Download - Designing RPD 321
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SDS321
McCrackens Removable Partial Prosthodontics.
Chapter 10 & 19
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Our objective should be the perpetual preservation of what remains
rather than the meticulous restoration of what is missing.
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Preserving what remains
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Designing RPD
On the basis of information gathered from the clinical examination
and the analysis of the study casts,
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Designing RPD
the components of an RPD framework are so
selectedthat the resulting design is estheticallypleasant and is least harmfulto the remaining tissues.
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As a result of the examination and diagnosis, thedesign of an RPD must originate on the diagnostic
castso that all the mouth preparation are carried outwith a specific design in mind. This could beinfluenced by the following factors,
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Factors influencing the RPD Design
1. One arch is to be restored or both
a. Orientation of the occlusal plane.
b. Space available for restoring missing teeth.
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Factors influencing the RPD Design
c. Occlusal relationship of the remaining teeth.
d. Arch integrity and tooth morphology.
Overlay rest
Over-denture
Long rest
Over-denture
Vertical space
Retentive area
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Factors influencing the RPD Design
2. Remaining abutment support / periodontal health / need for splintingor future additions.
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Factors influencing the RPD Design
3. Tooth or Tooth & tissue supported prosthesis.
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Factors influencing the RPD Design
4. Need for abutment modification clasp design.
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Factors influencing the RPD Design
5. Type of major connector indicated e.g., a torus.6. Materials to be used for framework, bases, & teeth.
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Factors influencing the RPD Design
7. Patients past experience, i.e., patients inability to accept
lingual bar or palatal bar major connector.
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Factors influencing the RPD Design
8. Replacing a single tooth or anterior teeth RPD or FPD.
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Difference between two types of RPDs
Tooth Supported Tooth & tissue Supported
class III & IV class I & II
1. Support Abutment teeth Combination of abutment teeth
and soft tissues.
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Difference between two types of RPDs
Tooth Supported Tooth & tissue Supported
class III & IV class I & II2. Impression Anatomic form Anatomic and functional forms
(altered cast technique).
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Difference between two types of RPDs
Tooth Supported Tooth & tissue Supported
class III & IV class I & II
3. Indirect No denture rotation Needed to resist any denture base
Retention hence, not needed lifting away from the tissues.
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Difference between two types of RPDs
Tooth Supported Tooth & tissue Supported
class III & IV class I & II
4. Base type Metal base no future Acrylic base future reline is
reline is required. anticipated due to bone loss.
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Difference between two types of RPDs
Tooth Supported Tooth & tissue Supported
class III & IV class I & II
5. Clasp design Circlet/Embrasure/Ring Stress release design RPI /
No stress release RPC, - wrought wire clasp.
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Components of an RPD Framework
(Review)
Circumferential Clasps
Circlet / conventional / C clasp
Embrasure claspReverse action / Hairpin clasp
Ring clasp
Multiple clasp
Half & half clasp
Combination clasp
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Components of an RPD Framework
(Review)
Infra Bulge or Bar type Clasps
1. T bar
2. Y bar
3. L bar
4. I bar
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system
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Factors for the Choice of a Direct Retainer
1. The type of an RPD:
a. tooth supported:- any type of clasp can be used.
b. tooth-tissue supported:- stress releasing (I bar) is used.
2. The location of the undercut on the abutment tooth in relation tothe saddle area (circlet / ring / hairpin).
3. The periodontal health of abutment (cast / wrought clasp).
4. The size of an abutment tooth (cast / wrought clasp).
5. The presence of a tissue undercut combination clasp.
6. Esthetic considerations I bar clasp in the distal undercut orcirclet clasp in the mesial undercut on anterior abutment.
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Components of an RPD Framework
(Review)Maxillary Major Connectors
1. Single Palatal Bar
2. Single Palatal Strap3. U shaped Palatal Connector
4. Anterior & Posterior Palatal Straps / Bars
5. Palatal Plate
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Factors for the Choice of a Maxillary
Major ConnectorThe rigidity and location in relation to the gingivae and the
vibrating line posteriorly is critical.
1. Its design depends on the number and location of the saddleareas and emerges finally after connecting them together, e.g.,modified palatal strap or anterior posterior palatal straps majorconnectors.
2. Single palatal bar and U shaped connectors are seldom used.
The later design may be used in the presence of a large palataltorus.
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Components of an RPD Framework(Review)
Mandibular Major Connectors
1. Lingual Bar2. Lingual Plate
2b.Interrupted Lingual Plate
3. Double Lingual Bar
4. Labial Bar
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Factors for the Choice of a Mandibular
Major Connector
It must be rigid and properly located in relation to thegingivae and movable oral tissues.
1. Depth of anterior lingual sulcus (8 mm or less).
2. Periodontal health of the anterior teeth (bar or plate).
3. Class I edentulous arch may necessitate lingual plate
for additional resistance to horizontal rotation.
4. Anterior spacing (interrupted plate or Continuous bar).
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Components of an RPD Framework
(Review)
Posterior Rest Seats
1. Occlusal rest.
2. Long occlusal rest.
3. Embrasure rest.
4. Onlay/overlay rest.
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Components of an RPD Framework
(Review)
Anterior rest seats
1. Cingulum / inverted V rest.2. Ledge rest.
3. Ball rest.
4. Incisal rest.
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Selection of a Denture Base
Types:
1. Metal base (class III & IV).
2. Acrylic resin base (class I & II)
The single important factor in the design of a saddle area andfor the choice of a denture base material is the anticipated need forfuture reline.As class I & II RPDs may require future reline of thesaddle areas (to compensate for the bone loss due to the rotationalmovement occurring under occlusal load), an acrylic resin denture
base in indicated.
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Step by Step Procedure to Design
As a start, guiding planes should be marked on the proximalsurfaces of the abutment teeth adjacent to the saddle areas, accordingto the selected path of insertion.
Step 1: Plan Tooth Support
For bounded saddles, place the
prepared rest seats on the occlusal,
cingulum, or incisal surfaces of the
abutment teeth, near the edentulous
areas.
For distal extension saddleareas,the rest seats are placed on the mesial
side of the abutment, i.e., away from the saddle areas.
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Step by Step Procedure to Design
Step 2: Design & Locate the Connectors.The final shape and form of the palatal major connector
develops after connecting the tooth supported and tooth-tissuesupported units of the arch together.
The choice of a mandibular major
connector, however, depends on thedepth of the anterior lingual sulcus.
The minor connectors will then be
placed to connect other parts of the
RPD (rests, retainers, artificial
teeth, etc..) to the major connector.
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Step by Step Procedure to Design
Step 3: Plan Retention:Ideally, a direct retainer should be placed on either side of the
saddle area.Its location on the tooth is dependent on the presence ofa suitable undercut0.01.A bracing or
reciprocal arm should also be included.
For a distal extension saddle, an I-bar
retainer is preferred, as a part of RPI.
This design should also include an
indirect retainer to minimize rotation
of the denture base away from thetissues.
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Step by Step Procedure to Design
Step 4: Connect retainers to the support units:Supra-bulge clasp is connected to the occlusal rest or the
guiding plate.Infra bulge clasp is connected to the mesh work minorconnector in the denture base.
Step 5: Outline and join the saddle areas(denture base)to these selected or
drawn components of the RPD
framework.
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Designing Mandibular Framework
Check List Locate Guide planes POI.
Plan Support.
Select the major connector.
Place the minor connectors forocclusal rests, clasps, artificial
teeth. Plan retention (direct & Indirect).
Connect the retainers to theframework components.
Outline and connect the saddleareas to the major connector.
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