classification system for partially edentulous arches / dental implant courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing Dental Educationwww.indiandentalacademy.com

CONTENTS
 Introduction.
 Need for classification.
 Requirements of classification.
 Different systems of classification.
 Conclusion.
 References .
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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 .

 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.

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.

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.


EVOLUTION OF DIFFERENT
SYSTEMS OF CLASSIFICATION

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.

 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.

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.

 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.

Class 2- Diametric ; Partially edentulous
arch in which two diametric opposite teeth
are chosen as abutment teeth for the
attachment of the direct retainer.

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.

Class 4 – Multilateral ; A partially edentulous
arch in which two or more teeth are chosen
as abutment for the attachment of the direct
retainer

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

CLASS I
Class I - Bilateral edentulous areas located posterior to the
natural teeth.

CLASS II
Class II - A unilateral edentulous area located posterior to
the remaining natural teeth.

CLASS III
Class III – A unilateral edentulous area with natural teeth
remaining both anterior and posterior to it.

CLASS IV
Class IV – A single, but bilateral (crossing the midline), edentulous
area located anterior to the remaining natural teeth.

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.

Dr. O.C. Applegate –1960
attempted to expand the kennedy
classification by adding classes 5 and 6

 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.

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

 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.

Rule 4- If 2 molar is missing
and not to be replaced it is not
considered in the
classification

 Rule 5-The most posterior edentulous area or areas
determine the classification.

Rule 6 –Edentulous areas other than those
determining the classification are referred
to as modification spaces and are
designated by there number.

 Rule 7 – The extent of modification is not considered
only the number of additional edentulous areas.

Rule 8- There can be no modification areas
in class4 arches .Any edentulous area lying
posterior to single bilateral area determine
the classification

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.

 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.

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

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.

 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:

Variation 1- Missing posteriors predominate.
A) Posteriors missing anteriors in
place .
B) Posteriors missing some
anteriors missing

Variation 2 - Missing anteriors
predominate.
A) anteriors missing posteriors
present.
B)anteriors missing some
posteriors missing

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.

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

Variation 2- Missing anteriors
predominate.
A) None.
B) Anteriors missing some posteriors
missing

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-

Variation 1- Missing posteriors
predominate.
a)None .
b) Posteriors missing some anteriors
missing.

Variation 2- Missing anteriors predominate.
a) Anteriors missing posteriors in place
bilaterally.
b)Anteriors missing some posteriors missing

Class 3-Tissue bearing complete
dentures.
The complexity of any neurohrs
classification is obvious and seldom
used.

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.

Class2 – Bilateral space with teeth posterior to one
space.
Class 3 – Bilateral space with teeth posterior to both
space

Class 4 – Unilateral space with
no teeth posterior to it .The
opposite arch is unbroken.

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.

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) .

Class 2 - Shortening of dental arches (free
end).
Class 3 – Combination of 1 and 2 .

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.

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.

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.

Friedmans classification
-1953
 He introduced ABC classification where ,
 A – Anterior.
 B - Bounded posterior.
 C - Cantilever.

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.

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.

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.

Craddocks Classification-1954
 Classified partial dentures as ;
 Class 1 –saddles supported on both
sides by substantial abutment teeth.

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

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.

Class 1 – An arch with one free end
denture base.
Class 2-An arch with two free end
denture base.

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.

Class 4 – An arch with an anterior
edentulous space with five or more
anterior teeth missing .

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.

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.

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.

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.

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.

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.

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.

Class 5- Abutment teeth are unilateral in
relation to denture base and these may
be unilateral or bilateral.

Avants Classification-1966
 Similar to Kennedys classification
without any improvements.
 The classification was based on
anterior and posterior segments
of the arch.

Costas Classification-1974
 It is based on anterior ,lateral and
terminal spaces.

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.

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.

 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.

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.

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