Sie sind auf Seite 1von 66

Dr.

Nesreen Salim
RPD CLASSIFICATION
The common classification system used in the UK for
partial dentures is that devised by Kennedy. This
Classification is based on the frequency of the partially
edentulous state. It is descriptive of the anatomical
form of the respective arch and merely provides an
overall description of where the saddles are without
outlining the size of the saddles.
The classification advocated by Beckett outlines the
source/s of support.
DIFFERENTIATION BETWEEN TWO MAIN
TYPES OF REMOVABLE PARTIAL DENTURES
The Class I and Class II tissues underlying the base
and only limited support from the abutment teeth .
Class III abutment teeth at each end of the
edentulous space
Impression tech.
Need for indirect retainers.
Need for relining in future.
Components of RPD
Supporting Elements
These may be rests on the crowns of teeth, coronal
restorations, root faces of teeth, mucosa or implants.
Retaining Elements
These are termed direct retainers and may be clasps,
precision retainers, guiding plates acting on surfaces.
Connecting Elements
These may be major connectors, which join up the saddles,
or minor connectors that join rests or direct retainers to the
major connector.
Anti-rotational Components
Often referred to as indirect retainers, although they also
function as supporting elements for the framework.
Denture Base Material and Flange
The denture base material and denture flange may serve as
one or more of the above components.
Principles of design
1. Outline the saddles and determine which ones need to
be restored.
2. Decide on the nature of the support.
3. Decide on how best to maximize retention.
4. Decide on how best to unite the saddles.
5. Decide whether anti-rotational devices are required
and, if so, how this is achieved.
6. Re-assess for hygiene and, with an eye on the future,
maintenance of the prosthesis (e.g. relining, repair and
replacement of components of precision attachments)
and the prognosis of the remaining dentition.
7. Decide on how the occlusion is to be planned and, at
the same time, plan with appearance in mind.
Simply:
1. Saddles.
2. Support.
3. Retention.
4. Bracing and reciprocation.
5. Connector.
6. Indirect retention.
7. Review of completed design.
Design of tooth borne RPD
Draw the design on the study cast/s as well as on the
prescription form.
The study casts should be articulated and the occlusion
examined to confirm the clinical examination and identify
any problems this may pose for the construction of the RPD
(e.g. space for components of the RPD such as occlusal rests)
It is necessary at this stage to make use of the surveyor and
mark the path of insertion of the denture, undercuts on the
teeth, depth of any undercuts, and the presence of
unwanted undercuts, which will need to be blocked out.
Outlining the saddles: determine the places where it is
intended to place RPD saddle areas
The principle of tilting the cast to
enhance retention is that by so
altering the path of insertion (1) a
rigid part of the denture can
enter an area of the tooth surface
or an area of the ridge which is
undercut relative to the path of
displacement (2).
In this example, providing
retention by engaging the distal
undercut (*) of the canine may
well look more pleasing than a
clasp arm on the same tooth.
Outlining Support: Rest seats, preparation is a
prerequisite 1- to direct forces down the long axes of
the teeth, because these are the forces teeth can
withstand much better than lateral or jiggling forces.
2- definite seat ensures there are no sharp edges to
irritate the tongue.
3- Rests also act as indirect retainers for Kennedy Class I
and Class IV partial dentures.
A guide surface* allows a reciprocating component to
maintain continuous contact with a tooth as the
denture is displaced occlusally. The retentive arm of
the clasp is thus forced to flex as it moves up the tooth.
It is this elastic deformation of the clasp that creates
the retentive force.
Guide surfaces ensure that the patient removes the
denture along a planned path (1). The clasps are
therefore flexed to the extent for which they were
designed. Without guide surfaces the patient may tilt
or rotate the denture on removal (2), causing clasps to
flex beyond their proportional limit.
The reciprocal element which is in contact with the side of the tooth opposite
the retentive clasp can also play an important role in the effectiveness of the
latter, and thus in the overall retention of the denture. (1) A horizontally
directed force is produced as a retentive arm is displaced in an occlusal
direction over the bulbosity of a tooth. If the clasp arm is unopposed the tooth
is displaced in the periodontal space and much of the retentive capability will
be lost. (2) If the retentive clasp is opposed by a rigid component which
maintains contact with the tooth as the retentive arm moves over the bulbosity
of the tooth, displacement of the tooth is resisted, the retentive arm is forced to
flex and thus the efficiency of the retentive element is increased. This principle
is known as reciprocation. It is thus apparent that reciprocation is required as
the denture is being displaced occlusally whilst the bracing function, as
mentioned earlier, comes into play when the denture is fully seated.
1) A clasp is effective in retention from its position when the
denture is fully seated to where it escapes over the bulbosity of
the tooth. This vertical measurement may be termed the
'retention distance'. It will be appreciated that the reciprocal
element on the other side of the tooth should be in continuous
contact with the tooth surface as the retentive arm traverses the
'retention distance'. Effective reciprocation can be achieved
either (2) by a clasp arm contacting a guide surface of similar
height to the 'retention distance', or (3) by a plate making
continuous contact with the tooth surface as the retentive arm
moves through its 'retention distance'. (4) If the reciprocating
clasp is placed on a tooth without an adequate guide surface, it
will lose contact with the tooth before the retentive arm has
passed over the maximum bulbosity of the tooth and fail to
provide effective reciprocation.
Bracing
The horizontal forces are resisted by placing rigid
components of the denture (bracing components)
against suitable vertical surfaces on the teeth and
residual ridges. Parts of a denture resting against the
stippled areas will resist the forces whose directions
are shown by the arrows. It is important to
appreciate that bracing occurs only when the
denture is fully seated.
Ladder-like minor connector (open): provides
excellent attachment of acrylic resin bases, minimizes
warping of bases resulting from the release of inherent
strains in compression-molded acrylic resin.
Mesh pattern minor connectors: to attach acrylic resin
denture bases to the framework. rigid and possessing
adequate strength, bulk of connector itself may
contribute to weakening of acrylic resin base.
Selecting the Major Connector
Maxilla: plate, strap, ring (anterior-posterior palatal
strap), horseshoe.
The ring design, and all bar types of major connector,
tends to have a number of edges noticeable to the
tongue, and are thicker although they cover less tissue.
Plate designs tend to be thinner and less noticeable,
but do cover a wider area of the palate.
Where there is a torus, or the patient wishes to avoid
too much palatal coverage, a horseshoe design or ring
design is indicated.
Mandible: 1- The lingual bar +ve hygienic since it does not
cover over the teeth but a depth of functional lingual sulcus of at
least 8 mm is required to combine stability of the denture with
health to the remaining dentition, -ve considered to be more
noticeable to the tongue, and cannot act, on its own, as an
indirect retainer with distal extension cases.
2-The lingual plate +ve more acceptable to the tongue, can act as
an indirect retainer, -ve it does of course cover over the lingual
surfaces of the lower anterior teeth, thus predisposing to caries
and gingival/periodontal irritation. The appearance may also be
poor if there is spacing between the teeth.
3-The sublingual bar which fits in the lingual pouch beneath the
tongue and is +ve less noticeable, more rigid. ve more bulky
than a lingual bar (it is half pear-shaped and requires a 10 mm
space from lingual gingival margins to the lingual reflection),
careful attention must be paid to the impression technique,
using functional tongue movements to roll the impression
material while it is setting.
4-The dental bar may be used where there is a limited
lingual sulcus, but as this fits onto the cingulum region of
the teeth and has to be -ve bulky for strength, it may not be
readily acceptable to the patient.
5-The labial or buccal bar is recommended for lingually
inclined lower anterior teeth such as Skeletal III cases.
6- The Kennedy bar is a combination of a continuous clasp
on the lingual surfaces of the lower anterior teeth and a
lingual bar. This type of major connector tends not to be
well perceived by patients owing to the number of edges
that are in contact with the tongue
Selection of connector type. Selection of the
type of connector(s) is based on four factors:
mouth comfort, rigidity, location of denture
bases, and indirect retention.
Tooth shape influences retention by determining the
depth and steepness of undercut available for clasping.
Clasps 1 and 2 are positioned in the same amount of
undercut and therefore provide the same overall
retentive force. However, for the same small vertical
displacement, clasp 1 is deflected more than clasp 2
and therefore offers greater initial resistance to the
displacing forces.

undercut area nearer to the saddle: ring clasp


Tilted molar: ring clasp
When guide surfaces are used to provide resistance to displacement of the denture in an
occlusal direction, the retentive portion of the clasp needs only to resist movement along
the path of withdrawal and therefore can be positioned solely with reference to the red
survey line.
A gingivally approaching clasp positioned at the cross-over point of the survey lines resists
movement along both the path of withdrawal and the path of displacement without being
permanently deformed by movement along either path.
?
?
?
?
?
M D
? ?
1-Maximum contact of proximal plate minor connector with
guiding plane produces more horizontal distribution of
stress. 2- Minimum contact or disengagement of minor
connector with guiding plane allows rotation around
fulcrum located on mesio-occ1usal rest, producing more
vertical distribution of stress to ridge area. 3- Minor
connector contact with guiding plane from marginal ridge
to junction of middle and gingival thirds of abutment tooth
distributes load vertically to ridge and horizontally to
abutment tooth.

Das könnte Ihnen auch gefallen