Lec.

1 Prosthodontics

INTRODUCTION TO REMOVABLE PARTIAL

DENTURES
Partial Dentures:
A removable partial denture or a fixed partial denture that restores a partially
edentulous arch; a partial denture can be described as a removable partial denture

the prosthesis, respectively.

I. Removable Partial Denture (RPD):

A removable denture that replaces some teeth in a partially edentulous arch; the
removable partial denture can be readily inserted and removed from the mouth by
the patient.
It is either acrylic type or metallic type (cobalt/chrome).

Acrylic RPD Metallic type (cobalt/chrome) RPD

Partial denture construction: The science and techniques of designing and

constructing partial dentures.

Removable prosthodontics:
The branch of prosthodontics concerned with the replacement of teeth and
contiguous structures for edentulous or partially edentulous patients by artificial
substitutes that are readily removable from the mouth by the patient.

Objectives for RPD construction:

1. Restore esthetic (especially for anterior teeth).
2. Restore function (phonetic and mastication) for proper speech, proper occlusion
and proper food mastication.
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3. To prevent apposing teeth extrusion or migration and tilting of adjacent teeth.
4. To fill empty space or spaces.
5. Prevent disease atrophy by a form of stimulation to the underlying tissue and
ridge.
6. For proper muscular balance.
7. To restore the psychological status of the patient.

Causes of teeth loss:

1. Caries (main cause in a young people below 35 years).
2. Periodontal diseases (main cause in old people above 35 years).
3. Trauma or accident (such as receiving a blow or falling down on them).
4. Congenital missing teeth.

Indications of removable partial dentures:

1. Distal extension situations (free end situation).
2. Long span tooth-bounded edentulous area.
3. Need for cross-arch (bilateral) stabilization.
4. Excessive loss of the residual ridge.
5. Unusually sound abutment teeth.
6. If the prognosis of remaining teeth is questionable or reduced periodontal
support of remaining teeth (these teeth cannot support fixed prostheses).
7. After recent extraction (need immediate replacement of extracted teeth).
8. Patient younger than 18 years old.
9. Economic consideration.

II. Fixed partial denture:

Any dental prosthesis that is luted, screwed, or mechanically attached or
otherwise securely retained to natural teeth, tooth roots, and/or dental
implants/abutments that furnish the primary support for the dental prosthesis and
restoring teeth in a partially edentulous arch; it cannot be removed by the patient.

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Indications for fixed partial denture:
1. Unilateral bounded edentulous short span.
2. Class IV Kennedy classification with normal loss of bone.
3. Modification area located anteriorly with Class I or with Class II Kennedy
classification for simplifies the design of removable partial denture.

III. Dental implant therapy:

A prosthetic device made of alloplastic material(s) implanted into the oral
tissues beneath the mucosal and/or periosteal layer and on or within the bone to
provide retention and support for a fixed or removable dental prosthesis.

The dental implants are considered adjuncts in fixed and removable therapy.
However, not all patients are candidates for dental implant therapy.

Contraindications for dental implant therapy

1. Unfavorable regional anatomy.
2. Uncontrolled systemic disease.
3. Extreme surgical risk.
4. High-dose head and neck radiation.

TERMINOLOGY AND DEFINITIONS

Denture supporting structures: The tissues (teeth and/or residual ridges) that
serve as the foundation for removable partial or complete dentures.

Diagnostic cast: A life-size reproduction of a part or parts of the oral cavity

and/or facial structures for the purpose of study and treatment planning.

Support: The foundation area on which a dental prosthesis rests; with respect to
dental prostheses, the resistance to forces directed toward the basal tissue or
underlying structures.
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Stability: The quality of a complete or removable partial denture to be firm,
steady, or constant, to resist displacement by functional horizontal or rotational
stresses.

Retention: That quality inherent in the dental prosthesis acting to resist the forces
of dislodgment along the path of placement.
(e. g., the force of gravity, the adhesiveness of foods, or the forces associated with
the opening of the jaws).

Support, stability, and retention become more meaningful when they are thought
of in terms of providing resistance to movement of a removable partial denture.

Interim, or provisional, denture: A fixed or removable dental prosthesis, or

maxillofacial prosthesis designed to enhance esthetics, stabilization, and/or
function for a limited period of time, after which it is to be replaced by a definitive
dental or maxillofacial prosthesis; often such prostheses are used to assist in
determination of the therapeutic effectiveness of a specific treatment plan or the
form and function of the planned definitive prosthesis.

Abutment: A tooth, a portion of a tooth, or that portion of a dental implant that

serves to support and/or retain a prosthesis.

Height of contour: A line encircling a tooth and designating its greatest

circumference at a selected axial position determined by a dental surveyor.

Undercut: The portion of the surface of an object that is below the height of
contour in relationship to the path of placement.

When used in reference to an abutment tooth, is that portion of a tooth that lies
between the height of contour and the gingiva.

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 When it is used in reference to other oral structures; the contour of a cross-
sectional portion of a residual ridge or dental arch that prevents the insertion of a
dental prosthesis.

The angle of gingival (cervical) convergence: The angle of gingival

convergence is located apical to the height of contour on the abutment tooth; it can
be identified by viewing the angle formed by the tooth surface gingival to the
survey line and the analyzing rod or undercut gauge of a surveyor as it contacts the
height of contour.

Path of insertion (placement): The specific direction in which a prosthesis is

placed on the residual alveolar ridge, abutment teeth, dental implant abutment(s),
or attachments.

Guiding planes: 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.

Guiding plane surfaces are parallel to the path of the placement (insertion) and
parallel to each other; preferably these surfaces are made parallel to the long axes
of abutment teeth.
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Bounded edentulous area: It is an edentulous area that is bounded and
supported by natural teeth at both ends.

Free-end edentulous area: It is an edentulous area that is bounded and

supported by natural teeth at one end.

Extension base or free end extension RPD: It is a removable partial denture

that is supported and retained by natural teeth only at one end of the denture base
segment and in which a portion of the functional load is carried by the residual
ridge, it is tooth - tissue - supported RPD.

Fulcrum line of rotation of a removable partial denture: A theoretical

line around which the RPD tends to rotate.

Saddle or denture bases: The part of a denture that rests on the foundation
tissues and to which teeth are attached.

Basal seat or denture foundation area: The oral anatomy available to

support a denture.

Retainer: Any type of device used for the stabilization or retention of a

prosthesis.

Treatment plan: The sequence of procedures planned for the treatment of a

patient after diagnosis.

Nesbit prosthesis: Eponym for a unilateral removable partial denture that

restores missing teeth on one side of the arch only, without a cross-arch major
connector.

Unilateral removable partial denture design

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‫االستاذ الدكتور رغداء كريم جاسم‬
‫ا ‪.‬د رغداء كريم جاسم‬
Lecture: 11 ‫ علي نعمه احمد حسين‬:‫د‬

Prosthodontics
Types of clasp assemblies:
They are of two types:-
1. Clasps designed without movement accommodation.
2. Clasps designed to accommodate distal extension functional movement.
Clasps designed without movement accommodation: It is also named suprabulge clasp or
occlusally approach clasp since the clasp approaches the retentive undercut from the occlusal
direction.
Clasps for tooth-borne partial dentures (Class III and IV) have one function to prevent
dislodgment of the prosthesis without damage to the abutment teeth. Since there is little or
no rotation caused by tissue ward movement of the edentulous area (as happens in distal
extension cases) stress releasing properties are usually not required. These clasps can also be
used in modification spaces for tooth and tissue supported removable partial dentures (Class
I and II).
Circumferential (Circle or Akers) clasp:
 The circumferential clasp will be considered first as an all-cast clasp and it is the
simplest one.
 The basic form of the circumferential clasp is a buccal and lingual arm originating
from a common body (principle occlusal rest and minor connector).
 The circumferential clasp has only one retentive clasp arm, opposed by a nonretentive
reciprocal arm on the opposite side.
 It approaches the undercut area from an occlusal direction so it is called (occlusally
approaching clasp) since it is coming to the undercut area from above the bulge area
so-called (suprabulge clasp) and since it is pulling the tooth during action also called
pull clasp and also called Aker clasp.
 The retentive arm begins above the height of contour, and curves and tapers to its
terminal tip, in the gingival 1/3 of the tooth, well away from the gingival.
 The bracing (nonretentive reciprocal) arm is in the middle 1/3 of the tooth, and is
broader occlusal – gingivally, does not taper and is either entirely above the height of
contour or completely on a prepared guiding plane – it should never be designed into
an undercut, as it is a rigid element.
 Support is provided by occlusal rest; stabilization is provided by occlusal rest,
proximal minor connector, lingual clasp arm and rigid portion of buccal retentive clasp
arm occlusal to the height of contour; retention is realized by the retentive terminal of
buccal clasp arm; reciprocation is provided by nonflexible lingual clasp arm. Clasp
Assembly engages more than 180 degrees of abutment tooth's circumferences.

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Indications:
 It is a most logical clasp to use with all tooth-supported partial dentures because of its
retentive and stabilizing ability.
 On free end extension when minimal undercut is utilized.
Contraindication:
 When the retentive undercut may be approached better with a bar clasp arm.
 When esthetics will be enhanced by using bar clasp arm.
Advantages:
 Excellent bracing qualities.
 Easy to design and construct.
 Less potential for food accumulation below the clasp compared to bar clasps.
Disadvantages:
 More tooth surface is covered than with a bar clasp arm because of its occlusal origin.
 On some tooth surfaces, particularly the buccal surface of mandibular teeth and the
lingual surfaces of maxillary teeth, its occlusal approach may increase the width of the
occlusal surface of the tooth.
 In the mandibular arch, more metal may be displayed than with the bar clasp arm.
 Its half-round form prevents adjustment to increase or decrease retention. True
adjustment is impossible with most cast clasps.
The circumferential type of clasp may be used in several forms:
1. Ring-type clasp:
 Ring clasp, which encircles nearly all of a tooth from its point of origin.
 Usually used with mesially and lingually tilted mandibular molars or the undercut is
on the same side as the rest seat (i.e. adjacent to edentulous span).
 The clasp should never be used as an unsupported ring because if it is free to open and
close as a ring, it cannot provide either reciprocation or stabilization. Instead, the ring-
type clasp should always be used with a supporting strut on the nonretentive side,
with or without an auxiliary occlusal rest on the opposite marginal ridge. The
advantage of an auxiliary rest is that further movement of a mesially inclined tooth is
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prevented by the presence of a distal rest. In any event, the supporting strut should be
regarded as being a minor connector from which the flexible retentive arm originates.
 Reciprocation comes from the rigid portion of the clasp lying between the supporting
strut and the principal occlusal rest.
 The ring-type clasp should be used on protected abutments whenever possible because
it covers such a large area of the tooth surface.

Indications:
 It is used when a proximal undercut cannot be approached by other means. For
example, when a mesiolingual undercut on a lower molar abutment (isolated lower
molar such as in Class II modification one) cannot be approached directly because of
its proximity to the occlusal rest area and cannot be approached with a bar clasp arm
because of lingual inclination of the tooth.
 It may be used in reverse on an abutment located anterior to a tooth-bounded
edentulous space when a distobuccal or distolingual undercut cannot be approached
directly from the occlusal rest area and/or tissue undercuts prevent its approach from a
gingival direction with a bar clasp arm.

Contraindication:
 Excessive tissue undercuts prevent the use of a supporting strut.
Advantages:
a. Excellent bracing (with supporting strut).
b. Allow the use of an available undercut adjacent to the edentulous area.

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Ring clasp (s) encircling nearly the entire tooth from its point of origin. A Clasp originates
on the mesiobuccal surface and encircles the tooth to engage the mesiolingual undercut. B,
Clasp originates on the mesiolingual surface and encircles the tooth to engage the
mesiobuccal undercut.
Disadvantages:
 Covers a large area of the tooth surface, therefore requiring meticulous hygiene.
 Very difficult to adjust due to the extreme rigidity of the reciprocal arms.
 The lower bracing arm should be at least 1mm from the free gingival margin and
relieved to prevent impingement of the gingival tissues.
2. Embrasure (double Akers) clasp:
 The embrasure clasp always should be used with double occlusal rests, even when
definite proximal shoulders can be established. This is done to avoid interproximal
wedging by the prosthesis, which could cause separation of the abutment teeth and
result in food impaction and clasp displacement.
 In addition to providing support, occlusal rests also serve to shunt food away from
contact areas.
 Embrasure clasps should have two retentive clasp arms and two reciprocal clasp arms,
either bilaterally or diagonally opposed.

Example of use of embrasure clasp for a Class II partially edentulous arch: Embrasure clasp
on two left molar abutments were used in the absence of posterior modification space.
Indications:

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Used in a quadrant where no edentulous area exists, In an unmodified Class II or Class III
partial denture, where there are no edentulous spaces on the opposite side of the arch to aid
in clasping.

Occlusal and proximal surfaces of adjacent molar and premolar prepared for embrasure
clasp. Note that rest seat preparations are extended both buccally and lingually to
accommodate retentive and reciprocal clasp arms.
Disadvantages:
o Extensive interproximal reduction is usually required.
o Covers large area of tooth surface – hygiene considerations.
Other less commonly used modifications of the cast circumferential clasp are:
1. Back action clasp:
o The back-action clasp is a modification of the ring clasp.
o It is used on premolar abutment anterior to edentulous space.
o The undercut can usually be approached just as well using a conventional
circumferential clasp, with less tooth coverage and less display of metal.
o Its use is difficult to justify.

2. Multiple clasps:
The multiple clasps are simply two opposing circumferential clasps joined at the terminal
end of the two reciprocal arms.

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Indications:
o It is used when additional retention and stabilization are needed, usually on
tooth-supported partial dentures.
o It may be used for multiple clasping in instances in which the partial denture
replaces an entire half of the dental arch.
o It may be used rather than an embrasure clasp when the only available retentive
areas are adjacent to each other.
Disadvantage:
o Its disadvantage is that two embrasure approaches are necessary rather than a
single common embrasure for both clasps.
3. Half-and-half Clasp:
o It is consists of a circumferential retentive arm arising from one direction and a
reciprocal arm arising from another.
o The second arm must arise from a second minor connector, and this arm is used
with or without an auxiliary occlusal rest.
o Its design was originally intended to provide dual retention, a principle that
should be applied only to unilateral partial denture design.
o Reciprocation arising from a second minor connector usually can be
accomplished with a short bar or with an auxiliary occlusal rest, thereby
avoiding so much tooth coverage.
o There is little justification for the use of the half-and-half clasp in bilateral
extension base partial dentures.

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4. Reverse-action clasp (Hairpin):

o Ring clasp or bar clasp originating on the opposite side of the tooth can be used
with the same result getting from reverse- action clasp.
o The upper part of the arm of this clasp should be considered a minor connector,
giving rise to the tapered lower part of the arm. Therefore only the lower part of
the arm should be flexible. With the retentive portion beginning beyond the
turn, only the lower part of the arm should flex over the height of the contour to
engage a retentive undercut.
o The bend that connects the upper and lower parts of the arm should be rounded
to prevent stress accumulation and fracture of the arm at the bend.
Advantage:
o Clasp arm is designed to permit engaging a proximal undercut (undercut
adjacent to edentulous space) from an occlusal approach.

Disadvantages:
o Esthetically objectionable when using an anterior abutment.
o The clasp covers a considerable tooth surface and may trap debris.
o Almost impossible to adjust.
o Difficult to fabricate.
o Insufficient flexibility on short crowns due to insufficient clasp arm length.
Indications:
o When a proximal undercut must be used on a posterior abutment and when
tissue undercuts, tilted teeth or high tissue attachments prevent the use of a bar
clasp arm.
o When lingual undercuts may prevent the placement of a supporting strut (of ring
clasp) without tongue interference.
o May be used on abutments of tooth-supported dentures when proximal undercut
lies below the point of origin of the clasp.
Disadvantages of circumferential clasps in summary:
 A large amount of tooth surface is covered by clasp assembly.
 It alters the gross morphology of the clinical crown.
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Clasps designed to accommodate distal extension functional movement:

Two strategies are adapted to either:
 Change the fulcrum location and subsequently the "resistance arm" engaging effect
(mesial rest concept clasp assemblies).
 Minimize the effect of the lever by use of a flexible arm (wrought-wire retentive
arm).
Change the fulcrum location and subsequently the "resistance arm" engaging effect:
Mesial rest concept clasps assemblies (RPI, RPA, and Bar clasp): These are proposed to
accomplish movement accommodation by changing the fulcrum location to prevent harmful
tipping or torquing of the abutment tooth and prevent more denture base movement. This is
concept includes RPI and RPA clasps.
RPI clasp:
RPI clasps are referring to the: R = Rest always mesial, P = Proximal plate, and I = I-bar.
These are component parts of the clasp assembly. Basically, this clasp assembly consists of:
o A mesioocclusal rest of a premolar or mesiolingual surface of a canine with the
minor connector placed into the mesiolingual embrasure, but not contacting the
adjacent tooth (prevents wedging).

Occlusal view
 A distal guiding plane, extending from the marginal ridge to the junction of the middle
and gingival thirds of the abutment tooth, is prepared to receive a proximal plate. The
buccolingual width of the guiding plane is determined by the proximal contour of the
tooth.

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 The proximal plate (essentially a wide minor connector) is located on a guide plane on
the distal surface of the tooth. The plate is approximately l mm thick and joins the
framework at a right angle.
 The I-bar in conjunction with the minor connector supporting the rest provides the
stabilizing and reciprocal aspects of the clasp assembly.

 I-bar should be located in the gingival third of the buccal or labial surface of the
abutment in a 0.01-inch (0.25mm) undercut. The whole arm of the I-bar should be
tapered to its terminus, with no more than 2 mm of its tip contacting the abutment. The
retentive tip contacts the tooth from the undercut to the height of the contour. This
area of contact along with the rest and proximal plate contact provides stabilization
through the encirclement. The bend in the I-bar should be located at least 3 mm. from
the gingival margin. This distance will prevent food entrapment and provide the length
for the necessary flexibility in the clasp arm.

 The clasp is usually cast and is placed just below the height of the contour line.

 On the canine, the I-bar is located in the mesiobuccal undercut and is reciprocated
directly by the proximal plate.

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The horizontal portion of the approach arm must be located at least 4 mm from the gingival
margin and even farther if possible.

Bar-type clasp assembly:

A: Occlusal view. Component parts :( proximal plate minor connector, rest with minor
connector, and retentive arm) tripod the abutment to prevent its migration. B: The proximal
plate minor connector extends just far enough lingually so that it combines with the mesial
minor connector to prevent the lingual migration of the abutment. C: On narrow or tapered
abutments (mandibular first premolars), the proximal plate should be designed to be as
narrow as possible but still sufficiently wide to prevent lingual migration. D: I-bar retainer
located at the greatest prominence of the tooth in the gingival third. E: Mesial view of I-bar
illustrating the retentive tip relationship to the undercut and a region superior to the height of
contour, which serves stabilization function in the encirclement.

Occlusal view of RPI bar clasp assembly. Placement of l-bar which is depending on the
position of proximal plate in relation to guiding plan on proximal tooth surface: (A) On the
distobuccal surface. (B) At greatest mesiodistal prominence. (C) On the mesiobuccal surface.

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The bar clasp arm arises from the denture framework or a metal base and approaches the
retentive undercut from a gingival direction.

The bar clasp arm has been classified by the shape of the retentive terminal. Thus it has been
identified as T, Y, L, I, U and S. I shape bar is preferred than other shapes because this shape
being biologically and mechanically sound.

If the abutment teeth demonstrate contraindications for a bar-type clasp a modification

should be considered for the RPI system (the RPA clasp; Akers clasp).
Contraindications:
 Deep cervical undercuts - food trap or impingements result.
 Severe soft tissue or bony undercuts - food trap or impingements result.
 Insufficient vestibular depth for approach arm, because this reduces the advantageous
length of the arm and made the clasp too close to the gingival margin it (requires 4 - 3
mm from the free gingival margin, 1 mm for the thickness of the approach arm).
 Pronounced frenal attachments area – impingement.
 The excessive buccal or lingual tilt of the abutment tooth.
RPA clasp; Akers clasp:
This clasp assembly is similar to the RPI design (consists of a mesial occlusal rest,
proximal plate, except a wrought wire circumferential clasp (Akers) is used instead of the I-
bar. This clasp arises from the proximal plate and terminates in the mesiobuccal undercut. It
is used when there is insufficient vestibule depth or when a severe tissue undercut exists.

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There are several other types of bar clasps; for example:

Infrabulge clasp:
It is designed so that the bar arm arises from the border of the denture base, either as an
extension of a cast base or attached to the border of a resin base. It is made more flexible
than the usual bar clasp arm.

Advantages:
 Its interproximal location, which may be used to esthetic advantage. And Increased
retention without tipping action on the abutment.
 Less chance of accidental distortion resulting from its proximity to the denture border.
 Minimize the effect of the lever by use of a flexible arm (wrought- wire retentive
arm).
Combination clasp:
 Another strategy to reduce the effect of the Class I lever in distal extension situations
is to use a flexible component in the "resistance arm,” which is the strategy employed
in the combination clasp. The combination clasp consists of a wrought-wire retentive
clasp arm (round, uniformly tapered 18-gauge platinum-gold-palladium alloy or
chrome- cobalt alloy wrought- wire) and a cast reciprocal clasp arm.
 The retentive arm (wrought-wire) is almost always circumferential, but it also may be
used in the manner of a bar, originating gingivally from the denture base.
 The cast reciprocal arm may be in the form of a bar clasp arm, it is usually a
circumferential arm.

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Advantages:
o The flexibility.
o The adjustability.
o The esthetic appearance of the wrought-wire retentive arm over other retentive
circumferential clasp arms).
o Minimum of tooth surface covered because of its line contact with the tooth,
rather than having the surface contact of a cast clasp arm.
o A less likely occurrence of fatigue failures.
Disadvantages:
o It involves extra steps in fabrication, particularly when high-fusing chromium
alloys are used.
o It may be distorted by careless handling on the part of the patient.
o Because it is bent by hand, it may be less accurately adapted to the tooth and
therefore provide less stabilization in the suprabulge portion.
o It may distort with function and not engage the tooth.
Indications:
o When maximum flexibility is desirable, such as on an abutment tooth adjacent
to a distal extension base where only a mesial undercut exists on the abutment
or a weak abutment or where a large tissue undercut, contraindicates a bar- type
direct retainer.
o It may be used for its adjustability when precise retentive requirements are
unpredictable and later adjustment to increase or decrease retention may be
necessary.
o When esthetic required overcast clasps, because wrought -wire is round, light is
reflected in such a manner that the display of metal is less noticeable than with
the broader surfaces of a cast clasp.
The various types of cast circumferential clasps may be used in combination with bar clasp
arms. Circumferential and bar clasp arms may be made either flexible (retentive) or rigid
(reciprocal) in any combination as long as each retentive clasp arm is opposed by a rigid
reciprocal component.

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Lec.2 Prosthodontics ‫رغداء كريم‬.‫د‬

CLASSIFICATION OF PARTIALLY EDENTULOUS

ARCHES
Need for classification:
1. To formulate a good treatment plan.
2. To anticipate the difficulties common to occur for that particular design.
3. To communicated with a professional about a case.
4. To design the denture according to the occlusal load usually expected for a
particular group.

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.
4. Serve as a guide to the type of design to be used.

*Removable partial dentures may be classified according to the

type of support into:
1. Tooth supported prosthesis: is a prosthesis or part of the prosthesis that
depends entirely on the natural teeth (abutments) for support.
For partially edentulous patients the prosthetic options available include:
 Natural tooth - supported fixed partial dentures.
 Natural tooth – supported removable partial dentures.
 Implant - supported fixed partial dentures.
Retention is derived from direct retainers on the abutment teeth, tooth supported
RPDs do not move appreciably in function.

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year / College of Dentistry/ Page 1
2. Tooth - tissue supported prosthesis: is a prosthesis or part of the
prosthesis that depends on the natural teeth (abutment) as well as the residual ridge
and tissue for support. Also called true partial denture, it includes a free end
extension.

The tooth – tissue supported RPD supported at one end by natural teeth, which
essentially do not move, and at the other end by the denture bearing tissues(mucosa
overlying bone) which moves because of the resiliency of the mucosa.

3. Tissue supported prosthesis: is one which is supported entirely by mucosa

and underlying bone.

Tissue supported RPDs are primarily supported by tissues (mucosa overlying

bone) of the denture foundation area. Tissue supported RPDs usually have plastic

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year / College of Dentistry/ Page 2
major connectors and are, therefore, usually interim RPDs. Tissue supported RPDs
will move in function because of the resiliency of the mucosa.

Retention for tissue supported RPDs is customarily provided by wrought wire

retentive clasp arms on selected natural teeth.

Tissue supported RPDs have the potential to cause soft tissue damage and
periodontal attachment loss and accordingly should be used for only a short period
of time.

*Removable partial dentures may be classified according to the

type of material used into:
1. Acrylic (Temporary RPDs): is the RPD made of acrylic and artificial teeth,
retentive wires (clasp) may be used for retention.
2. Cr/Co (Chrome/Cobalt)-metal RPDs (Definitive RPDs): is the RPD made of
metal or alloys and artificial teeth, acrylic may be used as a denture base.

Removable partial dentures may be classified according to the

type of treatment:

1. Definitive RPDs:
Definitive RPDs are constructed after extensive diagnosis, treatment planning,
and through preparation of the teeth and tissue for the prosthesis. The length of
service of definitive RPDs is intended to be many years this meaning the cobalt
chromium alloy removable partial dentures.
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2. Interim RPDs:
Interim RPDs are usually constructed as part of the preparation of the mouth for
definitive RPD, FPD or implant treatment. The length of service of interim RPDs
is generally planned to be a year or less, they are frequently referred to as temporary
RPDs example of that is the acrylic removable partial dentures.

* Classification based on arch configuration:

The most widely accepted system of classification of RPDs and partially
edentulous arches was proposed by Dr. Edward Kennedy in 1923. It is based on the
configuration of the remaining natural teeth and edentulous spaces. This systemwas
further defined and expanded upon by Dr. O.C. Applegate and Dr. Jacques Fiset.

The values of the Kennedy – Applegate – Fiset classification system are that:
1. It is relatively simple and easy to remember.
2. Extremely comprehensive and very practical.
3. Universally accepted.
4. It permits logical approach to the problem of design.
5. It permits immediate visualization of the partially edentulous arch or RPDs
designed for that arch.
6. It indicates the type of support for the RPD, which suggest certain physiological
and mechanical principles of treatment and RPD design.

Kennedy – Applegate – Fiset classification system

According to this classification system, partially edentulous arches

are classified into four basic classes:

Class I: Bilateral edentulous areas located posterior to the natural teeth.

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Class II: A unilateral edentulous area located posterior to the remaining natural
teeth.

Class III: A unilateral edentulous area with natural teeth remaining both anterior
and posterior to it.

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Class IV: A single, but bilateral (crossing the midline), edentulous area located
anterior to the remaining natural teeth.

Edentulous areas other than those determining the basic classes

were designated as modification spaces and written as a number 1, 2,
3… depending on the number of the extra edentulous spans.
Example:

Class III, modification 2

Applegate’s rules governing the application of the Kennedy

classification method:
*Rule 1
Classification should follow rather than precede any extractions of teeth that
might alter the original classification.

* Rule 2
If a third molar is missing and not to be replaced, it is not considered in the
classification.

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* Rule 3
If a third molar is present and is to be used as an abutment, it is considered in the
classification.

* Rule 4
If a second molar is missing and is not to be replaced, it is not considered in the
classification (e. g., if the opposing second molar is likewise missing and is not to
be replaced).

* Rule 5
The most posterior edentulous area (or areas) always determines the classification.

* Rule 6
Edentulous areas other than those determining the classification are referred to
as modifications and are designated by their number.
* Rule 7
The extent of the modification is not considered, only the number of additional
edentulous areas.

*Rule 8
There can be no modification areas in Class IV arches. (Other edentulous areas
lying posterior to the single bilateral areas crossing the midline would instead
determine the classification; see Rule 5.)

Examples of different partially edentulous arches cases

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3rd
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Lec.3 Prosthodontic . ‫د رغداء كريم‬. ‫ا‬

Surveying
The ideal requirements for successful removable partial denture are:
1. Be easily inserted and removed by the patient.
2. Resist dislodging forces.
3. It should be aesthetically pleasing.
4. Avoid the creation of undesirable food traps.
5. Minimize plaque retention.

This objective is achieved by a careful evaluation of a patient’s study casts. The

instrument used to aid the examination of the study casts is called a dental surveyor and
the procedure is known as surveying.

Surveying
It’s the determination of the relative parallism of two or more surfaces of the teeth
or other parts of the cast of the dental arch.

Survey
It’s the procedure of the locating and delineating the contour and position of the
abutment teeth and associated structures before designing a removable partial denture.

Objective of surveying
In order to plane those modifications to fabricate a removable partial denture thus
can be easily inserted in the mouth and retained in place during function.

Purposes (Objective) of Surveying the Diagnostic Cast

1. To determine the most desirable path of placement that will eliminate or minimize
interference to placement and removal.

Page 1
 When the restoration (RPD) is properly designed to have positive guiding planes,
the patient may place and remove the restoration with ease in only one direction.

Advantages of single path of placement (insertion):

A. Allows insertion and removal of prosthesis without interference.
B. Help to direct the force along the long axis of the tooth.
C. Provide frictional retention.
D. Minimize torque on the abutment teeth.
E. Cross arch stabilization.
F. Equalize retention.
2. To identify proximal tooth surfaces that are, or need to be, made parallel so that they
act as guiding planes during placement and removal.

Guiding planes: 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. They are:
A. Flat surfaces parallel to the path of insertion.
B. Represent the initial contact of the RPD.
C. Help to stabilize, control and limit the movement of the RPD.

Guiding planes (The prosthesis during placement)

(Vertically parallel surfaces on abutment teeth)

3. To locate and measure areas of the teeth that may be used for retention.
4. To determine whether tooth and bony areas of interference will need to be
eliminated surgically or by selecting a different path of placement.
5. To determine the most suitable path of placement that will permit locating retainers
and artificial teeth to the best esthetic advantage.
6. To permit an accurate charting of the mouth preparation to be made.
7. To delineate the height of contour (survey line) on abutment teeth and to locate areas
of undesirable tooth undercut those are to be avoided, eliminated, or blocked out.

Page 2
Undercuts could be:
A. Desirable undercut: this is useful in to retain RPD against dislodging forces.
B. Undesirable undercut: other than that used to retain the RPD; in most of the case
undesirable undercut interfere with placement and removal of the prosthesis or
produces damaging effects on the teeth and underlying structures. Such type of
undercut can be eliminated by:
 Block out with wax.
 Preparation and alteration of the tooth surfaces (within a limit).
 Crown restoration, in which the tooth surface can be reshaped to serve RPD
functions and requirements.
8. To record the cast position in relation to the selected path of placement for future
reference. This may be done by locating three dots (tripods) or parallel lines on the
cast; three dotes or lines, one anterior and two posterior to permit its reorientation.

A-B, The path of placement is determined, and the base of the cast is scored to record its relation to the
surveyor for future repositioning. C, An alternate method of recording the relation of the cast to the
surveyor is known as tripoding. A carbon marker is placed in the vertical arm of the surveyor, and the
arm is adjusted to the height by which the cast can be contacted in three divergent locations. The vertical
arm is locked in position, and the cast is brought into contact with the tip of the carbon marker. Three
resultant marks are encircled with colored lead pencil for ease of identification. Reorientation of the
cast to the surveyor is accomplished by tilting the cast until the plane created by three marks is at a
right angle to the vertical arm of the surveyor. D, Height of contour is then delineated by a carbon
marker.

Page 3
 Three dots (tripoding) Parallel lines

Dental surveyor
It’s as an instrument used to determine the relative parallelism of two or more
surfaces of the teeth or other parts of the cast of a dental arch.

Types of dental surveyors

The most widely used surveyors are:

1. Ney surveyor with non-swiveling horizontal arm.

The Ney surveyor is widely used because of its simplicity and durability.

Page 4
2. Jelenko surveyor with swiveling horizontal arm and has spring mounted paralleling
tool.

The Jelenko surveyor: Note the spring-mounted paralleling tool and swivel at the top of the
vertical arm. The horizontal arm may be fixed in any position by tightening the nut at the top of
the vertical arm.

Parts of dental surveyor (Ney type surveyor):

A. Platform on which the base is moved.
B. Vertical arm or upright column that supports the superstructures.
C. Horizontal arm from which surveying tools suspends.
D. Survey arm.
E. Mandrel for holding special tools.
F. Tools which are used for surveying (in sequence) include: analyzing rod, carbon
marker, undercut gauges, wax trimmer.
G. Table to which the cast is attached.
H. Base on which the table swivels.

Page 5
Analyzing rod
It’s a rigid metal rod used for diagnostic purposes in the selection of the path of
placement and to determine the undercut areas prior to scribing the height of contour
with the carbon marker.

Page 6
Carbon marker
It’s used for the actual marking of the survey lines on the cast. A metal shield is
used to protect it from breakage.

Carbon marker and metal shield

Undercut gauges
They are used to measure the extent of the undercuts on abutment teeth that are
being used for clasp retention, usually there are available in three gauges: 0.01, 0.02, and
0.03 inch. Undercut dimensions can be measured on teeth by bringing the vertical shaft
of the gauge in contact with a tooth and then moving the surveying arm up or down until
there is also contact with the terminal tip.

Page 7
Wax trimmer
It’s a knife used for trimming the excess wax which blocks out undesirable
undercut in such away to be parallel to each other and to the pre-determined path of
insertion.

Page 8
 Whenever possible, cast should be surveyed with the occlusal plane parallel to
the base of the surveyor so that the path of insertion is vertical to the occlusal plane.
Most patients will tend to seat the partial denture under force of occlusion. If the
path of insertions is other than vertical to the occlusal plane such seating may deform
the clasps.

Page 9
Lec. Prosthodontics ‫ رغداء‬.‫د‬

Retention and Removable Partial Denture

Retainers
In general a removable partial denture should have these requirements:
1- Support: The support derived from the abutment teeth through the use of rests
and from the residual ridge through the use of well fitting bases.

2- Stability: Removable partial denture must be stable against horizontal movement

through the use of rigid components like reciprocal arm of circumferential clasp
and minor connector. Removable partial denture must also be stable against
rotational movements through the use of rigid connector and indirect retainers.

3- Retention: Sufficient retention is provided by two means. Primary retention for

removable partial denture is accomplished mechanically by placing retaining
elements (direct retainers) on the abutment teeth. Secondary retention is provided
by the intimate relationship of the minor connector contact with the guiding planes
,denture bases, and major connectors (maxillary) with the underlying tissue .The
latter (secondary retention) is similar to the retention of complete denture. It is
proportionate to the accuracy of the impression registration, the accuracy of the fit
of the denture bases, and the total involved area of contact.

Retainers can be divided into:

I. Direct retainers.
II. Indirect retainers.
Direct retainers
A direct retainer: is any unit of a removable dental prosthesis that engages an
abutment tooth to resist displacement of the prosthesis away from basal seat tissue.
The direct retainer's ability to resist this movement is greatly influenced by the
stability and support of the prosthesis provided by major and minor connectors,
rests, and tissue bases.

Page 1
 The extracoronal retainer (Clasp type)
The extracoronal retainer is the most commonly used retainer for removable
partial dentures, which uses mechanical resistance to displacement through
components placed on the external surfaces of an abutment tooth in an area cervical
to survey line or in a depression created for this purpose. Usually a flexible arm is
forced to deform, so there will be resistance to removal.

Component parts, Function and position of clasp assembly parts

Component Part Function Location

Rest Support Occlusal, lingual and incisal rests.

Minor connector Stabilization Proximal surfaces extending from a prepared
marginal ridge to the junction of the middle
and gingival one third of abutment crown.
Clasp arms Stabilization Middle one third of crown.
(Reciprocation)
Retention Gingival one third of crown in measured
undercut.

Page 2
 Extracoronal circumferential direct retainer
Assembly consists of: (A) the buccal retentive arm;
(B) the rigid lingual stabilizing (reciprocal) arm;
and (C) the supporting occlusal rest. The terminal
portion of the retentive arm is flexible and engages
measured undercut. Assembly remains passive
until activated by placement or removal of the
restoration, or when subjected to masticatory
forces that tend to dislodge the denture base.

Factors affecting the magnitude of retention

I. Size of and distance into the angle of cervical (gingival) convergence
and how far into the angle of convergence the clasp terminal is placed
When the angle of convergence between two abutments differs, uniformity of
retention can be obtained by placing the clasp arms into the same degree of
undercut (i.e. both 0.01").A guiding principle of partial denture design is that
retention should be uniform in magnitude and bilaterally opposed amongst
abutments.
Greater angle of cervical convergence on
tooth (A) necessitates placement of clasp
terminus, (X), nearer the height of contour
than when lesser angle exists, as in (B).

3rd
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II. Flexibility of the clasp arm
This is influenced by the following factors:

1. Length of clasp arm

 Increase length of clasp arm increase the flexibility of it (increasing clasp
curvature increases length).

 Length of clasp arm is measured from the point where the taper begins.
 Length of clasp arm may be increased by using curving rather than straight
retentive arms.

2. Diameter of clasp
 The greater the average diameter of a clasp arm the less flexible it will be.
 If it’s taper is absolutely uniform, the average diameter will be at a point midway
between its origin and its terminal end. If its taper is not uniform, a point of flexure
and therefore a point of weakness will exist.
 The clasp should always taper from the body to the tip, being thicker where the
body is attached to the denture base metal or acrylic and thinnest at the end of the
arm.

The rigid clasp shoulder (S) originates from

the minor connector and projects across the
axial surface of the abutment. The relatively
flexible midsection of the clasp arm (M)
continues along the abutment surface and
approaches the height of contour. The
flexible clasp terminus (T) crosses apical to
the height of contour, contacting the
abutment on a surface undercut relative to
the path of prosthesis insertion and removal.

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3. Cross-sectional form of the clasp arm
Flexibility may exist in any form, but it is limited to only one direction in the case
of the half-round form (bidirectional flexure). The only universally flexible form
(omnidirectional flexure) is the round form, which is practically impossible to obtain
by casting and polishing.

When viewed in cross-section, a round clasp

(a) is able to flex in all directions, while a
half-round clasp (b) is restricted to
bidirectional flexure.

4. Clasp material
 Whereas all cast alloys used in partial denture construction possess flexibility;
their flexibility is proportionate to their bulk.
 Greater rigidity with less bulk is possible through the use of chromium-cobalt
alloys.
 Gold clasps are not as flexible or adjustable as wrought wire.
 Wrought wire clasp have greater tensile strength than cast clasps and hence can
be used in smaller diameter to provide greater flexibility without fatigue fracture.

5. Relative uniformity of retention

Having reviewed the factors inherent to a determination of the amount of retention
from individual clasps, it is important to consider coordination of relative retention
between various clasps in a single prosthesis.

6. Stabilizing-reciprocal cast clasp arm

 When the direct retainer becomes active, the framework must be stabilized against
horizontal movement. This stabilization is derived from either cross-arch framework
contacts or a stabilizing or reciprocal clasp in the same clasp assembly.

3rd
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  To provide true reciprocation, the reciprocal clasp must be in contact during the
entire period of retentive clasp deformation. This is best provided with lingual-
palatal, guide-plane surfaces.
 Its average diameter must be greater than the average diameter of the opposing
retentive arm to increase desired rigidity.

(Cast retentive arm) (Cast reciprocal arm)

The basic principles of clasp design

1. Encirclement: The principle of encirclement means that more than 180 degrees
in the greatest circumference of the tooth must be engaged by the clasp assembly.
The engagement can be in the form of continuous contact, such as in a
circumferential clasp (A), or discontinuous contact, such as in the use of a bar clasp
(B). Both provide tooth contact in at least three areas encircling the tooth: the
occlusal rest area, the retentive clasp terminal area, and the reciprocal clasp
terminal area.

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2. Support: The occlusal rest must be designed to prevent the movement of the
clasp arms toward the cervical.

A rest must prevent apical displacement of the

prosthesis. If this is not accomplished, the
underlying hard and soft tissues may damaged.

3. Reciprocation: Each retentive terminal should be opposed by a reciprocal

component capable of resisting any transient pressures exerted by the retentive
arm during placement and removal.

4. Clasp retainers on abutment teeth adjacent to distal extension bases should be

designed so that they will prevent direct transmission of tipping and rotational
forces to the abutment. In effect, they must act as stress breakers either by their
design or by their construction.

5. Retentive clasps should be bilaterally opposed, i.e., buccal retention on one side
of the arch should be opposed by buccal retention on the other, or lingual on one
side opposed by lingual on the other.

Retentive clasps should be bilaterally opposed.

This means using bilateral buccal or bilateral
lingual undercuts as shown on this Class III,
mod. 2 arch where the retention may be either
(a) bilaterally buccal or (b) bilaterally lingual.

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6. The amount of retention should always be the minimum necessary to resist
reasonable dislodging forces.

7. Reciprocal elements of the clasp assembly should be located at the junction of the
gingival and middle thirds of the crowns of abutment teeth. The terminal end of
the retentive arm is optimally placed in the gingival third of the crown. These
locations permit better resistance to horizontal and torqueing forces because of a
reduction in the effort arm.

8. Passivity: When the clasp is in its place on the tooth surface, it should be at rest,
the retentive tip of the clasp arm must be passive and remain in contact with the
tooth ready to resist vertical dislodging force, so when a dislodging force is
applied the clasp arm should immediately become active to engage tooth surface
resist vertical displacement.

3rd
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‫‪Lec 5‬‬ ‫ا‪.‬د رغداء كريم جاسم‬
Lecture: Prosthodontics [Link] Kareem

Minor Connector

Minor connectors are those components that serve as the connecting link between the major
connector or the base of a removable partial denture and the other components of the
prosthesis, such as the clasp assembly, indirect retainers, occlusal rests, or cingulum rests. In
many instances, a minor connector may be continuous with some other part of the denture.
For example, an occlusal rest at one end of a linguoplate is actually the terminus of a minor
connector, even though that minor connector is continuous with the linguoplate. Similarly the
portion of a partial denture framework that supports the clasp and the occlusal rest is a minor
connector, which joins the major connector with the clasp proper. Those portions of a
removable partial denture framework that retain the denture bases are also minor connectors.

Functions of Minor Connector

In addition to joining denture parts, the minor connector serves two other purposes.
1. Transfers functional stress to the abutment teeth.
This is a prosthesis-to-abutment function of the minor connector. Ocelusal forces applied
to the artificial teeth are transmitted through the base to the underlying ridge tissue if that
base is primarily tissue supported. Occlusal forces applied to the artificial teeth are also
transferred to abutment teeth through occlusal rests. The minor connectors arising from a

rigid major connector make possible this transfer of functional stress throughout the dental
arch.

2. Transfers the effects of the retainers, rests, and stabilizing components throughout the
prosthesis.
This is an abutment- to-prosthesis function of the minor connector. Thus, forces applied on
one portion of the denture may be resisted by other components placed elsewhere in the
arch for that purpose. A stabilizing component on one side of the arch may be placed to
resist horizontal forces that originate on the opposite side. This is possible only because of
the transferring effect of the minor connector, which supports that stabilizing component,
and the rigidity of the major connector.

Form and Location (Basic Types of Minor Connectors)

A. Minor connectors placed into embrasures between two adjacent teeth.
These connectors should be somewhat triangular shaped in cross section to minimize
intrusion into the tongue or vestibular spaces, while still providing adequate bulk for
rigidity as shown in the Figure (1).

1
Lecture: Prosthodontics [Link] Kareem

a
Figure 1: (a). A minor connector should join the major connector at a right angle and cover as
small an area of tissue as possible (b). The juncture to the major connector should be rounded
(arrow) not sharp (X) unless the juncture includes an acrylic finish line. Relief should be placed on
the master

A minor connector should fill the embrasure space so that a smooth surface is
presented to the tongue and so that areas where food can be trapped are minimized.
Ideally, a minor connector should not contact the teeth gingival to the height of
contour. If a minor connector fits tightly against an abutment below the height of
contour, a wedging force may be created during functional movements of the
framework. This wedging can result in increased tooth mobility. Alternatively, it may
be difficult to seat or unseat the framework.

B. Gridwork minor connectors that connect the denture base and teeth to the major
connector.
These minor connectors are adjacent edentulous spaces and usually connect the major
connector to a clasp assembly as well. Gridworks can be an open lattice work or mesh
type. The mesh type tends to be flatter, with more potential rigidity. Conversely the
mesh has been shown provide less retention for the acrylic if the openings are
insufficiently large. The lattice type has superior retentive potential, but can interfere
with the setting of teeth, if the struts are made too thick or poorly positioned. Both
types are acceptable if correctly designed.
Adequate mechanical retention of the denture base resin is gained by providing relief
under the minor connector gridwork to allow the acrylic resin to flow under the
gridwork. To allow for this space, relief wax is placed on the cast in the edentulous
areas prior to making a refractory cast (for fabricating the framework). Usually, one
thickness of baseplate wax is sufficient (about 1 mm of relief). After the framework
has been waxed and cast on the refractory model and returned to the master cast, the
space provided by the relief wax is available for the mechanical retention of the
acrylic resin (Figure 2).

Figure 2: Relief
under the minor
connector gridwork.

wax relief
2
Minor connectors originating from the gridwork in an edentulous area usually take the
form of vertical metal plates (proximal plates) that make broad contact with prepared guiding
planes. These proximal plates may or may not terminate in an occlusal rest, depending on the
Lecture: Prosthodontics [Link] Kareem

partial denture design. The plate is shifted slightly towards the lingual to increase rigidity,
enhance reciprocation and improve esthetics (Figure 3).

Figure 3: Minor connectors originating

from the gridwork in an edentulous
area (Proximal plates).

roximal late extended Iin uall

Tissue Stops
Tissue stops are integral parts of minor connectors designed for retention of acrylic-resin
bases. They provide stability to the framework during the stages of transfer and processing.
They are particularly useful in preventing distortion of the framework during acrylic-resin
processing procedures. Tissue stops can engage buccal and lingual slopes of the residual ridge
for stability.
Another integral part of the minor connector designed to retain the acrylic-resin
denture base is similar to a tissue stop but serves a different purpose. It is located distal to the
terminal abutment and is a continuation of the minor connector contacting the guiding plane.
Its purpose is to establish a definitive finishing index tissue stop for the acrylic-resin base
after processing.

Finishing Lines
The finishing line junction with the major connector should take the form of an angle not
greater than 90 degrees, therefore being somewhat undercut, Figure (4).

Figure 4: The intemal angles of external

finish lines should be slightly less than 90
degrees. This results in improved mechanical
retention for acrylic resin components.

Therefore, resin metal joints should be created only at the external surfaces. These
interfaces are referred to as finish lines. If they are located on the outer surfaces of major
connectors, they are called external finish lines. If they are positioned on the inner or tissue
surfaces, they are termed internal finish lines, Figure (5).

3
Lecture: Prosthodontics [Link] Kareem

3
5: A. Internal finish lines lt±sult from relief wax placed on the master cast prior to
duplication. Arrows indicate the presence of a well-defined veltical wall, l,vhich Viill
prothlce an internal finish line. B. Properly contoured relief wax results in a sharply defined
internal

The medial extent of the minor cormector depends on the lateral extent of the major
palatal connector. If the finishing line is located too far medially, the natural contour of the
palate will be altered by the thickness of the junction and the acrylic resin su)porting the
artificial teeth. If, on the other hand, the finishing line is located too far buccally, it will be
most difficult to create a natural contour of the resin on the lingual surface of the affificial
teeth. The location ofthe finishing line at the junction of the major and minor connectors
should be based on restoration of the natural palatal shape, with consideration given to the
location of the replacement teeth.