Do you have a diagnosis

and a treatment plan?

GUEST APPEARANCE

PROFESSOR
DAMIEN WALMSLEY
RPD – Top Tips for You
RPD – THE SYSTEM OF DESIGN

What is the periodontal

You have done
and restorative condition
Preliminary Impressions
of the teeth?

Do you need to Have you surveyed

articulate models? the casts?
 Learning Objectives
Learning Objectives
@  Understand
–  Decision making process for
Removable Partial Dentures

–  Stages of Partial Denture Design

@  Communicate
–  Design instructions to Laboratory
Top tip - take some time out
to do a denture design

Top tip decision Design Stages

(after surveying mounted
and articulated casts)

1. Saddles
Tooth 2. Support
3. Retention
Mucosa 4. Reciprocation and Bracing
5. Connection
6. Indirect Retention

Essential Reading Buy the Books

A clinical guide to
removable partial
denture design

Davenport et al. 2000

Ch 4 Saddles
pages 21-26
 Read the free article

A clinical overview of removable prostheses

McCord JF, Grey NJ, Winstanley RB, Johnson A.
Introduction. Dental Update. 2002 Oct; 29 (8) :375.

Followed by 5 articles
http://www.nature.com/bdj/journal/v189/n11/full/4800838a.html

Reduce area of occlusal table Design Stages

Use narrow posterior teeth (after surveying mounted
Omit the last tooth and articulated casts)

1. Saddles
2. Support
3. Retention
4. Reciprocation & Bracing
5. Connection
6. Indirect Retention
Creating success for mandibular RPD

Essential Reading Classification of support

A clinical guide to vertical force may be resisted by:-
removable partial
denture design

Davenport et al. 2000

@  mucosa
@  tooth
Ch 5 Support @  tooth mucosa
pages 27-33
 Quality of support

@  root area of the abutment teeth

@  extent of the saddles
@  expected force on the saddles

type of support available may

vary and assessment of its quality is
made during design procedures

Tooth support @  rest design

@  tooth preparation

Mucosa support @  saddle extension

@  quality of support

Tooth-mucosa @  free-end saddle

support @  difficult to treat

Does it work?

The shortened dental arch concept was accepted

by a great majority of dentists but not widely
practised

The shortened dental arch concept deserves to be

included in all treatment planning for partially
edentulous patients

Kanno T, Carlsson GE.

A review of the shortened dental arch concept focusing on the work
by the Kayser/Nijmegen group. J Oral Rehabil. 2006;33:850-62
Mucosa support

Walmsley AD
Acrylic partial dentures
Dental Update
2003; 30: 424-429

Free End Saddle

Distal Rest placement causes tilting

Foot Foot

Off the ridge retention

of acrylic base

Mesial Rest placement prevents tilting

Design Stages Essential Reading
(after surveying mounted
and articulated casts)
A clinical guide to
1. Saddles removable partial
2. Support denture design
3. Retention
4. Reciprocation and Bracing Davenport et al. 2000
5. Connection
6. Indirect Retention Ch 6 Retention
pages 35-46

Types of RPD Retention

1. Clasps
2. Neuromuscular forces
3. Physical forces
4. Guide Surfaces
5. Attchments

Top Tip - Don’t just rely on clasps

www.dental-app.com Top tips 4 Clasps

Keep to a minimum
Use wrought where possible
Watch the gum
Use other forms of retention
 Choice
of Clasp

✖ ✔
 Guide surfaces: Benefits
Guide surfaces
@  2 or more parallel axial surfaces on @  Increased stability
abutment teeth @  ‘frictional retention’

Benefits of Guide surfaces Guide surfaces

contour (shape)
@  Reciprocation
@  Prevent clasp deformation @  Natural
@  Aesthetics
@  Artificially
prepared

How long should it be?

@  Length
guiding plane as long as possible (Kratochvil) –
increased friction (retention & stability)

? but will torque abutment tooth if free end saddle

scenario.

Also consider periodontal support.

Other forms of mouth preparation

@  Bonded metal Crowns

@  Bonded composite contours

@  Surveyed crowns

Make it so
Final impressions
Final impressions
@  Alginate @  Alginate

@  First choice @  Individual (special) tray ensures even distribution

–  Tears rather than distort following removal
& thickness of material to ensure optimum
from DEEP undercuts. elastic recovery on removal from mouth.

@  Silicone
–  If undercut too severe, but more demanding

Chairside tray modification using cold

curing acrylic resin or greenstick
 Common faults

Metal Backings

Metal backings

Usually required for artificial maxillary

anterior teeth, where lower teeth almost
contact opposing mucosa……

Metal backings

…but how do you work out where the

metal is meant to go??
 Design Stages
(after surveying mounted
and articulated casts)

1. Saddles
2. Support
3. Retention
4. Reciprocation and Bracing
5. Connection
6. Indirect Retention

Essential Reading Reciprocation

A clinical guide to Prevents
removable partial
denture design
tooth movement
Davenport et al. 2000
escape

Ch 7 Bracing &
Reciprocation
pages 47-51
Design Stages Essential Reading
(after surveying mounted
and articulated casts)
A clinical guide to
removable partial
denture design

1. Saddles Davenport et al. 2000

2. Support
3. Retention Ch 9 Connectors
4. Reciprocation and Bracing
pages 57-64
5. Connection
6.  Indirect Retention

Design for Upper jaw Design for Lower jaw

Full coverage 1.  Lingual bar

Ring connector 2.  Sublingual bar

Bar connectors 3.  Lingual plate

Anterior
Posterior 4.  Continuous or dental bar
Mid palatal
5.  Labial bar

Design Stages Essential Reading

(after surveying mounted
and articulated casts) A clinical guide to
removable partial
1. Saddles denture design
2. Support
3. Retention Davenport et al. 2000
4. Reciprocation and Bracing
5. Connection Ch 8 Indirect
6. Indirect Retention Retention
pages 53-56
 Support for
indirect retainer

1. Tooth support

2. Mucosa support

System of Design

Top tip draw design on cast

Star Trek

2013