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RPD Lecture 1

This document provides an overview of removable partial dentures (RPDs). It discusses how tooth loss increases with age and the consequences like bone loss. RPDs are defined as removable prosthetics that replace some but not all teeth. Treatment objectives for RPDs include preserving remaining teeth, restoring function and aesthetics, and improving patient health and quality of life. Factors like materials used, retention and stability, and risks of damage are reviewed. Alternatives to RPDs like bridges and implants are also covered. Indications for when RPDs are appropriate are described.

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Parizad Naseri
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37 views15 pages

RPD Lecture 1

This document provides an overview of removable partial dentures (RPDs). It discusses how tooth loss increases with age and the consequences like bone loss. RPDs are defined as removable prosthetics that replace some but not all teeth. Treatment objectives for RPDs include preserving remaining teeth, restoring function and aesthetics, and improving patient health and quality of life. Factors like materials used, retention and stability, and risks of damage are reviewed. Alternatives to RPDs like bridges and implants are also covered. Indications for when RPDs are appropriate are described.

Uploaded by

Parizad Naseri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Removable Partial Dentures

Lecture 1
Tooth Loss and Age
• Tooth loss and age are linked
- Age goes up, tooth loss increases
• Frequently the last remaining teeth in the arch are the mandibular
anterior teeth
• It has been suggested that partially edentulous conditions are more
common in the maxillary arch, and that most commonly missing teeth
are the first and second molars
• Increase in the need for RPD's because people are taking care of their
teeth, and not loosing all
Consequences of Tooth Loss
• Bone Loss
- Greater in the mandible than the maxilla
- More positioned posteriorly than anteriorly
- Produces a broader mandibular arch, while constricting the maxillary arch
• Alteration to the oral mucosa
- The attached gingiva of the alveolar bone can become replaced with less
keratinized oral mucosa which is more readily traumatized
• Aesthetics
- Facial features change
- Lip support
- Decreased vertical support
Definition
• A Removable Partial Denture is a removable prosthodontic appliance that replaces
one or more, but not all, of the natural teeth and associated oral structures.
- It may be supported in the mouth by the natural dentition. (tooth-borne
removable partial denture)
- It may be supported by the natural dentition and mucosa (extension-based
removable partial denture)
- It may be supported by implants
- Can be removed from the mouth and replaced at will.
• RPD's are not merely mechanical devices that fill spaces. They are prosthetic
restorations that are therapeutic in nature and contribute to the overall health
of the partially edentulous patient.
Treatment Objectives
• Preserve the remaining natural teeth and their supporting structures
• Preserve the edentulous supporting area
• Restore aesthetic and phonetic function
• Improve masticatory efficiency
• Contribute to and restore the physical and mental health of the
patient. (Restore health, comfort and quality of life)
• THIS PHILOSOPHY ENFORCES OBLIGATIONS AND RESPONSIBILITIES
TO THE CLINICIAN BEYOND THE PURELY MECHANICAL CONCEPT.
• CAUSE NO DAMAGE!
Restoration of Oral Functions
• Restored masticatory function
• Good fit, securely attached and easy to insert and remove
• Aesthetically acceptable
• No impairment to phonetics
• Minimal tissue stress within physiologically acceptable limits
• Easy to clean and hygienically flawless
• High quality workmanship and dental precision
• Biocompatible materials
• High degree of functional reliability
• Prevent undesirable tooth movement (opposing arch)
• Preparation for complete dentures
Damages that may result
• Plaque accumulation
- May lead to chronic periodontitis and denture stomatitis
• Direct trauma from components
- Abrasion and fracture of restorations
• Transmission of excessive functional forces
- Tooth mobility
• Occlusal error from premature contact
- Tooth mobility
- Increase in bone resorption
- Facial Pain
• Denture stomatitis
Treatment Objectives and Philosophies
• Team approach (involve other professionals as needed)
• Practice for prevention, fixed or removable
• Biocompatibility
• Alternative treatments
• Future considerations and planning
Levels of RPD Restoration
• Temporary (acrylic)
- Clasps (wrought wire)
- Reinforcing and strengtheners
- Heat-cure vs cold cure
• Basic (chrome frame)
- Clasp supported partial
- Anchored on natural teeth
• Premium (chrome frame with C&B)
- Individually prepared retaining abutments, crown and bridge, attachments, implants
• Other
- Gasket denture
Alternatives to RPD's
Treatment Options (important for informed consent)
• No treament - ( on shortened dental arch)
- Most patients can function with a shortened dental arch
- Requires anterior teeth, plus 4 occlusal units minimum
• Fixed partial Denture - (Bridge)
- Requires abutments at opposite ends of edentulous space
- More expensive than RPD
- Must trim abutment teeth
- Can flex or fail if span is too long
• Implant Supported Prosthesis
- Most costly initially
- Closest replacement to natural teeth
• Complete denture (If few teeth left)
- If replacement of missing teeth is very complex or costly
Indications for RPD's
• Lengthy edentulous span (too long for a fixed prosthetic)
• No posterior abutment for a fixed prosthesis
• Excessive alveolar bone loss (aesthetic problems)
• Poor prognosis for complete dentures due to residual ridge morphology
• Reduced periodontal support of remaining teeth to support a fixed
restoration
• Cross arch stabilization of teeth
• Need for immediate replacement of extracted teeth
• Cost or patient considerations
Indications
• When a denture is needed during the rapid bone resorption following
tooth loss
- Immediate denture replacing anterior teeth
- Accident
- Failure of prosthesis
• As a diagnostic (or interim) denture until a definitive treatment plan is
formulated
- Alteration of vertical dimension/occlusion
- Determine how patient will respond to changed (TMD)

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