MOUTH PREPARATION

FOR REMOVABLE
PARTIAL DENTURES
DR.SHRUTIKA
II MDS
CONTENTS
• Introduction
• Objectives of the procedures
• Classification of mouth preparation
• Oral surgical consideration
• Periodontal consideration
• Orthodontic consideration
• Endodontic consideration
• Prosthodontic considerations
-Provision of support for periodontally
weakened teeth
-Reestablishment of arch continuity
- Developing guiding planes
- Changing height of contour
- Enhancing retentive undercuts
- Shaping the wax pattern
- Refining the cast restoration
- Rest seat preparations - Posterior teeth
- Anterior teeth
• Fabricating restorations to fit existing denture retainers
• Review of literature
• conclusion
• References
INTRODUCTION
• The preparation of the mouth is fundamental to a successful removable
partial denture service.
• Mouth preparation follows the preliminary diagnosis and the development
of a tentative treatment plan.
• Final treatment planning may be deferred until the response to the
preparatory procedures can be ascertained.
• In general, mouth preparation includes procedures that address conditions
that put comfortable prosthetic function at risk and include tooth alteration
that are required for proper tooth stabilization and support of the prosthesis.
 Objectives of the procedures
• To create optimum health and eliminate or alter any condition that would be
detrimental to the functional success of the RPD.

• It must be accomplished before the impression procedures are performed.

• Oral surgical and periodontal procedures should precede abutment tooth

preparation and should be completed far enough in advance to allow the
necessary healing period.

• At least 6 weeks should be provided between surgical and restorative dentistry

procedures.
 CLASSIFICATION
MOUTH PREPARATION
ORAL SURGERY PERIODONTICS ORTHODONTICS ENDODONTICS PROSTHODONTICS

• Extraction • Oral Hygiene • Tipped molars • Relief of pain • Preparation of

• Impacted Teeth Instructions abutment teeth.
• Malposed Teeth • Scaling and Root • Correction of • Endodontic
• Cysts and Planing malalignment considerations • Restorative
Odontogenic • Elimination of local dentistry(FPD)
Tumors irritating factors • Metal and
• Exostoses and Tori other than calculus ceramic • Procedures related
• Hyperplastic Tissue • Temporary restorations to occlusion.
• Muscle Attachments Splinting
and Frena • Periodontal Surgery
• Bony Spines and
Knife-Edge Ridges
ORAL SURGERY
Pre-Prosthetic Considerations in Partially
Edentulous Mouth
HARD TISSUE

• Extractions
• Impacted Teeth
• Malposed Teeth
• Cysts and Odontogenic Tumors
• Exostoses and Tori
• Bony Spines and Knife-Edge Ridges
• Dental Implants
• Augmentation of Alveolar Bone
SOFT TISSUE
• Polyps, Papillomas, and Traumatic
Hemangiomas
• Hyperkeratoses, Erythroplasia, and Ulcerations
• Hyperplastic Tissue
• Muscle Attachments and Frena
Completion of Required Surgical Procedures
• Extraction of unrestorable, teeth
that have insufficient periodontal
support,Unerupted or impacted.
• Surgery to eliminate tori or
prominent exostoses
• Preprosthetic procedures such as
implant placement, ridge
augmentation, and vestibular
extension.
• Surgical reduction of the tuberosities may be required to provide
adequate restorative space.

• Extremely supraerupted teeth and tipped molars should be extracted.

 PERIODONTAL
CONSIDERATION
PERIODONTAL PREPARATION
Objectives of Periodontal Therapy
1. Removal and control of all etiologic factors contributing to
periodontal disease along with reduction or elimination of BOP.
2. Elimination of, or reduction in, the pocket depth of all pockets with
the establishment of healthy gingival sulci whenever possible.
3. Establishment of functional atraumatic occlusal relationships and
tooth stability.
4. Development of a personalized plaque control program and a
definitive maintenance schedule.
Periodontal Diagnosis and Treatment
Planning
PHASE 1: Initial Disease Control Therapy
• Oral Hygiene Instructions
• Scaling and Root Planing
• Elimination of Local Irritating Factors Other Than Calculus
• Elimination of Gross Occlusal Interferences
• Temporary Splinting

PHASE 2: Definitive Periodontal Surgery

• Periodontal Surgery

PHASE 3: Recall Maintenance

 ORTHODONTIC
CONSIDERATION
Correction of Malalignment
• Malaligned teeth compromise the
contours and positions of
removable partial denture
components.

• Orthodontic movement of
malpositioned teeth should be
the first option.
• Tipped molars- ideally upright
teeth orthodontically
 ENDODONTIC
CONSIDERATION
Relief of pain and infection

• Necessary endodontic and surgical procedures

should be completed.
• Carious lesions should be treated.
RESHAPING TEETH
ENAMELOPLASTY
• We should ensure that recontouring accomplishes the desired objectives, but never
at the expense of overcutting the tooth.
• If the danger of overcutting is apparent, recontouring should first be accomplished
on a diagnostic cast.
• If it appears that recontouring will result in substantial tooth reduction, the
practitioner should consider the placement of properly contoured crowns.
• A carborundum-impregnated rubber wheel or point should be placed in a low-
speed handpiece.
• Light, intermittent pressure and moderate speed
• Severly malposed teeth and moderately
tipped molars can be corrected by
endodontic intervention followed by
full coverage restorations.
Complete- and partial-coverage restorations
• Restorations may be required for teeth displaying caries lesions, defective
restorations, fracture, or endodontic therapy.
• It must be carefully planned and constructed and must include the appropriate
undercuts, guiding planes, and rest seats.
• From a clinical perspective, it is essential that recontouring procedures be
completed before crown and onlay preparations are begun.
• Therefore, the placement of guiding planes should always precede the
preparation of teeth that are to receive fixed restorations.
Veneer Crowns for Support of Clasp Arms
• Veneer crowns must be
contoured to provide suitable
retention.
• The veneer must be slightly over
contoured and then shaped to
provide the desired undercut for
the location of the retentive clasp
arm.
PROSTHODONTIC
CONSIDERATION
 Provision of Support for Periodontally
Weakened Teeth
• Splinting may be accomplished
using fixed restorations or designing
the RPD to join teeth as a functional
unit.
• Fixed splinting is accomplished by
joining teeth with complete- or
partial-coverage restorations.
• The objective is to gain improved
resistance to applied forces.
• A major drawback of fixed splinting
is inability of the patient to
adequately clean the splinted teeth.
• Lingual plating in conjunction
with multiple facially positioned
clasp arms.
• Swing-Lock removable partial
dentures
Re-establishment of Arch Continuity
• When a lone-standing abutment is present, the practitioner should examine the remainder of
the arch to determine whether the patient would benefit from placement of a FPD.
• Teeth that have lost a moderate amount of supporting bone but display minimal mobility and
are strategically positioned in the arch may be retained to provide support for RPD.
• They resist movement of removable partial dentures toward tissues during function.
• If teeth that are located at the posterior end of a distal extension base, the prosthesis will
function as a Class III removable partial denture rather than a Class I or Class II prosthesis.
CLASSIFICATION OF ABUTMENT TEETH
The subject of abutment preparations may be grouped as follows:

1. Those abutment teeth that require only minor modifications to their

coronal portions;

2. Those that are to have restorations other than complete coverage

crowns; and

3. Those that are to have crowns (complete coverage).

 SEQUENCE OF ABUTMENT PREPARATIONS ON
SOUND ENAMEL OR EXISTING RESTORATIONS
1. Guiding planes preparation

2. Lowering the height of contour

3. After alterations of axial contours are accomplished and before rest seat preparations are
instituted, an impression of the arch should be made in irreversible hydrocolloid and a cast
formed in a fast-setting stone.

4. Rest seat preparation

1. GUIDE PLANE PREPARATION
• Abutment teeth adjacent to tooth-supported segments
• Abutment teeth adjacent to distal extension edentulous spaces
• Lingual surfaces of abutment teeth
• Anterior abutment teeth
 1. GUIDE PLANE PREPARATION
Guiding planes are those surfaces on the teeth, parallel relationship
to each other, so that they may serve to determine positively the
direction of appliance movement (Applegate 1954)

Two or more vertically parallel surfaces on abutment teeth and/or

fixed dental prostheses oriented so as to contribute to the direction
of the path of placement and removal of a removable partial denture,
maxillofacial prosthesis, and overdenture. (GPT-9) 11 5/8/2017
A natural
appearance is
obtained by full
contact of tooth
and RPD without
any space in
between.
Otherwise, the
area between the
teeth and the
prosthesis will
appear as a dark
space, which will
cause esthetic
problems
A reciprocating element must brace the abutment as the
retentive element passes to and from its fully seated
position, (a)If reciprocation is ineffective, potentially
destructive lateral forces (arrow) will be transferred to the
abutment (b) A properly prepared guiding plane permits
sustained contact between the reciprocal element and the
abutment and prevents the application of unopposed
lateral forces. 
The preparation guiding planes
• Guiding planes are surfaces on proximal or lingual
surfaces of teeth that are parallel to each other
and, more importantly, to the path of insertion and
removal of a removable partial denture.
• During the mouth preparation process, the
surveying table and cast should be readily
accessible to the practitioner.
• This permits the practitioner to visualize the
desired relationship between the dental bur and
the tooth to be recontoured.
 Abutment teeth adjacent to tooth-supported
segments
• A cylindrical diamond or carbide bur placed in a high-
speed handpiece is generally used for the preparation of
guiding planes.
• A light, sweeping stroke from the facial line angle to the
lingual line angle is used to create a gently curving plane.
• This surface should be 2 to 4 mm in occlusogingival height.
• Should not resemble a straight slice when viewed from the
occlusal or incisal surface.
• Prepared surfaces are polished with carborundum-
impregnated rubber point or wheel in a low-speed
handpiece with Light, intermittent pressure.
Abutment teeth adjacent to distal extension
edentulous spaces
• A cylindrical diamond or carbide bur is
used in conjunction with a highspeed
handpiece to prepare surfaces that are
parallel to the proposed path of insertion.
• A guiding plane prepared adjacent to a
distal extension space should be slightly
shorter than a guiding plane prepared
adjacent to a tooth-supported segment.
• 1.5 to 2.0 mm in height
• Abutment teeth adjacent to distal
extension edentulous spaces A
guiding plane adjacent to a distal
extension space is 1.5 to 2.0 mm
in height Reduced height results
in decreased contact with the
minor connector and permits
greater freedom of movement for
the removable partial denture.
Hence, potentially damaging
forces are minimized.
Lingual surfaces of abutment teeth
REASONS
1. To enhance reciprocation
2. To minimize the number of
pathways by which the prosthesis may
enter and exit its fully seated position.
3. To provide maximum resistance to
lateral forces.
• A lingual guiding plane should be 2 to
4 mm in occlusogingival height and
should be located in the middle third
of the clinical crown as viewed from
the mesial or distal surfaces
Lingual Surfaces Of Abutment
Teeth This is done to provide
maximum resistance to lateral
stresses A lingual guiding plane
should be 2 to 4 mm in occluso-
gingival height and should be
located in the middle third of the
clinical crown as viewed from the
mesial or distal surfaces
 Anterior abutment teeth
• To enhance stabilization of the prosthesis,
to decrease undesirable space between the
prosthesis and an abutment tooth, and to
increase retention through frictional
resistance.
• To reestablish the normal width of an
edentulous space.
• A cylindrical diamond or carbide bur may be
used to create the desired guiding planes.
• If the required changes cannot be made
without penetrating into the dentin, an
appropriate restoration should be planned.
 Ledges on Abutment Crowns
• A ledge on the abutment crown acts as a terminal
stop for the reciprocal clasp arm. It also augments
the occlusal rest and provides indirect retention for
a distal extension removable partial denture.
• A reciprocal clasp arm built on a crown ledge is
actually inlayed into the crown and reproduces
more normal crown contours
• Preffered in premolars and molars
• Placed at the junction of the gingival and middle
thirds of the tooth.
• Spark erosion technology is a highly advanced
system for producing the ultimate in precision fit of
the reciprocal arm to the ledge on the casting.
2. CHANGING HEIGHT OF CONTOUR

• The height of contour is often

changed to provide more favorable
positions for clasp arms or lingual
plating.
• Ideally a retentive clasp arm
should be located no farther
occlusally (or incisally) than the
junction of the gingival and middle
thirds of the crown.
• Tapered diamond bur in a high-
speed handpiece
• Maxillary posterior teeth tend to
tip buccally making placement
of retentive terminal
unaesthetic. Mandibular
posteriors tip lingually making it
difficult to place reciprocal arm
and lingual major connectors. In
both these situations, height of
contour will be near occlusal
surface.
• Minor recontouring of facial
surfaces will frequently permit
more ideal placement of the
bracing portion of the retentive
clasp arms. • Frequently
improve the position of the
survey line to allow placement
of the reciprocal clasp arm in its
proper position.
• Should establish an undercut of
0.010 inches relative to the
proposed path of insertion. It
should be highly polished.
Enhancing retentive undercuts
• The facial and lingual surfaces of the tooth must be
nearly vertical.
• A gentle depression is prepared
• The bur is moved in an anteroposterior direction
• Prepared using a round or football-shaped diamond
bur in a high-speed handpiece.
• 4 mm in mesiodistal length
• 3 mm in occlusogingival height.
• It should establish an undercut of 0.010 inches relative
to the proposed path of insertion.
 Shaping the wax pattern
• To accurately assess the contours of the wax pattern, the pattern is
dusted with a thin layer of powdered wax or zinc stearate.
• The height of contour is then marked using the analyzing rod in
the vertical arm of the surveyor.
• Following evaluation of contours, the pattern is reshaped using
wax carving instruments
• A 0.010-inch undercut is recommended
• Should be located at the mesial line angle or the distal line
angle.
• When using an I-bar clasping system, the undercut may be
positioned at the midfacial (or, rarely, at the midlingual) line angle.
• When the practitioner is satisfied with the axial contours of the
wax pattern, required rest seats are placed.
Refining the cast restoration
• The height of contour and guiding planes
are examined using the analyzing rod in
the vertical arm of the surveyor.
• A cylindrical bur or stone is then placed
in the handpiece for machining purposes.
 3. REST SEAT
PREPARATION
Rest seat: The prepared recess in a tooth or restoration
developed to receive the occlusal, incisal, cingulum, or lingual rest.
POSTERIOR TEETH ANTERIOR TEETH

• Occlusal rest seats • Cingulum rest seats

- In enamel - In enamel
- On an amalgam restoration - In a new cast-metal or metal- ceramic restoration
- Using dental bonding techniques
• Embrasure rest seats - Rest seat in metal-ceramic and all-ceramic crowns

• Incisal rest seats in enamel

• The components of a removable partial denture that transfer forces
down the long axes of the abutment teeth are called rests. –Stewart
• A rigid extension of a removable partial denture that contacts the
occlusal, incisal, cingulum, or lingual surface of a tooth or
restoration, the surface of which is commonly prepared to receive it.
GPT-9
• Rest Seat: the prepared recess in a tooth or restoration developed to
receive the occlusal, incisal, cingulum, or lingual rest. –GPT-9
 FUNCTIONS OF REST
 Support: Prevent movement of prosthesis toward the tissues.
• Force transfer: To direct the forces of mastication parallel to the long axis of
the abutment tooth
• To direct the forces of mastication parallel to the long axis of the
associated abutment.
• Prevents the gingival displacement of an RPD and maintains the
intended relationship between a clasp assembly and the associated
tooth.
• A rest may be used as an indirect retainer.
• In addition, a rest may be used to close a small space between teeth,
thereby restoring continuity of the arch and preventing food
impaction.
Rest Seat Preparations for Posterior Teeth
• These rest seats must be prepared before final impressions and master
casts are made.
• If rest seats are not adequately prepared, the forces transmitted from
the prosthesis to the abutments may not be directed within the long
axes of these teeth.
• This may result in irreparable damage to the abutments.
Occlusal rest seats in enamel
• The outline form - triangular, with the base of the triangle at the marginal ridge and the apex
pointing toward the center of the tooth.
• The apex of the triangle should be rounded, as should all external margins of the preparation
• The floor of the occlusal rest seat must be inclined toward the center of the tooth.
• The enclosed angle formed by the floor of the rest seat and the proximal surface of the tooth must
be less than 90 degrees
• It should be at least 1 mm thick at its thinnest point.
• Round diamond burs
• Finishing procedures are performed using a green stone
• Polishing is performed using a small, carborundum- impregnated rubber point in a low-speed
handpiece
• Boxing wax should be formed into a disk approximately 4 mm in thickness and 15 mm in diameter.
• The outline form of an occlusal rest
seat should be a rounded triangular
shape with the apex toward the center
of the occlusal surface. 
• It should be as long as it is wide, and the base of
the triangular shape (at the marginal ridge)
should be at least 2.5 mm for both molars and
premolars

The marginal ridge of the abutment tooth at the site of the rest seat
should be approximately 1.5 mm To permit a sufficient bulk of
metal for strength and rigidity of the rest and the minor connector.
• An occlusal rest seat should occupy one third to one half the
mesiodistal diameter of the abutment and approximately one half
the buccolingual width of the tooth measured from cusp tip to
cusp tip.
When using a round bur, care must be taken to ensure that mechanical
undercuts are not created,
(a)Round bur positioned above enamel surface,
(b)Bur moved vertically into enamel,
(c)Bur moved laterally,
(d)Upon removal of the bur, a distinct overhang is present
Occlusal rest seats on an amalgam restoration
• Amalgam alloys tend to deform when a sustained load is applied.
• Larger amalgam restorations present greater difficulties because of
their flow characteristics and increased susceptibility to fracture.
• Rest seats should not be placed entirely on amalgam. If a substantial
portion of the rest seat cannot be placed on sound tooth structure, then
a complete- or partial- coverage casting should be considered.
 RW Rudd. Preparing teeth to receive a removable partial denture. J Prosthet Dent 1999;82:536-49
Embrasure rest seats
• This preparation crosses the occlusal embrasure of two approximating posterior
teeth, from the mesial fossa of one tooth to the distal fossa of the adjacent
tooth.
• A diamond bur with a rounded end and tapering sides is ideal for preparing
embrasure rest seats.
• Diamond bur is then used to create the appropriate depth of the preparation.
• Contact between the teeth should not be broken since this may result in tooth
migration or food impaction.
• Clearance may be evaluated by placing two pieces of 18-gauge wire across the
preparation. The patient should be able to close without contacting these wires.
• Embrasure rest seat should be 3.0 to 3.5 mm wide and 1.5 to 2.0 mm deep
• A carborundum- impregnated rubber point
Rest Seat Preparations for Anterior Teeth
• Preferred over a cingulum or incisal rest seat on an anterior tooth.
• Canine is preferred to a lateral or central incisor.
• When a canine is not present, the practitioner must consider the
placement of rest seats on two or more incisors.
• The cingulum rest seat can be prepared nearer the rotational center of
the tooth,
Cingulum rest seats in enamel
• If tooth contours are favorable, sufficient enamel is present, and the patient exhibits
good oral hygiene.
• Outline form of a cingulum rest seat should be crescent shaped
• The rest seat should form a smooth curve from one marginal ridge to the other. When
viewed in profile, the rest seat should be V-shaped.
• The No. 38 bur is an inverted cone with side- and end-cutting surfaces.
• During the preparation process, the bur is oriented at a slight angle to the lingual
surface of the tooth. The bur is then used to create a crescent-shaped rest seat that
begins on one marginal ridge, passes over the cingulum, and terminates on the
opposite marginal ridge
Cingulum rest seats in a new cast-metal or
metal- ceramic restoration
• Cingulum rest seat should be
incorporated into the wax
pattern.
• The rest seat is then developed
using a cleoid-discoid carver or
similar instrument
Placement of cingulum rest seats using dental
bonding techniques
• Most mandibular canines do not exhibit properties that will permit the placement of
properly formed cingulum rest seats.
• In most instances, mandibular canines do not display prominent cingula, nor do they have
appreciable thicknesses of enamel on their lingual surfaces.
• When abutment contours will not permit the preparation of a conventional cingulum rest
seat, the practitioner may bond a small metal casting to the lingual surface of the tooth.
• The initial stages of tooth preparation are accomplished using a small, tapering diamond
bur in a high-speed handpiece. A limited area on the lingual surface of the proposed
abutment is prepared to a depth of 0.5 to 0.7 mm.
Rest seat in metal-ceramic and all-ceramic
crowns
• It is recommended that rest seats for metal-ceramic restorations be
constructed entirely in metal.
• The metal borders should extend at least 1 mm beyond the borders of
the proposed rest (in all directions).
An alternative cingulum rest seat
• The alternative cingulum rest seat may be described as a crescent-
shaped depression located in the middle and apical thirds of the
clinical crown
• The alternative cingulum rest seat is prepared using a No. 38
carbide bur or a small diamond disk in a high-speed handpiece.
• Attempts to create adequate depth often result in exposure of the
underlying dentin and complicate restorative therapy.
Incisal rest seats in enamel
• Least desirable
• Unesthetic and may interfere with occlusion.
• Located far from the rotational centers of the abutments. Hence, these teeth may be
damaged by tipping or torquing forces.
• Only on enamel surfaces. If a cast restoration is planned for an anterior abutment, a
cingulum rest seat should be included in the restoration
• In most instances, the disto-incisal surface
• Flame-shaped diamond bur in a high-speed handpiece. The bur is
oriented parallel to the proposed path of insertion, and a notch is
created.
• This notch should be located 2 to 3 mm from the proximal angle of the
tooth and should be 1.5 to 2.0 mm in depth. The notch is extended
slightly onto the facial surface of the tooth.
• On the lingual surface of the tooth, a small channel is created. This
channel helps disguise the thickness of the associated minor connector.
FABRICATING RESTORATIONS TO FIT
EXISTING DENTURE RETAINERS
Tooth preparation for rest seats for cobalt–chromium removable
partial dentures completed by general dental practitioners

• The aim of this project was to examine tooth preparations made by general
dental practitioners (GDPs) for occlusal and cingulum rest seats for cobalt–
chromium removable partial dentures(RPDs).
 A CAD-CAM device for preparing guide planes
for removable partial dentures: A dental technique
Scan the diagnostic cast using a laboratory scanner Evaluate the STL file for appropriate undercuts at
various axes and select a 3D axis as the path of
placement
 Build a rectangular 3D object for each tooth and
Determine the appropriate proximal and reciprocal
align them on the teeth according to the selected
planes facing the path of placement
proximal and reciprocal planes

Proximal guide plane

Rectangular 3D object built and aligned according to
(A) and reciprocal guide plane
analyzed plane.
(B)decided according to path of placement.
Build a 3-mm-thick offset structure, such as that Extract the overlapped area between the rectangular
for an occlusal device, for the maxillary STL file objects and the occlusal deviceeshaped object
• Export the STL files of the devices and fabricate by computer-aided manufacturing
(CAM).

• Set the device on the tooth, adjust if necessary, and prepare according to the proximal
and palatal reference planes of the device.

A, Devices positioned on cast.

B, Maxillary right device.
C, Maxillary left device.
D, Prepared tooth using proximal and palatal reference plane of device.
CONCLUSION
• The significant aspect of treatment with removable partial dentures is
the careful planning and excecution of mouth preparations and their
accurate reproduction through the fabrication process.
• Properly balanced and distributed forces can contribute to enchanced
longevity of both the remaining oral structures and the restoration.
REFERENCES
• Carr A B, Mc Givney G P, Brown D T, Minor connector in McCraken’s Removable partial
Prothodontics. 13th ed
• Stewart K L, Rudd K D, Kuebker W A, Minor connector in Stewart’s Clinical Removable Partial
Prosthodontics. 4th ed
• Mills ML. Mouth preparation for the removable partial denture. The Journal of the American Dental
Association. 1960 Feb 1;60(2):154-8.
• Rice JA, Lynch CD, McANDREW R, Milward PJ. Tooth preparation for rest seats for cobalt–
chromium removable partial dentures completed by general dental practitioners. Journal of oral
rehabilitation. 2011 Jan;38(1):72-8.
• Lee H, Kwon KR. A CAD-CAM device for preparing guide planes for removable partial dentures:
A dental technique. The Journal of prosthetic dentistry. 2019 Jul 1;122(1):10-3.
THANK YOU