Designing of partial denture necessitates a proper planning for the form and
extent of a dental prosthesis and studying of all the factors involved.
The prosthesis must be designed following the most favorable biomechanical
principles, as the proper design helps in reducing the harmful effects on the
supporting structures.
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Here a movable joint is placed between the direct retainer and denture base.
This joint may either be a hinge or a ball and socket or a sleeve and cylinder. Adding
these stress breakers to the junction of the direct retainer and the denture base, allows
the denture base to move independently.
This decreases the amount of force acting on the abutment. The combined
resiliency of the periodontal ligament and the stress director will be equal to the
resiliency of the oral mucosa overlying the ridge.
Examples for hinges include DALBO, CRISMANI, ASC 52 attachments.
Type I I
It has a flexible connection between the direct retainer and the denture base. It
can be a wrought wire connector, divided or split major connector or a movable joint
between two major connectors.
In a split major connector, the major connector is split by an incomplete cut
parallel to the occlusal surface of the teeth into two units namely the upper unit (more
near to the tooth) and the lower unit. The denture base is connected to the lower unit
and the rests and direct retainers are connected to the upper unit.
Advantages
The alveolar support of the abutment teeth is preserved as the stresses acting on
the abutment teeth are reduced.
The stress on the residual ridge and the abutment teeth are balanced.
Weak abutment teeth are well splinted even during the movement of the denture
base. Abutment teeth are not damaged even if relining is not done appropriately
(after the denture wears out).
Minimal requirement of direct retention.
Movement of the denture base produces a massaging effect on the soft tissues..
This avoids the frequent need for relining and rebasing.
Disadvantages
Design is complicated and expensive.
The assembly is very weak and tends to fracture easily. Distorts to rough
handling.
It is difficult to repair.
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It can be used only to counter the vertical forces on the denture. Inability to
counteract lateral stress acting on the ridge leads to ridge resorption.
Reduced stability against horizontal forces.
Both vertical and horizontalforces are concentrated on the ridge leading to
resorption.
Inappropriate relining leads to excessive ridge resorption.
Reduced indirect retention.
The split major connector tends to collect food debris at the area of split.
Physiologic Basing
This technique distributes the occlusal load between the abutment teeth and the
soft tissues by fabricating a denture based on a functional record. Functional record is
obtained by recording the tissues under occlusal load or by relining the denture under
functional stress. This technique involves making an impression of the soft tissues in a
compressed state.
The denture fabricated using a functional impression has one major
disadvantage. That is the denture tends to compress the soft tissues even at rest. This
can lead to excess ridge resorption. Since the denture is fabricated using a functional
record (compressed tissues), the soft tissues offer more resistance to further
compression. This increased resistance to compression provided by the oral mucosa
equates to that of the periodontal ligament of the abutment tooth. In this manner the
abutment tooth is protected from excessive forces and the denture can distribute
occlusal load evenly to the teeth and tissues.
Requirements for Physiological Basing
rigid metal framework
Functional occlusal rests
Indirect retainers to provide additional stability.
Well-adapted, broad coverage denture bases.
Advantages
Good adaptation of the denture base.
Simple design and economical.
Minimal direct retention decreases the
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They are a very small dentures which replacing one or two teeth on one side only and
often they are called (removable bridges).
(3) Tooth-and tissue born dentures:
They are supported by the soft tissue and the natural teeth.
The best example of this type is the RPD with distal extension bases. The tooth
structure provides the support interiorly, where soft tissue supports the denture base
posteriorly.
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Atmospheric Pressure
Effect of Gravity
Plastic molding between tissues / denture polished surfaces aid to little extent in
retention of partial denture
b] Mechanical means
(1) Direct retainers:
A- Intracoronal (precision attachments).
B- Extracoronal (clasps)
(2) Frictional fit between the denture and the abutment teeth.
(3) Parts of the denture base engaging in undercuts on the teeth.
(4) Parts of the denture base engaging in undercuts on the soft tissues.
(5) Indirect retainers. {Prevent rocking movements of the denture}.
C] Physiological means of retention:
1- The physiologic molding of the tissues around the polished surfaces of the
denture helps to perfect the border seal.
2- Neuromuscular control
Direct retainers:
A- precision attachments:
• They are fitted more to the small unilateral RPDs (side-plates).
• They are bought ready-made (usually the mail portion is attached to the
denture, while the other is soldered into a crown or large inlay in an abutment
tooth.)
B- Clasps:
1- To resist displacement of the denture by vertically applied forces .
2- To resist displacement of the denture by horizontal applied forces.
Selection of clasp:
Selection of the clasp depends mainly on (type of support, presence of
undercut area, and esthetics).
1- For bounded saddles: the retentive undercut present is used with any acceptable
clasp type.
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2- for distal extension base: Retainers for distal extension partial dentures, although
retaining the prosthesis, must also be able to flex or disengage when the denture
base moves tissueward under functional. stress releasing clasp is desired, which
equitably distribute the force between the abutment and the ridge;
a) If a mesiobuccal undercut is available on the terminal abutment, a combination
clasp with the wrought wire, back action, RPI, RPA clasps are used.
b) If the retentive undercut is located on the distobuccal surface, a bar clasp, and
the C clasp are used.
c) If mesiolingual undercut is present a reverse back action clasp is used.
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PARTIAL DENTURE DESIGN
Reciprocation:
It is the resistance to horizontal forces exerted on a tooth by the retentive clasp
arm during insertion and removal of the RPD.
This can be obtained by bracing clasp arm or plate contacting the tooth surface
while the movement of the retentive tips over the height of contour of the abutment.
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Stabilizing Components
- Stabilization is the resistance of partial denture to tipping forces.
Causes of tipping, rocking and rotation of RPD:
1- Different quality in the nature of the supporting structures
In tooth supported RPDs, the abutment teeth on both sides of the edentulous
area provide adequate support and resistance to rotational forces through
supporting rests and clasps placed on them.
In Tooth-tissue supported distal extension partial dentures derive support from
two different tissues. This results in vertical movement of the denture base either
in tissue-ward or tissue-away direction when occlusal forces act on artificial
teeth.
2- Sticky foods and muscle pull, acting on the periphery of the denture.
3- Intercuspation and occlusion of teeth
Resistance to vertical and lateral tipping forces (rocking) is gained by:
1. Adequate base coverage.
2. The use of three, and if possible four, widely separated areas of tooth support
3. Rigid bracing clasp arms
4. Balanced occlusal contact and reduction of cusp slope.
5. The use of additional rests serves as, indirect retainers.
6. Coverage of the rugea area acts as an indirect retainer.
Stabilizing components of the removable partial denture framework are those rigid
components that assist in stabilizing the denture against horizontal movement.
o minor connectors that contact vertical tooth surfaces
o reciprocal clasp arms
Minor connectors
• should have sufficient bulk to be rigid
• Little bulk to the tongue as possible.
• Should be confined to interdental embrasures whenever possible.
• When minor connectors are located on vertical tooth surfaces, it is best that these
surfaces be parallel to the path of placement.
A modification of minor connector design has been proposed that places the minor
connector in the center of the lingual surface of the abutment tooth. Proponents of this design
claim that it reduces the amount of gingival tissue coverage and provides enhanced bracing
and guidance during placement. Disadvantages may include increased encroachment on the
tongue space, more obvious borders, and potentially greater space between the connector and
the abutment.
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PARTIAL DENTURE DESIGN
Guiding Plane
It is defined as two or more parallel, vertical surfaces of abutment teeth, so
shaped to direct a prosthesis during placement and removal.
Guiding planes may be contacted by various components of the partial denture:
the body of an extracoronal direct retainer, the stabilizing arm of a direct retainer, the
minor connector portion of an indirect retainer, or by a minor connector specifically
designed to contact the guiding plane surface.
The functions of guiding plane surfaces are as follows:
(1) To provide for one path of placement and removal of the restoration (to eliminate
detrimental strain to abutment and framework during placement and removal).
(2) To ensure the intended actions of reciprocal, stabilizing, and retentive components
(to provide retention against dislodgment of the restoration when the dislodging force
is directed other than parallel to the path of removal and also to provide stabilization
against horizontal rotation of the denture).
(3) To eliminate gross food traps between abutment teeth and the denture.
Dimensions of guiding plane surfaces:
As a rule, proximal guiding plane surfaces should be about one half the width of the
distance between the tips of adjacent buccal and lingual cusps or about one third of the
buccal lingual width of the tooth. They should extend vertically about two thirds of the
length of the enamel crown portion of the tooth from the marginal ridge cervically.
Guiding planes squarely facing each other should not be
prepared on lone standing abutment. Minor connectors of
framework (gray areas) would place undue strain on abutment when
denture rotated vertically either superiorly or inferiorly.
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VII-Minor connectors:
Design considerations:
-it should be ensuring that there is 5 mm of space between adjacent vertical minor
connectors to prevent food impaction.
- must contact the guiding plane surfaces of the teeth to facilitate path of insertion
and provide bracing.
-should cross the gingival tissue abruptly and join the major connector at rounded
right angles. These allow them to cover as little as possible of the gingival tissues.
VIII- Esthetic:
The function and esthetics of removable partial denture are dependent on
the correct orientation of the occlusal plane. The main esthetic problem is the
presence of visible retainers in the buccal vestibule. Rotational path partial
denture may be used to improve esthetic
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a removable partial denture should replace only the missing posterior teeth after the
remainder of the arch has been made intact by fixed restorations.
Occasionally, it is necessary that several missing anterior teeth be replaced with the
RPD rather than by fixed restorations. This may be because of
• Accident or surgery,
• If esthetic requirements can better be met through using of teeth added to the
denture framework.
It is necessary to provide the best possible support for the replaced anterior
teeth. Ordinarily, this is done through the placement of occlusal or lingual rests, or
both, on the adjacent natural teeth, but when the edentulous span is too large to
ensure adequate support from the adjacent teeth, other methods must be used.
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The internal clip attachment differs from the splint bar in that the internal clip
attachment provides both support and retention from the connecting bar.
The cast bar should rest lightly or be located slightly above the tissue. Retention
is provided by one of the commercial preformed metal or nylon clips, which is
contoured to fit the bar and is retained in a preformed metal housing or partially
embedded by means of retention spurs or loops into the overlying resin denture
base. The internal clip attachment thus provides support, stability, and retention for
the anterior modification area and may serve to eliminate both occlusal rests and
retentive clasps on the adjacent abutment teeth.
Indications:
1- When salvage the roots and a portion of the crown of a badly broken-down
molar through endodontic treatment.
3- An unopposed molar may have extruded to such an extent that restoring the
tooth with a crown is inadequate to develop a harmonious occlusion.
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The vertical load applied on the saddle during mastication should be reduced in
order to minimize vertical displacement of the denture base. The vertical load may be
reduced by decreasing the size of the occlusal table and by maximum extension of
the denture base within the functional limits of muscular movements.
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PARTIAL DENTURE DESIGN
Stress breakers:
Thus, when a vertical load is applied, the stress breaker will allow movement of
the saddle towards the ridge to a greater extent than if the retainer unit is directly
connected to the saddle, although the ridge bone will be subjected to an increased
load. However, this load is widely distributed antero-posteriorly over the ridge and
not on the distal part only. Also flexibility of the stress breaker can be changed to
govern the distribution of load between the ridge aril abutments.
• Movable joints as hinges between the saddle unit and the retaining unit. e.g.
attachments like Dalbo or Crisimany attachments,
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PARTIAL DENTURE DESIGN
• Designs applying the stress breaking principle used in combination with the
main rigid connector (using flexible connection between the direct retainer and
the denture base ).{for detail see stress breaker}
- Lingual bar connector with flexible distal extension (having thinner section
than lingual bar (use of semi-flexible bar).
- Disjunct RPD.
Thus, bar clasps apply the stress-breaking principle. I-bar, RPI clasps are
examples of gingivally approaching clasps that provide a stress breaking effect
when a rigid connector is used in distal extension bases.
The resilient wrought wire arm allows some movement of the clasp over the
tooth, thus following the stress breaking principle. Back-action clasps are also
used in distal extension bases due to their stress breaking effect. It should be noted
that excessive resiliency is not favorable because it results in an unretained
denture.
It can be rarely used in young age, will developed ridge, and very short saddle.
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PARTIAL DENTURE DESIGN
2. Occlusally approaching clasp having resilient retentive wrought gold wire arm
(Combination clasp).
3. Back-action clasp.
5. Extended-arm clasp.
6. Ring clasp.
8. RPI clasp.
9. RPA clasp.
• The farther the anterior placement of the rest, the more vertical will be the
forces, the less is the horizontal component of force falling on the ridge,
The rest proximal plate, I bar clasp (RPI) and the reverse circlet clasps have
mesially located rests which can fulfill this requirement,
Advantages:
• Greater part of the occlusal load will be borne by the ridge and hence less
stresses and less torque on the abutment.
• Even distribution of the load 'in an antero-posterior direction. The bone near the
abutment will thus share the distal part of the ridge in bearing the occlusal load,
• Changing the direction of torque on the abutment from the distal to the mesial
side of the tooth where resistance to torque action will be supplied from the
neighbouring teeth.
Disadvantages:
• Wedging effect
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PARTIAL DENTURE DESIGN
Distribution of the occlusal load widely is effective in reducing the force per
unit area on the residual ridge.
The denture base should cover the largest possible area and should be adequately
extended to the functional limit of the surrounding musculature. The broader the
coverage, the greater the distribution of load, the more the ability of the denture to
withstand vertical and horizontal stresses.
V- Functional impression
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The normal mucosa covering the ridge can be recorded in its displaced
functional form rather than the anatomic form. This reduces movement of the denture
base towards the tissues during function, which in turn helps in reducing leverage and
torque on the abutment teeth.
The presence of a well formed residual ridge covered by healthy firm mucosa,
provides favorable partial denture support. However, the presence of tori or
hyperplasic tissues necessitates correction to improve the supportive ability of the
ridge.
Numerous esthetic clasp systems are available for distal extension RPD.These clasps
can either utilize the proximal, lingual, labial or buccal retentive undercut.
Examples: Mesiodistal clasp, the De-Van clasp, the Equipoise clasp and twin Flex
clasp
Class I partially edentulous cases when the remaining teeth are weak,
periodontally affected, and require splinting and stabilization are
sometimes treated using swing-lock partial dentures.
1) Under vertical load the posterior sink of the saddle is less marked due to:
- The submucosa covering the tuberosity has dense fibres than retromolar area.
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The main problem: is the same as with the bilateral free-end saddle denture including:
a) Torque of abutment.
b) Ridge resorption.
Management: as Class I-Kennedy RPD.
c) The problem of retention (similar saddle is not present on the other side)
Management: Additional retention must be provided on the intact side by:
- Clasping more than one tooth on this side
- More rigid types of clasp.
b) The problem of bracing (due to absence of rigid major connector)
Management:
- Cross-arch bracing (Through a rigid major connector).
- Bracing components.
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- The use of semi-flexible bar: This is more applicable with shot saddles, it
involves anterior placement of an occlusal rest.
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1- The occlusal rest is placed on the far zone of the abutment tooth.
2- The abutment is rigidly clasped, and joined to the clasp onto the
opposite dentulous side by a rigid connector (lingual bar).
- Split casting modifying the lingual plate: a split of appropriate length is made at
the inferior border of the plate.
1- The saddle is joined to the more flexible part of the plate. The
lower part must be flexible in the vertical direction, than
horizontal direction, so that the appliance will have lateral rigidity
to distribute horizontal force widely.
2- This design applied in long class II cases. (used with long saddle)
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PARTIAL DENTURE DESIGN
Retention on the side of the bounded saddle is dependent upon the ability of the
single molar tooth to withstand the loads applied; therefore:
i. If the periodontal condition of such a single standing tooth is good, rigid
construction is employed and frequent inspection of the appliance is essential so that
rebasing may compensate resorption under the free-end saddle. If this is not done, a
damaging torque will be applied to the single standing molar leading at least to
increased tilting and at worst to loosening and eventual loss.
ii. If the periodontal condition of such a single standing tooth is doubtful, it
may be possible to design the denture incorporating a flexible connector to the distal
extension saddle as already described. In addition less stress will be applied to the
tooth if wrought wire instead of cast metal is used for clasp construction.
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PARTIAL DENTURE DESIGN
Retention should not be considered the prime objective of design. The main objectives
should be the restoration of function and appearance and the maintenance of comfort, with
great emphasis on preservation of the health and integrity of all the oral structures that
remain.
Close adaptation and proper contour of an adequately extended denture base and
accurate fit of the framework aga- inst multiple, properly prepared gulde planes should be
used to help the retentive clasp arms retain the pros- thesis.
2- Clasps
a- The simplest type of clasp that will accomplish the design objectives should be employed.
b- The clasp should have good stabilizing qualities, remain passive until activated by
functional stress, and accommodate a minor amount of movement of the base without
transmitting a torque to the abutment tooth.
Wrought wire clasps. RPI, I-bar, combination clasps, back action, reverse back action
or reverse circlet clasps can be used.
d- Clasps should be strategically positioned in the arch to achieve the greatest possible control of
stress.
Class I prosthesis usually requires only two retentive clasp arms: one on each terminal tooth.
Thereciprocal or bracing arm must be rigid. This component of the clasp system can be
replaced by lingual plating.
The distal extension side should be designed with the same considerations as for a
class I prosthesis.
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PARTIAL DENTURE DESIGN
The tooth supported, or modification, side should usually have two retentive clasp
arms : one as far posterior and one as far anterior as tooth contours and esthetics permit.
If a modification space is present, it is usually most convenient to clasp a tooth anterior
and a tooth posterior to the edentulous space.
- The type of clasp and position of the retentive undercut can be selected for
convenience.
- Rigidity is required for all bracing arms. Lingual plating may be substituted.
- RPI - RPA
- Combination clasps
3- Rests
Rest seats should be prepared so that stress will be directed along the long axis of the
teeth.
Rest seats should be carefully located and prepared to avoid torque and allow
transmission of stresses along the long axes of abutment teeth.
The floor of the rest seat should inclined apically as it approaches the center of the
tooth. The angle between the minor connector and the rest should be less than 90˚ to
prevent slippage of the prosthesis creating an orthodontic like force and to direct the
forces along the long axis of the tooth.
Mesially placed rests are preferably used on abutment teeth. However, absence of a
rest adjacent to the edentulous area may permit packing of food. This could be avoided
by using .
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PARTIAL DENTURE DESIGN
Saucer-shaped rest seats are preferred over box shaped seats to avoid locking of the
rest and transmission of torque on abutments.
The occlusal rest must fit the tooth to minimize the food collection beneath it and
preserve their location in relation to the tooth.
4- Indirect Retention
The indirect retainer should be located as far anterior to the fulcrum line as possible.
Two indirect retainers should generally be used in a class I design, whereas one placed on
the side opposite the distal extension base may be adequate in a class II- design.
The indirect retainers should be positioned in teeth prepared with positive rest seats that
will direct forces along the long axis of the tooth.
2. Lingual plating can be used to extend the effectiveness of indirect retention to several
teeth. It must always be supported by positive rest seats.
5- Major connector
a- The simplest connector that will accomplish the objective should be selected.
2- Promotes cross-arch force transmission (contributes to cross arch stability and support)
b- Support from the hard palate should be used in the design of the maxillary major
connector when it would be beneficial.
c- Extension of the major connector onto the lingual surfaces of the teeth may be employed
to increase rigidity, distribute or eliminate potential food impaction areas. Lingual plating
should always be supported by adequate rest seats.
d- Antero posterior palatal bars and palatal plates are preferred for maxillary class I cases to
provide maximum support, direct and indirect retention.
e- For mandibular class I cases, lingual bars with terminal rests are preferred due to their
simplicity, limited coverage and patient's tolerance. However, mechanically, lingual plates
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PARTIAL DENTURE DESIGN
with terminal rests are biologically preferred due to their rigidity, distribution of lateral
forces and due to improved indirect retention.
6- Minor connectors
-Guiding planes are flat axial parallel surfaces in an occluso-gingival direction on the
proximal or lingual surfaces of teeth. They are 2-4 mm in height، extending from
the marginal ridge to the junction of the middle and gingival third of the
abutment tooth. The bucco-lingual width of the proximal plate is determined by
the proximal contour of the tooth.
-For bounded base a well-engineered guiding planes are contacted by the truss arms
of the framework as the prosthesis is inserted and removed, thus horizontal
wedging is virtually eliminated.
-The proximal plate together with the mesiolingually placed minor connector
provides stabilization and reciprocation of the assembly.
Guiding plane surface should be like area of cylindrical object It should be continuous surface
unbounded by even rounded line angle. B, Minor connector contacting guiding plane surface has
same curvature as does that surface. From occlusal view it tapers buccally from thicker lingual
portion, thus permitting closer contact of abutment tooth and prosthetically supplied tooth. Viewed
from buccal aspect, minor connector contacts enamel of tooth on its proximal surfaces about two-
thirds its length.
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PARTIAL DENTURE DESIGN
Diagrammatic illustration showing comparative width of the proximal plates for differently
contoured teeth. (A). Proximal plate (p) relatively wide due to the square contour of the 2nd
bicuspid. (B). Proximal palate (p) relatively narrow due to the tapering contour of the 1st
bicuspid. The proximal plate should be designed as narrow as possible but should prevent lingual
migration of the tooth. A narrow proximal plane permits greater exposure of the gingival tissue
(g).
8- Occlusion
2.A harmonious occlusion should be established with no interceptive contacts and with all
eccentric movements dictated by, or in harmony with, the remaining natural teeth.
3.Artificial
teeth should be selected and positioned to minimize stresses produced by the
prosthesis.
Smaller and/or fewer teeth, and teeth that are narrower bucco-lingually may be selected.
For mechanical advantage teeth should be positioned over the crest of the mandibular
ridge when possible.
Teeth should be modified if necessary to produces sharp cutting edges and ample
escape-ways.
9- Denture base
1.The base should be designed with broad coverage so that the occlusal stresses can be
distributed over as wide an area of support as possible. The extension of the borders must
not interfere with functional movements of the surrounding tissues.
2.Aselective pressure impression should record the residual ridge in a functional form. Or it
may be constructed in the static form if the stress breaking principle is applied.
3.The polished surfaces should be contoured to enable the patient to exercise maximum
neuromuscular control.
4. A combined metal-acrylic base is used to allow for future relining as bone resorption is
usually anticipated.
Recontouring
The contours of the natural teeth most often require adjustments for the proper placement
and functioning of the RPD.
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PARTIAL DENTURE DESIGN
3.Improve the occlusal plane by grinding of the cusp tips and incisal edges of
anterior teeth.
Excessive tooth contours are reduced by lowering the height of contour so that;
2. The retentive terminal is placed in the gingival third of the crown for
better esthetics and better mechanical advantage.
3. The reciprocal clasp is placed above the height of contour, but not higher
than the cervical portion of the middle third of the crown.
1- Restoring a single tooth or a short span unilateral area is not practical especially in
cases having bad oral hygiene and caries susceptibility.
2- Restoration of any missing tooth is necessary in order to: -Restore the integrity of
the dental arch, prevent tilting, drifting, rotation or overeruption of the remaining
natural teeth.
- Restore aesthetics.
II - Fixed bridges:
Fixed bridges are usually the treatment of choice for short span bounded
edentulous areas when:
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PARTIAL DENTURE DESIGN
a- Provision of lingual and buccal cusp contacts on the working side in lateral
movement.
b- Maximum extension of the rest seat preparation and the occlusal rest especially
to the buccal side. This keeps the axis of rotation as far buccally as possible and
ensures transmission of vertical component of force lingual to this axis.
- Extending the denture base on the vertical slope of the hard palate.
- Bracing arms located on the abutment tooth and the tooth adjacent to it.
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PARTIAL DENTURE DESIGN
- Conical shaped abutment teeth, weak teeth, or teeth having short crowns that
cannot provide adequate retention and bracing.
- In old patients.
1-Denture base:
The denture base is designed to fit the static rather than the functional form of
the ridge because the denture base is adequately supported on both sides by abutment
teeth, i.e. tooth supported.
- Weak posterior abutments that may be possibly removed and change the case into a
Kennedy class II
- Anterior edentulous spans requiring aesthetic that is provided by the colour of acrylic
resin.
- Patients susceptible to bone resorption that may require future relining e.g. diabetic
patient and after recent extractions.
2- Rests:
Rests are usually placed on the near zone of the abutment teeth to provide
adequate support (fig. 6-4). Rest seats can be prepared in either a box-shaped or saucer
-shaped configuration depending on the condition of the abutment teeth.
3- Clasps:
Rigid clasps are usually used on abutments bounding the edentulous area. An
embrasure clasp is used on the intact (dentulous) side.
4- Major connectors:
A lingual bar is used for mandibular denture and a palatal bar or palatal strap is
used for maxillary denture.
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PARTIAL DENTURE DESIGN
Modification of class III involving short saddle are common in upper jaw.
When the saddles are short and the abutment teeth are supported with sound healthy
bone, a number of small fixed bridges may be the treatment of choice. Also a
removable partial denture can be constructed.
When Class III having long edentulous spans and modification spaces, they are
usually considered tooth tissue supported dentures. Maximum coverage of the residual
ridge and palatal tissues is required to provide adequate denture support retention of
the denture abutment from physical forces as adhesion in addition to wrought wire
clasps.
When the condition of upper teeth is not good, the best result can be obtained
by using Every denture.
Every denture
Indication of Every denture:
Indicated in class III with many modifications and when the condition of the
abutment is not good.
By making. contact point, not contact area, the lateral forces are distributed
mesiodistally along many teeth in the arch. Porcelain teeth is preferable to reduce wear
in this cases. The lateral forces in Every denture are resisted by the palate, the buccal
mucosa and anterior abutment teeth if present.
3- Uncovered gingival
To prevent pockets between the denture and the tooth substance and allow natural
stimulation of the gingiva .
4- Contact of the denture with a stabilizer (round Wire) distal surface of the last
standing tooth:
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PARTIAL DENTURE DESIGN
This stabilizer (round Wire) is used to prevent distal drifting of this tooth.
- Free occlusion: Is a type of occlusion which permits the mandible to slide from one
position to another, with the upper and lower teeth in contact and without
intercuspation.
N.B. The base material will be acrylic resin with straight round wire used to form the
stabilizer positioned posterior to the last standing tooth on each side of the arch.
1.Retention can be achieved with much less potential harmful effect on the abutment teeth than
with the class I or II arch.
2- Clasps :
Tooth and tissue contours and esthetics should be considered, and the simplest clasp
possible selected.
If restorations are required to correct tooth contours, the wax patterns must be shaped
with the surveyor.
3- Rests
1.Rest seats should be prepared next to the edentulous space when possible.
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PARTIAL DENTURE DESIGN
2.Rests should be used to support the major connector and lingual plating.
4- Indirect retention
2.If one or both of the posterior abutment teeth are used for vertical support alone without retentive
clasp arms, the entire design must follow the requirements of a class I or II design.
- They must be rigid and meet the same requirements as for a class ! or II design.
6- Occlusion
7- Denture base
2.The extent of coverage of the residual ridge areas should be determined by appearance, comfort,
and the avoidance of food impaction areas.
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PARTIAL DENTURE DESIGN
Kennedy Class IV
!!
Kennedy class IV partial dentures are constructed to restore anterior edentulous
spans that cross the midline. Long class IV cases are designed following the principles
of free end saddle cases because the edentulous area exhibits abutments that lie
posterior to the edentulous area and lacks anterior abutments.
- Form of the dental arch; In V-shaped arches the artificial anterior teeth will be
more distant from the fulcrum axis, thus, the magnitude of displacing forces will
be more leading to excessive torque on abutment teeth.
2- Class IV cases occur at any age but are usually predominant in children and
adolescents because anterior teeth especially upper teeth are subjected to trauma.
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PARTIAL DENTURE DESIGN
3- The need for an esthetic restoration is a pre-requisite due to the anterior location
of the edentulous area.
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PARTIAL DENTURE DESIGN
The most commonly used temporary appliance for restoring anterior teeth is the
Spoon denture. It can be constructed for both children and adults.
Spoon Dentures
- The spoon denture usually covers a large area of the palate to attain
adequate support and to overcome the problem of retention usually
associated with temporary appliances.
- The lateral borders of the denture are usually placed 3-4mm away from the
gingival margin to avoid caries and gingivitis especially in children where
adequate oral hygiene measures cannot be fulfilled.
- It is usually extended to the junction of hard and soft palate in order to:
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PARTIAL DENTURE DESIGN
- Extending the posterior part of the palatal plate laterally above the survey line of
the first permanent molars. The first molar is then clasped by a 7mm stainless steel
wire in the form of an Adam's crib. This design may be used where it is possible
to adapte thin wire between opposing arches without interfering with occlusion.
- production of a cast cobalt chromium base with clasps engaging the buccal
undercuts of the molar teeth (T-shaped cobalt chromium denture).
o The nature of the mucosa: best retention is obtained from firm mucosa of
adequate thickness rather than thin mucosa.
o Form of the hard palate: Large palate having moderate slopes provides better
retention by adhesion and cohesion and good stability. Flat palate provides
better retention and less stability compared to palates exhibiting steep slopes
where better stability and less retention are anticipated.
o The degree of overlap of anterior teeth; the presence of deep overlap usually
associated with partial loss of teeth especially in adults induces excessive
stresses on the partial denture.
Advantages:
Cases having long, markedly curved edentulous spans as this may add
excessive stresses to abutments.
Retainers in the form of attachments or bar clasps are placed on the canines or
the first premolars. However, this places excessive stresses on the canines. For this
reason," the canines should be diagnosed with long well formed roots to resist torque.
In this case, the denture is designed with a combined denture base, rests on the
neighboring natural teeth for support, bar clasps as retainers, preferably on first
premolars, and an anterior palatal strap as the major connector.
It is indicated only when 1\ 1 are only missed and perfect bone support for
canines. Contra-indicated in cases where torque is marked as in excessive bone
resorption or more than 2 teeth are missing.
The clasps are placed as far posteriorly as possible. This system is more
favorable because it provides better retention and indirect retention. It is also
esthetically more satisfactory. Canines are also protected from torque that may be
implied by clasping.
In this case, the denture is designed with a combined denture base, rests on the
neighboring natural teeth usually canines for support and an Aker clasp (embrasure
clasp) or multiple Aker clasp placed on the two last standing molars on each side of
the dental arch.
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PARTIAL DENTURE DESIGN
Major connector: two palatal bar connectors arising from the saddle and placed
on the lateral walls of the palate equi-distance between the gingival margins and the
midline. The distal ends of the bars are attached to the posteriorly placed double Aker
clasps on both sides.
One section is cast in metal and is inserted from the palatal aspect of the ridge,
which enables the proximal undercuts of the abutment teeth to be engaged. The labial
section which carries the teeth and the labial flange is inserted from below in an
upwards and backwards path. It is frictionally retained to the first section by means of
split post matrices attached to the cast portion, which will engage a stainless steel tube
matrix in the labial section.
A design can also be used which incorporates a hinge between the two parts,
with the anterior flange and teeth being rotated into place and held in position by a
locking bolt. Retention may be improved by use of intracoronal attachments for the
first section.
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PARTIAL DENTURE DESIGN
electrolytic etching process. This improved the resin bond by establishing mechanical
retention between the micropores of the etched alloy surface and the composite resin
in a manner similar to its attachment to an etched enamel surface.
Teeth with inadequate support, large carious lesions, extensive restorations, and
evidence of severe attrition are not suitable for use as abutments.
The advantages of this technique are that a saddle of limited span can be
restored economically without loss of healthy tooth substance or the wearing of a large
partial denture. For aesthetic reasons it is not suitable where there is obvious soft tissue
loss.
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PARTIAL DENTURE DESIGN
Long anterior edentulous areas which may extend to include premolars usually
occur in adults. Hence, a permanent restoration in the form of metal partial dentures is
the treatment of choice.
- Multiple clasping is required to help in splinting of the remaining teeth and in order
to widely distribute the stresses and torque action. Since the remaining naturally teeth
are usually posterior teeth. Therefore the clasping system is usually better than in long
class I cases having anterior teeth as abutments.
- Stress breakers may not be necessarily used in upper class IV cases due to the
good support obtained from palatal coverage. However, a stress broken design may be
required if a long edentulous area covered by compressible tissues is to be restored.
- As with free end saddles frequent inspection and rebasing are necessary since only a
slight degree of rotation about the occlusal rests will open up a space between the
posterior periphery of the denture base and the hard palate, into which food will find
its way.
Usually required in adults who have lost the four lower anterior teeth through
periodontal disease or rarely caries. In this situation a cast metal denture is the
treatment of choice.
The design consists of bilateral lingual bars extending posteriorly from the
saddle, terminating in clasps; continuous clasping may or may not be present. The
saddle must be adequately tooth supported anteriorly, and this can be accomplished by
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PARTIAL DENTURE DESIGN
using rests on the mesial aspect of the occlusal surfaces of the premolars. The use
of the canines for support has the advantage of bringing the axis of rotation forward so
that the posterior clasping is consequently more effectively but will necessitate
extensive preparation of the teeth to provide effective seats for the rests on the cingula
or else the use of incisal edge rests with their obvious aesthetic disadvantages.
2.The esthetic arrangement of the anterior replacement teeth may necessitate their
placement anterior to the crest of the residual ridge, resulting in potential tilting
leverage.
Every effort should be made to minimize these stresses. Some possibilities follow:
3.A critical evaluation of each remaining tooth in the arch should be made with the
intent of retaining as many teeth as possible.
The shorter the edentulous area, the less will be the harmful tilting
leverage.
The major connector should be rigid, and broad palatal coverage should be
used in the maxillary arch.
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