Removable Partial Dentures: Key Concepts

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Questions and Answers

Which of the following scenarios would LEAST likely indicate the use of a removable partial denture (RPD)?

  • A young patient (under 17 years) with a high pulp horn.
  • A patient with periodontally sound teeth requiring a simple, single-tooth replacement. (correct)
  • A patient with a long edentulous span that is too extensive for a fixed restoration.
  • A patient who requires bilateral bracing for cross-arch stabilization.

A patient presents with an edentulous area that has a natural tooth on either side. This area would be best described as:

  • A distal extension edentulous area.
  • A bounded edentulous area. (correct)
  • A free end edentulous area.
  • An unbounded edentulous area.

Following a recent extraction, an RPD is considered primarily to:

  • Promote bone regeneration.
  • Improve esthetics or patient satisfaction. (correct)
  • Distribute occlusal forces evenly.
  • Provide essential structural support.

In the context of RPDs, what is the primary role of an abutment tooth?

<p>To support and/or retain the prosthesis. (D)</p> Signup and view all the answers

A patient who is missing all of their natural teeth is best described as:

<p>Edentulous. (D)</p> Signup and view all the answers

What is a key consideration for choosing an RPD over a fixed partial denture (FPD) in a young patient?

<p>The patient's pulp horns are larger, potentially complicating FPD placement. (A)</p> Signup and view all the answers

A patient with excessive loss of residual bone and a noticeable space under a pontic might benefit MOST from an RPD due to its ability to:

<p>Restore lost tissues with a labial flange. (B)</p> Signup and view all the answers

Which of the following scenarios might influence the choice of an RPD over other options due to economic considerations?

<p>When the patient has a limited budget and desires a functional solution. (C)</p> Signup and view all the answers

What is the primary reason classifications of partially edentulous arches are important in dentistry?

<p>To facilitate communication between the dentist and the laboratory technician. (D)</p> Signup and view all the answers

Which of the following is a critical requirement of an acceptable classification system for partially edentulous arches?

<p>Permit immediate differentiation between tooth-supported and free-end extension RPDs. (D)</p> Signup and view all the answers

In the context of removable partial dentures (RPDs), what does 'tooth and tissue-supported' signify?

<p>The RPD gains support from both the remaining natural teeth and the soft tissues. (C)</p> Signup and view all the answers

What is a disadvantage of clasps in removable partial dentures if not designed with esthetic considerations?

<p>They can be unaesthetic, especially when placed on visible tooth surfaces. (D)</p> Signup and view all the answers

Which of the following is an advantage of a removable partial denture (RPD) over a fixed partial denture (FPD)?

<p>RPDs do not require tooth reduction of adjacent teeth. (D)</p> Signup and view all the answers

What is the most likely consequence of an ill-fitting removable partial denture?

<p>Inflammation, ulceration, and bone resorption. (C)</p> Signup and view all the answers

According to the classification based on edentulous spans, what defines a Class II partially edentulous arch?

<p>Unilateral edentulous area located posterior to the remaining natural teeth. (A)</p> Signup and view all the answers

Within the context of partially edentulous arches, which class is LEAST common?

<p>Class IV (C)</p> Signup and view all the answers

According to Applegate's rules, how does the presence or absence of a third molar influence the Kennedy classification?

<p>A missing third molar is not considered in the classification if it is not to be replaced, but is considered if it will be used as an abutment. (D)</p> Signup and view all the answers

Why is preserving the residual ridge considered an important objective of removable partial dentures?

<p>To maintain support and stability for the denture, thereby slowing down bone resorption. (C)</p> Signup and view all the answers

A patient is missing their left second molar, and the opposing second molar is also missing. How would the rule related to this situation impact the Kennedy classification?

<p>The missing second molar is not considered in the classification because the opposing second molar is also missing. (D)</p> Signup and view all the answers

Why are there no modification spaces in Kennedy Class IV arches?

<p>If a posterior edentulous area exists alongside the anterior one in Class IV, the posterior area determines the class, making the anterior area a modification. (A)</p> Signup and view all the answers

Which of the following is a physiological consequence of tooth loss that removable partial dentures aim to address?

<p>Impairment of neuromuscular functions related to food manipulation. (C)</p> Signup and view all the answers

A patient presents with a bilateral edentulous area posterior to the natural teeth and one additional edentulous area in the anterior region. According to the Kennedy classification, how should this be classified?

<p>Class I, modification 1 (D)</p> Signup and view all the answers

Why might a patient opt for a removable partial denture over an implant-supported prosthesis, according to the text?

<p>The patient may not be able to afford or be a suitable candidate for implant care. (C)</p> Signup and view all the answers

When classifying a partially edentulous arch using Kennedy's classification as modified by Applegate, which of the following factors is considered last?

<p>The number of missing teeth in each edentulous span (C)</p> Signup and view all the answers

What is the primary purpose of restoring the continuity of the dental arch with a removable partial denture?

<p>To improve masticatory function. (A)</p> Signup and view all the answers

How do removable partial dentures contribute to improving esthetics for patients with missing anterior teeth?

<p>By restoring appearance and providing support to the lips and cheeks. (C)</p> Signup and view all the answers

In what way does an RPD assist in the restoration of impaired speech for some patients?

<p>By replacing missing teeth that contribute to proper speech articulation. (A)</p> Signup and view all the answers

Why is patient compliance with oral hygiene practices especially critical for patients wearing clasp-retained removable partial dentures?

<p>To minimize the risk of caries developing around the abutment teeth beneath the clasps. (A)</p> Signup and view all the answers

What is a potential disadvantage associated with clasp-retained removable partial dentures?

<p>Potential strain on abutment teeth due to improper design or loss of tissue support. (C)</p> Signup and view all the answers

Flashcards

Prosthesis

An artificial replacement of an absent part of the human body.

Dentulous Patients

Patients having a complete set of natural teeth.

Edentulous Patients

Patients having all their teeth missing.

Removable Partial Denture (RPD)

A removable dental prosthesis replacing one or more natural teeth.

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Free End Edentulous Area

An edentulous area with an abutment tooth on one side only.

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Abutment

A tooth, or portion of a dental implant, supporting a prosthesis.

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Indications for RPD

Circumstances that justify the use of removable partial dentures.

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Economic Considerations

Financial factors influencing patient choices on dentures.

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Preservation of Remaining Tissues

Maintaining health of remaining teeth and oral structures through removable partial dentures.

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Consequences of Tooth Loss

Tooth loss can lead to bone loss, changes in eating ability, and affect neuromuscular functions.

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Bone Loss Patterns

Bone loss is typically greater in the mandible and posterior regions than in the maxilla and anterior regions.

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Need for Removable Partial Dentures

Patients often have higher usage of removable partial dentures due to inability to pursue implants.

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Restoration of Dental Arch Continuity

Removable partial dentures restore the continuity of the dental arch to enhance chewing function.

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Improving Esthetics

Partial dentures enhance appearance and socially acceptable aesthetics by restoring missing teeth.

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Restoration of Impaired Speech

Partial dentures help restore clear speech that may be affected by missing teeth.

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Clasp-Retained Partial Disadvantages

Possible issues with clasp-retained dentures include strain on abutment teeth and potential for caries under clasps.

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Modification Spaces

Additional edentulous areas designated by their number in a partial denture classification.

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Class I Modifications

A classification of partial dentures with bilateral edentulous areas posterior to the remaining natural teeth.

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Applegate's Rule 1

Classification follows mouth preparations, as future extractions can alter the classification.

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Third Molar Rules

If missing and not replaced, the third molar is excluded; if present and used as an abutment, it is included in classification.

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Class IV Characteristics

Class IV has no modification areas because any posterior area would change the class to a different one.

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Hazards of Poorly Designed Partial Dentures

Issues like inflammation, ulceration, and sensitivity that can arise from ill-fitting partial dentures.

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Removable Partial Denture Advantages

RPDs are cheaper, easier to clean, repair, and require no tooth reduction compared to fixed dentures.

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Classification Purpose

To facilitate clear communication between dentists and technicians regarding partial dentures.

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Types of RPD Support

RPDs can be supported by both teeth and tissue, only teeth, or only tissue.

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Class I Partial Edentulous Area

Bilateral edentulous areas located posterior to remaining natural teeth.

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Class II Partial Edentulous Area

Unilateral edentulous area located posterior to the remaining natural teeth.

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Class III Partial Edentulous Area

A unilateral edentulous area with natural teeth both anterior and posterior to it.

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Class IV Partial Edentulous Area

A single, bilateral edentulous area located anterior to the remaining natural teeth.

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Study Notes

Introduction to Removable Partial Dentures

  • Batterjee Medical College, a center for science and technology, presented a lecture on removable partial dentures (RPDs).
  • The lecture was given on Monday, February 21, 2018, by Dr. Mahmoud El Homossany.
  • The presentation focused on the indications, contraindications and classification of RPDs, along with the terminology and components related to these dentures.

Terminology

  • Prosthesis: An artificial replacement for a missing body part, in this context, a missing tooth.
  • Dentulous Patients: Individuals with a complete set of natural teeth.
  • Edentulous Patients: Individuals with missing teeth within the dental arch.
  • Partially Edentulous Patients: Individuals with some missing teeth in the dental arch and at least one abutment tooth to support a partial denture.

Indications for Removable Partial Dentures

  • Absence of teeth posterior to an edentulous space: This occurs when there are no teeth behind an area without teeth .
  • A long span of missing teeth unsuitable for a fixed prosthesis: When the area of missing teeth is extensive, a removable partial denture is a viable alternative to a fixed partial denture.
  • Teeth with insufficient periodontal support for fixed partial dentures: If the support of teeth is weak or inadequate, a removable partial denture offers a safer option.
  • Excessive loss of residual bone: In situations with significant bone loss, a removable partial denture may be necessary for supporting the denture, and to restore lost soft tissue.
  • After tooth extraction to improve aesthetics: To improve appearances, removable partial dentures might sometimes be recommended, though mainly to ensure a satisfactory experience for the patient.
  • Patient need for bilateral bracing(cross arch stabilization): The need to stabilize the arches with braces on multiple sides of the mouth.
  • Young age (under 17 years): A removable partial denture is sometimes preferable for patient's under 17 years, especially when a fixed prosthesis can't be used due to issues, or lack of bone support.
  • Economic considerations, attitude, and desire of the patient: These factors could affect the decision between implants or a removable partial denture

Objectives of Removable Partial Dentures

  • Preservation of remaining tissues: Preserving the health of the remaining teeth, preventing muscle and temporomandibular joint (TMJ) dysfunction, and maintaining the health of the residual ridge. These strategies also intend to ensure the appropriate contour and space for the tongue.
  • Restoring continuity of the dental arch: This process is intended to improve the masticatory function, which is critical to good oral health.
  • Improving aesthetics and supporting the paraoral muscles, lips and cheeks: These objectives aim to improve the patient's appearance and comfort, restoring mouth function close to original function.
  • Enhance psychological comfort: The goal is that the prosthesis is acceptable in society, and it improves appearance to give psychological comfort.
  • Restoration of impaired speech: Addressing difficulties caused by missing teeth or structures.

Disadvantages of Clasp-Retained Partial Dentures

  • Strain on abutment teeth: Improper tooth preparation or clasp design can lead to strain and/or loss of tissue support under the distal extension denture bases.
  • Unaesthetic appearance of clasps: Poorly placed clasps can be unattractive, especially on visible teeth, if no esthetic plan is used.
  • Caries beneath clasp components: Improper cleaning of the denture and adjacent teeth can lead to cavities behind the clasp.

Advantages of Removable Partial Dentures Over Fixed Partial Dentures

  • Suitable for a greater variety of cases: Removable partial dentures are suitable for many cases of missing teeth, while fixed partial dentures may not be appropriate in all situations,.
  • Cost-effectiveness: Typically more affordable than fixed partial dentures.
  • Ease of cleaning: More easily cleaned compared to other dental appliances.
  • Easy repair: These appliances can be repaired more easily compared with others.
  • No tooth reduction required: Removal of a portion of a tooth or teeth for the appliance is not often necessary.

Classification of Partially Edentulous Arches (I- II)

  • Kennedy Classification: The classification system for partial arches, originally established by Kennedy.
  • Class I: Bilateral posterior edentulous areas.
  • Class II: Unilateral posterior edentulous areas.
  • Class III: Unilateral posterior edentulous areas with natural teeth present in the anterior and/or posterior region.
  • Class IV: Edentulous areas located in the anterior region or bilaterally anterior regions to the natural teeth.
  • Modifications: Additional edentulous areas are denoted by a number.

Applegate's Rules for Applying Kennedy Classification (Rule 1-8)

  • Rule 1: Classification should precede any extractions that may affect the original tooth classification.
  • Rule 2: Missing third molars are not included in the classification unless the tooth will be replaced.
  • Rule 3: Present third molars used as abutments are included in the classification.
  • Rule 4: Missing second molars, when the opposing second molar also missing, are not considered in the classification.
  • Rule 5: The most posterior edentulous area (or areas) determines the classification.
  • Rule 6: Additional edentulous spaces are referred to as modification spaces.
  • Rule 7: The extent of the modification doesn't affect the classification, but rather the number of the modification.
  • Rule 8: No modification areas are present in class IV arches. If a posterior edentulous region is located next to the anterior one, the posterior one defines the classification.

Components of Removable Partial Dentures

  • Denture base: The base of the denture, which replaces the missing tissue.
  • Artificial teeth: These teeth are used to replace the missing teeth.
  • Supporting rests: Components used to secure the dentures within the mouth.
  • Connectors (Major & Minor): Connect various components of the denture.
  • Retainers (Direct & Indirect): Designed to hold the partial denture securely within the mouth.

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