Mc Cracken chapter 3: Classification of Partially Edentulous Arches
- 1. Mc Cracken’s Removable Partial Prosthodontics Edition - XII Seminar Created By Dr. Joel Koshy Joseph MDS
- 2. Chapter 3 Classification of Partially Edentulous Arches
- 3. Chapter Outline 1. Requirements of an acceptable method of classification 2. Kennedy Classification 3. Applegate’s Rule for applying the Kennedy Classification.
- 4. Several classification of partially edentulous arches have been proposed and are in use: Like: Kennedy Cummer and Bailyn Beckett Godfrey, Swenson, Friedman Wilson Skinner Applegate Avant Miller The Kennedy method is probably the most widely accepted classification of partially edentulous arches.
- 5. Requirements of an acceptable method of Classification 1. It should permit immediate visualization of the type of partially edentulous arch that is being considered. 2. It should permit immediate differentiation between the tooth supported and the tooth and tissue supported removable partial denture. 3. It should be universally acceptable
- 6. Kennedy Classification • Edward Kennedy – 1925 • He divided all partially edentulous arches into 4 basic classes. • He divided partially edentulous arch in a manner that suggest certain principles of design for a given situation.
- 7. Class I Bilateral edentulous areas located posterior to the natural teeth. BILATERAL EDENTULOUS SPACE NATURAL TEETH
- 8. Class II A unilateral edentulous area located posterior to remaining natural teeth. UNILATERAL EDENTULOUS SPACE NATURAL TEETH
- 9. Class III A unilateral edentulous area with natural teeth remaining both anterior and posterior to it UNILATERAL EDENTULOUS SPACE NATURAL TEETH NATURAL TEETH
- 10. Class IV A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth BILATERAL EDENTULOUS SPACE NATURAL TEETH NATURAL TEETH MIDLINE
- 11. Applegate’s rules governing application of Kennedy Method Rule 1: Classification should follow rather than precede any extractions of teeth that might alter the original classification. If 17 and 15 as supposed to be extracted due to poor prognosis , then the Classification would change from Class II mod 1 to Class I, hence, finish with all required extraction then proceed for Classification.
- 12. Rule 2: If a third molar is missing and is not to be replaced, it is not considered in the classification Here, 18 and 28 both are missing, so the classification was supposed to be Class I mod 1. But since, 18 and 28 are not to be replaced, then they should not be considered in classification itself. Hence, the final classification would be Class II mod 1.
- 13. Rule 3: If a third molar is present and is to be used as an abutment, it is considered in the classification Here, 38 is present, and its supposed to be used as an abutment, hence it should be considered within the classification. Hence the final classification would be Class II Mod 1
- 14. Rule 4: If a second molar is missing and is not to be replaced, it is not considered in the classification ( if the opposing second molar is likewise missing and is not to be replaced) Here, 17 and 27 are missing. So, the classification is supposed to be Class I mod 2. But due to some reason, if this second molars are not supposed to be replaced, then the classification would change to Class III Mod 1.
- 15. Rule 5: The most posterior edentulous area (or areas) always determines the classification. Class I Mod 1 Class II Mod 2 Class III Mod 1
- 16. Rule 6: Edentulous areas other than those that determine the classification are referred to as modifications and are designated by the their number Posterior most edentulous space (Determines the Classification: Rule 5) Modification area 1 Modification area 2 Modification area 3 Modification area 4 Modification area 5 Class III Mod 5
- 17. Rule 7: The extent of the modification is not considered, only the number of additional edentulous areas Modification area 1 Even though there are 6 teeth missing in the modification area, the classification is written as Class III Mod 1 and not Class III mod 6 Edentulous space
- 18. Rule 8: No modification areas can be included in Class IV arches (other edentulous areas that lie posterior to the single bilateral areas crossing the midline would instead determine the classification.) Class IV Mod 2 would be incorrect Instead its Class II mod 2. As the posterior most edentulous space determines the classification Posterior most Edentulous space determining the classification Rule 5.
- 19. References: 1. McGarry TJ, Nimmo A, Skiba JF, et al: Classification system for partial edentulism, J Prosthodont 11(3):181-193, 2002. 2. Picture source: Mc Cracken Removable Partial Prosthodontics Edition 12.
Editor's Notes
- #5: The Kennedy method is probably the most widely accepted classification of partially edentulous arches.