4. Objectives of today’s class;
1. To get familiarized with the contents,
guidelines, assessment tools, do’s and don'ts in
this semester.
2. To know the branches in prosthodontics.
3. To know the basic definitions in prosthodontics.
4. Classification of partialdenture
5. To know the basic clinical and laboratory steps
involved in fabricating a partial denture
5. Assessment tools
• The following percentages (%) of the total grade
will be assigned:
• In-course assessments 40%
• o Quizzes, presentation and assessments10%
• o Midterm written and oral examination30%
• o Final examination 60%
• o Final written examination50%
• o attendance 10%
6. Introduction:
Prosthodontics (Prosthetic Dentistry);
It is the dental specialty pertaining to the
diagnosis, treatment planning, rehabilitation
and maintenance of the oral function,
comfort, appearance and health of the
patients with clinical conditions associated
with missing or deficient teeth and / or
maxillofacial tissues using biocompatible
substitute.
7. Prosthetics: is the art and science of designing and
fitting artificial substitutly to replace lost or
missing tissue.
Eg ; Denture; An artificial substitute for missing
natural teeth and adjacent tissues.
Removable prosthodontics: the replacement of
missing teeth and supporting tissues with a
prosthesis designed to be removed by the
wearer.
8. • Dentulous: An individual who has his/her
natural teeth present.
• Edentulous: The individual who has lost
his/her natural teeth.
• Depending on the number of teeth missing
they may be partially or completely
edentulous.
9. Reasons for tooth loss
• Traumatic injuries
• Caries
• Periodontal diseases
• Cysts, malignancies and tumors
• Radiation therapy for tumors
• Grossly malaligned teeth
• Iatrogenic extraction
• Congenitally missing teeth
• Failure to erupt (impacted teeth)
10. Sequelae of tooth loss
• Resorption: The socket gradually remodels
until it assumes the shape of the rounded
edentulous ridge.
• Tilting
• Drifting
• Occlusal disharmony leads to discomfort, pain,
or damage to temporomandibular joints.
14. Common terminologies used in
removable partial denture
Appliance: its adevice worn by apatient in the
course of treatment.
Eg. Orthodontic applaince
surgical applaince
space maintainer
Abutment: a tooth that supports a partial denture.
Retainer: A component of a partial denture that
provides both retention and support for the
partial denture
15. Immediate partial dentures
• A removable artificial denture that is placed
in the mouth immediately after the surgical
removal of all remaining teeth at the same
appointment as the tooth extractions to
maintain normal appearance and the ability to
chew food. It may be complete or partial.
16. Temporary removable partial denture
They are used in patient where tissue changes
are expected, where permanent prosthesis
can not be fabricated till the tissues stabilize.
they should never be used a permanent form
of treatment because of the danger of
destroying the remaining oral tissues.
17. Interim denture
A denture used for a short interval of time to
provide:
a. esthetics, mastication, occlusal support and
convenience.
b. conditioning of the patient to accept the
final prosthesis.
18. Transitional denture
May be used when loss of additional teeth is in
evitable but immediate extraction is not
advisable. Artificial teeth may be added to the
transitional denture as and when the natural
teeth are extracted.
19. Indications of RPD
• Age
• Abutment teeth
• Periodental support of remaining teeth
• Cross arch stabilazation
• Excessive bone loss
• Aesthetics
• Immediate teeth replacement after extraction
• Emotional problems
• Patient desire
20. RPD is generaly prefered in the
following clinacal conditions
• When more than two posterior teeth or four anterior teeth are missing
• If the canine and two of its adjacent teeth are missing(eg. Central incisor,
lateral incisor, canine)
• When there is no distal abutment tooth. Even single cantilever is not
generally preffered.
• Presence of multiple edentulous spaces
• If the teeth adjacent to edentulous spaces are tipped,they cannot be used
as an abutment for fixed prosthesis.
• If periodontally weakened teeth are present near the edentulous spaces
• Teeth with short clinical crowns
• Insufficient number of abutments.
• Severe loss of tissue on the edentulous space
• Old patients
21. RPD is generally avoid in the following
cases
• Patients with a large tongue which tends to
push the denture away
• Patient attitude: mentally retarded patients
cannot maintain a removable prosthesis.
• Poor oral hygiene
22. Classification of partially edentulous
arch
Kennedy classification: In 1923, Kennedy devised a
system that became popular due to its simplicity and
ease of application. A tremendous number of
possible combinations can be reduced to four simple
groups.
I. Bilateral free-end saddle
II. Unilateral free-end saddle
III. Unilateral bounded saddle
IV. Anterior bounded saddle, only
23. Class I - bilateral edentulous areas located
posterior to all remaining teeth.
24. • Class II - unilateral edentulous area located
posterior to all remaining teeth.
25. • Class III: Unilateral
edentulous area with
natural teeth remaining
both ant and post to it.
26. • Class IV : A single, but
bilateral (crossing the
midline), edentulous
area located anterior to
the remaining natural
teeth.
27. Applegate's Rules for Applying the
Kennedy Classification
Rule 1: Classification should follow rather than
precede extraction.
Rule 2: If the 3rd molar is missing and not to be
replaced, it is not considered in the
classification.
Rule 3: If the 3rd molar is present and to be
used as an abutment, it is considered in the
classification.
28. Rule 4: If the second molar is missing and not be
replaced, it is not considered in the classification
Rule 5: The most posterior edentulous area
determines the classification.
Rule 6: Edentulous areas other than those
determining classification are called modification
spaces.
Rule 7: The extent of the modification is not
considered, only the number.
Rule 8: There is no modification space in Class IV.