1. Clinical Protocol for Removable Partial Dentures

2. Diagnosis & Treatment Planning
Gather diagnostic info
Make preliminary impressions
Pour diagnostic casts

3. Mounting Diagnostic Casts
If required:
Extruded teeth
Severe attrition
Insufficient interarch space
Deep overbite, etc.
use Semiadjustable Articulator

4. Formulate Treatment Plan
Overall Treatment Plan
Specific RPD Treatment Plan
Select abutments, direct retainers
Major connectors
Position of rests, g.p., bracing & retentive arms

5. Critical!!! When RPD is part of treatment:
Draw design on surveyed cast
Design approved before any treatment started:
Affects direct restorations
Can influence need for/preparations for crowns
Insures RPD can be completed successfully
Survey, tripod, heights of contour

6. Formulate Treatment Plan
Discuss with instructor prior to discussing with patient
Provide rationale for design

7. Final Impressions for Partial Dentures
Framework Impression
Altered Cast Impression

8. Framework Impression Border Molded Custom Tray
Tray that is made for patient
Mold tray periphery with thermoplastic compound

9. Framework Impression
Material of Choice
Polyvinyl Siloxane

10. Framework Impression Polyvinyl siloxanes
Excellent dimensional stability
Good tear strength
No taste
Glove contamination
Relatively hydrophobic - improved

11. Prior to the Final Impression
No plaque or calculus
Healthy soft tissues
Initial therapy complete

12. Prior to the Final Impression
Make alginate impression to check:
Guiding planes
Rest seats
Retentive areas
Heights of contour

13. Framework Impression Syringe low viscosity material
Around abutment teeth
Over occlusal surfaces
Use care in rest seats
Do not over fill trays - overextension

14. Framework Impression Medium viscosity in tray Increased filler content
less shrinkage
Less displacement of soft tissues than high viscosities

15. Evaluating the Impression
Absence of Significant Voids
Any area where metal contacts abutment (e.g. rests, minor connectors)
Any area where major or minor connectors contact soft tissue

16. Evaluating the Impression
Peripheries well defined
Accurately records supporting tissues
Allows for all elements of design

17. Evaluating the Impression
Mandible
Measure FGM to floor of mouth
Record measurements
Transfer to cast - inferior framework border

18. Evaluating the Impression
No significant areas “burn-through”
Border molding not covered
Displaces the tissue
Change in contour caused by the border molding

19. Evaluating the Impression
Impression integrity
No significant tears
Not separated from tray

20. Evaluating the Impression
Impression integrity
No significant tears
Not separated from tray

21. Evaluating the Impression
Critical Anatomy Recorded
Vestibular depths
Hamular notches (marked)
Vibrating line (marked)
Retromolar pads
Frenal attachments
Floor of mouth (measured)

22. Preparation for Impression
Practice inserting & removing tray
Dry tissues

23. Preparation for Impression
Block out
large embrasures
bridge pontics
Don’t cover occlusion or framework surfaces

24. Preparation for Impression
Teeth must be DRY for wax to stick

25. Don’t Reseat Impression
Won’t fully seat over undercuts

26. Framework Impression Box & pour impression Survey & tripodize
Draw design
Send to Lab with Work Authorization for framework fabrication

27. Master Cast Pour in improved dental stone Type IV (Silky Rock)
Vacuum mix stone
Allow to set at least 1 hour
strength to resist fracture

28. Master Casts No significant bubbles or flaws
Teeth not fractured from cast
Includes all anatomical surfaces of final impressions
Includes 3-4 mm. land area

29. Master Cast Base parallel ridge 12 mm (.5”) thick (minimum)
Evidence of a dense stone surface
Clean & well trimmed (keep wet while trimming)

30. Pour Secondary Cast Draw design on secondary cast
Checked/corrected with instructor
Correct design on 2nd cast
Send to lab with 1st poured cast
lab will transfer the design to this cast

31. RPD Protocol Summary Diagnosis, Treatment Plan, Hygiene
Diagnostic Casts
Draw Design & list abutment modifications
Instructor Approval
Abutment modifications
Preliminary impression to check mod.’s
Final Framework Impression
Pour two casts

32. RPD Protocol Summary Draw design on 2nd cast
Instructor approval/corrections
Cast to Lab with 1st pour & prescription
Inspect framework waxup
Framework Adjustment
Altered Cast impression, if needed
Try-in with teeth in wax
Process, deliver to patient