Are You a Prosthodontics Pro?

Introduction to Removable Partial Dentures and Classification

• Removable partial dentures are used to replace some teeth in a partially edentulous arch, and can be easily removed by the patient.
• Prosthodontics is the branch of dentistry that deals with the restoration and maintenance of oral function, comfort, appearance, and health of the patient.
• The objectives of prosthodontic treatment are to eliminate oral disease, preserve the health of teeth and oral structures, and restore oral functions that are comfortable, esthetically pleasing, and do not interfere with speech.
• The consequences of tooth loss include loss of ridge volume, mucosal changes, altered chewing, and changes in facial features.
• Removable partial dentures are needed because partial edentulism is more common than complete edentulism, not all patients can afford implant treatment, and dentists need to understand how to maximize the benefits of this treatment modality.
• Fixed dental prostheses are securely fixed to natural teeth or implants and cannot be removed by the patient.
• Removable partial dentures are indicated when fixed dental prostheses are not a good choice due to long edentulous spans, lack of posterior abutment, structurally and anatomically compromised abutments, expected survival/value-cost, need to restore soft and hard tissue contour, severe loss of tissue on edentulous spaces, insufficient numbers of abutments, immediate replacement, transitional treatment, cross-arch stabilization, and ease of plaque removal.
• Removable partial dentures are contraindicated when fixed dental prostheses can be successfully used, oral hygiene is poor and caries susceptibility is high, lack of patient cooperation or appreciation, and when the prognosis for the remaining natural teeth is doubtful.
• The requirements of an acceptable method of classification for partially edentulous arches are that it should permit immediate visualization and differentiation between tooth- and tissue-supported removable partial dentures, and be universally acceptable.
• Kennedy's classification is the most widely used and universally accepted classification of partially edentulous arches, which includes Class I for bilateral edentulous areas located posterior to the remaining natural teeth, Class II for unilateral edentulous areas located posterior to the remaining natural teeth, Class III for unilateral edentulous areas with natural teeth remaining both anterior and posterior to it, and Class IV for a single, but bilateral (crossing the midline) edentulous area located anterior to the remaining natural teeth.
• Applegate's rules modified Kennedy's classification by adding eight rules, such as the classification should follow rather than precede any extractions of teeth that might alter the original classification, and the most posterior edentulous area (or areas) always determines the classification.
• The extent of modification areas in Applegate's rules is not considered, only the number of additional edentulous areas, and there can be no modification areas in Class IV arches.