Introduction to Partial Dentures PDF

Introduction Marketing Department Mon. Feb. 21. 2018 Introduction Introduction  Dr :Mahmoud El Homossany Objective: 1-Indications and Contraindication of removable partial denture 2-Classification of Partial denture Reference Chapter 1,3  TERMINOLOGY Prosthesis Is an a...

Introduction Marketing Department Mon. Feb. 21. 2018 Introduction Introduction  Dr :Mahmoud El Homossany Objective: 1-Indications and Contraindication of removable partial denture 2-Classification of Partial denture Reference Chapter 1,3  TERMINOLOGY Prosthesis Is 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  Edentulous Patients COMPLETE DENTURE Partially Edentulous Patients Patients having one or more but not their entire natural teeth missing. Removable Partial Denture = R.P.D Fixed bridge= F.P.D Implant Removable Partial Denture, R.P.D Fixed bridge Implant Removable Partial Denture (RPD) Removable dental prosthesis (appliance) replacing one or more natural teeth and associated oral structures Free End Edentulous Area (Distal extension edentulous area): An edentulous area, which has an abutment tooth on one side only Bounded Edentulous Area: An edentulous area, which has an abutment tooth on each end Abutment: A tooth, a portion of a tooth, or that portion of a dental implant that serves to support and/or retain prosthesis  INDICATIONS FOR REMOVABLE PARTIAL DENTURES 1- No abutment tooth posterior to edentulous space (Free end edentulous area) INDICATIONS FOR REMOVABLE PARTIAL DENTURES 2- Long edentulous bounded span, too extensive for fixed restoration INDICATIONS FOR REMOVABLE PARTIAL DENTURES 3- Periodontally weak teeth not sufficiently sound to support fixed- partial denture. Periodontally weak teeth Free end edentulous area Periodontally weak teeth 4- With excessive loss of residual bone, the use of labial flange or need to restore lost tissues. Excessive loss of residual bone With excessive loss of residual bone, space is seen under the pontic. INDICATIONS FOR REMOVABLE PARTIAL DENTURES 5- After recent extraction, usually done only to improve esthetics, or for patient satisfaction. 6- Need of bilateral bracing (cross arch stabilization) 7- Young age (less than 17 years).  Young Old Young age (less than 17 years) has a high pulp horn 8-Economic considerations, attitude and desire of the patient. OBJECTIVES OF REMOVABLE PARTIAL DENTURES Preservation of the Remaining Tissues A- Preservation of the health of the remaining teeth. B- Prevention of muscles and TMJ Dysfunction. C-Preservation of the residual ridge. D- Preservation of the tongue contour and space.  Consequences of Tooth Loss Anatomic Physiologic In general, bone loss is We are replacing both greater in the mandible the physical anatomic than in the maxilla and tools for mastication and the oral capacity more pronounced for neuromuscular Posteriorly than functions to anteriorly, and it manipulate food. produces a broader mandibular arch while constricting the maxillary arch. Need for Removable Partial Dentures Patient use of removable partial dentures has been high in the past and is expected to continue in the future. Some patients who are given the choice between a prosthesis entirely supported by implants or a removable partial denture are not able to pursue implant care. This contributes to higher use of removable partial dentures. Replacement of lost teeth prevents the migration of teeth into the edentulous area following the loss of the natural dentition Migration of teeth into the edentulous area following the loss of the natural Change the pattern of mandibular closure as a result of loss of some teeth Normal masticatory cycle OBJECTIVES OF REMOVABLE PARTIAL DENTURES Restore the Continuity of the Dental Arch to Improve Masticatory Function OBJECTIVES OF REMOVABLE PARTIAL DENTURES Improvement of Esthetics, and Providing Support to the Paraoral Muscles, Lips and Cheeks  OBJECTIVES OF REMOVABLE PARTIAL DENTURES Enhance psychological comfort *Restoration of anterior teeth improves and restores appearance *RPD should provide socially acceptable esthetics OBJECTIVES OF REMOVABLE PARTIAL DENTURES Restoration of Impaired speech OBJECTIVES OF REMOVABLE PARTIAL DENTURES Restoration of Impaired speech Possible disadvantages of a clasp-retained partial 1. Strain on the abutment 3. Caries may develop teeth often is caused by improper tooth preparation beneath clasp or clasp design, and/or components, loss of tissue support under distal extension especially if the partial denture bases. patient fails to keep 2. Clasps can be un-esthetic, the prosthesis and the particularly when they are placed on visible tooth abutments clean. surfaces without consideration of esthetic impact.  Tooth decay Inflammatory changes of soft tissues HAZARDS OF IMPROPERLY DESIGNED PARTIAL DENTURES Ill fitting denture Inflammation, ulceration ,gingival recession, bone resorption Sensitivity from acryl  ADVANTAGES OF REMOVABLE PARTIAL DENTURE OVER FIXED PARTIAL DENTURE 1- RPD constructed for any case whilst FPD are confined to short spans bounded by healthy teeth and with a normal occlusion. 2- Cheaper than fixed partial denture 3- They are more easily cleaned 4- They are more easily repaired 5- No tooth reduction is required  CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES Classifications are important to facilitate communication between the dentist and the laboratory technician Requirements of an Acceptable Classification: 1- Permit immediate visualization of the type of partially edentulous arch 2- Permit immediate differentiation between bounded and free extension RPD. 3- It should be universally accepted CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES I- Classification According to the type of support of the R.P.D.: 1-Tooth and Tissue Supported RPD (Tooth and tissue borne) 2- Tooth Supported RPD (Tooth-borne) removable partial denture 3-Tissue Supported RPD (Tissue borne)  Tooth and Tissue Supported RPD *Tissue Supported RPD Tooth Supported RPD  CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES II- Classification According to the most posterior edentulous span or spans Class I: Bilateral edentulous areas located posterior to the remaining natural teeth. Class II: Unilateral edentulous area located posterior to the remaining natural teeth. Class III: Unilateral edentulous area with natural teeth, both anterior and posterior to it Class IV: Single, bilateral edentulous area located anterior to the remaining natural teeth. Class I Class II Class III Class IV  The numeric sequence of the classification system is based on the frequency of occurrence of each class. Class I being the most common while class IV is the least common. Kennedy's classification was then modified by Applegate Additional edentulous areas are referred to as modification spaces and are designated by their number  Class I mod.1 Class II mod.3 Class III mod. 1 Class IV ????  Applegate's rules for applying Kennedy classification Rule1 Classification should follow mouth preparations, since further extractions may alter the class Rule1 X If the left molar is extracted class III becomes class II  Applegate's rules for applying Kennedy classification Rule2 If the third molar is missing and not to be replaced, it is not considered in the classification  Applegate's rules for applying Kennedy classification Rule3 If the third molar is present and to be used as an abutment, it is considered in the classification  Rule3 ???? ????  Applegate's rules for applying Kennedy classification Rule4 If the second molar is missing and not to be replaced, because the opposing second molar is also missing, it is not considered in the classification  Applegate's rules for applying Kennedy classification Rule5 The most posterior edentulous area (or areas) always determines the classification Applegate's rules for applying Kennedy classification Rule 6 Additional edentulous areas other than those determining the class are referred to as modification spaces and are designated by their number  Applegate's rules for applying Kennedy classification Rule7 The extent of the modification is not considered, only the number of additional edentulous areas  Applegate's rules for applying Kennedy classification Rule 8 There can be no modification areas in class IV arches, because if there is a posterior edentulous area beside the anterior one, the former will determine the class and the anterior edentulous area will be a modification to the class ???????  The Component Parts of Removable Partial Dentures Denture Base Artificial Teeth Supporting Rests Connectors: Major Connectors Retainers Minor Connectors Direct retainers Indirect Retainers 3 1 2 5 4 Thank You