Classification of rpd / dentist laboratory

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Classification of rpd / dentist laboratory

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. CONTENTS  Introduction.  Need for classification.  Requirements of classification.  Different systems of classification.  Conclusion.  References . www.indiandentalacademy.com
  3. 3. Introduction  The primary purpose of creating a classification system for partially edentulous arches is to enable the dentist to clearly communicate to a listener or reader , the condition of oral cavity in which missing teeth are to be replaced with a prosthesis.  It would be helpful to classify partial edentulous arches that share common attributes ,characteristics , qualities and trials . www.indiandentalacademy.com
  4. 4.  It has been estimated that there are over 65,000 possible combination of teeth and edentulous spaces in opposing arches.  Several classifications have been proposed and in use but a method which best classifies all possible configuration is still not achieved. www.indiandentalacademy.com
  5. 5. Need For Classification  To formulate a good treatment plan.  To anticipate the difficulties commonly to occur for particular design.  To communicate with professionals.  To design the denture according to occlusal load usually expected for a particular group. www.indiandentalacademy.com
  6. 6. REQUIREMENTS OF CLASSIFICATION Classification should satisfy these norms for acceptance : – 1. Allow visualization of the type of partially edentulous arch being considered. 2. Permit differentiation between tooth supported and tooth tissue supported partial dentures. 3. Serve as a guide to the type of design to be used. 4. Be universally accepted. www.indiandentalacademy.com
  7. 7.  EVOLUTION OF DIFFERENT SYSTEMS OF CLASSIFICATION www.indiandentalacademy.com
  8. 8. CLASSIFICATIONS  A number of classifications have put forward some have been over simplified and others are immensely complex.  One simple system classifies the prosthesis according to the type of support they receive from dental arch. Soft tissue supported. Tooth supported . Tooth tissue supported. www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10.  Demerits –  There are many possible variations of tooth tissue supported partial denture that is simplified and this does not adequately describe the design that must be considered.  Therefore this system is not suited for general use in discussing ,identifying or planning the prosthesis. www.indiandentalacademy.com
  11. 11. CUMMERS CLASSIFICATION SYSTEM 1920  It is based on the relationship of the edentulous spaces to the abutment teeth.  This was the first recognized classification by the professional .  It is based on the number and position of the direct retainer. www.indiandentalacademy.com
  12. 12.  Class 1- Diagonal ; Partially edentulous arch in which two diagonally opposite teeth are chosen as abutment teeth for attachment of the direct retainers with an indirect retainer as an auxillary attachment. www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. Class 2- Diametric ; Partially edentulous arch in which two diametric opposite teeth are chosen as abutment teeth for the attachment of the direct retainer. www.indiandentalacademy.com
  15. 15. Class 3 – Unilateral ; A partially edentulous arch in which one or more teeth on same side are chosen as abutment for the attachment of the direct retainer. www.indiandentalacademy.com
  16. 16. Class 4 – Multilateral ; A partially edentulous arch in which two or more teeth are chosen as abutment for the attachment of the direct retainer www.indiandentalacademy.com
  17. 17. KENNEDY CLASSIFICATION: Class I - Bilateral edentulous areas located posterior to the remaining natural teeth. Class II - A unilateral edentulous area located posterior to the remaining natural teeth. Class III – A unilateral edentulous area with natural teeth remaining both anterior and posterior to it. Class IV – A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth. www.indiandentalacademy.com
  18. 18. CLASS I Class I - Bilateral edentulous areas located posterior to the natural teeth. www.indiandentalacademy.com
  19. 19. CLASS II Class II - A unilateral edentulous area located posterior to the remaining natural teeth. www.indiandentalacademy.com
  20. 20. CLASS III Class III – A unilateral edentulous area with natural teeth remaining both anterior and posterior to it. www.indiandentalacademy.com
  21. 21. CLASS IV Class IV – A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth. www.indiandentalacademy.com
  22. 22. Advantages: 1. It Permits immediate visualization of the partially edentulous arch. 2. It Permits a logical approach to the problems of design. 3. It makes possible the application of sound principles of partial denture design. www.indiandentalacademy.com
  23. 23. Dr. O.C. Applegate –1960 attempted to expand the kennedy classification by adding classes 5 and 6 www.indiandentalacademy.com
  24. 24.  Kennedy referred to each additional edentulous area and not each additional missing tooth as a modification area and included them in the classification by number of such areas.  Class 1 arches being the most common and class 4 being the least common.  Class1 partial denture is designed as tooth tissue supported prosthesis.  Class 3 as wholly tooth supported partial denture.  Class2 as combination of 1 and 3 partly tooth tissue supported and partly tooth supported. www.indiandentalacademy.com
  25. 25. APPLEGATE RULES  Classified partially edentulous arches based on kennedys classification.  Any teeth require extraction it should be done prior to classification.  Applegate has given 8 rules as follows -  Rule 1- Classification should follow rather than precede extractions that might alter the original classification www.indiandentalacademy.com
  26. 26.  Rule 2- If 3 molar is missing and not to be replaced ,it is not considered in the classification.  Rule 3- If 3 molar is present and is to be used as abutment it is considered in the classification. www.indiandentalacademy.com
  27. 27. Rule 4- If 2 molar is missing and not to be replaced it is not considered in the classification www.indiandentalacademy.com
  28. 28.  Rule 5-The most posterior edentulous area or areas determine the classification. www.indiandentalacademy.com
  29. 29. Rule 6 –Edentulous areas other than those determining the classification are referred to as modification spaces and are designated by there number. www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32.  Rule 7 – The extent of modification is not considered only the number of additional edentulous areas. www.indiandentalacademy.com
  33. 33. Rule 8- There can be no modification areas in class4 arches .Any edentulous area lying posterior to single bilateral area determine the classification www.indiandentalacademy.com
  34. 34. BAILYN CLASSIFICATION -1928  Bailyn system introduced a classification based on whether the prosthesis is tooth borne ,tissueborne and combination of the two that is based on support.  Bailyn divided all removable partial dentures into anterior restoration and posterior restoration using the letters A and P. www.indiandentalacademy.com
  35. 35.  A - Anterior restorations where there are saddle areas anterior to the first bicuspid (premolar).  P -Posterior restoration saddle area posterior to canine.  Further they are subdivided into –  Class 1- Bounded saddle (not more than three teeth missing).  Class 2-Free end saddle (there is no distal abutment).  Class 3 –Bounded saddle (more than 3 teeth missing).  If both anterior and posterior teeth are missing to be mentioned separately . Examples; A1P1,A2P1 etc. www.indiandentalacademy.com
  36. 36. BailynsBailyns classification was the first to emphasize on theclassification was the first to emphasize on the importance ofimportance of supportsupport of partial dentures by remainingof partial dentures by remaining tissuestissues www.indiandentalacademy.com
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  38. 38. www.indiandentalacademy.com
  39. 39. NEUROHR CLASSIFICATION -1939  This system was classified according to the type of support available , but the system was unnecessary complex and not commonly used.  Many of the denture designs did not match the principles of classification.  Class 1 –Tooth bearing.  Class 2 –Tooth and tissue bearing.  Class 3 –Tissue bearing complete denture. www.indiandentalacademy.com
  40. 40.  Class 1 - Tooth bearing  Unilateral or bilateral case falls under the above classification when there are teeth posterior to all spans and when there are no more than four teeth missing in any space.  There are two possible variation: www.indiandentalacademy.com
  41. 41. Variation 1- Missing posteriors predominate. A) Posteriors missing anteriors in place . B) Posteriors missing some anteriors missing www.indiandentalacademy.com
  42. 42. Variation 2 - Missing anteriors predominate. A) anteriors missing posteriors present. B)anteriors missing some posteriors missing www.indiandentalacademy.com
  43. 43. Class 2- Tooth and tissue bearing.  Unilateral or bilateral case falls under the above classification when there are no teeth posterior to one or more spans or when there are more than 4 teeth in one or more spans (which includes canine).  Class 2 -subdivided into divisions with variations. www.indiandentalacademy.com
  44. 44. Division 1- When there are no teeth posterior to one or more spans. Variation 1-Missing posteriors predominate. a)Posteriors missing anteriors in place. b)Posteriors missing and some anteriors missing www.indiandentalacademy.com
  45. 45. Variation 2- Missing anteriors predominate. A) None. B) Anteriors missing some posteriors missing www.indiandentalacademy.com
  46. 46. Division 2-When there are teeth posterior in all spans ,but when there are more than 4 teeth including canine in any one or more spans Division 2 has two possible variations- www.indiandentalacademy.com
  47. 47. Variation 1- Missing posteriors predominate. a)None . b) Posteriors missing some anteriors missing. www.indiandentalacademy.com
  48. 48. Variation 2- Missing anteriors predominate. a) Anteriors missing posteriors in place bilaterally. b)Anteriors missing some posteriors missing www.indiandentalacademy.com
  49. 49. Class 3-Tissue bearing complete dentures. The complexity of any neurohrs classification is obvious and seldom used. www.indiandentalacademy.com
  50. 50. Mauks Classification -1942  Mauk proposed a classification based on number ,length and position of the edentulous spaces and the number and position of the remaining teeth.  According to the classification;  Class1 –Bilateral space with no teeth posterior to one space. www.indiandentalacademy.com
  51. 51. Class2 – Bilateral space with teeth posterior to one space. Class 3 – Bilateral space with teeth posterior to both space www.indiandentalacademy.com
  52. 52. Class 4 – Unilateral space with no teeth posterior to it .The opposite arch is unbroken. www.indiandentalacademy.com
  53. 53. Class 5 – Anterior space with unbroken posterior arches on both sides. Class 6 - Irregular spaces around the arch ,the remaining teeth may be single or in groups. www.indiandentalacademy.com
  54. 54. Wilds Classification - 1949  Wild proposed a simple but self explanatory classification little known in the English dental literature.  Class 1 –Interruption of dental arches (bounded) . www.indiandentalacademy.com
  55. 55. Class 2 - Shortening of dental arches (free end). Class 3 – Combination of 1 and 2 . www.indiandentalacademy.com
  56. 56. Godfreys Classification- 1949  Is based on location and size of the edentulous spaces.The specialty of this classification is that the main classes have no modifications.  Class A –Tooth borne denture base in the anterior part of the mouth . It may be unbroken five tooth space , broken five tooth space or unbroken four tooth space. www.indiandentalacademy.com
  57. 57. Class B – Mucosa borne denture base in the anterior region. It may be an unbroken six tooth space ,an unbroken five tooth space or a broken five tooth space . Class C - Tooth borne denture base in the posterior part of the mouth .It may be an unbroken three tooth space , broken three tooth space , an unbroken two tooth space or broken two tooth space. www.indiandentalacademy.com
  58. 58. Class D – Mucosa borne denture base in the posterior region.It may be an unbroken four tooth ,three tooth ,two tooth or a single tooth space. www.indiandentalacademy.com
  59. 59. Friedmans classification -1953  He introduced ABC classification where ,  A – Anterior.  B - Bounded posterior.  C - Cantilever. www.indiandentalacademy.com
  60. 60. Beckett and Wilsons Classification-1957  Based on ideas of Bailyns classification the following must be considered while determining the proportionate amount of support provided by the teeth and tissue .  1.The quality of the abutment support.  2.The magnitude of occlusal support .  3.The harmony of occlusion.  4.The quality of mucosa and residual ridge.  They believed every effort should be made to avoid tissue support alone. www.indiandentalacademy.com
  61. 61. Class 1 - Bounded saddle – Abutment teeth qualified to support the denture.Mucosa is not used for support. Class 2 –Free end. A)Tooth and tissue borne. B) Tissue borne. www.indiandentalacademy.com
  62. 62. Class3 –Bounded saddle –Abutment teeth not so qualified for support the denture as described in C lass1.  Wilson in 1957 elaborated the classification as follows –  Mandibular Kennedy class3 should be treated as class 1.  Maxillary Kennedy class3 should be treated as class1or3. www.indiandentalacademy.com
  63. 63. Craddocks Classification-1954  Classified partial dentures as ;  Class 1 –saddles supported on both sides by substantial abutment teeth. www.indiandentalacademy.com
  64. 64. Class 2 –Vertical biting forces applied to the denture resisted entirely by soft tissue. Class 3 –Tooth supported at only one end of the saddle www.indiandentalacademy.com
  65. 65. Swensons Classification 1955  Simple classification proposed by Swenson and Terkala .  It is not widely used .It is similar to Kennedys classification.The classes of Kennedys classification are dramatically changed. www.indiandentalacademy.com
  66. 66. Class 1 – An arch with one free end denture base. Class 2-An arch with two free end denture base. www.indiandentalacademy.com
  67. 67. Class 3 – An arch with an edentulous space posteriorly on one or both sides of the mouth but with teeth present anteriorly and posteriorly to each space. www.indiandentalacademy.com
  68. 68. Class 4 – An arch with an anterior edentulous space with five or more anterior teeth missing . www.indiandentalacademy.com
  69. 69. Subdivision –The four major classes are subdivided without denoting which tooth is missing. A - Anterior . P - Posterior AP – Anterior and posterior. Ex – Class2 A denotes bilateral distal extension base with some anterior missing. www.indiandentalacademy.com
  70. 70. Austin and Lidge Classification- 1957  Classification that described the position of teeth.  Class A –Missing anteriors.  A1: Missing anteriors on one side unilateral construction.  A2 :Missing anteriors on both sides  AB1: Missing anteriors with bilateral construction. www.indiandentalacademy.com
  71. 71. www.indiandentalacademy.com
  72. 72. Class P – Missing posteriors. P1 :Missing posteriors on one side unilateral construction. P2 : Missing posteriors on both sides. PB1: Posteriors missing on one side with bilateral construction. www.indiandentalacademy.com
  73. 73. Class AP – Missing anteriors and posteriors. AP1: Missing anteriors and posteriors on one side (unilateral construction). AP2: Missing anteriors and posteriors on both sides. APB1: Missing anteriors and posteriors on one side with bilateral construction. Any combination of the above may be possible.Ex A2P1 or A1P2. www.indiandentalacademy.com
  74. 74. www.indiandentalacademy.com
  75. 75. Watt et al Classification 1958  It is based on type of support.  Entirely tooth borne-the entire denture rests on the abutment.  Entirely tissue borne-the entire rests on tissue.  Partially tooth borne and partially tissue borne- these dentures rests on both teeth and tissues.  Generally most RPD come under this category. www.indiandentalacademy.com
  76. 76. www.indiandentalacademy.com
  77. 77. Skinners Classification 1959  His classification was influenced by Cummers classification. Similar to Cummers classification with five classes.  Class1 –Abutment teeth are present anterior and posterior to the edentulous space.It may be unilateral or bilateral.  Class2 – All the teeth are present posterior to the denture base which function as a partial denture unit.It may be unilateral or bilateral. www.indiandentalacademy.com
  78. 78. www.indiandentalacademy.com
  79. 79. Class3 –All abutment teeth are anterior to the denture base which function as a partial denture unit.it may be unilateral or bilateral. Class 4- Denture bases are located anterior and posterior to the remaining teeth these may be unilateral or bilateral. www.indiandentalacademy.com
  80. 80. Class 5- Abutment teeth are unilateral in relation to denture base and these may be unilateral or bilateral. www.indiandentalacademy.com
  81. 81. Avants Classification-1966  Similar to Kennedys classification without any improvements.  The classification was based on anterior and posterior segments of the arch. www.indiandentalacademy.com
  82. 82. Costas Classification-1974  It is based on anterior ,lateral and terminal spaces. www.indiandentalacademy.com
  83. 83. Osborne and Lamies Classification -1974  Similar to Watt et als classification.  Class 1 – Mucosa borne.  Class2 –Tooth borne.  Class 3 - combination of tooth borne and tissue borne. www.indiandentalacademy.com
  84. 84. Conclusion  Many classification of partial dentures and design have been proposed by different clinicians.  A classification is either one that describes the various tooth and saddle position like those of kennedy and others or one that looks more closely at the available support like those of Bailyn and others. www.indiandentalacademy.com
  85. 85.  Kennedy classification describes basic outline of any particular case and form a common partial denture language among dentist but it does not take into account the available support upon which the success or failure of any partial denture or bridge ultimately depends.  For this reason support classification is preferable. www.indiandentalacademy.com
  86. 86. References  Clinical removable partial dentures 2 edition stewart, rudd and kuber.  Mc Crackens Removable partial prosthodontics. 8 edition, Mc Givney castle Berry.  System of classifying partial edentulous arches . JPD 1970 vol24 no 1pg 24 –40. www.indiandentalacademy.com
  87. 87. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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