This document discusses potential risks associated with removable partial dentures (RPDs). It notes that RPDs can increase plaque and lead to tooth decay, gingivitis, and periodontal disease if not properly cared for. Other risks include bone resorption under the denture, trauma to gums from poor fitting dentures, worsening tooth mobility, bite problems, and root caries. The document outlines steps in RPD therapy and stresses the importance of evaluating teeth, designing the framework, educating patients, and conducting regular recalls to monitor oral health and denture fit. While RPDs can be an effective cost treatment, complications may occur, so rigorous research is still needed to improve designs and materials.

1. TissueDamage resultingfromremovable
partialdenture
Presented by:Stéphanie Chahrouk

2. Introduction
“RPDs can be indicated:
 To overcome financial limitations, as provisional prostheses
 To facilitate hygiene access
 To overcome biomechanical and pragmatic issues
associated with dental implants.
 Replacing lost hard and soft tissues, that result in a
need for esthetic support of The oro-facial structures,
 Transitional prostheses for the failing dentition,
 Long edentulous spans”
“The number of partially dentate adults is increasing, and many patients will require
replacement of missing teeth.
current treatment options also include fixed partial dentures and implants, removable
partial dentures (RPDs) can have advantages and are widely used in clinical practice.
However, a significant unwanted health consequences exist associated with current RPDs.”

3. “What are the Potential Risks of having a Removable
Partial Denture?”
“I-Plaque.
it will increase the amountof plaque inyourmouthif youdon’tproperlycare for
bothyour denture andyourteeth.
•It will cause:
(i) De-calcificationandtoothdecay
(ii) Gingivitis
(iii) Periodontal disease (gumdisease).”
As we know- dental wise- plaqueisthe rootof all evil.

4. “II- Resorption
“III- Trauma.
Any denture that rests on the gums (mucosal borne denture) will put pressure on the ridges
and underlying jaw bone
cause resorption over time.
A poor fitting denture,
lack of care on the part,
or both, will accelerate the process.”
If not properly designed your partial denture may directly traumatize your gums
cause wear and abrasion of your teeth from the incorrect position and design of clasps.”

5. “IV- Worsening of tooth mobility.
“V- Bite problems
• Excessive forces are put onto the teeth in directions and angles forwhich
they were not intended.
• Instead of supporting the remaining teeth, this can cause them to shift
and even become looser.”
If the partial denture is not designed properly, it can mean
•If the bite of the denture iswrong,yourteethmaynot close normallyandyoucan hitpart of
the denture before anythingelse
'premature contact'
Thiscan putextrapressure inthatarea makingpre-existingperiodontaldisease worse,
causingproblemswiththe gums,more resorptionof bone,ormeanyourmusclesmayadjustthe
wayyou close yourmouthto avoidit.
•resultinginTMJD andfacial pain”
Thiscan putincreasedstressesonsome of the musclesyouuse forchewing

6. “VI- Root caries
“VII- Denture stomatitis
• The more recession on his teeth will have from brushing
• Gum disease
• Denture clasps orsome combination of these.
The older the patient gets,
• is likely to be a significant problem"
Add poor hygiene, a lack of plaque control and lots of snacking on sugary
things and root caries
• this generalised inflammation can occur”
If plaque is kept in contact with the gums on the underside of the denture for long periods,

8. “The steps involvedinRPD-relatedtherapy include
 the evaluation of abutment teeth
 abutment tooth position
 abutment preparation
 adapting the RPD metal framework
 relating the edentulous areas to the metal framework
 communication with the laboratory
 patient education for home care and maintenance
 regular professional recall”
“Disadvantages of metal RPDs
 potential hypersensitivity
 esthetic issues with metal display,
 oral galvanism,
 adverse tissue reactions,
 osteolysis of abutment teeth,
 biofilm production”
 “A surface layer of protein typically forms on the metal prosthesis and is a critical
component of the biocompatibility of titanium.
 This initial protein layer may,
o enable colonization of microorganism in the area,
o Allowing the development of a biofilm.
 Antimicrobials are not effective in destroying biofilm
 Infections can only be treated with physical removal or disinfection of the
prosthesis.
 Removable prostheses also act as a reservoir for respiratory pathogens”.

9. “
 widely considered the best material for a denture framework,
 the physical properties of the material itself are not ideal.
 the fit of retainers after 8 years of normal use and found that the majority of metal
clasps were distorted and that over time they did not fit the abutment
correctly”
“Polymerframeworks
The disadvantages of polymer frameworks include:
 low thermal conductivity- Cause Burn
 brittleness-> Fracture
 less mechanical strength than metal (more
problematic for mastication),
 a high coefficient of thermal expansion
 low modulus of elasticity
 faster deterioration than metal
 Cytotoxicity because of the leaching of chemicals.”

10. “Irregularities in the denture
 can provide microhabitats for plaque biofilms,
 The provision of a prosthesis can result in bacteria that may be pathogenic and
difficult to treat.
 Because of mucosal inflammation, dentures can also cause trauma such as
o stripping of gingival tissue
o pain
o ulceration
 this can be addressed by using correct RPD design
 During recall appointments,
o particular attention should be paid to abutment tooth healt
o proper RPD adaptation
o tissue support
o occlusal function
o hygiene
o caries intervention strategies”
“Conclusions
In the coming years, the number of patients with partial edentulism will rise along with
the need for cost-effective treatments such as RPDs. Complications and treatment
failures may occur with RPDs, and rigorous research is needed to examine the
strengths and weaknesses of different RPD designs and new techniques and materials.
Proper evaluation of the dentition state, tooth position, abutment preparation, adapting
structures within the RPD, patient education, timely recall, and maintenance are only a
few of the steps required for success. Treatment with RPDs should ideally result in
improvements in overall oral health, patient satisfaction, and compliance.”.

11. References:
“McCracken's Removable Partial Prosthodontics - 13th Edition - Elsevier”