Removable Partial Denture Manual Robert W. Loney, DMD, MS 2011 Removable Partial Denture Manual Robert W. Loney, DMD, MS 2011 Table of Contents - i Table of Contents Introduction to Removable Partial Dentures ............................................................................. 1 Alternatives to RPD's .................................................................................................................. 1 Indications for RPD's .................................................................................................................. 1 Treatment Objectives .................................................................................................................. 1 Components of a Partial Denture ................................................................................................ 3 Classification .............................................................................................................................. 4 Kennedy Classification ....................................................................................................... 4 Applegate's Rules for Applying the Kennedy Classification ............................................. 5 Anatomy Tour for Complete and Partial Dentures ................................................................... 6 Irreversible Hydrocolloid Preliminary Impressions ............................................................... 11 Making the impression ............................................................................................................. 11 Evaluating Irreversible Hydrocolloid Impressions ................................................................... 12 Pouring a Model ....................................................................................................................... 12 Two-Pour Technique ................................................................................................................ 12 Trimming .................................................................................................................................. 13 Surveying, Path of Insertion, Guiding Planes .......................................................................... 14 Parts of a Surveyor: .................................................................................................................. 15 Selecting the Path of Insertion of a Removable Partial Denture .............................................. 16 The Optimal Path of Insertion .................................................................................................. 17 Selection and Preparation of Guiding Planes: .......................................................................... 20 The Effects of Guiding Planes on Retention and Stability ....................................................... 21 Alteration of Other Axial Contours .......................................................................................... 22 Summary of Removable Partial Denture Abutment Modifications ......................................... 23 Rests and Rest Seats ................................................................................................................... 24 Functions of Rests ..................................................................................................................... 24 Preparation of Rest Seats .......................................................................................................... 25 Rest Seat Form .......................................................................................................................... 25 Occlusal Rest Seats ............................................................................................................... 25 Lingual Rest Seats ................................................................................................................ 27 Composite Buildups for Cingulum Rests: ............................................................................ 30 Round Lingual Rest Seat Form ............................................................................................. 31 Incisal Rests .......................................................................................................................... 31 Table of Contents - ii Major Connectors ....................................................................................................................... 32 Functions of a Major Connector ............................................................................................... 32 Requirements of a Major Connector ......................................................................................... 32 I. Mandibular Major Connectors ............................................................................................ 33 Lingual Bar ....................................................................................................................... 33 Lingual Plate (Linguoplate) .............................................................................................. 34 Continuous Bar Retainer (Kennedy Bar, Double Lingual Bar) ........................................ 35 Labial Bar ......................................................................................................................... 35 II. Maxillary Major Connectors .............................................................................................. 35 Anterior-Posterior Palatal Strap ........................................................................................ 35 Full Palatal Plate ............................................................................................................... 36 Single Palatal Strap .......................................................................................................... 36 Anterior Palatal Plate ....................................................................................................... 37 Minor Connectors ....................................................................................................................... 38 Functions ................................................................................................................................... 38 Basic Types of Minor Connectors: ........................................................................................... 38 Gridwork Design ...................................................................................................................... 41 Direct and Indirect Retainers .................................................................................................... 43 Extra-Coronal Direct Retainers ................................................................................................ 43 Requirements of Direct Retainers ............................................................................................. 44 Factors affecting the magnitude of retention ............................................................................ 44 Direct Retainers For Tooth-Borne RPD’s ................................................................................ 46 1. Circumferential (Circle or Akers) clasp ........................................................................... 46 2. Ring clasp ........................................................................................................................ 47 3. Embrasure (Double Akers) Clasp .................................................................................... 47 4. "C" clasp (Hair-pin or Reverse action) ............................................................................ 48 Direct Retainers For Tooth and Tissue Borne RPD's ............................................................... 49 1. Bar Clasps ........................................................................................................................ 49 2. The R-P-I Clasp ............................................................................................................... 50 3. Combination Clasp .......................................................................................................... 52 4. RPA Clasp ...................................................................................................................... 52 The Distal Rest Concept ....................................................................................................... 52 Direct Retainer Selection .......................................................................................................... 55 Indirect Retainers ...................................................................................................................... 56 Denture Bases and Replacement Denture Teeth ..................................................................... 59 Functions ................................................................................................................................... 59 Materials ................................................................................................................................... 59 Flange Extension .................................................................................................................. 60 Acrylic Resin Finish Lines ................................................................................................... 61 Partial Denture Replacement Teeth ...................................................................................... 61 Table of Contents -iii Principles of