Patient Work Upa. Patient Interviewb. Data gathering 1. Chief complaint 2. History of present illness 3. Medical history 4. Dental History 5. Extraoral examination 6. Intraoral examination 1
Intraoral examination 1.Visual- • Position of teeth • Number of teeth • Caries • Condition of soft tissues • Restorations present • Oral Hygiene • Design possibilities related to esthetics and function • Occlusion • Vertical space • Horizontal rel’n of mand-maxilla in centric & eccentric positions
Intraoral examination2. Digital and exploratory- Firmness of teeth Depth of pockets Extent of caries Sensitivity of teeth Condition of restorations present Condition of soft tissue Action of tongue and muscles affecting denture borders
Intraoral examination3. Roentgenographic Pathology ( cysts, tumors, granulomas, etc) Amount of bone support Periodontal pockets Periodontal prognosis Caries Bone index areas
Framework The cast metal skeleton that provides support for the remaining components of the prosthesis.Connectors Join various parts of the partial together Major connector Minor connector
Retainer Known as a clasp, it supports and provides stability to the partial denture by partially circling an abutment tooth.Rest A metal projection designed to control the seating of the prosthesis.Artificial teeth Constructed from either acrylic or porcelain.
Components of RPD Framework Cingulum extension Proximal plates External Finish line Minor connectors Reciprocal compone Of clasp assembly0cclusal rest Retentive armRetentive arm
Unit of a partial denture frameworkthat connects all the parts of the prosthesislocated on one side of the arch to theopposite side of the arch.
CRITERIA FOR SELECTION1. SUPPORT – major requirement2. PRESENCE OF PALATAL TORI – may alter the requirements for the major connector3. NEED FOR ANTERIOR TEETH REPLACEMENT – requires a different configuration4. REQUIREMENT FOR INDIRECT RETENTION – not a major item of concern
CRITERIA FOR SELECTION5. NEED TO STABILIZE WEAKENED TEETH6. PHONETIC CONSIDERATIONS7. MENTAL ATTITUDE OF THE PATIENT
1. Palatal Strap2. Double Palatal bar/ Anteroposterior bar (AP bar)3. Palatal Horseshoe Connector4. Full Palate Connector
PALATAL STRAP Most versatile and widely used Can be made narrow or wider Rarely annoying No interference to phonetics and speech
PALATAL STRAP INDICATIONS 1. Class III edentulous areas 2. Tooth-bounded edentulous spans 3. Minimal need for palatal support 4. In cases where there are 3 supporting abutments.
PALATAL STRAP STRUCTURAL DETAILS Should be wide and thin. Areal coverage is governed by the length of edentulous span and the amount of support it requires. Anterior and posterior borders of the strap should be lightly beaded.
PALATAL BAR Narrow half-ovalThickest point at the center Gently curved
PALATAL BARShould not form a sharp angle at the juncture with the denture base
PALATAL BARADVANTAGE as an interim partial dentureDISADVANTAGES difficult to adjust little support from the palate limited to replacing one or two teeth on each side
DOUBLE PALATAL BAR /ANTEROPOSTERIOR (AP) BAR most rigid maxillary major connector rely on the abutment teeth
DOUBLE PALATAL BAR /ANTEROPOSTERIOR (AP) BAR INDICATIONS Anterior and posterior abutments are widelyseparated. Presence of torus palatinus Patients with mental attitude Replacement of anterior & posterior teeth Class I, II, and IV arches
DOUBLE PALATAL BAR /ANTEROPOSTERIOR (AP) BAR STRUCTURAL DETAILS ANTERIOR BAR- should be wide and flat. BORDERS- positioned in the depression andslopes of the rugae rather than on the crests. POSTERIOR BAR- slightly beaded - located well back in thepalate, just anterior to the vibrating line.
PALATAL HORSESHOE / U-SHAPED Major Connector U-shaped connector U-shaped connector used inreplacing missing anterior conjunction with palatal teeth reinforced backings
PALATAL HORSESHOE / U-SHAPED Major Connector INDICATIONS1. Several anterior teeth are missing2. Palatal torus that extend posteriorly and cannot be covered3. Periodontally weakened anterior teeth require some stabilizing support4. Deep palatal vault which needs stabilization
PALATAL HORSESHOE / U-SHAPED Major Connector STRUCTURAL DETAILS - thin - natural rugae should be reproduced- beaded posterior borders
PALATAL HORSESHOE / U-SHAPED Major Connector Least favorablemaxillary majorconnector due to its flexibility
FULL PALATE CONNECTOR/ COMPLETE PALATAL COVERAGE All Cast CompletePalate Major Connector All acrylic resin
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE Combination of Metal and Acrylic Resin
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE All Metal AvoidoverextensionsSlight beading
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE All Acrylic Maximum adhesion and seal Remaining teeth have a poor prognosis Young patients Short life expectancy of denture Alterations are needed
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE All Acrylic Disadvantage weaker and less rigid than the metal
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE Provides ultimate rigidity and support Wide distribution of the functionalload Very little movement of the baseduring function
FULL PALATE CONNECTOR/COMPLETE PALATAL COVERAGE STRUCTURAL DETAILS THIN Natural anatomy of the palate should be reproduced The material that covers the residual ridges should be refitted easily POSTERIOR BORDER- can be made of either metal or acrylic resin.
FULL PALATE CONNECTOR/ COMPLETE PALATAL COVERAGE STRUCTURAL DETAILS border must be precisely establishedMetal slight bead should be providedAcrylic post dam seal should be located inthe zone of the palate where the mucosa is resilient
SKELETAL DESIGNprovides less intrusion on to the tissues thicker in cross-section
CRITERIA FOR SELECTION1. Requirement for Indirect Retention2. Horizontal Stability and Stress Distribution3. Anatomic Considerations4. Esthetics5. Contingency Planning6. Patient Preference Factor
1. Lingual bar2. Kennedy bar or double lingual bar3. Lingual plate4. Labial bar5. Sublingual bar
LINGUAL BARSimplest typeShould be used whenthere are noextraordinaryrequirementsBetter tolerated bypatients than anyother type ofmandibular connector
LINGUAL BAR STRUCTURAL DETAILS SUPERIOR BORDER -should clear the gingivalmargins of the lower anteriorteeth by 2 to 3 mm. INFERIOR BORDER – mustnot interfere with the lingualfrenum or with thegenioglossus muscle.
LINGUAL BAR STRUCTURAL DETAILS Should follow the contour of the lingual surface of the mandible, with no actual contact with the mucosa. 0.5 mm – space between the tissue and the tissue-bearing surface of the bar.
DOUBLE LINGUAL Bar / KENNEDY Bar / SPLIT BarContinuous Lingual bar Excellent indirect retainer Horizontal stabilityDistributes stresses to all teeth
DOUBLE LINGUAL Bar /KENNEDY Bar / SPLIT Bar INDICATIONS Axial alignment of anterior teeth requiresexcessive block out. Presence of wide diastema. Crowded anterior teeth.
DOUBLE LINGUAL Bar / KENNEDY Bar / SPLIT Bar STRUCTURAL DETAILS Presence of verticalstop Lower bar- shouldconform to the design ofa lingual bar.
DOUBLE LINGUAL Bar / KENNEDY Bar / SPLIT BarAllows free flow of saliva and food through the interproximal embrasures
Interrupted DoubleLingual Bar Modification of Kennedy Bar When the Kennedy bar is cosmetically distracting because of a prominent diastema The UPPER BAR is indiscernible.
Interrupted Lingual Plate Modification of lingual plate Large interdental spaces Lingual plate is divided into units , extended onto the lingual surfaces
LABIAL BAR INDICATIONS Inoperable,large lingual torus. Severe inclination of lower anterior orpremolar teeth.
LABIAL BARSTRUCTURAL DESIGN Same with lingual bar,but a bit thinner.Main Problem ESTHETICS – bar ispositioned low into thelabial vestibule
STRUCTURAL DETAILS THAT APPLY TO ALL MAJOR CONNECTORS Rigidity Impingement of the Free Gingival Margin - at least 6 mm (maxillary) - at least 3 mm (mandibular) Avoidance of Dead-End Apertures Border Contour Beading the Borders