
spaces.

Facilitates communication
between dentists
Kennedy Classification

Class I
Bilateral edentulous areas
located posterior to all
remaining teeth
Kennedy Classification

Class II
Unilateral edentulous area
located posterior to all
remaining teeth
Kennedy Classification

Class III
Unilateral edentulous area
bounded by anterior &
posterior natural teeth
Kennedy Classification

Class IV
Single, but bilateral
(crossing the midline)
edentulous area located
anterior to remaining teeth
Applegate's Rules for the
Kennedy Classification

Rule 1:
Classification should follow rather
than precede extraction
Applegate's Rules for the
Kennedy Classification

Rule 2:
If 3rd molar is missing &
not to be replaced, it is not considered
in the classification
Applegate's Rules for the
Kennedy Classification

Rule 3:
If the 3rd molar is present and
to be used as an abutment, it is
considered in the classification
Applegate's Rules for the
Kennedy Classification
Rule 4:
If the second molar is
missing and not to be
replaced, it is not considered
in the classification
Applegate's Rules for the
Kennedy Classification

Rule 5:
The most posterior edentulous area
determines the classification
Applegate's Rules for the
Kennedy Classification

Rule 6:
Edentulous areas other than
those determining
classification are called
modification spaces
Applegate's Rules for the
Kennedy Classification

Rule 7:
The extent of the modification is not
considered, only the number
Applegate's Rules for the
Kennedy Classification
Rule 8:

There is no modification space in Class


IV
Classify the
Following Arches

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