about your speaker - cincinnatidental.org · about your speaker: m. nader sharifi, d.d.s., m.s....

About Your Speaker:

M. Nader Sharifi, D.D.S., M.S. holds a certificate in prosthodontics and a masters degree in biomaterials from Northwestern University. He received his dental education at the University of Illinois. He has presented numerous topics on implant dentistry since his graduation. His presentations on restorative dentistry and patient care have earned him recognition from esteemed study groups, societies and associations nationwide. Dr. Sharifi is a former assistant professor at Northwestern University and former on-call consultant for Nobel Biocare.

Dr. Sharifi currently maintains a full-time private practice of adult general dentistry in Chicago’s downtown loop. As a five day a week wet gloved dentist, he is interested in ensuring time saving and cost effective care. In 1996 he was named to the American Dental Associations Speakers Bureau and in 2007 Chicago Dental Society honored him with the Gordon Christensen Distinguished Lecturer Award.

If you would like, you can reach Dr. Sharifi easiest via the internet. Please feel free to direct any questions or comments at any time to his Email address at MNSDDSMS @ AOL.com.

2005 M. Nader Sharifi, D.D.S., M.S.

mailto:[email protected]

mailto:[email protected]

Removable Prosthodontic ClassificationM. Nader Sharifi, D.D.S., M.S.

I. Partially Edentulous: McGarry, et al.: J Prosthodontics 2002; 11:181-193.A. Class I

1. Edentulous area in a single arch only.2. Edentulism limited to 2 teeth in the maxillary anterior – or – 4 in the

mandibular anterior – or 2 in the posterior (molars excluded).3. Abutments are ideal and require no restoration.4. Angle Class I jaw classification.5. High, well rounded residual ridge.

B. Class II1. Edentulous areas can exist in both arches.2. Edentulism limited to 2 teeth in the maxillary anterior – or – 4 in the

mandibular anterior – or 2 in the posterior (molars excluded).3. Abutments or occlusion requires mild intervention. 4. Angle Class I jaw classification.5. High or low, well rounded residual ridge.6. Mild systemic or psychological modifiers.

C. Class III1. Edentulous areas can exist in both arches.2. Edentulism of more than 3 teeth in any area or 2 molars. 3. Abutments or occlusion requires moderate therapy.4. Angle Class I, II or III jaw classification.5. Occlusion is compromised with supra-eruption. 6. Moderate systemic or psychological modifiers.

D. Class IV1. Edentulous areas can exist in both arches.2. Edentulism of more than 3 teeth in any area or 2 molars.3. Abutments require multi-disciplinary treatment.4. Angle Class I, II or III jaw classification.5. Occlusion requires a change in vertical dimension. 6. Severe systemic or psychological modifiers.7. Hyperactive gag reflex. 8. Maxillary-mandibular incoordination (Parkinson’s) 9. Refractory patient (unrealistic expectations).


M. Nader Sharifi, DDS, MS • 30 North Michigan • Suite 1303 • Chicago, IL 60602 • 312-236-1576

Patient Name Social Security Number Date

Prosthetic Findings

Maxillary Arch: U Shaped V Shaped O Shaped Square Shaped

Ridges: High Low Post-extraction Knife-edged Basal bone

Hard Palate: Deep Shallow Medium Soft Palate Class

Tuberosities (R) (L) Torus Attached Mucosa %

Frenum: Anterior (R) (L) Teeth

Mandibular Arch: U Shaped V Shaped O Shaped Square Shaped

Ridges: High Low Post-extraction Knife-edged Basal bone

Lateral Throat Form Class Torus Attached Mucosa %

Buccal Shelf: Large Medium Small

Frenum: Anterior (R) (L) Teeth

Tongue: Position Movement

Saliva Consistency Amount

Jaw Classification: Class I Class II Class III

Existing Prosthesis: Pt.’s Opinion:

Retention: Good Adequate Poor Stability: Good Adequate Poor Support: Good Adequate Poor Esthetics: Good Adequate Poor Phonetics: Good Adequate Poor Occlusion: Good Adequate Poor

Facial Shape: Square Square-tapering Ovoid Triangular Round

Profile: Flat Rounded Inverted

Coloring: Hair Eyes Complexion


Course Outline: Something Old, Something New: RPDs and Attachments

I. Morning Session – Review Frame Design, Impression and Delivery II. Afternoon Session – Discuss Attachments and Combination Case Issues III. Something Old – RPDs; Something New – Attachments

A. Attachments may be added, but base design should remain1. Keep Guide Planes and Rest Seats2. Only Change Attachments for Clasps

IV. Kennedy Classification – Visual Learning (watch slides)V. Patient Evaluation

A. Partially Edentulous Case Classification - See Page 2 B. Anatomic Limitations – Problems with removable prosthodontic

success related to the clinical situation of the patient. Changes can only be achieved with surgical correction. (See Exam Sheet Pg 3)

C. Evaluation of Existing Prosthesis1. Retention – Doctor’s Perspective: Good/Adequate/Poor2. Stability – Doctor’s Perspective: Good/Adequate/Poor3. Support – Doctor’s Perspective: Good/Adequate/Poor4. Esthetics – Doctor and Patient Perspective

a) May not agree5. Phonetics – Doctor and Patient Perspective

a) Does the patient notice problems?6. Occlusion – Doctor and Patient Perspective

a) How does the patient eat?D. Clinical Limitations – Problems with the existing prosthesis due to

insufficient use of the available anatomy of the patient. Changes can be achieved with fabrication of a new prosthesis. 1. Are the patient’s complaints in line with their anatomic and

clinical limitations?2. Can we improve their current clinical situation?

VI. Removable Partial Denture Requirements – Retention, Stability, Support, Esthetics, Phonetics and OcclusionA. Retention – Clasp Arms and AttachmentsB. Stability – Guide Planes and Major ConnectorC. Support – Rest Seats, Major Connector and SaddlesD. Esthetics, Phonetics and Occlusion – Denture Teeth

VII. Removable Partial Denture ComponentsA. Guide Planes – Horizontal stop (lateral) is secondary requirement

of the remaining tooth in RPD design.1. Indication for Guide Planes – Path of insertion, stability.2. Preparation of Guide Planes – Parallel sided burs.3. Anterior versus Posterior Path of Insertion.


a) Eliminate one or the other with C&B or Implantsb) Or...apply posterior to anterior – check papilla areas

B. Reason for Rest Preps – Vertical stop is primary requirement of the remaining tooth for RPD design. Creates the Fulcrum line.

a) Shares Saddle Forces With Existing Teethb) Identifies Complete Seating of Prosthesisc) Keeps the Direction of Force Down Long Axisd) Can Create More than 180º encirclement e) Provides Indirect Retention

2. Rests for Cuspidsa) Cingulum (Chevron) Restb) Horizontal Rest – Fill exposed dentin with compositec) Finger Rest – No Vertical Stop – Indirect rest only

3. Rests for Premolars and Molarsa) Occlusal Rest – accentuating the mesial or distal pit

C. Indirect Retention1. Prevention of Saddle Area Lifting for Free-End Saddles2. Preparation – Tooth appropriate.3. Fulcrum Selection –

a) Combine most distal REST SEATS.b) Greatest perpendicular placement – contralaterally.c) Required for Kennedy Class I and IId) Necessary for Tooth Borne?

(1) Yes, Class III can act like a free-end (Class II)(2) Class IV is really a Class I turned around.

4. Indirect Retention as a Reline Indicatora) Need for Reline – Pressure on saddle lifts indirect rest.b) Confirms Reline Seating– No biting during impressionc) Adjust occlusion at delivery.

D. Clasp Design1. Suprabulge Clasps –above height of contour

a) Akers Clasp – Basic use (free-ends?)b) Wrought Wire Clasp – For wrong Side of Fulcrumc) Equipoise Clasp – Terminal tooth is an incisord) Ring Clasp – Tipped Mandibular Second Molar

2. Infrabulge Claspsa) I-Bar Clasp – Contraindications: molars, buccal

vestibule undercuts, lingual tipping and high frenumsb) T-Bar Clasp – Modification (not any more)

3. Free-End Saddle Clasp Designa) Major Options: Distal Akers vs. RPI

(1) Suprabulge versus Infrabulge


(a) Pushing versus Pulling Retention(2) Engage during load versus Disengage(3) “Esthetic” options

4. Clasp Conclusions:a) RPI – Free-End Saddlesb) Equipoise – Terminal Incisorsc) Akers – Always Points Backwardsd) Wrought Wire – Wrong Side of Fulcrum Line

5. Attachments – Ensure they are necessarya) Only replace clasps – Keep Guide Planes/Rest Seatsb) Intracoronal Attachments – Tooth Borne RPDs only

(1) Stern G/L, Number 7, etc.(2) Virtually all Intracoronal Attachments are Non-

Resilient – and we want them to be so that we gain support from fixed abutments.

c) Extracoronal Attachments – Preferred method(1) Must Double Abut. – Creates cantilever

(a) Law of Beams: Stress/Strain = (K)l 3

(2) Bredent Attachments – Smallest on the market(a) Non-resilient

(3) ERA – My favorite(a) Resilient (b) Has non-resilient Processing Component

(4) Can be used for relinesVIII. Removable Partial Prosthodontics Impression Techniques

A. Canned alginate – Will you weight measure the powder?B. Custom Tray Fabrication/Selection – Reinventing the wheel?C. Impression Materials

1. Irreversible Hydrocolloid (Alginate) – Mucostatic a) Canned Alginate – canned.b) “System 2” Syringable Alginate – Simple,

inexpensive, quick to retake when necessary.(1) System 2 with ERA attachment impression

procedure is outlined later in this handout.2. Rubber Base – For use with custom trays.3. Polyvinyl siloxane – not ideal, but best if you don't pour

a) Follow Massad/Dentsply Aquasil impression tech.4. Polyether – Ridgidity is best for Square imp. copings.

D. Free End Saddle Registration1. Altered Cast Technique – Lacks Confidence – reline is

required when it fails => Cut out the middle man and…


2. Reline at Delivery with PVS, Polyether, or Rubber Base a) Massad Aquasil PVS Technique – Dentsply DVD

(1) 30 to 60 seconds of border moldingb) Tissue Stop with Heavy Body (fast set)c) Border Mold with Monophase (regular set)

(1) Need ideal borders to procede - expect to repeatd) Final Wash with Light Body (regular set)

A. Hydrocast Reline Technique - This gives 24 hrs of border molding1. Fabricate RPD in standard fashion from System 2 Alginate

impression with one modification – Add three times normal relief for retention webbing in the saddles for the frame.

2. For Processing, ask your lab to process the lingual flange past the myohyoid ridge, but cut the facial flanges short (Use Myostatic Outline Technique). Have them relieve the saddle area acrylic after processing.

3. Mix Microseal and bench set for one minute. Load saddles and seat in the mouth for 7 minutes holding the framework in place – do not let the patient bite, nor apply pressure to the saddle areas. Trim Microseal to be 2 mm short of the flange. This is the “tissue stop” to support vertical.

4. Check and adjust the centric and eccentric occlusion – do it now, the RPD will be too sticky after the Hydrocast is used.

5. Mix Hydrocast and bench set for three to five minutes. Fill the denture with Hydrocast and seat it in the mouth.

6. Have the patient read aloud for ten minutes then remove 7. Trim excess Hydrocast with a hot spatula (#7 works great)8. Reseat, patient wears for 24 hours straight – including meals

and bedtime.(1) To clean: they only use fingers and running water.

9. At next day appointment pour stone to support the saddles & create a base overlapping onto the Hydrocast material. Send cast to the lab for a lab processed reline and then redeliver.

IX. Removable Partial Denture Framework DesignA. Framework Requirements

1. Stability – Guide Planes, Major Connector and Flanges2. Support – Rest Seats (fulcrum), Major Connector, Saddles3. Retention – Clasp Arms or Attachments

B. Basic Kennedy Class II Framework – Page 14 in this Handout1. Kennedy Class I and III – Page 17 and 18 in this Handout

C. Frame Fit More Important than Design1. Occlude Spray – Dry Frame, Spray Frame, Dry Teeth, Seat

Frame, Rock over Fulcrum Line, Remove & Adjust Shiny.


D. Class IV Rotational Path RPD1. Engage Fists under Guide Planes

E. Class III Rotational Path RPD1. Prefer Mesial Rest to Distal Rest for Rotational Point2. Length of Guide Plane Dictates Undercut, not Rest Seat

a) 3 mm Guide Plane: Standard 0.01” undercutb) Less than 3 mm Guide Plane: Use 0.02” undercut

3. Rotational Path Only for Tooth Borne RPDsF. Attachments necessary for Free-End Saddles

1. Prefer to Double Abut and Use Resilient Attachments (not stress breakers, resilient). Attachment Options

2. Attachments – ERA, Stern G/L and Dalbo attachments. SternGold-Implamed. 800-243-9942 ERA is Resilienta) This is my preferred attachment because it can be used

with the Black ERA male for relines – especially the Hydrocast walking reline. When ERA is resilient, abutment stress is zero. However, double abut for future protection – when case needs reline stress increases greatly.

3. Attachments – VKS - SG vertical or horizontal Bredent Ball attachment. Bredent USA, Miami, FL; 800-328-3965.a) Use vertical attachment on the guide plane (VKS) it is

non-resilient, but less than 2mm cantilever. I prefer to use these for strong lower canines (lateral as double abutment is fairly worthless).

b) Horizontal version (trailer hitch) increases cantilever but can be used resiliently (still prefer ERA)

4. Attachments – Ceka, Hader and Dolder Bars. Preat, 800-232-7732 (Ceka can be Resilient – so can SOME bars)

5. Attachments – Zaag, Locator. Zest Anchors 800-262-2310a) Zaag can be resilient, Locator is not – it rotates.

6. Attachments International 800-999-3003X. Occlusal Design – Not Covered in Lecture – Only on Handout

A. Lingualized Occlusion – Very Easy to Deliver this Occlusion1. Bilateral Working and Balancing Side Contacts2. Cusp Form Teeth in Maxilla, Flatter Plane in Mandible3. Indications – Esthetics with poor bone remaining or One

arch is natural, the other removable partial or complete.4. Controlled in Set-up on the Articulator.

a) Maxillary incisors, cuspids, premolars and first molar mesial cusps all on same plane.

b) Cusps then rise to shallow Curve of Spee.


c) Mandibular posterior teeth have central groove contact to palatal cusps of the maxilla.

d) No posterior contact of maxillary buccal cusps.e) Anterior open bite. If lowers are 0° – no overbite.

XI. Prosthesis Delivery – Not covered in Lecture – Only on HandoutA. Have confidence with the fit, spend time on bite.B. Lab should complete selective grind before breakout C. Use Occlusal Indicator Wax to eliminate centric prematurities.

1. Tap, tap, tap, squeeze with 80% pressure.2. If set up is lingualized occlusion, eliminate buccal contacts.3. Prosthesis - equal retention with and without wax

D. Eccentric Occlusion – Use horseshoe red/black articulating paper to develop working and balancing side contacts in group function.1. Lingualized – can do side-to-side and evaluate both sides

working and balancing at the same time.a) Red to Upper, adjust buccal molar contacts on upperb) Red to Lower, adjust lower buccal premolar contacts c) Visualize “hitches” and Ask Patient to Identify Themd) Red to Upper, slide side-to-side; Black to Upper, tap-

tap-tap in centric, then adjust the upper denture. e) Red to lower, slide side-to-side; Black to Lower, tap-

tap-tap in centric, then adjust the lower denture.f) In lingualized occlusion, eliminate all buccal contacts.g) Upper Prosthesis Should be Very Stabile In Eccentrics

XII. Post Delivery Adjustments – Not Covered in Lecture – Only on HandoutA. Most Sores are Occlusal Related: Always adjust occlusion first

1. Pressure Indicating Paste – Vertical dab, apply PIP to entire intaglio surface, seat and have patient chew up and down on cotton rolls while you move them around the arch.

2. Crestal Marks – Adjust centric prematurities with wax3. Non-crestal Ridge Marks – Adjust eccentrics with paper4. Flange Extensions – Adjust pink acrylic and pumice.

XIII. Combination Case – Start to Finish Detailed StepsA. First Visit: Initial Models – Diagnosis

1. Basic Study Casts – Staff can make these, but consider making them yourself as a “Trial Run” for the final impression.

2. Design Free End Saddle framework or Rotational Path framea) Free End Saddle Frame for Kennedy Class I, II, III (ignore last

tooth and then clasp at the end of your design process) and Class IV (free-end saddle turned around)

b) Nearly All Labs Can Assist, But Call and DiscussB. Second Visit and more: Caries Control, Endo & Perio PRN, C&B


1. First Complete all caries control, endo, perio and other treatement2. If C&B is involved, do the following steps, though they will be

repeated later, this is what makes combination cases successful.a) Visit 3+: System 2 impression of arch receiving combination

(1) Fabricate baseplates and wax rimsb) Visit 4+: Wax records, CR bite, tooth selection – lab sets teethc) Visit 5+: Wax trial – Then Process and Duplicate interim RPD

(1) Deliver interim partial denture PRN(2) Impress the model using the baseplate as the “impression

tray.” Use light body Rubber Base for this with a small amount of vasaline on the model.

3. Visit 6: Prep Crown and Bridgea) Seat Wax trial and confirm prep clearances b) Make final impression for crown and bridge with wax trial

PROPERLY seated(1) Use a stock impression tray. Cut a large hole in the

middle of the palate. When making the final impression of the preps, have the wax trial (with rubber base model impression) already seated. Inject light body PVS impression material for your preps and partially seat the loaded stock impression tray. Before fully seating the impression tray, press one finger through the hole you’ve made in the palate and ensure the wax trial is properly seated – then fully seat tray.

4. Laboratory Fabricates Crown and Bridgea) Use wax trial on Master Die model to ensure C&B are

planned, waxed, cast and fabricated to meet denture teethb) Use a Milled Anterior Strap when Indicatedc) Double Abut for Cantilevered Attachmentsd) Consider Ney MS attachment in #8//9 area to separate right

and left sides, create an appearance of separate crowns, and simplify preparation(1) Standard Use – Female Supports(2) Inverted – Male Supports(3) Have lab make die model before removing the wax up and

a solid model after removing the wax up (4) Fabricate C&B with an intimate understanding of where

the denture teeth are supposed to beC. Visit 7: Deliver Crown and Bridge – Impress for RPD Framework

1. Prepare for RPD – Guide Planes, Rest Preps, System 2 Imp.2. Prep Guide Planes on any other teeth in the arch First3. Prep Rest Seats on any other teeth in the arch second


4. Impression Options for RPD Frameworka) Pick Up Impression of C&B

(1) Have had problems with poor impressions in the palate – something that never happens with System 2.

b) Cement C&B – Make Standard RPD frame Impression(1) First Iteration I made an Impression of C&B without

any impression copings or attachments in place(a) Had problems with Lab guessing where the

black male was going to be for the pick up(2) Second Iteration I used ERA’s impression copings

(a) Had problems with frames that had a lot of adjustment then overseated the attachment

(3) Best Technique – Cement C&B and seat ERA Black males – then complete RPD Frame Impression

(a) Now lab knows exactly the shape of our pick up will be and they build up a flange around the male

(b) Now we can complete the pick up after the frame is adjusted – and before the case is processed.

(c) Order a separate wax rim for recordsc) System 2 Alginate Technique with ERA Attachments

(1) My preferred technique (2) Measure water for System 2 syringe gel and tray gel(3) Clean and clear intra-oral female component(4) Seat ERA BLACK MALE (with or without metal housing

– I prefer to skip the metal housings for RPDs since they are loose) ensure the attachment’s completely seated

(5) Make and Remove the System 2 Imp as Noted Above(6) Remove ERA BLACK MALE, save, but don’t place in imp(7) Pour the impression immediately – vacuum mix stone.(8) Send to the lab to fabricate RPD framework. The lab will

cast the frame with “Thickened” latticework around the stone where the ERA Black Males were positioned. During the Frame Trial, you’ll need to seat the Black Males again, and pick them up with GC Pattern Resin before making any centric relation records. Read on for recommendations.

d) Visit 7 Alternative Technique - System 2 Alginate Impression: Contact Ivoclar for video(1) Measure water for System 2 syringe gel and tray gel(2) Mix water & powder for syringe gel, back load syringe

with all the mixed alginate, place intra-oral tip on syringe – set aside.


(3) Mix water and powder for tray gel, load tray – ensuring to use enough pressure to extrude some alginate through the retentive holes on the tray. While using the syringe gel, have your staff soak the tray gel under cool water.

(4) Wipe the mouth with 2X2 gauze.(5) Use the syringe filled with syringe gel and beginning

behind the second molar (or most distal tooth) express the alginate out if the syringe while you follow the arch form along the occlusal surface to the midline – switch to the other side and repeat. Don’t repeat on the facial surfaces and don’t go back-and-forth.

(6) Remove the intra-oral tip and syringe material into the vestibule on the right and left side.

(7) If this is an upper impression, syringe a little material into the center of the palate, for a lower impression, syringe alginate into each lingual vestibule: back to the front.

(8) Receive the tray from your auxiliary and seat – only far enough to merge the syringe gel with the tray gel. Border mold gently – alginate is easy to over border mold.

(9) Set your timer and stabilize the impression. (10)Remove by loosening the alginate in the posterior

vestibule – not by using the handle. Soak and treat as you would any standard alginate material.

(11)Pour the impression immediately – vacuum mix stone.(12)Send to the lab to fabricate RPD framework

e) Visit 7 Alternative Technique: System 2 Alginate with ERA Impression Copings – The ERA way of doing it(1) Measure water for System 2 syringe gel and tray gel(2) Clean and clear intra-oral female component(3) Seat ERA impression coping, ensuring the attachment is

completely seated(4) Make and Remove System 2 Imp as Detailed Above(5) Remove the ERA impression coping.(6) Seat an ERA replica fully onto the ERA impression

coping and snap these replicas back into the impression – confirm seating.

(7) Pour the impression immediately – vacuum mix stone.(8) Send to the lab to fabricate RPD framework

D. Visit 8: Frame Trial – Most Important Step1. Use Occlude Spray

a) Clear rest seats and any attachments of food debris


b) Dry frame, spray with Occlude, dry teeth, seat, rock across fulcrum line

(1) Remove and check for shiny areas on the frame where the partial denture binds. Adjust rest seats and indirect retainers more than guide planes to achieve full seating of rest seats into the teeth.

c) Pick up attachments today if you did that impression technique(1) Seat the Black Males again, and pick them up with GC

Pattern Resin before making any centric relation records.(2) Grind master cast to remove “black male” from model

2. Complete wax records – a GREAT trick is to ask the lab to fabricate a separate baseplate and wax rim from the same model that the framework was made. That will allow you to check the framework for proper fit without baseplates attached to it AND we can do the Record visit the same day as the frame trial AND we can use an intra-oral tracing device if this is the upper by having an acrylic palate.a) Trim wax to be just below the proper occlusal planeb) Carve notches into bite rim on all edentulous areasc) Make CR record – Intra-oral tracing devices are ideal

3. Complete tooth selectionE. Visit 9: Wax Trial – Confirm Esthetics and Bite

1. Last chance to make changes without a feeF. Visit 10: Free-End Saddle Registration – Done 100% of the time –

always better to reline than to evaluate if you need a reline.1. Reline at Delivery – If ERAs were used, the Black Males need to

be in place now.a) PVS, Polyether, or Rubber Base gives you 30 seconds of

border molding versus 24 hours with Hydrocast techniqueG. Visit 11: Delivery – If ERAs were used, seat White Males in RPD

1. Centric Occlusiona) Use Occlusal Indicator Wax to eliminate prematurities.

2. Eccentric Occlusion – Use horseshoe paper for group function a) With Blue/Blue Horseshoe Paper – Slide side-to-side and Obliterate

Upper Molar Buccal Contacts and Lower Premolar Buccal ContactsH. Last Visit: One Week Post Delivery Adjustment – Confirm Centric and

Balance and Check for Sore Spots - most are occlusally created1. Use PIP to locate sore spots, but adjust occlusion, not intaglio

a) Crestal Marks – Adjust centric prematurities with waxb) Non-crestal Ridge Marks – Adjust eccentrics with paper

2. One post op is all that is scheduled unless major changes were madeIII. Big Three Concepts: Frame Design, Frame Fit, Saddle Adaptation


Partial Denture Lab PrescriptionM. Nader Sharifi, D.D.S., M.S. Lics. No.:30 North MichiganSuite 1303Chicago, IL 60602 Phone: 312-236-1576

Laboratory: Phone: Patient: Date Sent: Next Appt.: Time:

Tooth Guide Plane Rest Clasp Undercut

MaterialMajor ConnectorRetention WebbingTissue StopsOpposing Arch

Signature:


Partial Denture Lab PrescriptionM. Nader Sharifi, D.D.S., M.S. Lics. No.:30 North MichiganSuite 1303Chicago, IL 60602 Phone: 312-236-1576

Laboratory: Phone: Patient: Date Sent: Next Appt.: Time:

Tooth Guide Plane Rest Clasp Undercut

MaterialMajor ConnectorRetention WebbingTissue StopsOpposing Arch

Signature: Date



Kennedy Class I

Kennedy Class II


Modification Space

Kennedy Class III


Kennedy Class IV

✔Mesial #6 & 11 with Rotating 0.020” Undercut

Rotational Path

Reference List

Textbooks: (Sorry, I’ve yet to review an acceptable Attachment Textbook.)1. Brudvick, JS: Advanced Removable Partial Dentures. Quintessence Publishing Co.,

Inc. Chicago, IL 1999.2. Hayakawa I: Principles and Practices of Complete Dentures – Creating the Mental

Image of a Denture. Quintessence Publishing Co., Chicago, IL 2004.3. Johnson DL and Stratton RJ: Fundamentals of Removable Prosthodontics. Quintessence

Publishing Co., Inc. Chicago, IL 1980.4. Kratochvil FJ: Partial Removable Prosthodontics. W.B. Saunders Co., Philadelphia, PA

1988.5. Krol AH, Jacobson TE, Finzen FC: Removable Partial Denture Design - Outline

Syllabus. University of the Pacific Dental School, 1990. Call School6. McGivney GP, Castleberry DJ: McCracken’s Removable Partial Prosthodontics. 8th

Edition. C.V. Mosby, St. Louis, MO 1989.7. Sharifi MN: Essential Dental Handbook: Chapter on Removable Prosthodontics.

Edited by Edwab RJ, Penn Well Publishing Co., Tulsa, OK 2002. Call 800-752-9764 (10%Coupon: DOAE05)

8. Stratton RJ, Wiebolt FJ: An Atlas of Removable Partial Denture Design. Quintessence Publishing Co., Inc. Chicago, IL 1988.

9. Stewart KL, Rudd KD, Kuebker WA: Clinical Removable Partial Prosthodontics. C.V. Mosby, St. Louis, MO 1983.

Journal Articles:1. Atwood D: Clinical, cephalometric and densitometric study of reduction of residual ridges. J Prosthet Dent

1971; 26:280.2. Barco MT Jr, Flinton RH: An overview of four removable partial denture clasps. Int J Pros 1988; 1:159-64.3. Becker CM, Swoope CC, Guckes AD: Lingualized occlusion for removable prosthodontics. J Prosthet Dent

1977; 38:601.4. Berg E, Johnsen TB, Ingebretsen R: Psychological variables and patient acceptance of complete dentures. Acto

Odontol Scand 1986; 44:77.5. Berg T, Caputo AA: Comparison of load transfer by maxillary distal-extension removable partial denture with a

spring loaded plunger attachment and I-bar retainer. J Prosthet Dent 1992; 68:784-789.6. Brewer AA, Reibel RB, Nassif MN: Comparison of zero degree teeth and anatomic teeth on complete dentures.

J Prosthet Dent 1967; 17:28.7. Browning JD, Meadors LW, Eick JX: Movement of three removable partial denture clasp assemblies under

occlusal loading. J Prosthet Dent 1986; 13:549-557.8. Brudvik JS, Howell PG: Evaluation of eccentric occlusal contacts in complete dentures. Int J Prosthet 1990;

3:146-157.9. Burns DR, Ward JE: A review of attachments for removable partial denture design: Part 2 - Treatment Planning

and attachment selection. Int J Pros 1990; 3:169-170.10. Burns DR, Ward JE: A review of attachments for removable partial denture design: Part 1 - Classification. Int J

Pros 1990; 3:98-102.11. Chou TM, et al.: Photoelastic analysis and comparison of force transmission characteristics of intracoronal

attachments with clasp distal-extension removable partial dentures. J Prosthet Dent 1989; 62:313-319.12. Chow TW, Clark RK, Clarke DA: Improved designs for removable partial dentures in Kennedy Class IV cases.

Quintessence Int. 1988; 19:797-800.13. Clough H, Knodle J, Pudwill S, Myron L, Taylor D: A comparison of lingualized occlusion and monoplane

occlusion in complete dentures. J Prosthet Dent 1983; 50:176.


14. Colon A, Kotwal K, Mangelsdorff A: Analysis of the posterior palatal seal and the palatal form as related to the retention of complete dentures. J Prosthet Dent 1983; 47:23.

15. Curtis T, Langer Y, Curtis D, Carpenter R: Occlusal considerations for partially or completely edentulous skeletal class II patients. Part I: Background information. J Prosthet Dent 1988; 60:202.

16. Demer WJ: An analysis of mesial rest, I-Bar clasp designs. J Prosthet Dent 1976; 36:243-253.17. Eliason C: RPA clasp design for distal extension removable partial dentures. J Prosthet Dent 1983; 49:25.18. Feingold GM, Grant AA, Johnson W: Abutment tooth and base movement with attachment retained removable

partial dentures. J Dentistry 1988; 16:264-268.19. Feingold GM, Grant AA, Johnson W: The effect of partial denture design on abutment tooth and saddle

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Product List

1. Alma Gauge - For fabricating maxillary wax rims. Purchase through: Lantz Dental Prosthetics, Maumee, OH 800-788-5385.

2. Attachments – ERA, Stern G/L and Dalbo attachments. SternGold-Implamed. 800-243-9942

3. Attachments – VKS - SG vertical or horizontal Bredent Ball attachment. Bredent USA, Miami, FL; 800-328-3965.

4. Attachments – Ceka, Hader and Dolder Bars. Preat, 800-232-77325. Attachments – Zaag, Locator (OD on teeth). Zest Anchors 800-262-23106. Attachments – Attachments International 800-999-30037. Denture Teeth - Antaris/Postaris & Ortholingual. Ivoclar, 800-533-6825.8. Denture Teeth - Physiodens. Vita; 800-828-3839.9. Denture Teeth - Trublend. Dentsply; 800-877-0020.10.Denture Teeth - Enigma. Leach and Dillon Products; 800-535-2633.11.Denture Teeth - Myerson Lingualized Integration Teeth. Austenol; Chicago,

IL; 800-621-0381.12.Compound for border molding impression trays - Green Stick Compound.

Kerr, Romulus, MI; 800-537-7123.13.Denture Tooth Selection Face Shield - Trubyte Tooth Indicator. Dentsply;

800-877-0020.14.Fox Plane - For Leveling Occlusal Plane. Dentsply; 800-877-0020.15.Functional Impression Material - Hydrocast. Kay See Dental, Kansas City,

MO; 800-842-8844.16.Functional Impression Material - holds VDO for functional impressions –

Microseal. AMCO International; 800-523-074017.Intra-oral device for CR and occlusal evaluation - Coble Balancer. Purchase

through: Lantz Dental Prosthetics, Maumee, OH 800-788-5385.18.Central Bearing Device - Y & M Dental, Overland Park, KS 913-851-8079.19.Intra-oral post dam tissue marking sticks - Dr. Thompson’s Sanitary

Applicators. Great Plains Dental, Kingman, KS; 316-532-3888.20.Impression Material - System 1 & 2 Alginate. Ivoclar; 800-344-5457.21.Occlude - Marking RPD frameworks. Pascal Co. 800-426-8051.22.Occlusal Indicator Wax - For Occlusal Adjustments and Delivery of

Dentures. Kerr, Romulus, MI; 800-537-7123.23.Pressure Indicating Paste - For Post Delivery Adjustments of Denture Sore

Spots. Order from your dental supplier.24.Reline Material - New Truliner. Bosworth, Skokie, IL 708-679-340025.Rubber base impression material (light and medium) - Permlastic. Kerr,

Romulus, MI; 800-537-7123.


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