This document provides an introduction to removable partial dentures (RPDs), including their components and classifications. It discusses the key terminology used in RPDs and describes the different types of RPDs. Kennedy's classification system divides partially edentulous arches into four main classes based on the location of edentulous spaces. It also outlines Applegate's rules for applying the Kennedy classification. The main components of an RPD are reviewed as the major connector, minor connectors, rests, retainers, denture bases and teeth. Tooth-supported and tooth-tissue supported RPDs are compared.
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When treating a patient with a removable partial denture, the natural and artificial teeth, both functionally and esthetically, must co-exist in a harmonious relationship.
Occlusal harmony between a removable partial denture and the remaining natural teeth is a major factor in preservation of the surrounding structures.
In removable partial dentures, because of the attachment of the denture to abutment teeth, occlusal stresses can be transmitted directly to the abutment teeth and other supporting structures, which results in sustained stresses that may be more damaging than those transient stresses found in complete dentures.
A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
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References
• FUNDAMENTALS OF REMOVABLE PARTIAL PROSTHODONTIC DESIGN by Kenneth R. McHenry, D.D.S., M.S and Terrence McLean, D.D.S.
• Stewart's Clinical Removable Partial Prosthodontics, Fourth Edition by Rodney D Phoenix, D.D.S, M.S, David R Cagna, D.M.D, M.S and Charles F DeFreest, D.D.S
• McCRACKEN’S REMOVABLE PARTIAL PROSTHODONTICS, TWELFTH EDITION BY Alan B. Carr, D.M.D, M.S, and David T. Brown, DDS, MS
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Direct retainers /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
When treating a patient with a removable partial denture, the natural and artificial teeth, both functionally and esthetically, must co-exist in a harmonious relationship.
Occlusal harmony between a removable partial denture and the remaining natural teeth is a major factor in preservation of the surrounding structures.
In removable partial dentures, because of the attachment of the denture to abutment teeth, occlusal stresses can be transmitted directly to the abutment teeth and other supporting structures, which results in sustained stresses that may be more damaging than those transient stresses found in complete dentures.
A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
Prosthodontics seminar 3rd stage University of Anbar College Of Dentistry
Created By Mohammed Amer Hekma
Supervised by: Dr Osama Abdul Rasool Hammoodi
References
• FUNDAMENTALS OF REMOVABLE PARTIAL PROSTHODONTIC DESIGN by Kenneth R. McHenry, D.D.S., M.S and Terrence McLean, D.D.S.
• Stewart's Clinical Removable Partial Prosthodontics, Fourth Edition by Rodney D Phoenix, D.D.S, M.S, David R Cagna, D.M.D, M.S and Charles F DeFreest, D.D.S
• McCRACKEN’S REMOVABLE PARTIAL PROSTHODONTICS, TWELFTH EDITION BY Alan B. Carr, D.M.D, M.S, and David T. Brown, DDS, MS
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Direct retainers /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Overdentures are a useful treatment option in many clinical situations. A simple complete lower overdenture which encloses the roots of two root-treated canines has been shown above (Fig. 12.51). Cases can be more complicated than this. The reduction in the crowns of the teeth may have occurred due to tooth wear from a combination of erosion and attrition. In the elderly, where such tooth reduction has occurred, root canal treatment may not be necessary. The removal of the roots will not benefit the patient and the overdenture is the best form of treatment.
Less common situations, such as partial anodontia, cleft palate or loss of tooth crown substance in dentinogenesis imperfecta, may also require restoration using overdentures. The distinction between an onlay and an overdenture is not clear-cut and a potentially difficult partial denture treatment, such as the restoration of a free end saddle, may be helped by the coverage of a canine or molar tooth with a reduced crown rather than a more involved crown restoration.
In the case illustrated in Figure 12.53, an elderly patient has severe tooth surface loss. The aetiology of this wear must be diagnosed before treatment is commenced. For instance, is this wear a result of parafunction or erosion from the consumption of acidic drinks? The remaining dentition has been restored and a definitive overdenture placed.
Discuss the role of treatment plan in partial denture /certified fixed orthod...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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Similar to 15. introduction to removable partial dentures (20)
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3. Memorize and recall various
terminologies related to removable
partial dentures.
List the indications of removable
partial dentures.
Explain the components of RPD.
4. REMOVABLE
PROSTHODONTICS
It is devoted to replacement of
missing teeth and contiguous tissues
with prosthesis designed to be
removed by the wearer.
It includes two disciplines: removable
complete denture prosthodontics and
removable partial denture
prosthodontics.
7. REMOVABLE
PROSTHODONTICS
The branch of prosthodontics
concerned with the replacement of
teeth and contiguous structures for
edentulous or partially edentulous
patients by artificial substitutes
that are readily removable from
the mouth.
10. An interim removable partial
denture is a provisional prosthesis
intended to improve esthetics and
function until a more definitive form
of treatment can be given.
11. A transitional removable partial denture
may be used when loss of additional
teeth is expected, but immediate
extraction is not advisable.
Artificial teeth may be added to a
transitional removable partial denture as
natural teeth are extracted.
12.
13. A treatment denture may be used as a
carrier for treatment material, as a
protective covering for a surgical site, or
as a matrix for soft tissue healing.
In most instances, treatment dentures
are used along with tissue conditioners.
14.
15.
16. Interim, transitional, and treatment
prostheses are intended for short-term
applications and should never be used
for prolonged treatment.
The use of such prostheses over
extended periods may cause irreparable
damage to a patient's remaining teeth,
soft tissues, and bone.
17. Abutment: a tooth, a portion
of a tooth, or that portion of a
dental implant that serves to
support and/or retain a prosthesis.
37. No abutment tooth
posterior to the edentulous
space: When there is no tooth
posterior to the edentulous
space to act as an abutment, a
RPD is preferred.
38. Reduced periodontal support for
remaining teeth: In mouths where
bony support for the remaining teeth
has been severely compromised, the
abutments may be unable to support
FPD. In such cases RPD is preferred.
41. Need for cross-arch stabilization:
When stabilization of the remaining teeth
is needed to balance mediolateral and
anteroposterior forces (eg, after treatment
of advanced periodontal disease), cross-
arch stabilization frequently is required.
42. A fixed partial denture can provide
excellent anteroposterior stabilization,
but limited mediolateral stabilization.
Because removable partial dentures
are bilateral prostheses, cross-arch
stabilization is enhanced.
46. Excessive bone loss within the
residual ridge: When trauma,
surgery, or abnormal resorptive
patterns have caused excessive
bone loss, a clinician also must deal
with replacement of ridge contours.
A properly contoured RPD will
support the lips and cheeks, and to
reestablish desirable facial contours.
51. Physical or emotional problems
of the patient: The lengthy
preparation and construction
procedures for FPD’s can be
exhausting, especially for patients
with physical or emotional problems.
In many instances, RPD is indicated
to minimize patient-dentist contact
time.
52. Esthetics of primary concern:
It is often possible to attain a more
pleasing appearance by using a
RPD. This is true when the
practitioner must simulate the
appearance of diastemata, dental
crowding, dental rotation, or
extreme changes in the soft tissue
architecture.
53.
54. Immediate need to replace
extracted teeth: The replacement
of teeth immediately following
extraction is done using a RPD.
55. Patient desires: Patients
sometimes insist on removable
prostheses in place of fixed
prostheses (1) to avoid operative
procedures on sound, healthy
teeth; (2) to avoid the placement
of one or more implants; and (3)
for economic reasons.
58. Components of a RPD
1. Major connectors
2. Minor connectors
3. Rests
4. Direct retainers
5. Indirect retainers (CLASS I AND
CLASS II ONLY)
6. Denture bases
7. Teeth
61. 1. Major Connector: that part of
a RPD that joins the components
on one side of the arch to those on
the opposite side.
62. 2. Minor Connector: that
connecting link between the major
connector and the other units of the
prosthesis, such as the clasp,
indirect retainers, occlusal rests, or
cingulum rests.
63. 3. Rests: that unit of a RPD that
rests on a tooth surface to provide
vertical support is called a rest.
64. The prepared surface of an abutment
to receive the rest is called the rest
seat.
65. Rests are designated by the
surface of the tooth prepared to
receive them (occlusal rest,
cingulum rest, and incisal rest).
66. 4. Direct Retainer: that
component of a RPD used to
retain and prevent dislodgment of
the prosthesis.
67. 5. Indirect Retainer: that component
of a RPD that resists rotational
displacement of an extension base away
from the supporting tissues.
68.
69. 6. Denture Base: the part of a
denture that rests on the tissues
and to which teeth are attached.
73. Explain about Kennedy’s classification of
partially edentulous arches.
List Applegate’s rules to govern the
application of Kennedy system.
Compare between tooth supported and
tooth-tissue supported RPD.
74. There are more than 65,000
combinations of standing
teeth and edentulous spaces
which may be encountered
in each arch.
75. Requirements of an
acceptable method of
classification
The classification of a
partially edentulous arch
should satisfy the following
requirements:
76. 1. It should permit immediate
visualization of the type of
partially edentulous arch that
is being considered.
2. It should permit immediate
differentiation between the
tooth-supported and tooth-
tissue supported RPD.
77. 3. Serve as a guide to the
type of design to be used.
4. It should be universally
acceptable.
78. Dr. Edward Kennedy proposed
this classification in 1923 and is
the most popular classification.
This system is based on the
relationships of the edentulous
spaces to the abutment teeth.
Kennedy's Classification
82. Class IV
A single, but
bilateral
(crossing the
midline),
edentulous area
located anterior
to the remaining
natural teeth.
83. Class I arches are most common
while class IV arches were least
common.
84. Modification spaces
Each Kennedy classification, except
Class I, refers to a single edentulous
area. Additional areas of edentulism
may occur within a dental arch.
Kennedy referred to each additional
edentulous area—not each additional
missing tooth—as a modification
space.
85. Dr Kennedy included the number
of modification areas in the
classification (eg, Class I,
Modification 1; Class II,
Modification 3).
86. While the Kennedy system provided a
method for classification of partially
edentulous arches, there was some
uncertainty regarding its application.
In 1954, Dr O. C. Applegate provided
the following rules to govern
application of the Kennedy system:
Applegate’s rules – to govern the
application of Kennedy system
87. Applegate’s rules for classification
Rule 1: Classification should
follow rather than precede
extractions that might alter the
original classification.
88.
89. Rule 2: If the 3rd
molar is
missing and not to be replaced,
it is not considered in the
classification.
90.
91. Rule 3: If a 3rd
molar is present
and is to be used
as an abutment, it
is considered in
the classification.
92. Rule 4: If a 2nd
molar is missing
and is not to be
replaced, it is not
considered in the
classification.
93. Rule 5: The
most posterior
edentulous
area(s) always
determines the
classification.
94. Rule 6: Edentulous areas
other than those
determining the
classification are referred to
as modification spaces and
are designated by their
number.
100. A- CL IV
B- CL II MOD
2
C- CL I MOD
1
D- CL III MOD
3
E- CL III MOD
1
F- CL III MOD
1
G- CL IV
H- CL II
I- CL III MOD
6
101. Tooth supported RPD
A partial denture
that receives
support from the
natural teeth at each
end of the
edentulous space.
Also called as
bounded saddle.
103. Tooth-tissue supported RPD
The denture base that
extends posteriorly
and is supported by
teeth at one end only.
Also called distal
extension partial
dentures or free end
saddle.