1. Introduction and forces acting on Removable Partial Denture (RPD).

FORCES ACTING ON REMOVABLE
PARTIAL DENTURES
Dr. Amal Fathy Kaddah
Professor of Prosthodontics,
Faculty of Dentistry,
Cairo University

When you realize you've made a mistake, take
immediate steps to correct it.

Content of the course
Removable Partial prosthodontics
Classification of partially edentulous arches
Consequences of loss of teeth and distribution of forces in the oral
cavity
Objectives, Indications and Contraindications of RPDs
Advantages of RPD over fixed PD
Requirements of RPDs
Forces acting on removable partial dentures
Hazards and damaging effects of improperly designed partial dentures
Designs of different types of RPDs, biological and biomechanical
considerations during construction of RPDs.
Clinical and laboratory steps of RPDs

1. Examination
2. Primary impression
3. Pouring primary cast
4. Primary surveying
5. Mouth preparation
6. Final impression
7. Pouring master cast
8. Surveying the master cast
9. Draw the design
Steps of construction of rpd
Clinical and Laboratory steps

10. Preparing master cast for duplication
11. Duplication
12. Pouring refractory cast
13. Drawing design
14. Make wax pattern and sprue
15. Investing and casting
16. Finishing and polishing
17. Metal framework try-in
18. Jaw relationship registration
19. Acrylic teeth try-in
20. Processing of acrylic
21. Finishing and polishing
22. Insertion

Tissue Supported RPD
Tooth and Tissue Supported RPD
Tooth Supported RPD
The replacement of
missing teeth and
supporting tissues with
prosthesis designed to
be removed by the
wearer.
Removable prosthodontics

CLASSIFICATION OF PARTIALLY
EDENTULOUS ARCHES

*Tissue Supported RPD
Tooth and Tissue Supported RPD
Tooth Supported RPD
Classifications are important to facilitate communication
between the dentist and the laboratory technician

Unilateral RPD (Removable Bridge)
Should be used with caution, as the chance of the
denture becoming dislodged and aspirated is too great
* Long clinical crown of abutment tooth
• Buccal and lingual surfaces of the abutment tooth must be
parallel to resist tipping forces
* Retentive undercuts should be available on both the buccal
and lingual surfaces of each abutment
X
X

Bilateral RPD:
Which restore missing teeth and extended on both sides of
the dental arch

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.
Classification according to the most
posterior edentulous span or spans

Class I
Class IV
Class III
Class II

• Additional edentulous areas are referred to as
modification spaces and are designated by their
number.
• 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
Applegate's rules for applying Kennedy classification

Class I mod.1 Class II mod.3
Class III mod. 1 Class IV ????

Class ?????????
The third molar is missing and not to be replaced.

Consequences of loss of teeth and distribution of
forces in the oral cavity
Drifting, overeruption and inclination of the teeth
disturbed occlusion and loss of vertical dimension.
Disabilities associated with appearance.
Speech disabilities.
Reduction of masticatory efficiency.
Temporomandibular joint disorders.
Deviation of the mandible.
Resorption of the residual ridge.

 Disturbed occlusion and loss of
vertical dimension.
 Drifting, overeruption and inclination of the teeth
Consequences of loss of teeth and distribution of forces in the oral cavity

Disabilities associated with appearance.
Speech disabilities.

Change the pattern of mandibular closure as a
result of loss of some teeth
 Reduction of masticatory efficiency.
 Temporomandibular joint disorders.

 Deviation of the mandible.
 Resorption of the residual ridge

OBJECTIVES OF REMOVABLE PARTIAL DENTURES
Preservation of the Remaining Tissues
Improvement of Esthetics
Improve Masticatory Function
Restoration of Impaired speech
Enhance psychological comfort

Preservation of the remaining tissues
A- Preservation of the health of the
remaining teeth.
B- Preservation of the residual ridge.
C- Prevention of muscles and TMJ
Dysfunction.
D- Preservation of the tongue contour and
space.

Improvement of esthetics, and providing support
to the paraoral muscles, lips and cheeks

Normal masticatory cycle
Restore the continuity of the dental arch to improve
masticatory function

Dento-labial F,v

Linguo-dental sounds S,TH
Linguo-alveolar sounds
L, n, t, d....

Enhance psychological comfort
*Restoration of anterior teeth improves and
restores appearance
*RPD should provide socially acceptable esthetics

INDICATIONS FOR REMOVABLE
PARTIAL DENTURES
1- No abutment tooth posterior to edentulous space
(Free end edentulous area)

2- Long edentulous bounded span, too extensive for
fixed restoration

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, space
is seen under the pontic.

5- After recent extraction, usually done only to
improve esthetics, or for patient satisfaction.
6- Need of bilateral bracing
(cross arch stabilization)
7- Young age (less than 17
years).

8- Enhancing esthetics in anterior region, by the use
of translucent artificial teeth instead of dull fixed
partial denture pontic.
9-Economic considerations, attitude and desire of
the patient.

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

Contraindications of RPDs
• Whenever fixed or implants
restorations can be successfully
used.
• When prognosis of remaining natural
teeth is doubtful.
• Poor oral hygiene & high caries susceptibility.
• Lack of patient cooperation.

Retention
Reciprocation
Support
Indirect Retention (Stabilization)
RPD REQUIREMENTS
Bracing and Stabilization
A properly constructed partial denture must achieve
All should be within the physiological limits of
the tissues involved

• Forces acting on RPD and factors that influence
the magnitude of stresses transmitted to the
tissues.
Is the Planning of the form and extent of RPD, after
studying all the factors involved
• Controlling the stresses by RPD
• Design concepts
Removable Partial Denture Design
• Biomechanical aspect of RPD design

* Mechanical ----- related to forces and its
application to object----- looseness of
teeth , bone resorption……etc
Removable Partial Denture Design
• Biomechanical aspect of RPD design
* Bio ------ pertaining to living
systems-----inflammation,
Caries, bone resorption….etc

FORCES ACTING ON
REMOVABLE PARTIAL
DENTURES

The magnitude and intensity
The duration
The direction
The frequency
of these forces
The ability of living tissues
To tolerate forces is largely dependent upon
Maxfield

Fibers of periodontal ligament are
arranged such that their
resistance to vertical forces is
much greater than that to
horizontal forces
Tissues are adapted to receive
and absorb forces within their
physiological tolerance

Horizontal or
lateral forces:
Translatoty
or
Rotational
E

Class I Lever:
fulcrum: between E and R R X d1= E X d2
Direction of lever arm: E opposite R
Class I Lever:

Class II Lever: fulcrum at one end,
Resistance R: More than E (force)
Class II Lever:

Class I Lever:
Fulcrum: between E and R
R
Free end saddle partial denture
without indirect retention
1-
E
F

Class I Lever: fulcrum (F): between Effort (E)
and Resistance (R)
R X d1= E X d2
Direction of lever arm: E opposite R
R
E
F

Prevent rotation
of the free end
saddle around
the fulcrum line
INDIRECT RETAINERS
Class II Lever

Class II Lever: fulcrum at one end
Resistance R: More than E (force)
Direction of lever arm: the same at E and R

A beam supported only at one end, when
force is directed against unsupported end of
beam cantilever can act as first class lever
2-

a- When force is directed against unsupported end of beam
cantilever can act as first class lever Torque on the
abutment tooth
b- A cantilever design allows excessive vertical movement
toward the residual ridge.
F a b

Reverse Aker Clasp
F
Class ? Lever

Fencepost is more readily removed by
application of force near its top than by
applying same force nearer ground level
In B- abutment has been contoured to allow rather
favorable location of retentive and reciprocal arms.
A
B
3-

Class III Lever: fulcrum at one end
Resistance: less than E
Class III Lever:

Schematic diagram showing the
TMJ as a third –class lever
Sticky
food
Class III Lever: fulcrum at one end

POSSIBLE
MOVEMENTS OF THE
PARTIAL DENTURE

I- Type of movement
II- Causes
III- Function of the partial denture that resist
this movement
IV- Components of PD that provide this
function
Four possible movements of RPD

I- Tissue-ward movements
II- Tissue-away movements
III- Horizontal movements:
A) Lateral movements
B) Antero-posterior movements.
IV- Rotational movements
At least four possible movements of
the partial dentures exist

Vertical forces acting in gingival direction
tending to move the denture towards the
tissues
I- Tissue-ward movements
Control direction of force

• Mastication, swallowing and aimless tooth
contact, biting forces.
They occur during
• R.P.D. should be designed to resist this
movement by providing adequate supporting
components
•This function of the partial denture is called
“Support”

Support
• Adequate distribution of forces over the supporting
structure
• The Resistance to tissue ward
movement
• Transferring occlusal stresses
to the supporting oral
structures and decrease
forces / unit area

• Adequate Distribution of Forces Over the Supporting
Sttructure
• Decrease forces/unit area
• The Resistance to Tissue Ward Movement

This Function is Mainly Provided By:
Properly designed supporting rests
placed in rest seats, which are
prepared on the abutment teeth,
Broad accurately fitting denture bases
in distal extension partial dentures.
Rigid major connectors that are neither
relieved from the tissues nor placed on
inclined planes also provide support

Distribute the Forces Over the Supporting Structure

Is the Mandibular Major Connector play a role
in support of PD ????

Lingual plate ??????????
Relieved?????
On an inclined plane???????

II- Tissue-away movements
Vertical forces acting in an occlusal direction tending to
displace and lift the denture from its position

Tissue-away forces occur due to
“Retention”
• The action of muscles acting along the
periphery of the denture
• Gravity acting on upper dentures or by sticky
food adhering to the artificial teeth or to the
denture base.

Resistance to movement
of the denture away from
its tissue foundation
(resistance of a denture
to dislodgment)
Retention

Tissue-away forces occur due to
“Retention”
The action of muscles acting along the
periphery of the denture
Gravity acting on upper dentures or by
sticky food adhering to the artificial
teeth or to the denture base.

1. Have less surface area.
2. Are bathed in saliva.
3. Lower major connectors are relieved.
contrary to upper major connectors that are
well adapted and their borders are beaded
against the underlying tissues.
4. Strong movements of the tongue.
The effect of physical forces is less applicable to lower
dentures than upper because:

1-Adhesion
2-Cohesion
3-Interfacial
surface tension.
4-Atmospheric
pressure
6-Gravity
Mechanical
Retention
Physiological
Physical
-The physiologic
molding of the
tissues around the
polished surfaces
- Neuromuscular
control
• Direct retainers
• Indirect R.
• Frictional fit
• Parts of the
denture engaging
tooth and tissue
undercuts.

• Frictional fit
Mechanical means of
Retention
Indirect R.
Direct
retainers
Parts of the denture
engaging tooth and
tissue undercuts.
• Clasps
• Attachments

This Function Is Mainly Provided By:
1- Mechanical direct retainers, which
engage undercuts on abutment teeth
Attachments
2- Physiologic forces on polished surfaces
of denture bases
3- Physical forces on fitting surfaces of
denture bases

RETENTION
From:
• Direct Retainers
•Active I-Bars
• Indirect Retainers
•Rests on the other side of the axis of
rotation from the extension base
• Proximal Plates(Guide Planes)
Indirect retainer (rest)
Extension Base
???

Horizontal movements
A) Lateral movements
Horizontal forces developed when the mandible moves from
side to side during function while the teeth are in contact
Lateral movements have a
destructive effect on teeth
leading to tilting, breakdown of
the periodontal ligament and
looseness of abutment teeth.

Bracing
Resistance
to lateral
movement of the
partial denture

 Bracing clasp arms placed at or above
the survey line of the tooth
 Rigid major and minor connectors in
contact with axial (vertical) surfaces of
abutment teeth
 Proximal plates
 Adequate extension of the flanges
Lateral movement is resisted by:

Lateral movement is also resisted by:
 Reduction of cusp angle inclination of
the artificial teeth and balanced
occlusion.
 Providing balanced occlusal contacts
free of lateral interference.

From:
• Guide plates
• Bracing clasp arms
• Lingual plates
• Rests
• Denture bases
Active I-bar
Reciprocation
I-bar
Bracing and stability

B) Antero-posterior movements
Horizontal forces which occur during forward
and backward movement of the mandible
during function while the teeth are in contact
There is natural tendency for the upper
denture to move forward and for the lower to
move backward.

Forward movement of the upper denture could be resisted by:
Anterior natural teeth.
Palatal slope.
Maxillary tuberosity.
The natural teeth bounding the edentulous space.
The backward movement of the lower denture could be resisted by:
The slope of the retromolar pad.
The natural teeth bounding the saddle area.
Proximal plates.

Reciprocation
Nullifying the effect of pressure on one side of the teeth by
application of pressure, equal in amount, but in an
opposite direction, on the opposite side of the teeth.
Retention distance ??????
Palatal view
Proximal view
?

RECIPROCATION can be achieved by:
Reciprocal clasp arms contacting the tooth prior
to or at the same time the retentive tip crosses the
survey line of the tooth.
Parts of the major connectors……..?????
Proximal plates.
Cross arch reciprocation should also be provided.
Reciprocation

IV- Rotational movements
Rotational movements are due to the
variation in compressibility of supporting
structures, absence of distal abutment at
one end or more ends of denture bases,
and /or absence of occlusal rests or
clasps beyond the fulcrum line.

Stabilization
Is the resistance of partial denture to tipping (rocking
torsional forces)

1-Rotation of the extension denture
base around transverse fulcrum axis:
A) Rotation of the denture base
towards the ridge around the
fulcrum axis joining the two
main occlusal rests
B) Rotation of the denture base
away from the ridge around
the fulcrum axis joining the
two main occlusal rests

A) Rotation of the denture base towards the
ridge around the fulcrum axis joining the
two main occlusal rests
?

B) Rotation of the denture base away from
the ridge around the fulcrum axis joining
the two main occlusal rests

Components of RPD that
are used to reduces the
tendency the denture to
rotate in an occlusal
direction about the
fulcrum axis.
Indirect Retention

2-Rotation of all bases around a
longitudinal axis parallel to the crest of the
residual ridge

3-Rotation about an imaginary
perpendicular axis
F
Fish tail movements

4- Rotation due to occlusal interferences
Undesirable contacts occurring during
lateral movements

This movement is counteracted by:
 Providing adequate bracing
 A rigid major connector
 Broad base coverage
 Balanced contact between upper and lower teeth and
reduction of cusp slope.
 The use of additional rests on teeth other than the
abutment tooth serves as, indirect retainers.
 Coverage of the sloping part of the palate ant. (rugea
area) acts as an indirect retention.

Never laugh at anyone's dreams.
People who don't have dreams don't have much

HAZARDS and DAMAGING EFFECTS OF
IMPROPERLY DESIGNED PARTIAL DENTURES

CARIES
Stagnation of food causes tooth decay
Causes
1. No oral hygiene .
2. No periodic recall.
3. Components that allow
food accumulation.
Management
1. Better oral hygiene instructions.
2. Fluoride application.
3. Fillings, and full coverage
restorations.

Improperly designed PDs and not follow the biomechanical
aspect of the design cause:
Inflammation
Bone resorption
Periodontal membrane
destruction
PERIODONTAL PROBLEMS
CLASS 1 LEVER.
Pockets
Calculus formation

Management
1. Better oral hygiene instructions.
2. Avoid coverage of the gingival margin.
3. Some schools prefer biological designs, with the least no. of
components crossing the gingival margin.
1. Poor oral and denture hygiene.
3. Components that impinge on the gingival
margin.
PERIODONTAL PROBLEMS

Denture stomatitis is a candidiasis (fungal infection)
that occurs only beneath a denture.
It can be asymptomatic or symptomatic causing a burning
sensation, discomfort and bad taste.
(Candida albicans. Diploid fungus)
DENTURE STOMATITIS

Age: middle to old age
More common in females
Has been found in up to 70% of denture wearers
Denture sore mouth
Chronic atrophic candidiasis
Incidence
Begin with Mild erythema or redness of the
mucosa under the denture
DENTURE STOMATITIS

DENTURE STOMATITIS
Predisposing Factors
Wearing dentures at night
Dry mouth
Diabetes
Increased carbohydrate diet

Causes
1. Poor oral and denture hygiene.
2. Candida is the main cause (70%)
4. Mechanical irritation and bacterial infections
>> Components that mechanically impinge on
the mucosa.
5. Accumulation of microbial plaque
6. Other systemic diseases (Diabetes and HIV
(Human Immunodeficiency Virus).
DENTURE STOMATITIS

• Accumulation of plaque >>>
colonization by candida albicans >>>
Increased candidal enzymatic activity
due to >>> decrease salivary flow
and Ph >>> inflammation.
Pathogenesis
DENTURE STOMATITIS

Clinical features of denture stomatitis
 Marked redness or erythema and odema of
the mucosa in contact with dentures, Usually
occurs in the maxilla.
 Restricted to the denture bearing area often
with a sharply defined edge.
 Sometimes Patient has no complaints of pain.
 Uncommon complications
- Angular stomatits
- Papillary hyperplasia in palatal vault

 Depends on clinical findings
In presence of angular stomatitis or other
systemic lesions further investigations are
required
- Blood picture
- Smears and culture
- Biopsy in persistent or atypical lesions
- HIV serology
Diagnosis

Management
Patient education
Oral and denture hygiene instructions
Periodic recall, Relief of any impinging components
Treatment of any Systemic diseases such as diabetes
or anemia
Remove dental plaque
Antifungal therapy
- Nystatin drops
- Dakatrin gel(miconazole)

BONE RESORPTION
Ill fitting denture >> Inflammation,
ulceration, gingival recession > bone
resorption

Causes
1. Normal condition.
3. Components that mechanically impinge on the mucosa.
4. Systemic diseases.
Management
1. Relining appointments.
2. Periodic recall.
3. Relief of impinging
components.
4. Treatment of systemic
conditions.
BONE RESORPTION

Sensitivity from acryl
Management
1.Treatment of the systemic condition.
2. Remove the denture
RARE

T.M.J. DISORDERS
Improper occlusion causes T.M.J.
disorders.

TORQUE ON THE ABUTMENTS
Clasps with stress breaking action (class I&II)
Occlusal rest placed away from the saddle.
Distribute the load.
Record the ridge in functional form.
How do you solve the problem of torqueing?

Removable Partial prosthodontics
Classification of partially edentulous arches
Clinical and laboratory steps of construction of RPD
Consequences of loss of teeth and distribution of forces in
the oral cavity
• Drifting, over-eruption and inclination of the teeth
• Disabilities associated with appearance.
• Speech disabilities.
• Deviation of the mandible.
• Resorption of the residual ridge
• Reduction of masticatory efficiency.
• Temporomandibular joint disorders.
• Disturbed occlusion and loss of vertical dimension.
• Reduction of masticatory efficiency.
• Temporomandibular joint disorders
In Summary

Objectives of removable partial dentures
• Preservation of the remaining tissues
• Improve masticator function
• Restoration of impaired speech
• Improvement of esthetics
• Enhance psychological comfort
Indications and Contraindications for RPDs
Advantages of RPD over fixed PD
Requirements of RPD
Forces acting on removable partial dentures
Hazards and damaging effects of improperly
designed partial dentures.

References
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Davenport, J.C. and Pollard, A.: Aspects of partial denture design; University of Birmingham .U.K. 2005.
Davenport, J.C., Basker, R.M., Heath, J.R. and Ralph, J.P.: A colour Atlas of Removable Partial Dentures. Wolfe Medical Publications Ltd. 2005.
El Gamrawy, E. A.: Bas Garcia LT. The use of a rotational-path design for a mandibular removable partial denture. Compend Contin Educ Dent;25:552-567. 2004.
J. C. Davenport, R. M. Basker, J. R. Heath, J. P. Ralph, P-O. Glantz and P. Hammond: Clasp design, BDJ. JANUARY 27, VOLUME 190, NO. 2, PAGES 71-81. 2001
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J. C. Davenport, R. M. Basker, J. R. Heath, J. P. Ralph, P-O. Glantz and P. Hammond: Tooth preparation, MARCH 24, VOLUME 190, NO. 6, PAGES 288-294. 2001
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1. Introduction and forces acting on Removable Partial Denture (RPD).

1. Introduction and forces acting on Removable Partial Denture (RPD).

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