Clinical course — Removable Partial Denture 1. Forces acting on the removable partial denture 2. Mouth examination, diagnosis and treatment planning 3.Basic principles for designing the removable partial denture 4. Preliminary impression and diagnostic cast. 5. Mouth preparation for removable partial denture 6. Final impression 7. framework try-in 8. Occlusal relations for removable partial dentures 9. Trial insertion of waxed-up partial dentures. 10. Final fitting of the dentures 11. Patient's complaints following partial denture insertion 12. Damaging effects of removable partial dentures 13. Repair and relining of removable partial dentures

3. Dr. Amal KaddahDr. Amal Kaddah
Professor of ProsthodonticProfessor of Prosthodontic,,
Faculty of Oral &Dental Medicine,Faculty of Oral &Dental Medicine,
Cairo UniversityCairo University

5. Occlusal stresses are transmitted directlyOcclusal stresses are transmitted directly
to the abutment teeth and other supportingto the abutment teeth and other supporting
structures, the resultant stresses may bestructures, the resultant stresses may be
more damaging than those transientmore damaging than those transient
stresses formed in complete denture.stresses formed in complete denture.
Therefore, it is important in PD to establishTherefore, it is important in PD to establish
In complete dentures:In complete dentures:
In partial dentureIn partial denture::
Balanced occlusion is desirable onBalanced occlusion is desirable on
complete dentures because occlusalcomplete dentures because occlusal
stresses may cause instability of thestresses may cause instability of the
denture or trauma to the supportingdenture or trauma to the supporting
structuresstructures ..

6. Establishing functionalEstablishing functional
and harmonious occlusionand harmonious occlusion
in removable partialin removable partial
prosthodontics isprosthodontics is
essential for preservationessential for preservation
of the health of theof the health of the
Objective:Objective:

7. To establish satisfactory occlusionTo establish satisfactory occlusion
the following Steps are requiredthe following Steps are required::
Requirements of satisfactoryRequirements of satisfactory
occlusion:occlusion:
I.I. Analysis of the existing occlusion.Analysis of the existing occlusion.
II.II. Correction of existing occlusalCorrection of existing occlusal
disharmony.disharmony.
III.III.Recording the centric relation.Recording the centric relation.
IV.IV.Recording the functional eccentricRecording the functional eccentric
relations.relations.
V.V. Correction of occlusalCorrection of occlusal
discrepancies createddiscrepancies created during
processing of the removable partial

8. Diagnostic castsDiagnostic casts are fabricated toare fabricated to
analyze the case and to surveyanalyze the case and to survey
itit. Although some diagnostic. Although some diagnostic
casts may be occluded by hands,casts may be occluded by hands,
occlusal adjustments are muchocclusal adjustments are much
better accomplished on anbetter accomplished on an
adjustable articulator.adjustable articulator.

9. Casts are mountedCasts are mounted in relation to the axis-in relation to the axis-
orbital planeorbital plane in order to permit betterin order to permit better
interpretation of the occlusal plane ininterpretation of the occlusal plane in
relation the horizontal plane.relation the horizontal plane.
All widely used articulators [Hanau H.All widely used articulators [Hanau H.
series, Dentatus and Improved Gysi]series, Dentatus and Improved Gysi]
are semi-adjustable articulators andare semi-adjustable articulators and
can also be used for adjustingcan also be used for adjusting

10. 1- Reshaping or recontouring of remaining1- Reshaping or recontouring of remaining
teethteeth
2- Fixed restorations2- Fixed restorations3- Orthodontic treatment3- Orthodontic treatment
4- Prospective surgical preparation4- Prospective surgical preparation
 If the tooth can not be restored to aIf the tooth can not be restored to a
state of health.state of health.
 If its absence will permit a moreIf its absence will permit a more
serviceable and less complicated partialserviceable and less complicated partial
denture design.denture design.
 If it is so un-esthetically located as toIf it is so un-esthetically located as to
Extraction of teeth may beExtraction of teeth may be
indicated:indicated:

11. CommonCommon occlusalocclusal
disharmoniesdisharmonies::
1- Recontouring, through flat reduction1- Recontouring, through flat reduction
distallydistally
of the drifted tooth.of the drifted tooth.
2- Restoring the tooth by crowns.2- Restoring the tooth by crowns.
3- Orthodontic repositioning.3- Orthodontic repositioning.
Mesial inclination ofMesial inclination of
the posterior molarthe posterior molar
severelyseverely
Problem IProblem I
Solution:

12. Solution:Solution:
ApproximatelyApproximately 2mm of enamel2mm of enamel
can be removedcan be removed ,, but if thebut if the
extrusion is greater than 1-2extrusion is greater than 1-2
mm, placement ofmm, placement of anan
extracoronal metallicextracoronal metallic
restorationrestoration is indicated.is indicated.
In severe cases posteriorIn severe cases posterior
segmentsegment osteotomyosteotomy may bemay be
effective in correction of thiseffective in correction of this
problem.problem.
Anterior maxillary osteotomyAnterior maxillary osteotomy
may also be effective formay also be effective for
Problem IIProblem II
Loss of interarch distanceLoss of interarch distance

13. Problem III:Problem III:
Irregular or mal posed occlusalIrregular or mal posed occlusal
PlanePlane
Solution:Solution:
1- Enameloplasty if the extrusion is in1- Enameloplasty if the extrusion is in
one cusp (1-2 mm).one cusp (1-2 mm).
2- Extracoronal metallic restoration.2- Extracoronal metallic restoration.
3- Posterior or anterior segmental3- Posterior or anterior segmental
osteotomy.osteotomy.
4- Extraction of the malposed tooth or4- Extraction of the malposed tooth or
teeth.teeth.

14. Problem IV:Problem IV:
Traumatic vertical overlap of anteriorTraumatic vertical overlap of anterior
teethteeth
SolutionSolution::
EarlyEarly recognition ofrecognition of
the problem andthe problem and
treatment withtreatment with
orthodonticorthodontic oror
combinedcombined
orthodonticorthodonticor orthognathic surgical procedures are
the treatment of choice.

15. To establish and maintain a
harmonious relationship with all oral
structures and to provide a
masticatory apparatus that is efficient
and esthetically acceptable.
Why we Record the Jaw Relations ?

16. 1-The number and distribution of1-The number and distribution of
existing teeth.existing teeth.
2-The decision whether the teeth2-The decision whether the teeth
will be arranged in centricwill be arranged in centric
occlusion or centric relation.occlusion or centric relation.
According toAccording to

17. a.a. Occlusal relation using occlusal rims onOcclusal relation using occlusal rims on
recorded bases.recorded bases.
b.b. Jaw relation records made entirely on occlusionJaw relation records made entirely on occlusion
rims.rims.
a- Direct apposition of the casts, or,a- Direct apposition of the casts, or,
b- Interocclusal record with posterior teethb- Interocclusal record with posterior teeth
remaining:remaining:
1. Interocclusal wax record using squash1. Interocclusal wax record using squash
bite.bite.
2. Interocclusal wax record using occlusion2. Interocclusal wax record using occlusion
blocksblocks
3. Using Jone’s bite framework, or3. Using Jone’s bite framework, or
II- If there is no sufficient number of
teeth:
I - If there is sufficient number of teeth;I - If there is sufficient number of teeth;
either by:either by:

18. a- Direct apposition of castsa- Direct apposition of casts
If there are at least 3-4 positiveIf there are at least 3-4 positive
contacts between the posteriorcontacts between the posterior
natural teeth at each arch, thennatural teeth at each arch, then
the upper and lower casts canthe upper and lower casts can
be opposed by hands againstbe opposed by hands against
each other, sticky wax and wireeach other, sticky wax and wire
loops are needed to fix theloops are needed to fix the
casts togethercasts together..
AdvantageAdvantage::
Avoid errors from patientsAvoid errors from patients..
DisadvantageDisadvantage::
The occlusion is controlledThe occlusion is controlled
If stable occlusal contacts
are provided by the
remaining natural teeth,
Normally the OVD is provided by
the opposing natural teeth
contact
and it should not be changed.
I - If there is sufficient number of teeth;I - If there is sufficient number of teeth;
either by:either by:

19. b- Interocclusal records withb- Interocclusal records with
posterior remaining teethposterior remaining teeth
1. Interocclusal wax record using squash
bite.
2. Interocclusal wax record using occl.
Blocks.
3. Using Jone’s bite framework.
These techniques are used if there areThese techniques are used if there are
remaining posterior teeth but notremaining posterior teeth but not
sufficient to be opposed by hand e.g.sufficient to be opposed by hand e.g.
long span class III Kennedy PDlong span class III Kennedy PD ..

20. 1.. Interocclusal wax recordInterocclusal wax record usingusing
squash bite.squash bite.
This technique isThis technique is
carried out usingcarried out using
uniformly softeneduniformly softened
reinforced wax wafer,reinforced wax wafer,
corrected by zinc oxidecorrected by zinc oxide
paste or quick settingpaste or quick setting
stone over the wax tostone over the wax to
both side.both side. the patient

21. This technique is used if there are remainingThis technique is used if there are remaining
posterior teeth but not sufficient to beposterior teeth but not sufficient to be
opposed by hand e.g. class III Kennedy PD.opposed by hand e.g. class III Kennedy PD.
2. Interocclusal wax record. Interocclusal wax record
using occlusion Blocksusing occlusion Blocks

22. 3- Jone’s bite3- Jone’s bite
framework.framework.
This technique is carried out usingThis technique is carried out using
uniformly softened reinforced wax waferuniformly softened reinforced wax wafer
corrected by zinc oxide paste or quickcorrected by zinc oxide paste or quick
Interocclusal wax record using adjustable framework isInterocclusal wax record using adjustable framework is
performed to relate mandibular cast to the previously mountedperformed to relate mandibular cast to the previously mounted
maxillary castmaxillary cast..

23. Some of the advantages of using aSome of the advantages of using a
metallic oxide paste over wax as ametallic oxide paste over wax as a
recording medium for occlusal recordsrecording medium for occlusal records
includeinclude
1.1. Ease of displacement on closer.Ease of displacement on closer.
2.2. Accuracy of occlusal surface reproduction.Accuracy of occlusal surface reproduction.
3.3. Dimensional stability.Dimensional stability.
4.4. The possibility of some modification inThe possibility of some modification in
occlusal relationships after closer, if itsocclusal relationships after closer, if its
made before the material setsmade before the material sets
5.5. Reduced distortion during mountingReduced distortion during mounting
procedure.procedure.

24. Interocclusal wax record alone can be usedInterocclusal wax record alone can be used
but is the least accurate because of thebut is the least accurate because of the
1. Dimensional instability of wax after
cooling.
2. Excess wax that contacts the mucosa may
distort soft tissue and prevent accurate
seating of the wax records onto the stone
casts.
3. Distortion of wax during or after removal
from the mouth may also interfere with
accurate seating

25. 11--Occlusal relations using occlusalOcclusal relations using occlusal
record basesrecord bases
IndicationsIndications::
11--In case of distal extension areasIn case of distal extension areas..
22--Long teeth bounded saddlesLong teeth bounded saddles..
33--No contact between opposing natural teethNo contact between opposing natural teeth..
II- if there is no sufficient number of
teeth:

26. Inadequate toothInadequate tooth
numbernumber
to support the biteto support the bite
registrationregistration
materialsmaterials
Selectively adding the wire claspsSelectively adding the wire clasps
can improve thecan improve the
retention & stability of the recordretention & stability of the record
base for accurate jaw recordbase for accurate jaw record

27. Interocclusal RecordInterocclusal Record
Adequate toothAdequate tooth
numbernumber
vsvs..
Inadequate toothInadequate tooth
numbernumber
to support the biteto support the bite
registration materialsregistration materials
Bite registration materialsBite registration materials::
ZOE bite registration pasteZOE bite registration paste
Wax CompoundWax Compound
SiliconeSilicone
Keep the space for theKeep the space for the
bite registration materialbite registration material

28. 2. RPD Jaw Relation Records Using2. RPD Jaw Relation Records Using
Record Base Attached to theRecord Base Attached to the
Framework.Framework.

29. 33--Jaw relation records madeJaw relation records made
entirely on occlusion rimsentirely on occlusion rims
Used when there is noUsed when there is no
contact between thecontact between the
remaining naturalremaining natural
teeth.teeth.
 Maxillary completeMaxillary complete
denture opposed bydenture opposed by
mandibular PD.mandibular PD.
Maxillary class IMaxillary class I
partial denturepartial denture

31. 33--Jaw relation records madeJaw relation records made
entirely on occlusion rimsentirely on occlusion rims

32.  It is used when no occlusal contact occursIt is used when no occlusal contact occurs
between the remaining natural teeth, such asbetween the remaining natural teeth, such as
 1) a maxillary complete denture opposes a1) a maxillary complete denture opposes a
mandibular removable partial denture andmandibular removable partial denture and
 2) in rare situations in which the few remaining2) in rare situations in which the few remaining
teeth so not occlude. In any of these situations, jawteeth so not occlude. In any of these situations, jaw
relation records are made entirely on occlusionrelation records are made entirely on occlusion
rims.rims.
 The choice of method for determining the verticalThe choice of method for determining the vertical
dimension of occlusion and recording jaw relationsdimension of occlusion and recording jaw relations
is the same as that for complete dentures.is the same as that for complete dentures.
33--Jaw relation records madeJaw relation records made
entirely on occlusion rimsentirely on occlusion rims

33. Steps of Jaw RelationSteps of Jaw Relation
RecordsRecords
 Lip support (class IV) and occlusal planeLip support (class IV) and occlusal plane
adjustmentsadjustments
 Vertical Jaw Relations:Vertical Jaw Relations:
Rest Vertical Dimension ‘RVD’Rest Vertical Dimension ‘RVD’
Occlusion Vertical Dimension ‘OVD’Occlusion Vertical Dimension ‘OVD’
 Horizontal Jaw Relations:Horizontal Jaw Relations:
Centric RelationCentric Relation
Centric OcclusionCentric Occlusion
Eccentric RelationsEccentric Relations
• Protrusive relationProtrusive relation
• Lt & Rt Lateral relationsLt & Rt Lateral relations
 Face bow Registration.Face bow Registration.

34. The upper rim may require to be thinned
from the palatal aspect to accommodate
lower natural anterior teeth.
Lip Support and Occlusal plane adjustments

35. Position of Anterior Teeth dictated by Esthetics and Phonetics
The desired incisal level. This is decided by reference to adjacent teeth
and to resting level of upper lip

36. Determination of theDetermination of the
occlusal plane depends on:occlusal plane depends on:
1- Aesthetic base.1- Aesthetic base.
2- Functional base (chewing and2- Functional base (chewing and
speech).speech).
3- Physical and mechanical bases3- Physical and mechanical bases
(leverage action and(leverage action and
parallelism).parallelism).

37. a. The maxillary rim has modified to accommodate a
mandibular tooth
b. The mandibular rim is adjusted to indicate the position
of the teeth in the neutral zone. And the level of the
plane doesn’t exceed 2/3 of the retromolar pad
a. b.

38. Incisal level of the rim should be parallel
to the interpupillary line. The upper
posterior occlusal is parallel to the ala-
tragus line (Camper’s Line(

39. Fixed Position
Measurable
Identifiable
Relationship to natural dentition

40. The level of the occlusal plan shouldThe level of the occlusal plan should
be below the level of the maximumbe below the level of the maximum
convexity of the tongue to provideconvexity of the tongue to provide
denture stabilitydenture stability

41. The vertical distance
between two selected
points, one on the fixed
(maxilla) and one on the
Rest Vertical Dimension ‘RVDRest Vertical Dimension ‘RVD’’
Occlusion VerticalOcclusion Vertical
Dimension ‘OVDDimension ‘OVD’’
Inter-occlusal Distance /Inter-occlusal Distance /
Free way SpaceFree way Space
Vertical Jaw Relation

42. Vertical Jaw Relation
Rest Vertical DimensionRest Vertical Dimension
(RVD)(RVD)
Is the distance measuredIs the distance measured
when the mandible is inwhen the mandible is in
the rest position.the rest position.
Occlusal vertical DimensionOcclusal vertical Dimension
(OVD)(OVD)
Is the distance measuredIs the distance measured
when the occluding rimswhen the occluding rims
or teeth are in contact.or teeth are in contact.

43. • Isometric contraction
It is contraction of muscle
without shortening
Ring of closing, opening and post
vertebral muscles.
Elevator muscles
Contract
isometrically to keep
the mandible at rest
(tension without
shortening)

44. Inter-occlusal Distance
The distance between the occluding surfaces
of maxillary and mandibular teeth when the
mandible is in the rest position.
For a complete denture
patient, it is the difference
between RVD and OVD.
RVD – OVD = 4 mm
or RVD – 4 mm = OVD

45. Inter-occlusal DistanceInter-occlusal Distance
InIn natural dentitionnatural dentition itit
ranges from 2-4 mmranges from 2-4 mm
in the premolar area.in the premolar area.
The Freeway Space

46. Vertical Jaw RelationsVertical Jaw Relations
 Whom the opposingWhom the opposing
teeth do not provideteeth do not provide
stable occlusalstable occlusal
contacts,contacts, OVD has to beOVD has to be
measured as follows,measured as follows,
 RVD – OVD = 3 - 4 mmRVD – OVD = 3 - 4 mm
 If stable occlusal contactsIf stable occlusal contacts are provided by the opposing naturalare provided by the opposing natural
teeth, the existing OVD and CO relation should be recorded and notteeth, the existing OVD and CO relation should be recorded and not
be changed.be changed.
 For the patients whomFor the patients whom one of the arch is edentulousone of the arch is edentulous oror

47. Altering the Existing OVDAltering the Existing OVD
1. Symptoms of diminished OVD exist such as tired
aching muscles, unexplained pain in the head
and neck region, shortened nose-chin distance
(appearance of premature aging).
2. Excessive Free way Space or ‘over-closure’ of
the jaws.

48. Wearing of the teeth does not mean that
OVD should be increased – unless the
free-way space is greater than 4mm.
Altering the Existing OVDAltering the Existing OVD

49. How to alter the existing OVDHow to alter the existing OVD
1. Confirm the loss of vertical dimension by taking history,1. Confirm the loss of vertical dimension by taking history,
cephalometric examination, and the presence ofcephalometric examination, and the presence of excessiveexcessive
free-way spacefree-way space..
2. Increase the existing OVD2. Increase the existing OVD temporarilytemporarily by fabricating anby fabricating an
acrylic resin occlusal overlay appliance in maximumacrylic resin occlusal overlay appliance in maximum
intercuspation, ensuring that 4mm of freeway space mustintercuspation, ensuring that 4mm of freeway space must
exist.exist.

50. Restore the desired OVDRestore the desired OVD permanentlypermanently with the helpwith the help
of fixed and removable prosthesis (of fixed and removable prosthesis (mademade
simultaneouslysimultaneously) only) only after the physiologic responseafter the physiologic response
of the patient to this appliance is positiveof the patient to this appliance is positive..
Altering the Existing OVDAltering the Existing OVD

51. Altering the Existing OVDAltering the Existing OVD a case reporta case report

52. Altering the existing OVD – a case reportAltering the existing OVD – a case report

53. Horizontal Jaw RelationHorizontal Jaw Relation
Centric Relation
‘The most retruded position of the mandible to
maxilla at an established OVD’.
It is a bone to bone relation that is repeatable by the
patient. It remains constant throughout life & during
its recording, cuspal relation of the teeth is not
considered.

54. Maximum intercuspationMaximum intercuspation
‘The complete intercuspation of the opposing
teeth independent of condylar position
It is a tooth-tooth relation - a position of
habitual closure. GPT8

55. Horizontal Jaw RelationHorizontal Jaw Relation
The occlusion of opposing teeth when theThe occlusion of opposing teeth when the
mandible is in centric relation,mandible is in centric relation, This may or
may not coincide with the centric relation in
natural dentition GPT 9
Centric Occlusion

56. Do we need to Record – C.R or C.ODo we need to Record – C.R or C.O
In more than 90% of people, C.O (Max. IC) isIn more than 90% of people, C.O (Max. IC) is
0.1 - 2mm0.1 - 2mm in frontin front of the CRof the CR..

57. C.RC.R should be recorded, for distalshould be recorded, for distal
extension RPD, or when the opposingextension RPD, or when the opposing
arch is edentulous.arch is edentulous.

58. A face-bow record should also be takenA face-bow record should also be taken
for mounting the casts accuratelyfor mounting the casts accurately..
To relate the maxillary cast to the condylar
elements of the articulator at the same
orientation that the maxillary teeth have to the
mandibular condyles of the patient.
As the teeth move during opening, closing, and
lateral movements, the arc of closure of the teeth
on the articulator and the patient’s mouth should
remain identical to avoid any occlusal premature
contacts.

59. Mounting the Maxillary Cast Using Maxillary
Face Bow

60. Mounting mandibular cast on articulator.

61. Recording the eccentric relations
a. Protrusive relation.
b. Right and left lateral relations.
Eccentric relations are used to adjust
the articulator to reproduce the
various eccentric mandibular
positions. This is important for
setting up of teeth in balanced
occlusion.

62. Functional generating path methodFunctional generating path method
(Dynamic occlusion(Dynamic occlusion((
This technique produces an occlusion that is inThis technique produces an occlusion that is in
functional harmony with the facial skeletonfunctional harmony with the facial skeleton ,,
the musculature, the TMJ and the remainingthe musculature, the TMJ and the remaining
natural teeth.natural teeth.
The theory is based on that each toothThe theory is based on that each tooth
opposed to the edentulous space will makeopposed to the edentulous space will make
throughout all functional movements of thethroughout all functional movements of the
mandible. The artificial teeth maymandible. The artificial teeth may
Thus be positioned and formed so that it willThus be positioned and formed so that it will
remain in harmonious contact with itsremain in harmonious contact with its

63. AdvantageAdvantage::
It eliminates the need forIt eliminates the need for
adjustment of an articulatoradjustment of an articulator
and the need to make a faceand the need to make a face
bow transfer because.bow transfer because.
All the information desired areAll the information desired are
recorded in the pathway..recorded in the pathway..

64. DisadvantageDisadvantage::
1- If the two arches are partially1- If the two arches are partially
edentulous, the occlusion in one of theedentulous, the occlusion in one of the
arches must be complete before aarches must be complete before a
generated patient can be developed.generated patient can be developed.
2- If a partial denture is opposed by a2- If a partial denture is opposed by a
complete denture, the partial denturecomplete denture, the partial denture
must be constructed first in themust be constructed first in the
conventional method and then the CD isconventional method and then the CD is
constructed according to theconstructed according to the

65. TechniqueTechnique::
11--Construct an accurate, stable andConstruct an accurate, stable and
finished acrylic denture base attachedfinished acrylic denture base attached
to the metallic frameworkto the metallic framework..

66. 2- Fix the wax occlusion rim to the denture2- Fix the wax occlusion rim to the denture
base. This wax should be hard enough tobase. This wax should be hard enough to
support biting stress and should be toughsupport biting stress and should be tough
enough to resist fracture (Peek's purpleenough to resist fracture (Peek's purple
hard inlay wax).hard inlay wax).

67. 3- The occlusion rim wax3- The occlusion rim wax
must have enough heightmust have enough height
and width to record alland width to record all
extremes of mandibularextremes of mandibular
movement.movement.
N.B: There must be positive occlusal
contacts with the opposing dentition in
order to avoid loss of vertical dimension.

68. 4- The patient should wear the occlusion rim4- The patient should wear the occlusion rim
constantly for a period of 24 hours or moreconstantly for a period of 24 hours or more
including nighttime, except for removal duringincluding nighttime, except for removal during
meals.meals.

69. 5- The patient is instructed to chew and glide to curve the wax by5- The patient is instructed to chew and glide to curve the wax by
the opposing teeth (To perform all voluntary excursive andthe opposing teeth (To perform all voluntary excursive and
involuntary movements).involuntary movements).
6- If during this period the wax occlusion rim has not been6- If during this period the wax occlusion rim has not been
reduced to the natural occlusal contact. The patient isreduced to the natural occlusal contact. The patient is
instructed to use it for another 24 hours, till the registration isinstructed to use it for another 24 hours, till the registration is
completed and accepted.completed and accepted.
7- The accepted occlusion rim should show a continuous intact7- The accepted occlusion rim should show a continuous intact
glossy surface indicating a functional contact with opposingglossy surface indicating a functional contact with opposing
teeth in all extremes of movements.teeth in all extremes of movements.

70. 88--Boxing the occlusal rim with waxBoxing the occlusal rim with wax
filled with hard stone to form thefilled with hard stone to form the
occluding templateoccluding template..

71. 9- The whole9- The whole
assembly is thenassembly is then
mounted onto amounted onto a
hinge articulator.hinge articulator.
10- Open the10- Open the
articulator andarticulator and
remove the wax andremove the wax and
arrange the teeth toarrange the teeth to
the opposingthe opposing
natural or artificial teeth and the
occlusion is established.

72. 11- Teeth are arranged and11- Teeth are arranged and
modified to occlude with themodified to occlude with the
template and not according totemplate and not according to
rules of setting up of teethrules of setting up of teeth ..

73. Causes of failure of adequateCauses of failure of adequate
occlusion in functionalocclusion in functional
generating path techniquegenerating path technique::
11--Unsupported baseUnsupported base..
22--Wrong occlusionWrong occlusion..
33--Unacceptable occlusal planeUnacceptable occlusal plane..

74. If you seeIf you see
someonesomeone
without awithout a
smilesmile,,
give them one ofgive them one of
yours!yours!

76. a-a- Avoid placing the artificial teethAvoid placing the artificial teeth over theover the
retromolar padretromolar pad area to avoid shunting of thearea to avoid shunting of the
denture anteriorly.denture anteriorly.
b- Positioning of the mandibular buccal cuspsb- Positioning of the mandibular buccal cusps on theon the
buccal turn point of the crest,buccal turn point of the crest, so as to direct theso as to direct the
occlusal stresses towards the buccal shelf of bone,occlusal stresses towards the buccal shelf of bone,
which is a primary stress bearing area.which is a primary stress bearing area.
c- Positioning of the maxillary buccal cuspsc- Positioning of the maxillary buccal cusps slightlyslightly
buccal to the maxillary ridge,buccal to the maxillary ridge, which is anwhich is an
unfavorable condition, but it is counteracted byunfavorable condition, but it is counteracted by
direct retainers on the other side of the PD or bydirect retainers on the other side of the PD or by
contact in the balancing or working sides (balancedcontact in the balancing or working sides (balanced
occlusion).occlusion).
d- Using ofd- Using of narrow artificial teethnarrow artificial teeth buccolingually orbuccolingually or
using of smaller size canines and premolars instead

77. a- Avoid placing the artificial teetha- Avoid placing the artificial teeth
over the retromolar pad area toover the retromolar pad area to
avoid shunting of the dentureavoid shunting of the denture
anteriorly.anteriorly.

78. b- Positioning of the mandibular buccalb- Positioning of the mandibular buccal
cuspscusps on the buccal turn point of theon the buccal turn point of the
crest,crest, so as to direct the occlusalso as to direct the occlusal
stresses towards the buccal shelf ofstresses towards the buccal shelf of
bone, which is a primary stressbone, which is a primary stress
bearing area.bearing area.

79. c- Positioning of the
maxillary buccal cusps
slightly buccal to the
maxillary ridge, which
is an unfavorable
condition, but it is
counteracted by direct
retainers on the other
side of the PD or by
contact in the
balancing or working
sides (balanced
Relation of buccal surfaces with the
canine.

80. d- Total occlusal load applied may be reduced by using
comparatively smaller posterior teeth
less muscular force will be required to penetrate food
bolus with reduced occlusal table, thereby reducing
forces to supporting oral structures

81. Desirable Occlusal ContactDesirable Occlusal Contact
Relationship for Removable PartialRelationship for Removable Partial
denturedenture::
1.1. In centric occlusionIn centric occlusion :: Simultaneous bilateralSimultaneous bilateral
contacts of opposing posterior teeth must occurcontacts of opposing posterior teeth must occur
((Occlusal harmony between a RPD and theOcclusal harmony between a RPD and the
remaining natural teeth is a major factor inremaining natural teeth is a major factor in
the preservation of the health of theirthe preservation of the health of their
surrounding structuressurrounding structures ).).
2.2. Occlusion in bounded saddleOcclusion in bounded saddle (tooth borne(tooth borne
class III) must be in harmony with the remaining naturalclass III) must be in harmony with the remaining natural
teeth.teeth.
3.3. For a PD opposed by an upper CD:For a PD opposed by an upper CD: bilateralbilateral

82.  During protrusion, posterior contact isDuring protrusion, posterior contact is
needed in order to distribute the forcesneeded in order to distribute the forces
to the entire basal seat of CDto the entire basal seat of CD..
4. Class I (mandibular) opposed4. Class I (mandibular) opposed
by maxillary CD:by maxillary CD:
 Balanced occlusion is required
for stability of CD and to
minimize the tipping stresses
on the CD.

83.  In working side there must be contactIn working side there must be contact
to distribute the stresses over theto distribute the stresses over the
greatest possible areas in order togreatest possible areas in order to
improve the masticatory function.improve the masticatory function.
 In balancing side and in protrusion thereIn balancing side and in protrusion there
must be contact to achieve stability ofmust be contact to achieve stability of
the PDthe PD..
55..Class I mandibular PDClass I mandibular PD
opposed by upper naturalopposed by upper natural
dentitiondentition::

84.  Working and balancing sides’Working and balancing sides’
contact between thecontact between the
opposing teeth are essentialopposing teeth are essential
for balanced occlusion tofor balanced occlusion to
achieve stability.achieve stability.
6.6. Class I mandibular PDClass I mandibular PD
opposed by a class I maxillaryopposed by a class I maxillary
PDPD::

85. In working side there must beIn working side there must be
contact.contact.
Balancing side contacts would notBalancing side contacts would not
enhance the stability since it is aenhance the stability since it is a
unilateral PD.unilateral PD.
77..Class II (maxillary orClass II (maxillary or
mandibular) opposed bymandibular) opposed by
natural dentitionnatural dentition

86.  Contact is required in centric positionContact is required in centric position
between the anterior teeth to prevent over-between the anterior teeth to prevent over-
eruption of the natural opposing teeth.eruption of the natural opposing teeth.
 During eccentric position, contactDuring eccentric position, contact
anteriorly should be avoided to eliminateanteriorly should be avoided to eliminate
the unfavorable forces to the upper ridge,the unfavorable forces to the upper ridge,
and also to enhance the stability of the PD.and also to enhance the stability of the PD.
88..Class IV maxillary PDClass IV maxillary PD
opposed by mandibular naturalopposed by mandibular natural
teethteeth

87.  Working side contact is required if theWorking side contact is required if the
canine guidance does not take molarscanine guidance does not take molars
out of contact during working.out of contact during working.
 Balancing and protrusive contacts areBalancing and protrusive contacts are
not required since it is a tooth bornenot required since it is a tooth borne
PD and there is no need for denturePD and there is no need for denture
stabilitystability..
99..Class III mandibular PD opposedClass III mandibular PD opposed
by a class III maxillary PDby a class III maxillary PD::

88. Mother TerezaMother Tereza

89. THANK YOU
THANK YOU