introduction and preview of RPD

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Produced by
Dr Hamada Mahross
Assistant professor of
prosthodontics
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Dr. Hamada Mahross

2. Clinical removable partial denture
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Course Information
Course Title Clinical Removable Prosthodontics 1
Course Code 522 PSD
Credit Hours 2 Credit hours / one clinic & one lecture
Academic Level Level 9.
Prerequisites 423 PSD Pre-Clinical Removable Prosthodontics 2
Year / Semester 1st semester 2021/2022
Course Director Dr. Hamada Zaki Mahross
Dr. Hamada Mahross

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Course Contents
Lecture References
Introduction to the course
Diagnosis & treatment planning of partially edentulous patient.
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 4, 12.
Biomechanics of RPDs
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 10.
Principles of partial denture designing & Writing work
authorization
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 13, 14.
Mouth Preparation for RPD
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co.2011 chapter 15, 16.
Impression materials and procedures for RPD
Removable Partial Dentures, A Clinician’s Guide by John
D. Jones & Lily T. García, Blackwell Publishing, 2009.
Fitting the metal framework
McCracken’s Removable Partial Prosthodontics 12 th
edition, Mosby Co. 2011 Chapter 17.
Dr. Hamada Mahross

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Establishing occlusal relationship for RPD
Removable Partial Dentures, A Clinician’s Guide by John
D. Jones & Lily T. García, Blackwell Publishing, 2009.
Stewart’sClinical Removable Partial Prosthodontics 4th
edition, Quintessence Pub Co; 2008 Chapter 14, 15.
Try-in completion and delivering the RPD
Stewart’s Clinical Removable Partial Prosthodontics 4th
edition, Quintessence Pub Co; 2008 Chapter 16.
Patient complaints following insertion of the RPD
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 18.
Laboratory procedures for construction of RPDs
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 18, 21, 22.
Repair, Relining & Rebasing the Removable Partial Dentures
McCracken’s Removable Partial Prosthodontics 12th
edition, Mosby Co. 2011 Chapter 12.
Revision
Final Exam
Dr. Hamada Mahross

5. Student assessment methods
1. Written exam. (Mid-term & Final-term exam.)
2. Oral exam. (For practical understanding as an item of evaluation criteria.)
3. Final Practical exam.
Weighing of assessment components
1. Practical student work. (30%)
2. Practical final exam. (Oral and practical 20 %)
3. Midterm written exam. (20%)
4. Final written exam. (30%)
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Dr. Hamada Mahross

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Dr. Hamada Mahross

7. INTRODUCTION To
REMOVABLE PARTIAL
DENTURES
(RPD)
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8. Objectives
At the end of this lecture the students must be knowing:
1- Different terminology used during course study.
2- Indication ,advantages and objectives of RPD.
3- Methods of RPD classification.
4- Steps of RPD construction clinically and laboratory.
5- Different casts used during treatment with RPD.
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Dr. Hamada Mahross

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Contents
- Terminology & definitions.
- Classifications of partial dentures.
- Applegate's rules
- Partial denture components.
- Steps of RPD constructions
- Different casts used during RPD construction.

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Dr. Hamada Mahross

11. •Prosthesis
Is an artificial replacement of an absent Part of the human
body.
•Completely Edentulous Patients
Patients having all their teeth missing .
•Partially Edentulous Patients
Patients having one or more but not their entire natural teeth
missing.
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Dr. Hamada Mahross

12. partial dentures
• Removable Partial Denture
= R.P.D • Fixed bridge=
F.P.D
• Implant; fixed or removable
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Dr. Hamada Mahross

13. Removable Partial Denture (RPD)
• it is an appliance or device
replacing one or more natural
teeth but not all the teeth and
associated oral structures
which can be removed with the
patient.
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14. Partial edentulous areas;
Posterior
Free End Edentulous Area (Distal extension
edentulous area):
An edentulous area, which has an abutment
tooth anterior to it, may be;
- Unilateral (class II Kennedy) or
- Bilateral (Class I Kennedy).
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Unilateral
Bilateral
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Middle
Bounded Edentulous Area:
- An unilateral edentulous area, which has
an abutment tooth on each end, anterior
and posterior to it (Class III Kennedy).
Anterior
(mesial extension edentulous area)
Single, bilateral edentulous area located
anterior to the remaining natural teeth.
(Class IV Kennedy).
Partial edentulous areas;
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16. Abutment:
- A tooth, a portion of a tooth, or that
portion of a dental implant that serves to
support and/or retain prosthesis.
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17. INDICATIONS
Of
REMOVABLE PARTIAL DENTURES
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Dr. Hamada Mahross

18. 1- No abutment tooth posterior to
edentulous space (Free end edentulous area)
unilateral or bilateral. [Free end saddle]
2- Long edentulous bounded span, too
extensive for fixed restoration. FPD
INDICATIONS FOR REMOVABLE
PARTIAL DENTURES
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FPD
RPD
Free end saddle
Dr. Hamada Mahross

19. 3- Periodontally weak teeth not sufficiently
sound to support fixed- partial denture.
4- With excessive loss of residual bone, the use
of labial flange or need to restore lost tissues.
Why ????
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Dr. Hamada Mahross

20. • why/ ???
 If fixed bridge used With excessive
loss of residual bone, space is seen
under the pontic can affect;
- Esthetic
- Impact food (oral health)
- Annoying the patient.
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Dr. Hamada Mahross

21. Excessive loss of residual bone use of flanged denture to restore lost
tissues (tissue + teeth)
INDICATIONS FOR REMOVABLE
PARTIAL DENTURES
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22. 5- After recent extraction or surgery;
usually done only to improve esthetics, or for
patient satisfaction e.g. immediate denture.
6- Young age (less than 17 years) due to high pulp
horn.
Young
INDICATIONS FOR REMOVABLE
PARTIAL DENTURES
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7- Need of bilateral bracing (cross arch stabilization);
- In case of fixed restoration the bridge only attached on
surrounding abutment and no need for extension to other
side of the arch (unilateral bracing and stabilization)
- In case of RPD extension to other side is obligatory
even replacing short span to engage more abutment (for
more bracing and stabilization) and wide distribution of
load. (bilateral bracing and stabilization).
Dr. Hamada Mahross

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• Cross arch stabilization and bracing must be
considered during RPD design, as in case of upper
class I if used palatal anterior strap or plate only the
most remote posterior part of saddle subjected to
flexure ( Tail-fish movement) causing metal fatigue
and damage to underling structure so, the posterior
two saddle must be connected with posterior palatal
bar or strap crossing the arch for more stabilization.

25. 8- Enhancing esthetics in anterior region,
by the use of translucent artificial teeth
instead of dull fixed partial denture pontic.
Or replace gingival tissue with red acrylic.
9- Economic considerations, attitude and
desire of the patient.
10- suitable for medically compromised
patient, or patients with deficient
supporting structure for implant or fixed
restoration.
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Dr. Hamada Mahross

26. – Muller M. De Van’s dictum, (1952)
“It is more important to preserve what already exists than to
replace what is missing”
OBJECTIVES OF REMOVABLE PARTIAL
DENTURES
The main objective of any prosthetic procedures is the preservation;
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Dr. Hamada Mahross

27. OBJECTIVES OF REMOVABLE PARTIAL DENTURES
1- Preservation of the Remaining Tissues;
A- Preservation of the health of the remaining
teeth.
B- Prevention of muscles and TMJ Dysfunction
C-Preservation of the residual ridge.
D- Preservation of the tongue contour and space.
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Dr. Hamada Mahross

28. - Replacement of lost teeth prevents the migration of teeth into
the edentulous area following the loss of the natural dentition.
- Change the pattern of mandibular closure and Normal
masticatory cycle as a result of loss of some teeth.
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OBJECTIVES OF REMOVABLE
PARTIAL DENTURES
Dr. Hamada Mahross

29. 2- Restore the Continuity of the Dental Arch to
Improve Masticatory Function.
3- Improvement of Esthetics, speech and Providing
Support to the Para-oral Muscles, Lips and Cheeks
and vertical dimension of face.
4- Enhance psychological comfort
OBJECTIVES OF REMOVABLE
PARTIAL DENTURES
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Dr. Hamada Mahross

30. ADVANTAGES OF REMOVABLE PARTIAL DENTURE OVER
FIXED PARTIAL DENTURE
1- RPD constructed for any case whilst FPD are confined to short spans bounded by healthy
teeth and with a normal occlusion.
2- Cheaper than fixed partial denture
3- They are more easily cleaned
4- They are more easily repaired
5- No tooth reduction is required
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Dr. Hamada Mahross

31. CLASSIFICATION OF PARTIALLY
EDENTULOUS ARCHES
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Dr. Hamada Mahross

32. CLASSIFICATION OF PARTIALLY EDENTULOUS
ARCHES
WHY??????
Classifications are important to facilitate communication
between the dentist and the laboratory technician.
Requirements of an Acceptable Classification:
1- Permit immediate visualization of the type of partially
edentulous arch
2- Permit immediate differentiation between bounded and
free extension RPD.
3- It should be universally accepted
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Dr. Hamada Mahross

33. CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
I- Classification According to the Extent of the Removable Partial
Denture:
1- Unilateral RPD (Removable Bridge)
2- Bilateral RPD
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Dr. Hamada Mahross

34. CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
So, the following considerations must be
observed:
1- long clinical crown of abutment tooth to
increase lateral bracing.
2- Buccal and lingual surfaces of the abutment
tooth must be parallel to resist tipping forces.
3- Retentive undercuts should be available on both
the buccal and lingual surfaces of each abutment.
X
√
Unilateral RPD (Removable Bridge)
The problem with unilateral appliance is less stability
as no cross arch stabilization.
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Dr. Hamada Mahross

35. N.B
Unilateral RPD (Removable Bridge) should
be used with caution, as the chance of the
denture becoming dislodged and aspirated is
too great
Caution
thermo flex
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Dr. Hamada Mahross

36. Bilateral RPD:
which restore missing teeth and extended on both sides of the dental arch.
- Extend to other edentulous side to restore missed teeth or other sound side to add more
retentive and stabilizing component.
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
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Dr. Hamada Mahross

37. CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
II- Classification According to the type of support of the R.P.D.:
1- Tooth Supported RPD (Tooth-borne) removable partial denture
2- Tissue Supported RPD (Tissue-borne) removable partial denture
3-Tooth and Tissue Supported RPD (Tooth and tissue borne)
Tooth Supported RPD
Tissue Supported RPD
Tooth and Tissue Supported RPD
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Dr. Hamada Mahross

38. CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
II- Classification According to the most
posterior edentulous span or space location
( Kennedy’s classification)
Class I: Bilateral edentulous areas located posterior to
the remaining natural teeth.
Class II: Unilateral edentulous area located posterior to
the remaining natural teeth.
Class III: Unilateral edentulous area with natural teeth,
both anterior and posterior to it
Class IV: Single, bilateral edentulous area located
anterior to the remaining natural teeth.
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Dr. Hamada Mahross

39. • The numeric sequence of the classification system is based on the frequency of occurrence of each
class.
• Class I being the most common while class IV is the least common.
• Kennedy's classification was then modified by Applegate
• Additional edentulous areas are referred to as
modification spaces and are designated by their
number.
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES
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Class Class
modification
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40. Applegate's rules for applying
Kennedy classification
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Dr. Hamada Mahross

41. Applegate's rules for applying Kennedy classification
Rule1
Classification should follow mouth
preparations, since further extractions
may alter the class.
Ex. If the left molar is
extracted class III becomes
class II
X
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Dr. Hamada Mahross

42. Applegate's rules for applying Kennedy classification
Rule2
If the third molar is missing and not to be
replaced, it is not considered in the
classification.
Rule3
If the third molar is present and to be used
as an abutment, it is considered in the
classification.
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Dr. Hamada Mahross

43. Rule4
If the second molar is missing and not to be
replaced, because the opposing second molar
is also missing, it is not considered in the
classification.
Rule5
The most posterior edentulous area (or areas)
always determines the classification.
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44. Applegate's rules for applying Kennedy classification
Rule 6
Additional edentulous areas other than those
determining the class are referred to as
modification spaces and are designated by their
number.
Rule7
The extent of the modification is not considered,
only the number of additional edentulous areas .
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Rule 8
There is no modification areas in class IV arches, because if there is a posterior
edentulous area beside the anterior one, the former will determine the class and
the anterior edentulous area will be a modification to the class.
Applegate's rules for applying Kennedy classification
Dr. Hamada Mahross

46. Practice for classifications
X
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X
Dr. Hamada Mahross

47. The Component Parts
of Removable Partial Dentures
• RPD component parts:
1- Denture base carry the teeth
2- Connectors
– major connector
– minor connector
3- Retainers
– direct retainer (clasp or attachment)
– indirect retainer
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48. Steps of Removable Partial
Dentures construction
I- Clinical steps
II- Laboratory steps
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Dr. Hamada Mahross

49. 1- History taking , examination & diagnosis.
2- primary impression in suitable stock tray.
Clinical step
Steps of Removable Partial Dentures construction
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Dr. Hamada Mahross

50. 3- Pouring the impression in dental stone, to construct
the diagnostic cast;
a. Surveying the study cast & designing of the RPD
b. Initial Design is drawn on the study cast
c. Construction of the special tray
Laboratory steps
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Dr. Hamada Mahross

51. 4- Mouth preparation
5- Final impression
Clinical steps
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Dr. Hamada Mahross

52. 6- Pouring the impression for
making master cast.
a- Surveying the master cast.
b- transferring the design from
the study cast & drowning it
on the master cast.
c- Block- out & relief of the
master cast (modified master
cast).
Laboratory step
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Dr. Hamada Mahross

53. 7- Duplication of the master cast by extra hard
stone to withstand melting point to make
investment or refractory cast or modified cast
(modified by relief and blackout).
- Drying the investment cast & beeswax dip
Laboratory step
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54. 8- Waxing up the framework
- Spruing the waxed framework
- Investing refractory cast
- Burnout of wax pattern
Laboratory step
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55. 9- Casting the framework
10- Removing the casting framework
from model for Finishing &
polishing and cut sprues.
Laboratory step
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Dr. Hamada Mahross

56. 11- Fitting & try-in the framework in
the Pt’s mouth.
12- Special impression procedures for
tooth-tissue support RPD.
Clinical steps
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57. 13- Pouring functional
impression or altering the
master cast.
14- Construction of record
block
Laboratory step
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Dr. Hamada Mahross

58. 15- Recording jaw relationships
- Orientation of planes (occlusal plane , midline,
canine line, high and low lip line).
- Vertical dimension relation (OVD and RVD)
- Centric relation record
- Face bow record.
- selection of artificial teeth
Clinical steps
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Dr. Hamada Mahross

59. 16- Mounting the master casts
on an articulator
17- Setting up of artificial teeth
Laboratory step
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Dr. Hamada Mahross

60. 18- Esthetic try- in & waxed denture try-
in.
Clinical steps
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61. 19- processing of acrylic
- Flasking
- Wax elimination.
- Packing of acrylic resin
- Curing of acrylic resin
- Deflasking, finishing & polishing
Laboratory step
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Dr. Hamada Mahross

62. 20- Insertion & delivery
of the finished
denture
Clinical steps
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Dr. Hamada Mahross

63. Different Types of Casts and impressions used
in RPDs Construction
1- Diagnostic Cast, Primary cast, study cast
2- Secondary cast, master cast, working cast
3- Refractory Cast, investment cast, modified cast
4- Altered cast
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Dr. Hamada Mahross

64. Diagnostic Cast& primary cast
• Used as a diagnostic aid. May be
considered as primary cast and used
for special tray construction.
• Made from diagnostic impression
or primary impression.
• Made before mouth preparation,
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Dr. Hamada Mahross

65. Master Cast
• More definite cast, made after mouth preparation .
• Used for surveying, final design drawing, duplicated to refractory
cast, final construction of the denture.
• Knowing by all mouth preparations appear on it (rest seat, guide
planes, …etc.
• Made from secondary impression.
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Dr. Hamada Mahross

66. Refractory Cast
• It is a cast made after modification and duplication of master cast.
• Made of material that withstand high melting point temperatures of metal
without disintegrating (called also investment cast, modified cast).
• Used for waxing up framework, construction of cast metal framework.
• Knowing by blocking out, relief and other feature on master cast.
• Made from duplicated master cast.
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Dr. Hamada Mahross

67. Altered Cast
• Made for teeth-mucosa borne type partial denture,
• Made after framework construction and functional
impression make.
• Constructed from master cast and new pouring free end
area recorded by functional impression.
• Used for final denture construction.
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Dr. Hamada Mahross

68. Summary
• RPD is an appliance for replacing one or more natural teeth with their associated oral structures and
can be removed with the patient.
• RPD is an appliance used for all cases not accepted the fixed bridge.
• using of RPD can preserving the remaining tissue, teeth, TMJ, masticatory efficiency, speech and
esthetic.
• there are many method for RPD classification according to location of edentulous area, type of
support or denture extent.
• clinical and laboratory steps must be followed regularly for good end come results.
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Dr. Hamada Mahross

69. Quizzes
• A tooth, a portion of a tooth, or an implant that serves to support and/or retain prosthesis termed:
a- Framework.
b- Occlusal rest.
c- Abutment.
d- Proximal plate.
• A unilateral edentulous area, which has an abutment tooth on each end, anterior and posterior to it, this edentulous area can be classified as:
a) Class I Kennedy
b) Class II Kennedy
c) Class III Kennedy
d) Class IV Kennedy
• It is a cast made after modification and duplication used for waxing up framework, construction of cast metal framework:
a) Master cast
b) Refractory cast
c) Altered cast
d) Diagnostic cast
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Dr. Hamada Mahross

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References
1- Stewart’s Clinical Removable Partial Prosthodontics 4th edition, Quintessence Pub
Co; 2008 chapter 1, pg:
14-46.
2- McCracken’s Removable Partial Prosthodontics 12th edition, Mosby Co. 2011
chapter 3 pg: 17-20
Dr. Hamada Mahross

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Dr. Hamada Mahross

72. Thank You
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Dr. Hamada Mahross