Download to read offline
Journal club RPI RPA clasp in cast partial dentures.pptx
- 1. Journal club Dr. VaibhavDeshpande MDS II
- 2. Maxillary andmandibular distal extension rehabilitation: combination of cast partial denture with RPI system and flexible partial denture: a case report
- 3. ABSTRACT IntroductionThe aim of this paper is to present a case of partial edentulous in maxillary and mandibular arch. Removable partial denture (RPD) is one of the various treatment options available for the replacement of teeth for partially edentulism patients
- 4. INTRODUCTION Distal extensionRPD is represented as one of the most critical treatment statuses for achieving successful long- term prognosis and preservation of the remaining natural teeth and their supporting structures In bilateral distal extension RPDs, the problems raised are related to the difference in support between the abutment teeth and the residual ridges. Cast partial denture compared with acrylic partial denture provides better result in terms of retention, stability, comfort and periodontal health of abutments
- 5. RPI CLASPDESIGN Features -The design characteristics that allow an RPI clasp to release from an abutment tooth when occlusal forces are applied to the denture base In addition, the clasp gives good resistance to occlusal displacement, covers a minimum of tooth structure Contraindications- Insufficient vestibular depth will not allow the I bar to be kept 3 mm away from the gingival margin, which is desirable for its protection. When a tissue undercut below the abutment teeth is present, relief for the approach arm of the I bar may be so extensive that it is uncomfortable to the patient.
- 7. RPA CLASPDESIGN The RPA clasp was developed to deal with the problems encountered with the use of the RPI clasp. The initials signify rest, proximal plate, and Akers clasp arm. The mesial rest and proximal plate are designed identically to those of the RPI clasp. The difference is in the retentive arm. An Akers, or circumferential clasp arm, arises from the superior portion of the proximal plate and extends. Around the tooth to engage the mesial undercut. Mouth preparation is the same as that for the RPI clasp. A rest seat is placed on the mesio-occlusal surface of the tooth and a guiding plane prepared on the distal surface
- 9. Aim and objective This case report describes bilateral partial edentulism in maxillary and mandibular ridge restored with cast partial denture and the flexible partial denture respectively
- 10. Case presentation 56-year-oldfemale The patient had a history of multiple grossly decayed posterior teeth in both maxillary and mandibular arches which were extracted two years back Extra oral examination showed no evidence of facial asymmetry or TMJ abnormalities. Intra-oral examination showed a dentate situation of Kennedy’s Class 1 in maxillary arch and Kennedy’s Class 1 Mod.1in mandibular arch. All teeth except 16, 17, 18, 26, 27, 28 were present in maxillary dentition. 24 was restored with a porcelain fused metal crown
- 11. In mandibulardentition all teeth were present except 34, 36, 37, 38, 46, 47, and 48.
- 12. Treatment planning Thepatient was recalled for the diagnostic impressions and were made with irreversible hydrocolloid impression material After evaluating the diagnostic casts, surveying of the maxillary cast was done followed by designing (a) cast partial denture for the maxillary arch and (b) flexible partial denture w.r.t mandibular arch
- 13. The maxillarydenture design had planned as anterio-posterior palatal strap as major connector and RPI clasp system on 15 and 25 was adapted for better aesthetics and function. The distal occlusal rest seat was planned w.r.t 14 and mesial occlusal rest seat w.r.t 15 & 25, and the cingulum rest seats w.r.t 13 and 23 for indirect retainers. Required mouth preparations were carried out. Once the preparations were evaluated, the final impressions were made using polyvinyl siloxane addition silicone material
- 14. Framework trialis done and for checking the adaptation. The maxillary occlusal Rim was then fabricated and the maxillomandibular relation was recorded. The patient was recalled for the try-in and necessary adjustments, followed by the conventional processing and the final insertion.
- 16. Discussion Cast partialdenture with respect to maxillary arch is considered ideal in this case as patient Horizontal forces are harmful forces and applied on the supporting teeth and the alveolar ridge. To minimize their effect, it is important that the retentive and the stabilizing arm of the clasp to be fitted correctly in the appropriate areas on the tooth and also is important to find the right direction of insertion of the denture itself desired for cost effective swift treatment.
- 17. Advantages of Ibar Food accumulation is minimized because tooth contours are not significantly altered. Minimize torquing forces and direct occlusal loads parallel to long axis of abutments. Clasp terminus disengages from tooth when occlusal load is applied to the adjacent distal extension base. Lateral forces are minimized as approach arm does not contact the abutment
- 18. Conclusion The designof distal extension removable dentures should be chosen after proper evaluation of each patient situation and consider the merits and demerits of the components if not planned accordingly. In this case the patient expectations regarding the rehabilitation of function and the aesthetics were fulfilled economically within a short span of treatment time by not involving any invasive dental procedures.
- 19.