1. Introduction to Removable Partial Dentures (RPD’s)
Prosthodontics
Definitions
Treatment Options for Partially Edentulous
Treatment Sequence for RPD’s
RPD Classification
Clinical Anatomy Tour

2. Prosthodontics Maxillofacial Removable Fixed Implants
Restoration or replacement
of missing teeth & contiguous tissues
Maxillofacial
Congenital Conditions
Cleft palate
Acquired Conditions
- Injuries
- Cancer
Facial & Intraoral
Prostheses
Removable
Complete Dentures
Removable Partial
Dentures
- Conventional
- Attachment
Fixed
Crowns, Onlays
Fixed Partial Dentures
(Bridges)
Implants

3. Treatment Objectives Oral Health
Preserve remaining teeth & tissues
Restore/improve:
Mastication
Esthetics & Phonetics
Health & comfort
Quality of Life

4. Treatment Options Partial Edentulism
No Replacement
Fixed Partial Denture (FPD)
Removable Partial Denture (RPD)
Implant crowns/FPD
Extractions & Complete Denture

5. Treatment Option: No Replacement Shortened Dental Arch (SDA)
Patients can function with as few as 20 occluding teeth
No significant difference in
chewing
discomfort
JCDA Sept 07, 73:593-4

6. No Replacement Shortened Dental Arch (SDA)
Require Anterior teeth occlusal units
Opposing PM’s = 1 occlusal unit
Opposing M’s = 2 occlusal units
Symmetric loss need 4 units
Assymetric loss need 6 units

7. Treatment Options Partial Dentures
Prosthesis replacing one or more, but not all teeth
Supported by teeth (abutments) and/or mucosa
May be fixed or removable
Fixed Partial Denture (FPD)
Removable Partial Denture (RPD)

8. Treatment Option: FPD Patients prefer to RPD Porcelain ± Metal
Cemented
Need tooth (abutment) at either end

9. Treatment Option: FPD Must prepare (grind down abutments)
If too long, flexes, loosens or breaks
More expensive

10. Treatment Option: RPD Removed & replaced by patient Less expensive
Won’t necessarily improve function if patient has ≥ 4 occlusal units

11. Indications for RPD's Edentulous area too long for fixed prosthesis
Longer than 4 units is more complex

12. No posterior abutment for a fixed prosthesis
Indications for RPD's
No posterior abutment for a fixed prosthesis

13. Excessive alveolar bone loss (esthetic problem)
Indications for RPD's
Excessive alveolar bone loss (esthetic problem)

14. Poor prognosis for complete dentures due to residual ridge morphology
Indications for RPD's
Poor prognosis for complete dentures due to residual ridge morphology

15. Indications for RPD's Reduced periodontal support of remaining teeth
Won't support a fixed prosthesis)

16. Other Indications for RPD's
Need for immediate replacement of extracted teeth
Cost/patient desire considerations
Cross-arch stabilization of teeth needed

17. Treatment Option: Complete Dentures
Remaining teeth are hopeless
Other options are too complex/expensive

18. Treatment Option: Implant Prostheses
Implant Crowns
Implant Bridges
Implant Dentures

19. Partially Edentulous Treatment Options?

20. Definitive (permanent?)
Types of RPD’s
Interim
Definitive (permanent?)

21. Interim Denture (Provisional; Temporary)
Used for short time to provide:
Esthetics
Mastication
Occlusal support

22. Interim Denture
Partial denture made while crowns are being fabricated for a definitive RPD)

23. Transitional Denture Prosthesis to which teeth will be added
Replaced after post-extraction tissue changes
Made with intention of subsequently altering it

24. Definitions Retention: Resistance to removal from the tissues or teeth
Stability: Resistance to movement in a horizontal direction (anterior-posteriorly or medio-laterally
Support: Resistance to movement towards the tissues or teet

25. Definitions Abutment: A tooth that supports a partial denture.
Retainer: A component of a partial denture that provides both retention and support for the partial denture

26. Components of an RPD Major Connector Connects parts together
Principal functions:
Unification
Rigidity

27. Components of a RPD Minor Connector
Connects other components to the major connector
Principle functions:
Unification
Rigidity

28. Components of an RPD Direct Retainer
Provides retention against dislodging forces.

29. Components of an RPD Direct Retainer
'Clasp' or 'clasp unit' composed of:
Rest
Retentive arm
Reciprocal arm
Minor connector

30. Components of an RPD Denture Base Covers the residual ridges
Supports the denture teeth

31. Treatment Sequence for RPD’s
PLAN RPD BEFORE ANY OTHER TREATMENT BEGINS
Dx & Trt Plan, mounted casts
Draw design on surveyed cast, list abutment modifications
Instructor Approval of design prior to any treatment, other than emergencies

32. Partially Edentulous Arch Classification
May be over 65,000 possible combinations of teeth and edentulous spaces.
Facilitates communication between dentists

33. Kennedy Classification
Bilateral edentulous areas located posterior to all remaining teeth

34. Kennedy Classification
Class II
Unilateral edentulous area located posterior to all remaining teeth

35. Kennedy Classification
Class III
Unilateral edentulous area bounded by anterior & posterior natural teeth

36. Kennedy Classification
Class IV
Single, but bilateral (crossing the midline) edentulous area located anterior to remaining teeth

37. Applegate's Rules for the Kennedy Classification
Classification should follow rather than precede extraction

38. Applegate's Rules for the Kennedy Classification
If 3rd molar is missing & not to be replaced, it is not considered in the classification

39. Applegate's Rules for the Kennedy Classification
If the 3rd molar is present and to be used as an abutment, it is considered in the classification

40. Applegate's Rules for the Kennedy Classification
If the second molar is missing and not to be replaced, it is not considered in the classification

41. Applegate's Rules for the Kennedy Classification
The most posterior edentulous area determines the classification

42. Applegate's Rules for the Kennedy Classification
Edentulous areas other than those determining classification are called modification spaces

43. Applegate's Rules for the Kennedy Classification
The extent of the modification is not considered, only the number

44. Applegate's Rules for the Kennedy Classification
There is no modification space in Class IV

45. Classify the Following Arches