This document discusses occlusion in removable partial dentures. It outlines several types of occlusion including static and dynamic occlusion. Desirable occlusal contacts are bilateral contacts of posterior teeth in centric occlusion. Methods for establishing occlusion include direct apposition of casts if enough teeth remain, interocclusal records with posterior teeth, or using occlusal rims. The functionally generated path method can also be used to develop a dynamic occlusion record without an articulator. Proper occlusion is important for the success, comfort and longevity of removable partial dentures.
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.
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
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.
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
Indian Dental Academy: will be one of the most relevant and exciting
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implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
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A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
Neutral Zone
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature.of.the tongue are equal and balanced with the.forces exerted by the buccinators.muscle of the cheek.laterally and the orbicularis.oris muscle anteriorly
Impression for distal extension bases /certified fixed orthodontic courses b...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 provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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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.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
Neutral Zone
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature.of.the tongue are equal and balanced with the.forces exerted by the buccinators.muscle of the cheek.laterally and the orbicularis.oris muscle anteriorly
Impression for distal extension bases /certified fixed orthodontic courses b...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 provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
4- Revision >> Concepts of occlusion for 4th year Students.AmalKaddah1
Occlusion for Removable Prosthodontics.
Revision:
What 'occlusion' is and why it is important
Definitions.
Difference between natural and artificial Occlusion.
Types of artificial posterior teeth
Problems with anatomic and non-anatomic teeth
Factors affecting selection of tooth forms.
Rational for Arranging Posterior Teeth in Balanced Occlusion
Contraindications of balanced occlusion.
Types of Balance as Related to Complete Denture
- Lever balance
-Occlusal Balance.
Balanced Occlusion and Factors affecting Balanced Occ. (Third year)
Concepts of occlusion (Balanced and Non balanced Occlusion).
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.for more details please visit
www.indiandentalacademy.com
selective grinding 1/cosmetic dentistry course by Indian dental academyIndian dental academy
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.
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.for more details please visit
www.indiandentalacademy.com
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.
This journal club presents a case of prosthetic
rehabilitation of an amputated thumb. It emphasizes that
prosthetic replacement is a better option for aesthetic and
psychological improvement, particularly in cases where the
victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning
of thumb cannot be restored even by multiple surgeries. In
the present case, a 20 years old female patient, with
missing thumb of her right hand was rehabilitated aesthetically by a non-invasive and cost effective prosthetic
procedure by using heat temperature vulcanizing silicone
material. The prosthesis (the thumb) was attached using
medical adhesives. On 3 months recall appointment, no
complications were observed. The prosthesis was in good
shape and required no further intervention. The prosthetic
thumb lacks the sensation of a normal or reconstructed
thumb, although it does not require the multiple procedures
of surgical reconstruction and the accompanying loss of
time for rehabilitation and healing
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
A removable partial denture or complete denture that covers & rests on one or more remaining natural teeth, the roots of natural teeth, &/or dental implants (GPT-8)
The elderly population is rapidly increasing, as is their need for dental treatment.
Considering the number of partially or completely edentulous patients, various types of treatment may be indicated, including conventional complete dentures and both tooth-supported and implant-supported overdentures.
A RPD derives support from two main sources periodontally sound natural teeth & residual alveolar processes and associated soft tissues.
A RPD that is supported by healthy natural teeth possesses adequate stability and retention to resist functional displacement.
However, a RPD that is not entirely bounded by natural teeth will move when a load is applied.
Prosthetic rehabilitation of a xerostomia patient with a mandibularsplit salivary reservoir denture
Xerostomia is defined as dryness of the mouth due to lack of normal secretions of saliva
Mucosal lubricants eg. wet mouth (ICPA Health Products Ltd),aqwet (Cipla Ltd)
Salivary stimulants eg. colgate dry mouth relief.
Healthy diet intake.
Salivary substitutes ( liquid or gel form ).
Chewing gums.
Proper water intake.
Salivary reservoirs
One of the objectives in complete denture prosthetics is to produce a harmonious appearance of the denture when in the patient’s mouth.
A denture usually perceived as esthetics when the teeth and bases are in harmony with the facial musculature as well as the size & shape of the head.
The selection of artificial teeth & their arrangement to meet esthetic requirements demand artistic skill in addition to scientific knowledge.
Fabrication of removable palatal augmentation prosthesis on a complete denture to reduce weight and maintain hygiene
The retention of a palatal augmentation prosthesis (PAP) is negatively affected by its weight thus, making this device as light as possible is important for clinical success.
However, hollowing the device to reduce weight may cause hygiene issues due to moisture intrusion.
An alternative technique with a removable veneer-type PAP for a complete denture was developed.
This resulted in positive outcomes in terms of reducing the weight and maintaining the hygiene of the prosthesis.
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
The threshold between microstomia and a normal mouth
opening is defined as an interlabial measurement less
than 45 mm and/or an interincisal distance less than 40
mm.20 Zweifel et al6 further refined that statement by
defining the average vertical mouth opening as 40 to 50
mm, a functional opening as 25 to 35 mm, and a severely
limited opening as 10 to 24 mm. However, no definitive
description has been presented of the width of mouth
opening that should prompt the use of a foldable or
sectional denture.
Mouth opening exercises have been described for
patients with scleroderma but not for those with facial
exercises and appliances used long after facial burns is
scarce, but exercises may be of value in the treatment of
these patients.
The use of sectional trays and record bases may be
essential to obtaining accurate impressions of a patient
with microstomia. An accurate tray and record base is
required to consistently obtain the position of the tray
and record base related to the reference anatomic
structures.
While maxillary bone resorbs toward the center of the
maxilla, mandibular bone resorbs laterally in posterior
areas and lingually in the anterior region. This may allow
the fabrication of maxillary dentures with a smaller width.
To provide support, however, the buccal flanges of
mandibular complete dentures should overlay the bone
horizontally at the buccal shelf region, which may extend
buccally 10 mm or more from the residual ridge top.
These factors explain the presence of several mandibular
collapsible or foldable dentures in the literature versus
few articles describing techniques for maxillary sectional
dentures. The use of implants may allow less extension of
the borders, providing comfort and ease of use for
patients with microstomia.26
Gypsum Products commercially available are hemihydrate form of calcium sulfate. Gypsum products used in Dentistry are broadly classified into 5 types
Type 1- Impression Plaster
Type 2- Model Plaster
Type 3- Dental stone
Type 4- Die Stone high strength low expansion
Type 5- Die Stone high Strength High Expansion
Non fluid wax technique to record Posterior Palatal Seal Area, uses mixture baseplate wax and sticky wax. shows superior handling characteristics and better dimensional stability as compared to Correcta wax and other waxes used in fluid wax technique.
Assesment of Self Evaluation Of Dental Appearance Among Non-Dental Undergradu...Dr. Prathamesh Fulsundar
Orthodontist routinely evaluate patients and prescribe treatment plans in order to satisfy the often stated goals of good dental function, stability of teeth & jaw position & dental aesthetics. however aesthetics has variability in individual judgments, it can differ for patients and dentists making it difficult to make generalized statements hence the aim of this study was to assess the self evaluation and satisfaction of dental appearance among non dental undergraduate students and their attitude towards orthodontic treatment.
Long treatment duration has been a major drawback of the conventional fixed orthodontic treatment. Cyclic Loading (Vibrations within physiological limits) has proved to be effective in accelerating the rate of tooth movement.
Treatment of oral submucous fibrosis can be done by using various natural remedies and plant extracts. The article describes some of these therapies for the treatment of OSMF
The greater treatment time is one of the major drawbacks associated with fixed orthodontic therapy.Micro-osteoperforation has proved to be effective in reducing the duration of conventional orthodontic treatment.
Homeopathic Arnicai to Control Orthodontic Pain-A Substitute to Conventional...Dr. Prathamesh Fulsundar
Pain and discomfort associated with fixed orthodontic treatment has always been a major factor in causing patient dropouts, the conventional method of using NSAID's hampers the tooth movement, as a result a need for newer alternatives to control pain has developed. Arnica montana serves as an effective substitutes to control pain and discomfort without hampering the rate of orthodontic tooth movement.
Photobiomodulation technique uses low intensity lasers and light in the red to near infrared zone (600 to 1000 nm wavelength) which brings about biological changes at the cellular level thus initiating the bone remodeling. As a result accelerates orthodontic tooth movement without causing any harm to the periodontal tissues
Facial trauma is routinely diagnosed in most of the road traffic accidents. A brief anatomy of mid face and various means of diagnosis and surgical management of mid face trauma is explained in the above presentation.
Dental plaque is one of the major predisposing factor for various dental and periodontal diseases. thus effective measures for dental plaque control is essential in order to achieve good oral hygiene. mechanical plaque control is highly effective in management n control of dental plaque however chemical plaque control measures can be used as an adjunct to mechanical methods.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Contents
Introduction
Occlusion
Types of occlusion
Desirable occlusal contacts for RPD
Methods for establishing occlusal relations
• Direct apposition of casts
• Inter-occlusal records with posterior teeth remaining
Occlusal relations using occlusion rims on record bases
• Methods of recording jaw relations
Conclusion
References
4. 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.
INTRODUCTION
5. Failure to provide and maintain adequate occlusion on the
removable partial denture is primarily a result of
1. Lack of support for the denture base.
2. Failure in establishing occlusion to a single static jaw
relation record.
3. Unacceptable occlusal plane.
INTRODUCTION
6. Establishment of a satisfactory occlusion for the removable
partial denture patient should include the following:
1. Analysis of the existing occlusion
2. Correction of existing occlusal disharmony
3. Recording of centric relation or an adjusted centric occlusion
4. Harmonizing of eccentric jaw movements for a functional
eccentric occlusion
5. Correction of occlusal discrepancies created by the fit of the
framework and during processing of the removable partial
denture.
INTRODUCTION
7. The restoration of the lost vertical dimension of occlusion.
Occlusal harmony with the remaining natural teeth.
Improvement in mesio-distal cuspal relationships when
some mandibular position other than centric relation has been
acquired or forced because of malocclusions resulting from
loss of teeth.
The correction of mandibular rotation occurring as a result
of unilateral loss of posterior teeth.
OBJECTIVES OF OCCLUSION
REHABILITATION
IN RPD
8. DEFINITION
Occlusion can be defined as the static relationship between the
incising or masticating surfaces of the maxillary or mandibular
teeth.” (GPT 9)
Occlusion is discussed into-
STATIC RELATIONS
DYNAMIC RELATIONS
9. STATIC RELATION:-
Static relation in occlusion are those which occur in many
possible contacts of teeth without interposition of food.
Static relations in occlusion include
Centric occlusion
Protrusive occlusion
Right& left lateral occlusion
Intermediate occlusion
10. DYNAMIC RELATION:-
•It is primarily concerned with opening and closing movements
involved in mastication while static concept is concerned
primarily with tooth contacts made at various positions.
•In this concept, Jaw movements and tooth contacts are made as
teeth of one jaw glide over teeth of opposing jaw and are not
functional movements or contacts.
•This phase of occlusion is admitted to be controlled by TMJ,
muscles, ligaments and teeth.
It is influenced by:
TMJ
Musculature (contraction and relaxation times of muscle)
Resistance of food and relative tolerance of supporting tissues.
Occlusal plane
Occlusal form of teeth
11. BALANCED ARTICULATION exists when there is bilateral,
simultaneous, anterior and posterior occlusal contact of teeth in centric and
eccentric positions.
CANINE-PROTECTED ARTICULATION is a form of mutually
protected articulation in which the vertical and horizontal overlap of the
canine teeth disengage the posterior teeth in the excursive movements of
the mandible.
MUTUALLY PROTECTED ARTICULATION is an occlusal scheme
in which the posterior teeth prevent excessive contact of the anterior teeth
in maximum intercuspation, and the anterior teeth disengage the posterior
teeth in all mandibular excursive movements.
12. GROUP FUNCTION exists when there are multiple contact relations
between the maxillary and mandibular teeth in lateral movements on the
working side whereby simultaneous contact of several teeth acts as a group to
distribute occlusal forces.
LINGUALIZED OCCLUSION is a form of denture occlusion that
articulates the maxillary lingual cusps with the mandibular occlusal surfaces in
centric, working and nonworking mandibular positions.
MONOPLANE ARTICULATION is the arrangement by which teeth are
positioned in a single plane.
13. 1. Simultaneous bilateral contacts of opposing posterior teeth
must occur in centric occlusion.
2. Occlusion for tooth-supported removable partial dentures may
be arranged similarly to the occlusion seen in a harmonious
natural dentition, because stability of such prosthesis results
from the effects of direct retainers at both ends of the denture
base.
DESIRABLE OCCLUSAL CONTACT
RELATIONSHIPS FOR RPD
14. 3. Bilateral balanced occlusion in eccentric positions should be
formulated when a maxillary complete denture opposes the
removable partial denture. This is accomplished primarily to
promote the stability of the complete denture.
15. 4. Working side contacts should be obtained for the mandibular
distal extension denture. These contacts should occur
simultaneously with working side contacts of the natural
teeth to distribute the stress over the greatest possible area.
16. 5. Simultaneous working and balancing contacts should be
formulated for the maxillary bilateral distal extension
removable partial denture whenever possible.
17. 6. Only working contacts need to be formulated for the
maxillary or mandibular unilateral distal extension
removable partial denture.
Balancing side contacts would not enhance the stability of
the denture because it is entirely tooth supported on the
balancing side.
18. 7. In the Kennedy Class IV removable partial denture
configuration, contact of opposing anterior teeth in the
planned inter cuspal position is desired to prevent
continuous eruption of the opposing natural incisors.
Contact of the opposing anterior teeth in eccentric positions
can be developed to enhance incisive function but should be
arranged to permit balanced occlusion without excursive
interferences.
19. 8. Artificial posterior teeth should not be arranged farther
distally than the beginning of a sharp upward incline of the
mandibular residual ridge or over the retromolar pad.
A harmonious relationship of opposing occlusal and incisal
surfaces alone is not adequate to ensure stability of distal
extension removable partial dentures.
Bilateral eccentric contact of the mandibular distal extension
removable partial denture need not be formulated to stabilize the
denture. The buccal cusps, however, must be favorably placed to
direct stress toward the buccal shelf, which is the primary support
area in the mandibular arch.
20. In such positions, the denture is not subjected to excessive
tilting forces.
On the other hand, the artificial teeth of the bilateral, distal
extension, maxillary removable partial denture often must be
placed lateral to the crest of the residual ridge.
21. 1. If there are sufficient number of teeth-
Direct apposition of the casts
Interocclusal record with posterior teeth remaining using
interocclusal wax record.
2. If there is no sufficient number of teeth-
Occlusal relation using occlusal rims on recorded bases.
Jaw relation records made entirely on occlusal rims.
Functionally generated path method (dynamic occlusion).
METHODS FOR ESTABLISHING OCCLUSAL
RELATIONSHIPS
22. It is used when sufficient opposing teeth remain in contact to
make the existing jaw relation, or when only a few teeth are to
be replaced on short denture bases and no evidence of occlusal
abnormalities is found.
If there are:
at least 3-4 positive contacts between the posterior natural
teeth at each arch and the upper and lower casts can be
opposed by hands against each other.
sticky wax and softened-metal reinforced wafer.
1- DIRECT APPOSITION OF CASTS
23. • ADVANTAGE: Avoid errors from patients.
• DISADVANTAGE: the existing vertical dimension must be
followed
24. 2- INTEROCCLUSAL RECORDS WITH POSTERIOR
TEETH REMAINING
It is a modification of the direct apposition of casts method,
used when sufficient natural teeth remain to support the
removable partial denture (Kennedy Class III or IV) but the
relation of opposing natural teeth does not permit the occluding
of casts by hand
25. A definite procedure for making inter-occlusal wax records is
given as follows:
A uniformly softened, metal-reinforced wafer of base-plate
or set-up wax is placed between the teeth, and the patient is
guided to close in centric relation.
Correct closure should have been rehearsed before
placement of the wax so that the patient will not hesitate or
deviate in closing.
The wax then is removed and immediately chilled
thoroughly in room-temperature water.
It should be replaced a second time to correct the distortion
that results from chilling and then again chilled after
removal.
26. All excess wax should now be removed with a sharp knife.
The chilled wax record again should be replaced to make
sure that no contact with soft tissue occurs
Three important details to be observed:
1. Make sure that the occlusion is satisfactory before
making the interocclusal record.
2. Be sure that the casts are accurate reproductions of the
teeth being recorded.
3. Trim the record with a sharp knife wherever it engages
undercuts, soft tissue, or deep grooves.
27. 3- OCCLUSAL RELATIONS USING OCCLUSAL
RIMS ON RECORD BASES
Indications:
• In case of distal extension areas.
• If tooth-supported edentulous space is large
• No contact between opposing natural teeth.
In these instances, occlusion rims on accurate record bases must
be used. Simple wax records of edentulous areas are never
acceptable.
28. 4- METHODS OF RECORDING JAW RELATIONS
Making the Record Block:
After carefully verifying the fit and occlusion of the RPD
framework intra-orally and after performing the altered cast
procedure, an auto polymerizing acrylic resin base is usually
attached to the framework saddle areas. A base-plate wax
base may also be formed.
29. A wax occlusal rim is then placed over the
resin base, while considering the width
and height dimensions of the natural
missing teeth
30. The framework with the attached record block is first tried
in the mouth for reconfirming the fit of framework.
The height of the wax occlusal rims are so adjusted
intraorally that 1mm of space exists between the opposing
teeth & the rims.
For two opposing rims, occlusal plane is adjusted on one of
the rims, e.g., mandibular distal extension wax rim.
31.
32. Additionally, adjusting the occlusal plane of the
remaining natural teeth may be indicated using
“enameloplasty”.
33. The patients is instructed to close in maximum intercuspal
Position.
The rims are reduced in height until it is just out of occlusal
contact.
34. The recording medium (wax or ZnO paste) is then placed
The patient is then guided in the desired centric occlusion
position.
35. 5- FUNCTIONALLY GENERATED PATH
(DYNAMIC OCCLUSION)
The functionally generated path is a method of developing
occlusal relationships on simple instrumentation without using a
semi- or fully adjustable articulator that has been programmed to
match the patient’s mandibular movements.
Using the removable partial denture framework as a base, a
dynamic recording of the occlusal patterns is generated in the
patient’s mouth under normal functional conditions.
36. FUNCTIONALLY GENERATED PATH METHOD
PROCEDURE:
Occlusion rim is created on the base plate using hard inlay wax
and visible gap is left between opposing teeth and the rim
initially.
Softened inlay wax is added to the rim and the framework is
placed intra-orally.
Patient is then asked to close in centric occlusion to indent the
soft wax.
37. It is ensured that all natural teeth are in contact and the
framework is removed when the wax gets hardened. Wax is
softened again and the previous exercise is repeated.
Now, the patient is instructed to protrude his/her mandible in
forward direction without losing teeth-contact until the incisors
were at edge-to-edge relationship.
Similarly, the lateral excursive pathways are also recorded for
both right and the left side.
The patient is instructed to glide the mandible through all
possible excursive movements to ensure capturing all border
movements.
38. The wax is repeatedly softened between each biting episode.
Once all excursive pathways are recorded, the record is
hardened by keeping under the cold water.
It is observed that the inlay wax is smoothly carved and
shaped by the stylus action of the opposing maxillary cusps.
MOUNTING OF THE CASTS-
The record is reseated and secured onto the master cast and
boxing is done with the modeling clay and the modeling wax.
39. Only wax registration and areas for vertical stops are left
exposed and it is filled with the dental stone to form
occluding template.
Recording the functionally generated path eliminates the need
to reproduce mandibular movements on the articulator and
hence the mounting is done on a simple three-point (mean
value) articulator.
40. SUMMARY
CLINICAL SITUATION REHABILITATION
Maxillary complete denture
opposes the removable partial
denture
Bilateral balanced occlusion in
eccentric positions
Kennedy Class IV removable
partial denture
Contact of opposing anterior teeth
in the planned inter cuspal relation
Maxillary bilateral distal extension
removable partial denture
Simultaneous working and
balancing contacts
Maxillary or mandibular unilateral
distal extension removable partial
denture
Only working side contacts
41. CONCLUSION
For a successful removable partial denture, the occlusal
pattern of the natural teeth should be harmonized with the
temporomandibular joints
This same occlusal pattern should be incorporated into the
artificial teeth.
When this procedure is followed, the comfort, efficiency,
and longevity of the removable partial denture is greatly
enhanced.
42. REFERENCES
McCracken, W. L.: Functional Occlusion in Removable Partial
Denture Construction, J. PROS. DEN. 8:955-963, 1958.
Stewart K L, Rudd K D, Kuebker W A, Stewart’s Clinical
Removable Partial Prosthodontics. 3rd ed.
Jeffreys FE, Platner RL. Occlusion in removable partial
dentures. J Prosthet Dent 1960;10:912-920.
John R. Ivanhoe, DDS* , Kevin D. Plummer, DDS, Removable
partial denture occlusion, Dent Clin N Am 48 (2004) 667–683
Davis Henderson, D.D.S., Occlusion in removable partial
prosthodontics J. Pro&et. Dent. February. 197’2
Such an arrangement will compensate for the unfavorable position, the maxillary artificial teeth must occupy in relation to the residual ridge, which is usually lateral to the crest of the ridge. However, this desirable relationship often must be compromised when the patient’s anterior teeth have an excessively steep vertical overlap with little or no horizontal overlap. Even in this situation, working side contacts can be obtained without resorting to excessively steep cuspal inclinations.
6. Balancing side contacts would not enhance the stability of the denture because it is entirely tooth supported by the framework on the balancing side.
7.unless they are otherwise prevented from extrusion by means of a lingual plate or auxiliary bar, or by splinting.
6. Balancing side contacts would not enhance the stability of the denture because it is entirely tooth supported by the framework on the balancing side.
7.unless they are otherwise prevented from extrusion by means of a lingual plate or auxiliary bar, or by splinting.
Such an unfavorable position can cause tipping of the denture, which is restrained only by direct retainer action on the balancing side. To enhance the stability of the denture, it seems logical to provide simultaneous working and balancing contacts in these situations if possible
With this method, opposing casts may be occluded by hand. The occluded casts should be held in apposition with rigid supports attached with sticky wax to the bases of the casts until they are securely mounted in the articulator.
The FGP records were planned to record the maxillomandibular relationship with the cast metal framework in place. Before recording the FGP, it was confirmed that the metal framework along with the denture base was firm, stable, and retentive intraorally. It was also examined that there were no interferences in the anterior guidance and the posterior teeth had acceptable occlusal anatomy.
The cross-linked acrylic resin teeth matching the shade of patient’s natural dentition were selected. Teeth were arranged high up initially, and then progressively modified to exactly fit the occluding template at the established vertical dimension