Introduction

Prosthodontics Laboratory 8 : Design principles or RPD .

Done by : Enas Salameh and Osama Yousef .

A few notes before we get started:
Please make sure to download this script and view it digitally, the design of
the RPD requires the use of colors.
As youll see, weve added lots of pictures for each case . But the pictures
are showing the patient's mouth, remember we dont do the design process
inside the patient mouth this is only for educational purposes.
Always refer to the pictures.



In order to make the design for the partial denture and choose the most
appropriate one for your case, you have to know all the components of the partial
dentures. In the clinics there is an examination sheet containing all the details
about different components of the partial denture design (ex. rests, clasps, missing
teeth and other details). It's a two dimensional representation of a three
dimensional design, it should include all the information in the patient mouth and
not only the ones that can be seen on the cast (such as teeth mobility, depth of the
sulcus, opposing teeth, type and location of restorations on teeth, shade of teeth),
these are major aspects a dentist must consider during construction of an RPD.




A systemic and initial sequence should be followed in making the design
(Acquiring the 2D information):
1- Determine missing teeth and which teeth are going to be replaced, (not all
teeth should be replaced). explain when teeth are not replaced-
2- Outline the saddle area.
3- Determine the location and type of rests that aid in support when forces are
directed toward the tissues. ( rests provide support ).
4- Determine the location and type of direct retainers (clasps) that aid in
retention when forces are directed away from tissues. (Clasps provide
retention)
5- Choose the appropriate major & minor connectors to connect all previous
components together.
6- Double check to make sure if your design requires indirect retention,
sometimes the design might not need an indirect retention.
7- Refine the design.

If you follow this sequence you will end up with a good design.

This sequence is the simplest and initial sequence for making a design and it
doesnt take into account a lot of other information. It works well on a piece of
paper assuming that the patient is (2-diminsional) ,but patients mouths are with
movable soft tissues , mobile teeth, restorations ,crown and bridges .So its only
good as an initial design .








In addition to the initial sequence, there are also other steps we can follow
(Acquiring the 3D information):
1- First, I need to Survey the cast to determine:
a) Where the survey line lies on the teeth.
b) the favorable and unfavorable undercuts.
c) The position of the undercut whether it's mesial or distal, for the clasp
assembly. (ex, what's the point of bringing the clasp down from the
mesial to the disto-facial surface if it has no undercut there)





2- Check the opposing teeth to see if the occlusion allows me to put a clasp on
this site or not, because sometimes there is no enough room for it , or the
occlusion is not favorable ( there is super-erupted teeth there ) .
3- Determine the functional depth of the sulcus.
4- Look out for Caries or restorations (according to the type of restoration you
either put a rest or not, ex, Composite and GIC can't hold rests so we dont put
rests there, However, in amalgam you can put a rest if only the remaining
thickness of amalgam is 2 mm, if it's less than 2 mm I can't put a rest on it
because it will break down).
In severe cases of broken tooth ,you can put a crown on it , and on the crown
you can put the rest (the crown has metal inside it which is better to go with the
metal of the partial denture and the metal is the part of the crown that should
be in contact with the rest not porcelain)
The sequence of surveying :
1- Anterior-posterior Guide planes
2- Laterally retention
3- Make sure there are no interferences soft
or hard.
4- Check esthetics

5- Periodontal health of the toothMobility (grade I,II,III ) the amount of
incorrect movement of a tooth due to the surrounding periodontal disease or
gum disease , this classification with or without the disease :
Grade 0 : No apparent mobility (healthy tooth)
Grade 1 : buccolingual movement which is less than 1 mm ( minimum
movement) ,used for support but questionable to be used for retention
(used wrought wire clasp on it).
Grade 2 : buccolingual movement that is 1-2 mm ( moderate movement )
,not a good abutment. Some doctors wont use it for neither support or
retention but if you decide to use it youll have to plan for failure
Grade 3 : severe buccolingul movement greater than 2 mm with (severe
movement) vertical depression ( comes up and down ), needs to be
extracted).

6. Check if there is gingival inflammation. (bleeding on probing)
7. Crown to root ratio, in some cases there is gingival recession, and just 1/3 of
the tooth is inside the bone but the rest of it is exposed which is not good for
support. Sometimes you may have a lower first molar that is weaker than lower
incisor.
For such teeth (mentioned above) it changes what type of rests and retainers I may
use ,and also sometimes I need to do something called Planning for failure.


Cobalt chromium RPD is a definitive prosthesis but not permanent, definitive
means that at this time this is the best prosthesis that you can provide the patient
with. But you know that for example within 5 or 6 years the patient is going to lose
his two lower central incisors. Then you have 3 choices:
1- After 6 years extract the teeth and make a new prosthesis.
2- Make a transitional prosthesis for the next 6 years (not a very good choice).
3- More intelligent option: design the prosthesis in a way that even though its
definitive but it can be modified later on.
So your first choice is to use a lingual bar for this case but because you know that
the two centrals will be lost later on, design the denture with lingual plate so that
the metal will reach anterior teeth, when the teeth are extracted you can send it to
the lab and attach teeth to the original prosthesis, this is called Designing for
change or designing for failure.
After acquiring information about your case, combine the 2 previous sequences (
both 2D and 3D information ) and see how the 3D affect your initial design and
modify it or refine it, also check if the design is hygienic , esthetic ,non-esthetic
and so on.


Each design differs from
others, and we can't discuss
10000 different designs together, so you have to know the different component of
the design, their indications and contra-indications .However; the way to simplify
it is by having different classifications for dentures (Kennedy's Classification).
The use of classifications is important for communications between dentist-dentist,
dentist-technician, and these classifications represent the number of missing teeth
which is important as each type of group of missing teeth indicates a general type
of design, but they don't represent the access of rotation is it away or toward the
tissue.
The other type of classification is the type of support:
Tooth- Borne: Class III and short class IV
Tooth-Tissue borne :Class I, class II and long class IV ( in very very
rare cases class lll )
There are two main movements inside the mouth:
1- Away from the tissue which requires retention.
Classification
2- Toward the tissue which requires support/rests
You have to look at each specific case to know whether it requires direct
retention and/or indirect retention, and the type of support that it requires.

What is the simplest designs? Class III designs.
Our next talk will involve talking about the most common and conventional RPD
designs .



1- Kennedy class III: usually requires Quadrilateral
design.
this is Kennedy class III modification one, with 4 abutments
,the design is like a table with 4 legs which is stable .For
support and retention there are 4 corners, even if there were
teeth instead of the modification area I still want a
quadrilateral design ,and in very rare cases I may use a
tripodal design . ( see images 1 and 2 ) .



Conventional Design
1
2



2- Kennedy class II :
Like the case which we were working on in
lab,Kennedy class II modification one .

What type of design you probably have?
there are 3 abutments ,so it is called tripodal
design like a chair with 3 legs , it's acceptable
but not that great .( image 3 ,4)




3- Kennedy class I :
Like a chair with two legs, the design will have two
abutments, you can balance it but if you use it too
much ultimately it will fall over.
This design is called bilateral design .because we
will have a rotation around this axis .( images 5 ,6).


4- Kennedy class IV :
4
5
6
Depending on the length (extenstion) of the edentulous area it can be bilateral or
quadrilateral designs, because a short span class IV will have 4 abutments, just
like tooth-borne prosthesis so the design will be quadrilateral design.
Where as in long span class IV it's like a reverse for class I so it will be a bilateral
design. So its either bilateral or quadrilateral depending on the length.
By looking at Kennedy classifications and knowing whether its tooth supported or
tooth-tissue supported you can understand the general design that you are going to
have, but what complicates things is the modifications spaces and indirect
retention.
After talking a general idea about the design you should place rests, retention,
connect everything together, double check if you need indirect retention.
That means I need to know denture components very well.
The next talk will involve rather a quick revision about the different components of
the RPD design.






A) Extra oral rests:
1- Occlussal Rests (mesial or distal ) :
- Near the edentulous space (in
bounded saddles)
RPD Components
Types of
7
Types of retention/
- Or Away from edentulous space (in distal extension)

Occlusal rests are not esthetic but they are very good because they are near the
long axis of the tooth, they load the tooth axially, and you have to have a good
relation with opposing teeth. (image 7 ) .

2- Cingulum Rests: are on the lingual surface of the tooth. They are good abutments
on canines, they are closer to the axis of rotation than incisal rests , more esthetic
than others .However, the problem is that we can usually place them in maxilla but
in the mandible there is not enough cingulum enamel to place it effectively,
sometimes yes but usually no.(image 8 ).






3- Incisal Rests: they are good rests but they are not
esthetic and they are too far away from the axis of
rotation, the rest will come over the mesial or the
distal part of the incisal ridge .the are used on
anterior teeth which are not strong enough,and the
root of the teeth are not effective ,so this type of
rests is my last resort.( image 9 ) .

B) Intraoral rests: but were not going to talk about
them in this semester.
8
9


When the patient bites down or the denture comes away the clasps can do lots of
damage to the last teeth which are on the arch because the teeth move very little
and the tissue moves a lot. (The posterior area is having lots of movement ; hence
its the soft tissue while the front area which is the teeth is having a less movement,
the difference in the amount of motion creates an
axis of rotation .
Which mean these last teeth will take on lots of load,
and its my job to take advantage of the natural teeth
and put a rest and clasp on them but its also my job to
design the clasp in such a way that theres a stress
release. So I dont want to burden these teeth , Id
choose between moving the denture ( falls out ) or to
burden these teeth Id choose to let the denture falls
because I dont want to lose these natural teeth due to
too much load.
By Stress Distribution:
1- Non-stress releasing :
a) Circumferential clasp :1- simple circlet
(aker clasp),comes from the edentulous area
2-Reverse circlet (comes away from the
edentulous area)
b) Ring clasps: go all around the tooth especially with mesiolingual
undercuts. ( image 10 )
c) Embrasure clasps (two simple circlets) double Akers clasps. ( image 11)
d) C-clasp (hair-pin clasp) (image 12) 1- difficult to fabricate
2- Not very hygienic
3- the tooth has to be tall enough to compensate
with it
1
0
1
1
4- Its difficult to adjust inside the patient's mouth,
any wrong move will destroy the clasp.
** Not our favorite choice but it's one of the
choices
Try to use the best choice, but sometimes you
have to go down till you reach the most
unaesthetic.
** Sometimes I can re-contour enamel to
change the survey line
1
2

1
2




If the
undercu
t is
located
on the
distobu
ccal
surface
of the
tooth
,the rest
will be
on the
mesio-
occlusal
surface
and the
retentiv
e arm
will be
on the
buccal
surface
and the
reciproc
al arm on the lingual surface of the tooth simple circlet circumferential clasp
(image 13 ).

1
3
However if the undercut is on the mesiolingual surface,we use reverse circlet
instead of putting the rest on the mesial I put it on the distal and the clasp starts
from the distal and comes to the undercut, but the other choice is to use ring clasp
.the rest is on the mesial and go around the tooth until I reach the mesiolingual
undercut .( image 14 )






1
4
My choice to the clasp depends on type of support and the location of the
undercut on the tooth (mesial/distal , Buccal/lingual)


2-Stress releasing:
In Kennedy class I, class II and long span class IV there will be rotation of the
denture, when the patient bites down I don't want the clasp to engage the tooth
so I use stress releasing clasps.
1. RPI clasp
2. RPA clasp
3. Combination clasp.
4. Reverse circlet in rare cases.
Why the location of the rests and clasps is important in
tooth borne prosthesis and especially tooth-tissue borne
prosthesis?
In bounded saddle areas (tooth-borne) like the image
15, the rests will be on both abutments near the edentulous
area, the rest should be as close as possible to the area where support is needed and
where the load will be on. So if the patients bites down on the first abutment there
will be support from the
rest on that tooth, and if
he bites on the other
abutment the rest on it
will provide the support
too, and if the occlussal
force is on the
edentulous area the
support will be
distributed to both rests.

1
5
1
2
3 4
1 = survey line
2 = Simple circlet clap
3 = guide plane
4 = soft tissue
Tooth-tissue borne
1
6
In tooth tissue borne prosthesis the case is different .The following example is
wrong, we wrote it just to show you why we don't put the rest near edentulous
area in tooth-tissue borne dentures:
In this example the rest is near the edentulous area and the guide plane is attached
to it plus a
normal survey
line with simple
circlet clasp (
like image 16).
( look image 17
from here )
when the patient
bites down I
don't need
retention ,I need
support ,the soft
tissue will be
compressed ,but
the rest will not
compress , it
will take support
first after the
tissue ,so what I
have here is a seesaw, the rest is the fulcrum axis
and a rotation axis on the rest ,everything behind
the fulcrum is going to go down ,everything in
front of the fulcrum will go up ,so when the
patient bites down will be as if he is extracting his
tooth which is a bad design , and when eating
sticky food the denture will go up and the clasp will
go down ,so this system is bad .
So the idea to put the rests near the edentulous area
in tooth-tissue was bad, there are luckily other
1 = Fulcrum axis
2 = rotation axis
*Notice how the movement of arrow 4 will make the
clasp harm the tooth as if its the patient extracting his
tooth
1

2
3

4
Tooth-tissue borne
1
7
1 2
3
1 = Rest
2= Guide plane
3= I-bar
RPI
1
8
1
9
systems and designs that will help me overcome this, lets check them out :
There are multiple solutions:
1- RPI : instead of putting the rest mesially put it distally ,with a guide plane and an
I-bar. ( image 18 , 19)






Where is the
fulcrum axis?
When the patient
bites down he will
continue closing
until he finds a hard
thing on the tooth
which is the rest, so we moved the fulcrum axis and not like the previous example.
1 = Rest
2= Guide plane ( short )
3= I-bar ( retentive arm is mid-fiacilly )
4 = soft tissue
5 = survey line
6 = undercut
1
2
5
3 6
4
RPI
RPI


1
2
*Notice the direction of the clasp in arrow 1 and how
it moved down and not harming the patient when he
close down
2
0
And as you know anything behind the fulcrum will go down, in this case its the I-
bar clasp. And ofcoruse anything in front will go up.( image 20 ).
In other words the RPI will remove the stress from the tooth that's why it is a
stress releasing design, the clasp will move away from the undercut.
When I don't want retention the clasp goes down when I need retention the clasp
becomes engaged .so it's a good clasp.
For RPI we have to two ways to build the design:
The first one is called Kroll design in which we have short guide plane
(1/3 or 1/2 of the occlussal gingival height of the tooth) ,and the retentive tip
is mid facially or slightly mesiofacially ,
The other design is Kradovich which is to put the tip distofacially which
we don't follow.






2- RPA Design: it's
similar to RPI but A
represents Aker
(occlusally
approaching clasp)
which is connected to
the guide plane not
the rest .When the
patient bites down the
clasp will go down
RPA
1 = rest
2 = guide plane
3 = Aker ( occlusally approaching clasp )
* Notice how the Aker is connected to the guide
plane and not the rest as in RPI
1
2
3
2
1
because it's below the fulcrum ,so it's an acceptable design but it's not esthetics
and the I-bar is much more flexible because it's longer and it won't hurt the
tooth that much .( image 21)
RPI is better than RPA but they work by the same mechanic in which the
rest is found mesially and the clasp disengages when the patient bites, and
the clasp engages when the mouth is open. (images 18 , 19 and 21)

3- What if I cant put the rest on the
mesial and I need to put it on the distal? I
should think of something that will
provide some retention and at the same
time it wont hurt the tooth.
Ill change the material of the clasp ;
Ill use a wrought wire (0.8mm) ,we said
that its fibrous not granular and the
cross section is circular ; these
proprieties gives the wrought wire its
flexibility . (Image 22).
We put a bracing arm on the lingual
which is cast reciprocation, when the patient bites down it will engage the tooth
but the amount of engagement minimal. So if I had to use the rest on the distal
Ill follow up this concept which is called combination clasp, 0.8 mm wrought
wire and cast reciprocation as a bracing arm on the lingual which will certainly
give me the minimum amount of engagement * between the clasp (wrought wire )
and the tooth , keep in mind this is not my first choice .

So as a general rule : I bar first choice, and RPA wrought wire (combination ) 2nd
choice , RPI is the best choice in esthetic and flexibility

The next compound that were going to discuses is the major connectors.
1 = rest ( notice its on the distal )
2 = wrought wire ( 0.8 mm )
3 = cast reciprocation ( bracing arm )
1
2
3
2
2





Superior border should be at least 3 mm from gingival margin.
If 3 mm is not possible then extend the borders into cingulam.
TYPE INDICATIONS
Lingual Bar 1- If the functional depth of the lingual sulcus is
greater or equal to 8 mm.
2- First choice for tooth-borne RPD
Contraindicated in the presence of
mandibular tori.
Lingual Plate 1- If the Functional depth is less than 5 mm.
2- When future loss of natural teeth is anticipated.
3- If lingual tori are present.
4- Periodontal splinting of teeth.
5- When posterior teeth have been lost and
additional indirect retention is desired.
Double lingual Bar
(Kennedy)
1- When contact with remaining mandibular
anterior teeth is indicated but open embrasures
exist.
Labial Bar 1- Mandibular teeth are severely inclined
lingually.
2- Large lingual tori that cannot be removed.
3- Labial Vestibular depth should allow superior
borders to be at least 3 mm below the gingival
margin.
Major connectors
Mandibular Major
2
3

First choice is lingual
bar the bar itself is 5mm
and I need 3 mm
between the bar and the
soft tissue of the free
gingival margins and I
also need 1 mm below at
the bottom where the
sulcus is . This will gives
a total of 9 mm. Some
might remove the 1 mm
below resulting in 8 mm
total but 8 is the
minimal. ( image 23)



General Notes:
They should be at least 6 mm away from gingival margins, if this is not
possible then extend borders into the cingulam.
Width of the major connector is proportional to the required support.

Palatal Bar anteroposterior width is less than 8 mm.
Palatal Strap anteroposterior width is between 8-12 mm.
Palatal Plate anteroposterior width is greater than 12 mm.
TYPE INDICATIONS
Maxillary Major

Lingual bar


5 mm
1 mm

3 mm
1
2
3
1 = suclus
2= lingual bar
3= free gingival margins
TOTAL = 9
mm
8 MM
MINUMM


Midpalatal Strap 1- Tooth-borne RPD when posterior teeth are
missing.
2- (may be used for tooth-tissue borne RPD when
minimal palatal support is required)
Anterior palatal strap
(Horseshoe)
1- Tooth borne RPD when anterior teeth are
missing.
2- When palatal torus can't be removed.

*Contraindicated in tooth-tissue borne RPD.

Anteroposterior Palatal
Strap
1- Tooth-borne /tooth-tissue borne RPDs when
replacement of anterior and posterior teeth is
required.
2- If palatal torus cannot be removed.
Modified palatal Plate 1- Tooth tissue borne RPD.
2- When complete palatal coverage is not required
or not acceptable for the patient.
Provides great support than previous designs.
Complete (full) palatal
plate
1- Long span bilateral tooth-tissue borne RPD with
or without anterior tooth replacement.
2- Whenever maximum muco-osseous support is
desired.
Cannot be used in presence of torus.
Palatal Bar 1- Short span class III replacing one or two teeth
on each side.
Should be avoided as possible
Anteroposterior palatal
Bar
1- When anterior and posterior abutments are
widely separated.
2- Short span class III replacing one or two teeth on
each side.
NOT first choice in maxillary major
connectors.
Contraindicated in patient with reduced
periodontal support.
In Summary : In the mandible ,I need 3 mm distance between the major connector
and the gingival ,but if I don't have this 3 mm I use a plate that cover the cingulum
and I have to use a plate instead of a bar .
In the Maxilla, I need 6 mm between the major connector and the teeth.
In both maxilla and mandible, the distance between two adjacent minor connectors
should be equal or greater than 5 mm I leave this space because self-cleansing and
hygienic reasons, but if the distance was less than 5 mm I should cover
everything using a plate.

Lattice
Meshwork (more room for teeth inter-occlusaly)
Metal base (beads retention) provides best type of retention but it can't be
relined, so it's usually good for small spaces (e.g. a bounded area consisting
of only one tooth ) .

Now we turn out attention into another subject which is indirect retention.



A) In bounded areas:
If there is a bounded area, what stop the movement of the partial denture upward
are the direct retentions (retentive arms of the clasps) on both abutments.
B) In the tooth-tissue borne:
Well do as we did earlier Ill put a bad example just to show you a few concepts:

Minor
Indirect Retention
If you look at the picture (24) you
can see we have a free end with no
teeth, we have a rest and clasp. So
far weve talked about how we are
handling the load that is acting on
the denture or the seating force, but
now Im interested in knowing how
the denture will react against the
displacing force (retention)., so
lets say that there is a displacing
force coming on the denture (a
force that is acting on it maybe
from the patient or anything else)?
the first thing that is going to stop it
from going up is the clasp tip so the
axis of rotation is now not on the
rest but on the clasp, this axis of
motion is causing a movement in the
denture and although the clasp is
preventing the denture from going out
(support) its creating a rotational
motion in the denture.
What should I do to remove this axis of
motion on the tip of the clasp thus
removing this unwanted movement?
What Ill do is that I extend the partial
denture forward and putting a rest on
the tooth that is in front of that point.
( image 25)
Now if it tries to rotate, the rest we just added will prevent this rotational
movement and because it provides retention far away from the edentulous space
(or in the other side of rotational axis) and because its not a clasp it is called :
INDIRECT RETIENTION . (image 25).


2
notice in 1 which is the clasp , how we
have an axis of rotation as in 2 . And
notice how the denture is rotating is in 3
1
3
2
4

1
2
3
Notice here how we extended the
denture as in 1 . Notice the anterior
tooth as in 2 which we put on it a rest
as in 3 that worked as an indirect
retainer
2
5

Kennedy class I and class II and long span class IV always need indirect
retention, plus in rare cases in class III where there is no retainer on one corner
you have to put indirect retainer.
Now that we nearly finished the theory part of this lab , were moving into a much
easier subject which is the design
Advice: Solve as many designs as possible, the more designs you work on the
better














Case
There is a color coding that you have to follow during
designing the denture (it may differ from one book and another
but this one that we follow in JUST):
Abutment selection -------------(Yellow)
Missing teeth ---------------------(put an X )
Rests-------------------------------(Purple)
Connectors ,major or minor ---(Grey)
Direct retention------------------(Red)
Indirect retention----------------(Green)
Resin retention------------------ (Black)

Case 1: Maxillary arch with 3 missing teeth on both sides, the teeth
are (5,6 and 7) . Kennedy class III modification 1 , (image 26)
2
6




The following data you have to write are found in the paper given to you earlier,
above at the top of the page youll have :
First, determine the missing teeth and what type of Kennedy classification you
have Kennedy class III modification 1 (write it down on the top of the
examination paper).
Determine what is the support classification (tooth-tissue borne or tooth-borne )
tooth-borne in this case.
In this case, where I should put my abutments?
They should be near the edentulous area, so the
abutments will be (4 and 8 ) on both sides and they
are sound teeth, so mark them with yellow color on
the paper .( image 26 ).
Second: Outline the saddle area. ( image 27 ).
Third: Determine the location of the rests (support)
with purple color .In tooth-borne design they should
be near the edentulous area like the picture ( 28), so
it depends on the space created by the edentulous
area.
Fourth: Determine the location and types of direct
retainers; the simplest clasp assembly is occlusally
approaching wrought wire (simple circlet clasp) ,so
you have 4 clasps, each clasp has retentive arm on
the buccal surface of the tooth (marked by an arrow
at its end) and a reciprocating arm on the lingual
2
7
2
8
2
9
surface (marked with a small point at its end).(image 29).



Fifth, I need now to connect everything together
by choosing the most appropriate minor and major
connectors .for the minor connector as we have a
maxillary denture we commonly use meshwork that
will provide more room.( image 30 ).
For Major connectors it depends on how large the
edentulous spaces are, in this case I have 3 missing
teeth on both sides and the abutments provide me
with support and I don't need additional support from
the major connector, so there will be 2 choices ,the
simplest one will be the mid-palatal strap which
should be 8-12 mm anteriposteriorly, if it's more than
12 mm it will become a plate . (image 31).
If the number of missing teeth on both sides is more
(like from canine to 3
rd
molar) then I can open up the
center and use anterposterior palatal strap.
Sixth, If I look at this design and draw an axis of
rotation ,and the denture tries to go up, the clasps
on the abutments will prevent this movement
therefore I don't need indirect retention on the
opposing side even though there is a rest there
anyway, that's why in Kennedy class III
modification one usually doesn't require
indirect retention .
But let's say that I can't put a clasp on the anterior
abutment on the premolar because of esthetic and
3
0
3
1
3
2
mobility reasons, I will still have 4 rests for support that's why it's called
quadrilateral design in term of support ,however; if the denture tries to come out in
this abutment ,I don't have a clasp that prevents this movement ( so here I need
retention ) so I must have an indirect retention (rest) on the opposing 3
rd
molar
,since it's already there then the problem is solved , I just need to put a green color
on it to indicate its an indirect retention .(image 32).






So first as we said were going to color the primary
abutments with the color yellow. ( image 34).
Case
Case 2: Mandibular arch with 4,5 and 6 missing on the right side and
5 on the left the functional depth of the sulcus lingually is 6 mm
,buccaly on the right side of the patient is 3 mm and on the left side is
6 mm . ( image 33 ) .
3
3
3
4
After that were going to put the rests mesially or distally , depending as we said
on the edentulous areas . But NOTE the canine I put it on the cingulum not on
the mesial or distal. (image 35).



After that we mark the edentulous areas, and lets
assume we have an undercut that is 0.25 mm as in
the picture. ( image 36 ) .
( look at image 37 while reading this ) Now that I
have support I look for retention and were going
to use a regular clasp and a reciprocation arm on
the right molar. On the canine what should I put
here? You might say I want to put an I-bar , but I
cant put it here in this situation because the
functional depth in that area is 3 mm and the
minimum for the I-bar is 4 mm and I also cant
use gingivally approaching clasp because of the
depth of the sulcus (3 mm). I can use an occlusaly
approaching clasp or wrought wire clasp. Well go
with the regular C-clasp (although its not good
esthetically )
On the left molar where I have an undercut on the
mesio-lingual what should I do? I have several
choices :
I can try and create an undercut by contouring
or adding materials to the tooth or even drill a
small cavity (0.5 mm) and this is called
DIMPLE inside the tooth in the other areas of
the tooth where there is no undercuts BUT this
3
5
3
6
3
7
is usually not a very good idea and I have to avoid it and make it my last
choice.
So lets see what other options I have here, simple circuit ( image 38 )? I cant
use that here because of the undercut, what about reverse circuit (image 39)? It
actually works I can use it, but Ill have to change the location of my rest and
itll complicate my design. What are the other options? What about the ring
clasp? the ring clasp is very long as you can see ,
so we have two options for the ring clasp A) we
put a rest on the distal and in addition to the
mesial rest ( two rests image 40 )
B) or we add something called strut or bracing
strut . ( image 41).
But probably the best choice here is to go with the ring clasp with or without the
distal rest (the second rest).

What about the premolar, what
type of clasps Im going to put
here? Because the functional
depth there is 6mm I can place
an I-bar ( image 37).
And now we need to combine
everything together, on the
right side Ill put a lattice . and on the left side where we
only have one tooth its preferable to put a metal base (
notice how we draw it its very important) . ( image 42) .
3
8
3
9
4
0
4
1
4
2













Now we need to select a major connector the function depth in the middle as we
said is 6mm, my first choice is lingual bar but with 6mm depth can we use lingual
bar? No, the next choice is lingual plate , and while using the lingual plate I have to
cover the cingulum for the teeth involved as in the picture ( 43 ) but note the
drawing is not very accurate on the cingulum .















With the lingual plate, two problems rise:
4
3
Now after Ive put the major connector, I want to refine my design, at the left
side where I have an edentulous area consisted of only one missing tooth and
bounded by the molar and the premolar. Weve put clasps on the molar and
premolar. But you have to know that when we have only one missing tooth
there is no need to have two teeth with both clasps, so now I can either
remove the I-bar from the premolar or the ring clasp from the molar as long
as one of them will still provide support for the missing tooth.
Another thing is that the lingual plate covers the right canine
now you ask yourself am I going to avoid the lingual plate in
that area and make like a window ( or space ) or am I going to
cover it with the lingual plate ? What determine the answer is
that can I leave 3mm for the free gingival margins and 5mm
for the plate, in this case probably not because itll become too
crowded and itll be a fine space for sticky food to get into.
But remember sometimes I need to
create that space especially if Im
using the lingual bar. (Image 44 :
shows the shape of the windows if we
didnt put the plate on the tooth ) .
(Image 45: shows how we plated that
space and now its covered with
lingual plate).






Case 3
4
4
4
5
Note the dr in this case didnt specify the functional depths just to
ease things for us.
Keendy class ll , mod 1 . With 4, 5 and 6 missing on the right and
5,6,7 and 8 on the left . This is as you know tooth-tissue borne, and
as we said we already know that we need indirect retention . ( image
46 ).












We start solving this design as always, marking the
primary abutments yellow .( image 47 ).
And then as always Im going to draw the rest for support
for the right side its a bounded edentulous area so I have
to be near it. on the right however I dont have a bounded
edentulous space but I have a distal extension in
this case as you already know I have to put the rest
away from the distal extension which is on this
case the mesial.( image 48).
Now I look for retention , on the right canine
Im going to put a gingivally approaching I-
bar or RPI system ( again remember the dr
didnt give the functional depth to make things
clear , dont bother yourself with it ) I added a
regular c-clasp for the molar and for the
4
6
4
7
4
8
4
9
premolar on the left I added RPI system also . ( image 49).




For the minor connectors were going to use
meshwork. An important note when drawing
the meshwork is that you have to draw it
probably it should go over just the crest of the
ridge and lingually it should be about 1/3 of
the distance from the crest of the ridge to the
mid-palatine raphe. (Unfortunately the dr
drawing was very unclear in the demo , I
couldnt see his drawing , so stick with his
directions and the following drawing is not
that accurate : image 50 ).
For the major connector its probably either modified palatal plate or anteieor-
postieor paltal plate. The doctor asked what if I put a torus at the middle the answer
would be. As we know from the mid material its going to be ant-post palatal plate
.And if the torus reaches the vibrating line we go with a horse-shoe. The dr added a
small torus at the middle and he went with the ant-post palatal plate.
Now a question rises, when putting the ant-post palatal plate, where should it meet
with the teeth? Should I put the plate on the right premolar (meaning should I plate
the right premolar?) or I dont have to put the plate and let it be free on the lingual
surface with its reciprocating arm? I can do either one, many dentist would rather
stay away from the gingiva and just put a finger or arm ( of plate ) on the
reciprocating arm and continue the plate . (image 51 , notice how the plate is
coming out from the rest as an extension and the tooth is not plated ). On the
posterior as you remember I need to cross the midline at right angles, and I want to
cover as much of the edentulous area as possible. Another question rises, should I
put the plate on the lingual surface of the right molar or should I start the plate at
5
0
only the mesial surface at the rest? The answer actually is to start putting the plate
on the mesial as long as I have a distance of 6 mm .( image 51 notice the red line is
the midline and the plate is with right angle to it.).




Now lets evaluate the axis of rotation.
Remember this case is tooth-tissue borne
and to evaluate the axis of rotation put
your pen down on the paper, start from the
back where the distal extension is and not
where the bounded saddle. After that start
moving you pen like the images (52 ) and
then draw the rotational axis passing by the
clasps as in ( 53).
Now you can see we have an axis or
rotation that passes from clasp tip to
clasp tip. So what do I need on the
other side of this axis of rotation? I
need a rest that is going to provide
me with indirect retention, luckily I
already have that on the right canine
. But now I have another problem,
what if the patient bites here (star
on image 51 ) what will happen to
the other side ? ( which is the right
canine ) the clasp will start harming
the tooth and tries to extract the
tooth as we said earlier , for this
5
1
very reason some dentist prefer not to put a clasp on that right canine or put a very
weak clasp ( wrought wire ) .
Remember that in tooth-tissue borne I care about both the forces that are acting
away from the tissue and toward the tissue on the distal extension areas. so in
short the axis or rotation should be looked at away from the tissue and toward the
tissue .














As always we start by identifying the primary
abutments and coloring them yellow.( image 55)

Case 4
5
2
5
3
Keendy class 1 . With 5,6,7 and 8 missing on the right and 4,5,6,7
and 8 missing on the left . functional depths as in image 54
5
4
5
5
And then as always were going to place the rests, again notice how we
placed the rest of the right premolar on the mesial (away from the distal
extension area).(image 56).






After that were going to place the clasps,
starting from the left canine where the
functional depth is 2 mm , I can add
combination clasp ( which we already said
its a wrought wire and cast reciprocation on
the lingual surface ) . On the right premolar I
can add an I-bar since I have 6 mm ( so Ill
put an RPI system here ) .(image 57).

For the minor connector , well go with the lattice
but notice we only draw 2/3 the way and leave 1/3
at the end as in the picture.(image 58).
Now whats my major connector? As always my
first choice is always lingual bar, and because I
have 9 mm functional depth at the middle and
lingual bar requires at least 8 mm in that case I
can place a lingual bar . Now on the right
premolar the question rises again, am I going to
put the plate on the tooth or extend an arm that
is attached to the plate? Well in this case since
the premolar has a limited space ( it has 3 mm
but no 5 mm mesio-distally ) were going to put
the plate on it ( plate it ) . In the left canine I can
make an arm that is attached to the plate, there is
5
7
5
8
5
9
no need to plate it . Why ? because here the canine has enough space and unlike
the premolar .( Image 58 notice how the canine is not plated and the premolar is ).
~The end.
Done by : Enas Salamah and Osama Yousef.