Tamer Mohamed Nasr Mostafa

BDS, MSc, PhD Implant Prosthodontics

Prof. of Prosthodontics
Faculty of Dentistry, Tanta University & Al-Salam University
Scientific reviewer in the International Journal of Prosthodontics,
Journal of Prosthetic Dentistry, BMC Oral Health, Clinical Oral
Investigations, Journal of International Oral Health
Different Classes of R.P.D
How to manage????
 Designing
 Support.

 Retention.

 Bracing.

 Reciprocation.

 Connection.

 Indirect retention.
 Stress equilizing.
Rules of The Game

Abutment

Ridge Design
CLASS I KENNEDY CLASSIFICATION
- Bilateral edentulous area located posterior to the remaining
natural teeth
 * possible movements of lower free end
partial denture.

I-Vertical movements
II- Lateral movements
III- Antero-Posterior
movement
 IV- Rotational movements

- occurs around 3 axises:-

1) Fulcrum Axis.
2) Sagital Axis.
3) Vertical Axis.
 Problems of free-end saddles
1- Lack of posterior abutment so lack of adequate support and retention
2-Diffrence in displaceability between abutment teeth and mucosa
covering ridge causes-Rotation of the denture around fulcrum axis
 Problems of free-end saddles
3- Torque to the
abutment and
periodontal
breakdown
4- Alveolar ridge
resorption and more
resorption occurs if
relining neglected.
 Managements
1) Reducing the load .

2) Distribution of the load between the abutments & the

ridges :-
i) By varying the connection between clasps & saddles by:-
a) Combining rigid connection & occlusally approaching clasping .
b) Combining rigid connection & gingivally approaching clasping .
c) Stress breaker.

ii) By anterior placement of occlusal rest.

iii) By Mucco-compression.

3) Wide distribution of the load :-

i) Over more than one abutment tooth on each side .
ii) Over the maximal area of edentulous ridge .
 1) Reducing the load
* This is achieved by reducing the occlusal table by the
following methods :-

A) antero-posteriorlv ;-
i- leaving a tooth-off saddle .
ii- using canines & premolars instead of premolars & molars .

B) bucco-lingually ;-
i- using narrow teeth .
ii- remove the lingual cusps of lower posterior teeth .

C) Flat teeth
 2) Distribution of the load between
the abutments & the ridges
a) Combining rigid connection & occlusally approaching clasping
 2) Distribution of the load between
the abutments & the ridges
b) Combining rigid connection & Gingivally approaching clasping .
 2) Distribution of the load between
the abutments & the ridges
a) Stress Equilizer.
Capable of relieving or eliminating torque on the abutment teeth
of a partial prosthesis by allowing some movement between the
saddle and the direct retainer
 When to use?????
(Indications)
1-Distal extension saddles (class1, 2, and 4)
2- Long bounded saddle with weak abutment
3- Weak abutment teeth& moderate developed ridge
4- With internal attachment in free end saddles
 Types of stress equalizers
1-movable joint between direct retainer and saddle
EX:-Hinge type-stress-breaker
2-flexible connection between direct retainer and
saddle
Split major connector
2-flexible connection between direct retainer and
saddle
Distally extended lingual bar
 Drawbacks
Still Ridge resorption.
 Decrease effectiveness of indirect retainer.
 Continuous maintenance, Easily distorted.

 Well trained technician.

 Difficult construction, repair.

 Expensive.
3-Clasps with stress breaking action
 Gingivally approaching clasps except Devan clasp
 Occlusally approaching clasps
 Reverse Aker clasp
 Back action clasp
 Reverse back action clasp
 R.P.A.
 Extended arm clasp.
 Ring (bounded saddle., isolated molar)
 Combination clasps (wrought wire + casted)
 B) Anterior placement of occlusal rest.
a) RP1 clasp.
 3) Wide distribution of the load

a) Over more than one

abutment tooth on each side
-Double Aker clasp
-Extended Aker clasp
- Lingual plate

b) Over the maximal area of

edentulous ridge .
 THE KENNEDY CLASS II
DENTURE
 Definition:-
 Problems :
 Designs :-
 1) Rigid clasping & rigid connection

* Indication :-
1- short saddle.
2- well supported abutments.
3- well developed ridge.
4- normal mucosal thickness
1
 2. Rigid clasping & flexible connection :
* Rigid clasping——————> lateral
stability.
anterior placement of occlusal rest
*more applicable in shorter saddles
• occlusal rests on 2 cingulae
• * using lingual bar of sufficient
thickness (rigidity).
* Saddle is joined to the retainer by
semi-flexible bar.
* Thinner section ling. Bar stress
breaking action.
 3. Stress equilizer & flexible connection :
indicated in reverse conditions of previous design
Displaceable mucosa, long saddle, poor abutment condition
 Split casting modifying a lingual plate
* splitting of lingual plate made at the inferior borders of the plate &the saddles are attached to the
lower more flexible part while the clasp is attached to the rigid more superior part of the plate.
• The lower bar must be more flexible in the vertical than in horizontal force.
* denture has lateral rigidity to distribute horizontal forces widely.
So, make its section wider than its depth
( broad horizontal. & thin vertically)

Disadvantages:-
the split opens slightly in function & liable to trap the tongue or food particles especially with long
saddle where the split is Anteriorly placed.
Modified Class II
 THE KENNEDY CLASS III
DENTURE
Unilateral bounded edentulous space (saddle) with
the abutment teeth being anterior and posterior to
the edentulous space.
THE KENNEDY CLASS III DENTURE

Applegate has suggested that Kennedy class III situations

should be subdivided into three groups according to the
clinical conditions and the type of treatment required into:
group A, B and C.
 Group A (Class VI)

The saddles are short the abutment teeth are healthy.

 Implant

Fixed bridge= F.P.D Removable Partial Denture = R.P.D

 Designs of R.P.D

Unilateral P.D side plate P.D

 Def.
it is a RPD covering only one side of
the arch .
 Indications:-
 1) Short bounded saddle "only 1
or 2 missed teeth".
 2) Good abutment support.
 3) only in patient with ideal
occlusion.
 4) patient with minimal horizontal
movements & low cusp angles.
**Tooth relation ship in lateral excursion:-
 Measures used to avoid instability“
1) Provision of the buccal & lingual cusp contacts:-
a) improve the occlusion by selective grinding
b) use adjustable articulator when setting up the teeth
 Measures used to avoid instability“
2) Using wide occlusal rest especially buccally
 Measures used to avoid instability“
3)Provision of adequate bracing :- by
a) covering the vertical stope of hard plate.
b) bracing clasp arms
c) deeper& square type occlusal rest( Box shaped ) .
4) Provision of adequate retention

- Clasping (Double Aker clasp)

" double retention & double bracing
 Sectional Partial denture
"Two part P.P."
Indications:-
1) Sever proximal under cuts where

History
2) Unilateral p.d. can't be used.
Consists of:- 2 sections
Section A:-
inserted from infront backwards & engages the
mesial under cut of the distal abutment tooth.
Section B:-
inserted from behind forwaeds & fits over the first
section & engages the distal under cut of mesial
abutment.

* The 2 sections are then locked together by the

patient by means of achrome alloy bolt.
 Group B
May be due to:-
* - long saddle .
*- Poor root shape or length the of
abutments ,
*- Excessive occlusal loading ,
*- Bone resorption around abutments .

Management:-
* Using bilateral denture "cross arch
stabilization"
*using rigid clasp on the other side.
*Obtain support from adjacent tooth to
abutment by :-
-Splinting abutment to them
-Multiple "double" clasping or resting.
Bilateral denture
 Group C (Class V)
long bounded saddle with one of the abutment teeth can not assume any support for the denture,
A typical example is when the posterior abutment is the 2nd or 3rd molar and the anterior
abutment is the lateral incisor which can not assume any support or bracing for the denture, so the
anterior extremity of the denture is considered as free end saddle.
 Group C (Class V)
1- Skeleton design.
2-A denture with broad palatal
coverage
3-stress breaker device.
 Every’s denture
*Indication:-
Presence of 2 or more saddles & the abutment are
weak & Periodontically affected ( mobility) with
questionable prognosis .
Design:-
* vertical load is resisted by broad palatal coverage.
* Lateral load is resisted by palatal tissue & standing
teeth of anterior segment
* Anteroposterior load is resisted by hard palate &
standing posterior teeth.
* Broad palatal coverage by acrylic plate
*The nature of contact point ( not area contact)
between the terminal tooth in the saddle & the
abutment
-> No lateral stresses on the abutment.
-> No torque on standing natural teeth.