Removable Partial Denture

1. INTRODUCTION &
CLASSIFICATION OF
REMOVABLE PARTIAL DENTURE
MADE BY:
Abhinav Mudaliar(2010-
2011)

2. DEFINITION- PROSTHODONTICS
 Defined as the “branch of dentistry pertaining
to the restoration and maintainence of oral
function,comfort,appearance and health of
the patient by restoration of natural teeth or
the replacement of missing teeth and
contiguous oral and maxillofacial tissues with
the artificial substitution.

3. BRANCHES
3 major divisions:
-fixed prosthodontics
-maxillofacial prosthetics
-removable prosthodontics
complete partial
extracoronal intracoronal

4. REMOVABLE PROSTHODONTICS
 It is devoted to replacement of missing teeth &
contigous tissues with prosthesis designed to be
removed by the wearer.It includes two disciplines:
removable complete denture prosthodontics and
removable partial denture prosthodontics. A RPD
may be extracoronal or intracoronal depending on
what type of retention is used to keep it in the
mouth.

5. COMMON TERMINOLOGIES USED IN RPD
Appliance
It is a device worn by a patient in the course
of treatment. e.g. orthodontic appliance, surgical
,space maintainer.
Abutment
“A tooth,a portion of a tooth ,or that portion of a
dental implant that serves to support & or retain a
prosthesis.”
Retainer
The fixation device ,or any form of attachment
applied directly to an abutment tooth & used for
the fixation of a prosthesis, is called retainer.

6. Extracoronal partial denture
The retention of this prosthesis depends on the exact
parallelism of the two retentive units.
Tooth supported RPD
A partial denture that receives support from the natural
teeth at each end of the edentulous space or spaces.
Tooth tissue supported RPD
The denture base that extends anteriorly/ posteriorly
and is supported by teeth at one end and tissue on the other
end – distal extension partial dentures.

7. Temporary removable partial denture
They are used in patient where tissue
changes are expected, where a permanent
prosthesis cannot be fabricated till the
tissues stabilize.
Interim denture
It is a temporary partial denture used for a
short period to fulfill aesthetics, mastication
or convenience until a more definite form of
treatment can be rendered.

8. Transitional denture
May be used when loss of additional teeth is
inevitable but immediate extraction is not advisable
or desirable. Artificial teeth may be added to the
transitional denture as and when the natural teeth
are extracted.
Treatment denture
It is used as a career for treatment material. It is
used when the soft tissues have been abused by
illfitting prosthetic devices.

9. Centric relation
It is the most posterior relation of mandible to
the maxilla at the established vertical dimension
from which lateral movements could be made.
Eccentric Relation
Relationships of the mandible to maxilla other
than centric relation that occur in horizontal plane.
Centric Occlusion
It is the maximum intercuspation between the
upper and lower teeth.

10. INDICATIONS FOR RPD
 Length of edentulous: RPD preferred for longer
edentulous arches.
 Abutment tooth: When there is no tooth posterior
to the edentulous space to act as an abutment, a
RPD is preferred.
 Periodontal support of remaining teeth: When it
is poor RPD is preferred because it requires less
support from the abutment teeth.
 Cross arch stabilization: When a remaining teeth
have to be stabilized against lateral and anterior-posterior
forces, a RPD is indicated.

11.  Excessive bone loss: In RPD, the artificial tooth can
be positioned as per the operators preferences and
the denture base can be fabricated to provide required
support and aesthetics.
 Aesthetics: RPD provide better aesthetics because
the denture base gives the appearance of a natural
tooth arising from the gingiva.
 Immediate tooth replacement after extraction
 Emotional problems: The appointment for removable
partial denture is shorter and less demanding to
patient.
 Patient desires: Patient insist on RPD over FPD for
the following reasons:
 To avoid operative procedures on normal tooth.
 For economic reasons.

12. RPD IS GENERALLY PREFERRED IN THE
FOLLOWING CONDITIONS:
 When more than 2 posterior teeth or 4 anterior
teeth are missing.
 If the canine & two of its adjacent teeth are missing.
 When there is no distal abutment tooth.
 Presence of multiple edentulous spaces.
 If the teeth adjacent to edentulous spaces are
tipped ,they cannot be used as an abutment for a
fixed prosthesis.
 If periodontally weakened teeth are present near
the edentulous spaces.

13.  Teeth with short clinical crowns.
 Insufficient number of abutments
 Severe loss of tissue on the edentulous
space.
 Old patients

14. REQUIREMENTS OF AN ACCEPTABLE METHOD
OF CLASSIFICATION .
 It should permit immediate visualization of
the type of partially edentulous arch that is
being considered.
 It should permit immediate differentiation b/w
the tooth supported & the tooth and tissue
supported RPD.
 It should be universally acceptable.

15. CLASSIFICATION OF REMOVABLE PARTIAL
DENTURE:
Requirements of classification:
 Allow visualization of the type of partially
edentulous arch that is being considered.
 Allow differentiation between tooth supported
and tooth-tissue supported partial dentures.
 Serve as a guide to the type of design to be
used.
 Be universally accepted.
There are many classification available for
classifying edentulous arches. The most
common ones are:

16. CUMMER’S CLASSIFICATION:
This is the first professionally recognized classification. It
was introduced by Cummer in 1920.
According to him partial dentures can be classified into
four types based on the position of direct retainers:
 Diagonal: Two direct retainers are diagonally opposite
to one another.
 Diametric: Two direct retainers are diametrically
opposite to one another.
 Unilateral: Two or more direct retainers present on the
same side.
 Multilateral: Three(rarely four) direct retainers in a
triangular(rarely quadrangular) relationship.

19. KENNEDY’S CLASSIFICATION
 Class I: bilateral
edentulous areas
located posterior to
the remaining
natural teeth.
Class II: unilateral
edentulous areas
located posterior to
the remaining
natural teeth.

20.  Class III: unilateral
edentulous area with
natural teeth anterior
and posterior to it, i.e.
this indicates a single
edentulous area which
doesn’t cross the
midline of the arch,
with teeth present on
both sides of it.

21.  Class IV: single,
bilateral edentulous
area located anterior
to the remaining
natural teeth. This is a
single edent. area,
which crosses the
midline of the arch,
with remaining teeth
present only posterior
to it.

22. APPLEGATE'S MODIFICATION (1960)
 Applegate modified the above classification
based on the condition of the abutment to
include 2 or more additional groups:

23.  Class V: edent. area
bounded anteriorly
and posteriorly by
natural teeth but in
which the anterior
abutment (e.g. LI) is
not suitable for
support. It is basically
a class III situation for
the anterior abutment
cannot be used for
any support.

24.  Class VI: edent. area
in which the teeth
adj.to the space are
capable of total
support of the required
prosthesis. This
denture hardly
requires any tissue
support. Most of the
RPDs are tooth tissue
supported. Hence this
condition is classified
as a separate group.

25. APPLEGATE’S RULES
 Rule 1: classification should follow rather than
precede extractions that might alter the original
classification.
 Rule 2: if the third molar is missing and not to be
replaced, it is not considered in the classification.
 Rule 3: if the third molar is present and is to be
used as an abutment, it is considered in the
classification.
 Rule 4: if the second molar is missing and is not to
be replaced, it is not considered in the
classification.

26.  Rule 5: the most posterior edentulous area or areas always
determine the classification.
 Rule 6: edentulous areas other than those, which determine
the classification, are referred to as modification spaces and
are designated by their no:
 Rule 7: the extend of the modification is not considered, only
the no: of edentulous areas, i.e. the no: of teeth missing in
the modification spaces is not considered only the no: of
additional edentulous spaces are considered.

27.  Rule 8: there can be no modification areas in
class IV. Because any additional edentulous
space will definitely be posterior to it and will
determine the classification.

28. BECKETT & WILSON’S CLASSIFICATION
 They decided that the following must be
considered while determining the
prpportionate amount of support provided by
the teeth & tissue.
 a)the quality of abutment support. b)the
magnitude of occlusal support. c)the
harmony of the occlusion. d)the quality
of the mucosa &residual ridge.

29.  class I:bounded
saddle.abutment
teeth qualified to
support the
denture.mucosa is
not used for
support.
 Class II:free-end
a)tooth-&- tissue-borne
b)tissue-borne.

30.  Class III:bounded
saddle.abutment
teeth not so
qualified to support
the denture as
described in classI.

31. BAILYN’S CLASSIFICATION
 Proposed by Bailyn,it was the first
classification to give importance to support of
partial dentures by remaining tissues.he
used descriptive letters like A& P .A-anterior
restorations,where there are saddle areas
antr to the 1st bicuspid P-posterior
restoration, where there are saddle areas
posterior to the canine.

32. FURTHER THEY ARE SUBCLASSIFIED AS
FOLLOWS:
 classI: bounded
saddle(not more
than 3 teeth
missing)
 Class 2:free end
saddle(there is
no distal
abutment tooth)

33.  Class 3:bounded
saddle(more than 3
teeth missing)
 Class1 is tooth
supported,class2&3
are tooth-tissue
supported.In cases
where anterior &
posterior teeth are
missing ,the class of
anterior &posterior
teeth are mentioned
seperately,eg:A1P1,A
2P1,A1P3.

35. NEUROHR’S CLASSIFICATION:
Proposed in 1939, it is also based on support derived.It
is not commonly used due to its unnecessary
complexity.
Class I:Tooth-bearing
A unilateral or bilateral case falls into the above
classification when there are teeth posterior to all
spans and when there are no more than four teeth
missing in any space. There are two possible variation
in this class.
 Variation 1:Missing posteriors predominate.
--- Posteriors missing, anteriors in place.
--- Posteriors missing, some anteriors missing.
 Variation 2:Missing anteriors predominate.
--- Anteriors missing, posteriors present.
--- Anteriors missing, some posteriors missing.

37. Class II: Tooth and tissue-bearing
A unilateral or bilateral case falls into the above classification
when there are no teeth posterior to one or more spans or
when there are more than four teeth(which include a
canine) in one or more spans. Class II is further sub-divided
into divisions with variations under each:
Division 1:When there are no teeth posterior to one or more
spans:
 Variation 1:Missing posteriors predominate.
---Posteriors missing, anteriors in place
---Posteriors missing, some anteriors missing
 Variation 2:Missing anteriors predominate.
---None
---Anteriors missing , some posteriors missing

39. Division 2: When there are teeth posterior in all spans,
but when there are more than four teeth(including a
canine) in any one or more spans.
 Variation 1:Missing posteriors predominate.
--- None
--- Posteriors missing, some anteriors missing
 Variation 2:Missing anteriors predominate.
--- Anteriors missing, posteriors in place
--- Anteriors missing, posteriors missing
Class III: Tissue bearing complete dentures

41. MAUK’S CLASSIFICATION:
Proposed by Mauk in 1942, it is based on number,
length and position of the remaining teeth.
 Class I: Bilateral space with no teeth posterior to it.
 Class II: Bilateral space with teeth present posterior to
one space.
 Class III: Bilateral space with teeth present posterior to
both spaces.
 Class IV: Unilateral space with no teeth posterior to it.
 Class V: Anterior space with unbroken posterior
arches on both sides.
 Class VI: Irregular spaces around the arch. The
remaining teeth are single or in small groups.

44. GODFREY’S CLASSIFICATION:
Proposed in 1951, it is based on the location and size
of edentulous spaces.
 Class A: Tooth-borne denture base in the anterior part
of the mouth. It may be an unbroken five- tooth space,
broken five-tooth space or an unbroken four-tooth
space.
 Class B: Mucosa-borne denture base in the anterior
region. It may be an unbroken six-tooth space, an
unbroken five-tooth space, or a broken five-tooth
space.
 Class C: Tooth-borne denture base in the posterior
part of the mouth. It may be an unbroken three-tooth
space, a broken three-tooth space, an unbroken two-tooth
space, or a broken two-tooth space.

45.  Class D: Mucosaborne denture base in the
posterior region. It may be an unbroken four-tooth,
three-tooth, two-tooth, or a single-tooth
space.