Prostho GTSL

Prostho GTSL
Partially Edentulous Patients: having one or more but not their entire natural teeth missing
RPD: components of prosthodontics pertaining to the restorations and maintenance of oral
function, comfort, appearance and health of the patient by replacement of missing teeth
and craniofacial tissues with artificial substitute.
Free End Edentulous Area: an edentulous area which has an abutment tooth on one side
only
Bounded Edentulous Area: an edentulous area which has an abutment tooth on each end
Abutment: a tooth, a portion of a tooth or that portion of a dental implant that serves to
support and retain prosthesis
Indications for RPD:

1. No abutment tooth posterior to edentulous space (free end edentulous area)
2. Long edentulous bounded span which is too extensive for fixed restoration
3. Periodontally weak teeth not sufficiently sound to support denture

4. Excessive loss of residual bone which means the use of labial flange is needed
5. After recent extraction usually done to improve esthetics or for patient satisfaction
6. Need for bilateral bracing (cross arch stabilization)
7. Young age (less than 17 yrs old) because young age have higher pulp horn
8. economic considerations, attitude and desire of patient.
9. enhancing esthetics in anterior region instead of using fixed partial denture pontic
Contraindications
1.Kurangnya gigi yang tepat sebagai dukungan, retensi, stabilisasi gigi tiruan sebagian
lepasan,
2.Rampan karies atau kondisi periodontal yang tidak sehat,
3. Kebersihan rongga mulut yang buruk,
4. Pasien menolak pilihan perawatan karena alasan estetik/tidak kooperatif.
5.Umur lanjut,mempertimbangkan sifat dan kondisi penderita
6.Penyakit sistemik (epilepsy,DM yang tidak terkontrol)
Objectives of RPD
1. preserve health of remaining teeth, muscles, TMJ, residual ridge, tongue contour
2. elimination of oral disease
3. restore oral function (comfort, esthetic, speech)
Consequence of tooth loss

1. aesthetics
2. speech
3. drifting, tilting, over-eruption
4. loss of masticatory efficiency
5. loss of vertical dimension
6. deviation of mandible
7. loss of alveolar bone
RPD can:
1. support periodontally weakened teeth
2. restore vertical facial dimension
3. prevent tmj, tooth drifting
4. stimulate non-used tissues
5. support collapsed structure such as muscles of lips and cheeks
6. improve OHI
Advantages of RPD
1. cheaper than FPD
2. easily cleaned
3. easily repaired
4. no tooth reduction is required
Classification Kenedy
Criteria for Classification
1. the most posterior edentulous area determines the class
2. The size of mod is not important
3. If a third molar is missing and not to be replaced, it is not considered in determining the
class
4. no modification in Class IV
Class 1: bilateral free end edentulous area posterior to natural teeth
Class II: unilateral free end edentulous space posterior to natural teeth
Class III: Unilateral bounded edentulous space
Class IV: A single edentulous area crossing the midline
Applegate added 2 more classes:

Class V: edentulous area bounded anteriorly and posteriorly by natural teeth in which THE
ANTERIOR ABUTMENT IS NOT SUITABLE FOR SUPPORT
Class VI: edentulous situation in which the abutment tooth is capable of total support
Modifications
Advantages of Kenedy’s Classification

1. allows visualization of partially edentulous arch
2. differentiates between tooth supported and tooth tissue supported
3. type of design can be decided
4. universally accepted
5. aids in discussing, identifying and planning the design
Other Classifications
Cummers Classif: classified partial dentures rather than edentulous space (Kenedy)
Charles Bailyn Classif: A for anterior saddle to premolars, P for saddle areas posterior to
canine
Neurohrs Classif: complicated, ada classes and variations
Friedmans System: A is anterior space, B is bound posterior space, C is cantilever situation
Osborne Lammie: Class 1 is mucosa borne, Class 2 is tooth borne, Class 3 is combination
RPD must have:

1. Support: resistance to vertical seating forces produced by teeth and mucosa
2. Retention: Resistance to vertical displacing forces
3. Stability: Resistance to horizontal and lateral displacement
Designing Support
1. Tooth support: when abutment teeth available at both ends of denture base (bounded
saddle). Most common is occlusal rest
2. Mucosa support: the mucoperiosteum covering residual alveolar bone which allows
varying degree of displacement. The amount of displacement depends on :
 amount of pressure
 thickness of mucosa
 area covered by denture (wider the area, lesser the displacement)
 Fit of denture base
 Type of impression (anatomical, functional or selective pressure)
3. Tooth-Mucosa support (bilateral free end saddle): posterior mucosa support, anterior
tooth support
Designing Retention
Retention should be designed to counteract dislodging forces. Retention is gained by
mechanical means:
1. Direct retainers: intercoronal (clasps) and intracoronal (precision attachment)
2. Indirect retainers
Designing Bracing and Stability

Bracing is providing resistance to lateral movement of RPD, causes of tipping, rocking and
rotation. Quality of supporting structure. Of the free end base create an axis of rotation
around which this appliance is rotated, this is called as fulcrum line (imaginary line
extending between the two main abutment)
Components of RPDs
1. major connectors
2. minor connectors
3. Rests
4. Direct retainers
5. stabilizing or reciprocal components
6. indirect retainers
Major Connectors
Component of the RPD which connects all parts of prosthesis directly or indirectly. It
provides the cross arch stability to help resist displacement by functional stresses.

Prostho GTSL

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Prostho GTSL

Indications for RPD:

3. Periodontally weak teeth not sufficiently sound to support denture

Consequence of tooth loss

Class III: Unilateral bounded edentulous space

Class IV: A single edentulous area crossing the midline

Applegate added 2 more classes:

Advantages of Kenedy’s Classification

RPD must have:

Designing Bracing and Stability

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