Removable Partial Dentures: A Practitioners’ Manual

✍ Scribed by Olcay Şakar (editor)

• Publisher: Springer
• Year: 2024
• Tongue: English
• Leaves: 417
• Edition: 2
• Category: Library

✦ Synopsis

This clinical guide, now in an extensively revised second edition, describes the latest developments in planning, materials, and techniques for successful fabrication of removable partial dentures (RPDs). The fabrication of conventional and digital RPDs are demonstrated in a simple and easy-to-understand format, with the aid of numerous color figures and video clips with scientific support on each page. Care has been taken to provide reliable guidance on all aspects of clinical practice relating to RPDs. Readers will find information on decision-making regarding treatment options, clasp-retained RPDs and esthetic solutions, attachments and double crown systems in RPDs, implant-assisted RPDs, maintenance and post-insertion problems for all types of RPDs, the role of RPDs in the management of temporomandibular disorders and the treatment of maxillofacial defects, the re-establishment of occlusal vertical dimension and maximal intercuspation, the rules for disinfection in prosthodontic practice.

✦ Table of Contents

Foreword
Preface and Acknowledgments
Preface and Acknowledgments to the First Edition
Contents
Part I: Introduction to Removable Partial Dentures
1: Current Status on Partial Edentulism and Removable Partial Dentures
Further Reading
2: The Effects of Partial Edentulism on the Stomatognathic System and General Health
2.1 Definitions
2.2 Consequences of Tooth Loss
Further Reading
3: Classification of Partially Edentulous Arches
3.1 Kennedy Classification
3.1.1 Applegate’s Modification (Kennedy-Applegate Classification System)
3.1.2 Applegate’s Rules
3.2 Implant-Corrected Kennedy Classification System
Further Reading
Part II: Treatment Planning, Mouth Preparation and Impression Procedures
4: Biomechanics of Removable Partial Dentures
4.1 Definitions
4.2 Understanding Biomechanical Aspects
4.2.1 Rotational Movement
4.2.1.1 Rotational Movement in the Sagittal Plane Around the Horizontal Fulcrum Line
4.2.1.2 Rotational Movement in the Frontal Plane Around the Anteroposterior Horizontal Fulcrum Line
4.2.1.3 Rotational Movement in the Horizontal Plane around the Vertical Fulcrum Line
4.2.2 Biomechanical Design Principles
4.2.2.1 The Inclined Plane
4.2.2.2 The Lever
4.2.2.3 Mechanical Advantage
4.3 The Displacement of the Removable Partial Denture
4.3.1 Movement Toward the Tissue
4.3.2 Movement Away from the Tissue
4.4 Factors that Are Related to the Force Transfer to the Abutment Teeth and the Residual Ridges
4.4.1 The Residual Ridge Support
4.4.2 The Length of the Edentulous Span
4.4.3 The Periodontal Support of the Abutment Teeth
4.4.4 The Design of the Removable Partial Denture
4.4.5 The Design of the Direct Retainer
4.4.6 The Antagonist Dentition
Further Reading
5: Diagnosis and Treatment Planning in Partially Edentulous Patients
5.1 Definitions
5.2 Diagnostic Casts and Occlusal Analysis
5.2.1 The Importance of Diagnostic Casts
5.2.2 The Impression and Casts for Diagnostic Models
5.2.3 Using the Diagnostic Casts for Decision Making
5.2.3.1 Periodontal Status
5.2.3.2 Coronal Status
5.2.3.3 Analysis of the Existing Occlusion
5.2.3.4 Deciding the Type of the Prosthesis
Classification System for Partial Edentulism
Location and Extent of the Edentulous Areas
Condition of the Abutment Teeth
Occlusal Scheme
Residual Ridge Characteristics
Removable Partial Denture Indications
Shortened Dental Arch Concept
5.2.3.5 Using the Diagnostic Casts for Pretreatment
Indications of Occlusal Equilibration
The Rules of Occlusal Equilibration
Maximal Intercuspal Position-Centric Relation Adjustments
Eccentric Adjustments
Further Reading
6: Preparation of the Mouth for Removable Partial Dentures
6.1 The Importance of Preprosthetic Preparations
6.2 Periodontal Preparation
6.2.1 Oral Hygiene Motivation and Ensuring Hygiene Ability
6.2.2 Scaling and Root Planing (SRP)
6.2.3 Respecting the Biological Width and Surgical Crown Lengthening
6.2.4 The Importance of Keratinized Gingiva and Free Gingival Grafts
6.3 Oral Surgical Interventions
6.3.1 Preparation of the Bony Base
6.3.2 Soft Tissue Interventions
6.3.3 Removal of Teeth or Tooth Remnants
6.4 Restorative Approach: Fillings and Root Canal Treatment
6.5 Preprosthetic Soft Tissue Conditioning Procedures
6.6 Orthodontic Preparation
Further Reading
7: Preparation of the Abutment Teeth for Removable Partial Dentures
7.1 Definitions
7.2 Relationship of Guide Surface and Guide Plate
7.3 Preparation of Rest Seats
7.3.1 Forming of the Retentive Area
7.4 Crowning the Supporting Tooth/Teeth
Further Reading
8: Impression Materials and Procedures for Removable Partial Dentures
8.1 Definitions
8.2 Material and Tray Selection for Preliminary Impressions
8.3 Final Impressions
8.3.1 Tray Selection for Single-Step Final Impressions
8.3.2 Impression Materials for Single-Step Final Impressions
8.4 Handling the Impression
8.5 Functional Impressions
8.5.1 The Altered Cast and Its Modifications
8.5.2 Single Tray Functional Impressions
8.6 Impressions for Relining and Rebasing
Further Reading
Part III: Clasp Retained Removable Partial Dentures
9: Major and Minor Connectors
9.1 Definitions
9.2 Major Connectors
9.2.1 General Aspects of Major Connectors
9.2.2 Maxillary Major Connectors
9.2.3 Mandibular Major Connectors
9.3 Minor Connectors
9.3.1 General Aspects of Minor Connectors
9.3.2 Types of Minor Connectors
Further Reading
10: Rests and Rest Seats
10.1 Definitions
10.2 Functions of the Rests
10.3 Forms of Rest and Rest Seat Preparations
10.3.1 Occlusal Rests
10.3.2 Lingual (Cingulum) Rests
10.3.3 Incisal Rests
Further Reading
11: Direct and Indirect Retainers
11.1 Definitions
11.2 Direct Retainers
11.2.1 Retentive Clasp Assemblies
11.2.1.1 Retention
11.2.1.2 Support
11.2.1.3 Stability
11.2.1.4 Reciprocation
11.2.1.5 Encirclement
11.2.1.6 Passivity
11.2.2 Factors Affecting the Amount of Retention of a Clasp Assembly
11.2.3 Types of Clasp Assemblies
11.2.3.1 Circumferential (Suprabulge) Clasps
11.2.3.2 Bar (Infrabulge, Roach) Clasps
11.2.4 Stress-Controlling Clasp Design for the Distal Extension Removable Partial Dentures
11.2.4.1 RPI Clasp Design
11.2.4.2 RPA Clasp Design
11.2.4.3 Combination Clasp
11.2.4.4 Rarely Used Infrabulge Clasps
11.3 Indirect Retainers
Further Reading
12: Esthetic Solutions for Removable Partial Dentures
12.1 Definitions
12.2 Non-metal Clasp Dentures
12.2.1 General Advantages of Non-metal Clasp Dentures and Thermoplastic Resin Materials
12.2.2 General Disadvantages of Non-metal Clasp Dentures and Thermoplastic Resin Materials
12.2.3 The Basic Principles for Clinical Use of Non-metal Clasp Dentures with Different Thermoplastic Resin Materials
12.3 Rotational Path Removable Partial Dentures
12.3.1 Advantages of the Rotational Path Removable Partial Denture Design
12.3.2 Disadvantages of the Rotational Path Removable Partial Denture Design
12.3.3 Steps of Clinical and Surveying Procedures
Further Reading
13: Establishing Occlusal Relationships
13.1 Definitions
13.2 Deciding the Type of Horizontal Relation
13.2.1 Using the Maximal Intercuspal Position as a Reference
13.2.2 Using the Centric Relation as a Reference
13.2.3 Exceptional Cases in Using Maximal Intercuspal position/ Centric Relation as a Reference
13.3 Deciding the Type of Base Plate
13.3.1 Using a Base Plate (or Metal Framework) and Occlusion Rims to Record Horizontal Jaw Relations
13.3.2 Using Check-Bite Method to Record Horizontal Jaw Relations
13.4 Articulators
13.4.1 Using Face-Bow
13.4.2 Important Aspects of Articulator Selection
13.4.3 Properties of a Suitable Articulator
13.5 Clinical Procedure
Further Reading
14: Surveying and Laboratory Procedures
14.1 Definitions
14.2 Surveying
14.2.1 Structural Units of a Surveyor
14.2.2 Objective of Surveying
14.2.3 Surveying: The Procedure
14.2.3.1 Systematic Steps of Surveying
14.2.3.2 Tripoding
14.2.3.3 Evaluation of Potential Abutment Teeth
Guiding Planes/Guiding Plates
Retention
Reciprocation
14.2.3.4 Grinding the Diagnostic Cast
14.3 Laboratory Procedures
14.3.1 Final Casts, Mounting in the Articulator and Diagnostic Wax-up
14.3.2 Model Analysis: Mounting of Posterior Teeth
14.3.2.1 Occlusion: Sagittal Stability
14.3.2.2 Occlusion –Transversal Stability
14.3.3 Try-in and Preparation for the Cast Metal Frame
14.3.3.1 Planning
14.3.3.2 The Bios and the Ney Clasp Systems
14.3.3.3 Construction of the Metal Framework
Further Reading
15: Initial Placement and Adjustments
15.1 Definitions
15.2 The Timing of Delivery Appointment
15.3 The Goals of Delivery Appointment
15.3.1 Making the Insertion of the Removable Partial Denture Comfortable By Adjusting the Clasp Arms, Overpressure Points on the Impression Surface and Overextended Borders
15.3.2 Checking the Esthetics of the Prosthesis and Making Individualization By Cosmetic Grinding
15.3.3 Adjusting Centric and Eccentric Occlusion
15.3.4 Instructing the Patient How to Maintain the Prosthesis, the Mouth, and the Remaining Teeth
Further Reading
Part IV: Advanced Retention and Support Auxiliaries for Removable Partial Dentures
16: Attachments and Double Crown Systems for Removable Partial Dentures
16.1 Definitions
16.2 Classification of Attachments
16.2.1 Classification of Attachments According to Their Function
Solid Attachments
Resilient Attachments
Class 1a
Class 1b
Class 2
Class 3
Class 4
Class 5
Class 6
16.2.2 Classification of Attachments According to Their Location on Abutment Teeth
Intracoronal Attachments
Extracoronal Attachments
Dalbo S
Dalbo Mini
Preci-Vertix
MK1
Ceka
ASC 52
Clinical Procedures of Extracoronal Attachments
Stud Attachments
Types of Stud Attachments
Preci-Clix
Swiss Dalbo System
Gerber Unit
TiSi.snap
Locator
Clinical Procedures of Stud Attachments
Bar Attachments
Fundamentals of Bar Designs
Hader Bar
Dolder Bar
Ackermann Bar
Clinical Procedures of Bar Attachments
16.3 Double Crown Systems
16.3.1 Telescopic Crowns
16.3.2 Conical Crowns
16.3.3 Double Crowns with Clearance Fit (Marburg Double Crown System)
Clinical Procedures of Double Crown Systems
Further Reading
17: The Role of the Dental Implant in Removable Partial Dentures
17.1 Dental Implants and Removable Partial Dentures
17.2 Important Hints for Clinicians
17.2.1 Main Indications for IARPDs
17.2.2 Contraindications for IARPDs
17.2.3 Advantages of IARPDs
17.2.4 Disadvantages
17.3 Main Alternatives and Different Treatment Modalities with Dental Implant Use as RPD Support
17.3.1 Edentulism
17.3.2 Kennedy Class I and/or II Situation
17.3.3 Kennedy Class III Situation
17.3.4 Kennedy Class IV Situation
17.4 Useful Facts Concerning Implant-Assisted Removable Partial Dentures
17.4.1 Attachments and Different Strategies
17.4.2 Complications and Maintenance Requirements
Further Reading
Part V: Digital Workflow of Removable Partial Dentures
18: Data Acquisition and Designing
18.1 Definitions
18.2 Background
18.3 Data Acquisition
18.3.1 Digital Scan
18.3.2 The Advantages of Digital Scan in Removable Partial Denture Manufacturing
18.3.3 The Disadvantages of Digital Scan in Removable Partial Denture Manufacturing
18.3.4 Scanning Strategy
18.3.5 Maxillomandibular Relationship Record
18.4 Design of Digital Removable Partial Dentures
Further Reading
19: Manufacturing and Materials
19.1 Definitions
19.2 Manufacturing Techniques
19.2.1 Subtractive Manufacturing
19.2.2 Additive Manufacturing
19.2.2.1 Indirect Additive Manufacturing Techniques
19.2.2.2 Direct Additive Manufacturing Techniques
19.3 The Advantage of Digitally Fabricated Removable Partial Denture Frameworks
19.4 The Disadvantage of Digitally Fabricated Removable Partial Denture Frameworks
19.5 Denture Base and Denture Teeth
19.6 Materials for Digital Removable Partial Dentures Framework
19.6.1 Metal-Based Frameworks
19.6.1.1 Cobalt Chromium
19.6.1.2 Titanium
19.6.2 Metal Free-Based Frameworks
19.6.2.1 Polyaryletherketone Polymers (PAEK)
Polyetheretherketone (PEEK)
Polyetherketoneketone (PEKK)
19.6.2.2 Polyamide (Nylon)
19.6.2.3 Polyoxymethylene (Acetal Resin)
19.6.2.4 Aryl Ketone Polymer (AKP)
19.6.2.5 Graphene-Based Polymers (GBP)
19.6.2.6 Zirconia
Further Reading
Part VI: Reestablishing Normal Stomatognathic Function in Partially Edentulous Patients
20: Management of Temporomandibular Disorders in Partially Edentulous Patients
20.1 Definitions
20.2 Relationship Between Partial Edentulism and Temporomandibular Disorders
20.3 Occlusal Splints
20.3.1 How Do Occlusal Splints Rehabilitate Temporomandibular Disorders
20.3.2 Occlusal Splint Design in Partial Edentulism
Further Reading
21: Reestablishing Occlusal Vertical Dimension and Maximal Intercuspal Position in Partially Edentulous Patients
21.1 Definitions
21.2 Main Reasons for Decreased Occlusal Vertical Dimension in Dentate Individuals
21.2.1 Tooth Wear
21.2.2 Tooth Loss and Migration of the Teeth and/or Alveolar Process
21.2.3 Congenital and Acquired Anomalies
21.2.4 Severe Dental and Skeletal Malocclusions
21.3 The Advantages and Possible Consequences of Increasing the Occlusal Vertical Dimension
21.4 Determination of New Occlusal Vertical Dimension and Evaluation of the Adaptation Period
21.5 Basic Clinical Steps of Increasing the Occlusal Vertical Dimension
21.6 Overlay Removable Partial Dentures
21.6.1 Advantages of Overlay Removable Partial Dentures
21.6.2 Potential Disadvantages of Overlay Removable Partial Dentures
21.6.3 Occlusal and/or Esthetic Materials for Overlay Removable Partial Dentures
21.6.4 Clinical and Laboratory Procedures for Fabricating an Overlay Removable Partial Denture
Further Reading
22: Prosthetic Treatment of Partially Edentulous Maxillofacial Defect Patients
22.1 Definitions
22.2 Etiology of Maxillofacial Defects
22.2.1 Congenital and Development Defects
22.2.2 Acquired Defects
22.3 Pre-surgical and Pre-prosthetic Evaluation
22.4 Maxillary Defects
22.4.1 Classification of Maxillary Defects
22.4.2 Surgical Resection and Reconstruction of Maxilla
22.4.3 Prosthetic Workflow of Maxillary Defects
22.4.3.1 Surgical Obturation
22.4.3.2 Interim Obturation
22.4.3.3 Definitive Obturation
22.5 Mandibular Defects
22.5.1 Classification of Mandibular Defects
22.5.2 Surgical Resection and Reconstruction of Mandible
22.5.3 Prosthetic Workflow of Mandibular Defects
Further Reading
Part VII: Maintenance and Postinsertion Problems of Removable Partial Dentures and Infection Control in Practice
23: Postinsertion Problems
23.1 Definitions
23.2 Pain and Discomfort Related to Soft Tissues or Remaining Teeth
23.3 Difficulty Seating or Removing the Removable Partial Dentures
23.3.1 Incomplete Seating of a Rest and Clasp Assembly on the Related Abutment
23.3.2 Seating Problems Due to Pronounced Soft Tissue Undercuts
23.3.3 Patient-Related Factors
23.4 Lack of Retention and Stability
23.4.1 Broken Clasps or Loss of the Precision Attachments
23.4.2 Decrease in the Function of the Clasps or Precision Attachments
23.4.3 Overextended or Underextended Denture Bases
23.4.4 Deflective Occlusal Contacts
23.4.5 Loss of the Contact Between the Removable Partial Denture and the Underlying Soft Tissue
23.5 Functional Problems
23.5.1 Gagging
23.5.2 Eating or Chewing Difficulties
23.5.3 Phonetic Problems
23.5.4 Tongue or Cheek Biting
23.5.5 Food Impaction or Collection on the Removable Partial Denture Borders
23.6 Esthetic Problems
23.6.1 Esthetic Zone
23.7 Compromised Periodontal Health and Mucosal Lesions Due to Wearing of Removable Partial Dentures
23.8 Allergic Reactions
Further Reading
24: Maintenance
24.1 Definitions
24.2 Relining and Rebasing
24.2.1 Relining Tooth-Supported Removable Partial Dentures
24.2.2 Relining Distal Extension Removable Partial Dentures
24.2.3 Step-by-Step Procedures for Direct or Indirect Relining
24.2.3.1 Direct Relining
24.2.3.2 Indirect Relining
24.3 Repairs
24.3.1 Denture Base Repairs
24.3.2 Repair of Major or Minor Connectors
24.3.2.1 Soldering or Brazing
24.3.2.2 Laser Welding
24.3.2.3 Repair with Splinting Using Metal Conditioners
24.3.3 Repair of the Rests or Direct Retainers
24.3.3.1 Repair with a Wrought Wire Clasp
24.3.3.2 Repair with Soldering a Wrought Wire Clasp
24.3.3.3 Repair with a Cast Clasp
24.3.3.4 Chairside Repair with a Cast Clasp
24.3.4 Repair of Fractured or Lost Artificial Teeth
24.3.5 Loss of a Natural Tooth Necessitating Its Replacement
24.3.6 Other Repairs
24.3.6.1 Repair of an Abutment
24.3.6.2 Fabricating a New Precision Attachment Removable Partial Denture Without Changing the Crowns
24.3.6.3 Activating or Changing the Attachment Components of Removable Partial Dentures
24.3.6.4 Maintenance of the Implant-Supported Removable Partial Dentures
24.4 Hygiene Maintenance of the Removable Partial Dentures
24.4.1 Mechanical Hygiene Maintenance
24.4.2 Chemical Hygiene Maintenance
Further Reading
25: Disinfection and Hygiene Protocols
25.1 Definitions
25.2 Understanding the Aspects of Sterilization and Disinfection
25.3 Classification of the Disinfectants
25.4 Heat Sterilization in the Dental Office
25.5 Infection Control in Removable Partial Denture Practice
25.5.1 Infection Control for Impressions and Impression Trays
25.5.2 Infection Control for Stone Cast
25.5.3 Infection Control for Removable Partial Denture
25.5.4 Infection Control for Burs and Handpieces
25.5.5 Infection Control for Occlusal Rims and Interocclusal Record Materials
25.5.6 Infection Control for Pumice
25.5.7 Infection Control for Dental Chair
25.5.8 Recommendations for the Cleaning and Decontamination of Clinic Environments
Further Reading
Index