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MOUTH PREPARATION
FOR RPD
Dr. Rassam Al-Subari, PhD
Assistant Professor of Prosthodontics
(IUST)
Introduction
Mouth preparation is carried out after proper
examination and diagnosis until arriving to
acceptable treatment plan. Mouth preparation is an
essential step upon which the success of partial
denture depends.
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Objectives of mouth preparation in removable partial
denture
[Link] establish a state of health in the supporting & contiguous
tissues.
[Link] eliminate interferences or obstructions to the placement,
removal, & function of the prosthesis.
[Link] establish an acceptable occlusal plane.
[Link] alter natural tooth form to accommodate the requirements of
form & function of the prosthesis.
Mouth preparation
The important factors in mouth preparation are:
I. Surgical preparation.
II. Periodontal treatment.
III. Operative treatment and endodontically treatment.
IV. Correction of the occlusion.
V. Preparation of abutment teeth to receive the partial denture
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Mouth preparation
I. Surgical Preparation:
All Preprosthetic surgical treatment for the RPD patient should
be completed as soon as possible
1. Extraction of teeth diagnosed as unrestorable.
2. Removal of impacted teeth
3. Removal of residual roots
Mouth preparation
I. Surgical Preparation:
4. Removal of sever Malposed teeth
5. Excision or removal of hyperplastic and flabby tissue.
6. Removal of tori and other bony projections.
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Mouth preparation
I. Surgical Preparation:
7. Removal of Cysts and Odontogenic Tumors
8. Modified of Muscle attachments and Frena
9. Correction of Bony Spines and Knife-Edge Ridges
Mouth preparation
I. Surgical Preparation:
10. Polyps and papillomas
11. Hyperkeratoses, and ulcerations
12. Dental Implants
13. Augmentation of Alveolar Bone
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Mouth preparation
II. Periodontal treatment :
1. Periodontal scaling
2. Elimination of local irritating factors
3. Elimination of periodontal pockets
Mouth preparation
III. Operative and Endodontics treatment:
1. Operative treatment
2. Endodontics Treatment
3. post and core buildups
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Mouth preparation
IV. Occlusal orthodontic devices and correction of
Occlusion :
These procedures correct discrepancies in how the upper teeth
meet the lower teeth. This treatment sometimes involves the
construction of removable orthodontic devices. Occlusal
adjustment known as occlusal equilibration, which is the
modification of occlusal form, to produce simultaneous
occlusal contacts and harmonizing cuspal relations.
Mouth preparation
V. Preparation of Abutment Teeth
The criteria for abutment tooth evaluation and selection are
based on the following aspects:
1. Caries, gingival inflammation and oral hygiene
2. Location of teeth and occlusal analysis
3. Form, position and size of teeth and supporting structures
4. Tooth vitality
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V. Preparation of Abutment Teeth
Objectives of preparation of abutment tooth:
1- Develope an acceptable path of placement
2- Improve esthetics
3- Enhance comfort
4- Promote favorable biomechanical properties
a- Retention
b- Stability
c- Support
V. Preparation of Abutment Teeth
V-1 Guiding Planes
V-2. Height of contour adjustment ( Survey line)
V-3. Retentive grooves
V- 4. Rest seats
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V. Preparation of Abutment Teeth
V-1 Guiding Planes
Definition:
They are surfaces made parallel to the path of insertion and
removal. They permit the placement and withdrawal of
removable partial denture according to only one path of
movement.
V-1 Guiding Planes
Dimension:
a- Occlusogingival: (fig.1)
- Confined to occlusal one third.
- Two to three milliertrs in length.
- Flat occlusogingivally.
Fig.1. Illustration of occlusogingival dimension of a guiding plane prepared in the
occlusal on third
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V-1 Guiding Planes
Dimension:
b- Faciolingual dimension: (fig.2)
- Confined to proximal surface.
- Three to four milliertrs in width.
- Round faciolingually in harmony with existing contour.
Fig.2. Illustration of faciolingual dimension of a guiding plane demonstraiting rounded
contour.
V-1 Guiding Planes
Dimension:
c- Prepared with cylindrical diamond burs. (fig. 3)
Fig.3. Cylindrical diamond bur prepares the guiding plane.
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V-2. Height of contour adjustment ( Survey line)
- Permits circumferential clasp location at the junction of the
middle and gingival one third of tooth occlusogingivally
(fig. 4).
Fig. 5. Cylindrical diamond bur used to Fig.4. Repreesentation of proper
modified the survey line circumferential clasp arm location.
(A) Facial view. (B) Lingual view.
V-2. Height of contour adjustment ( Survey line)
- Establishes retentive undercuts at the junction of gingival
and middle one third occlusogingivally.
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V-3. Retentive grooves:
- Increases depth of undercut. (fig. 6)
- Dimension: Proportional to retention required.
- Prepared with cylindrical diamond burs.
Fig. 6. The survey line demonstrates the absence of adequate mesiofacial undercut.
V- 4. Rest seats
- Rests require the preparation of rest seats.
- Tooth support is provided through rests requiring
prepared rest seats to ensure axial force direction.
- Tooth modification must be completed to permit a
minimum thickness of base metal alloy of 1.5 mm at
the junction of any rest with its minor connector.
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V-4. Rest seats
1- Occlusal rest seats
a. Conventional
• Indication : Posterior teeth.
• Dimension: Fig.7. Diagram Demonstrates
- Apically inclined or spoon spoon shaped rest seat preparation.
shaped (fig.7). Occlusal view A). Facial view(B)
- From the occlusal view, the
outline forme resembles a
round triangle .
- One third of the faciolingual Fig.8. Diagram Demonstrates
width of tooth. (fig.8) faciolingual dimensions of
occlusal rest.
V- 4. Rest seats
1- Occlusal rest seats
a. Conventional
• Dimension: Fig. 9. A round diamond bur
- The length of the cavity should prepares the occlusal rest seat.
be equal to 1/3 of the occlusal table in the mesiodistal
direction (equal to 2.5 mm)
- 1.5 mm marginal ridge reduction
required for base metal alloy.
- Prepared with a round bur.
(fig. 9)
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V- 4. Rest seats
1- Occlusal rest seats
a. Conventional
• Dimension:
- occlusal rest seats for embrasure
clasps require adequate tooth
reduction to permit a sufficient
thickness for the rests, minor
connector and clasp arms.(fig.10)
Fig.10. A round diamound bur
prepares adjacent occlusal rest seats (A).
The completed rest seats and occlusal
embrasure preparation(B).
V- 4. Rest seats
1- Occlusal rest seats
b. Extended: When the lower molar is severely tipped to
the mesial and the lingual, it is often best to use a rest
only, as the clasp often gets bent or broken.
• Indication : Posterior teeth.
• Dimension:
- Slight apical inclination.
- Greater than one half the
mesiodistal width of the tooth. Fig. 11. A round bur
- Prepared with a round bur. prepares the extended
(fig.11) occlusal rest seat.
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V- 4. Rest seats
2- Incisal rest seats
Indication: Anterior teeth
Advantages: Does not require a prominent cingulum
Disadvantages:
- Unfavorable esthetic
- Unfavorable mechanical leverage
V- 4. Rest seats
2- Incisal rest seats
Dimensions:
-The notch is approximatelly 2 mm
in width and 1.5 mm in depth
-Faciolingually: Convex
-Mesiodistally: Convex
-Prepared with cylindrical burs
Fig. 12. Incisal rest seats
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V- 4. Rest seats
3- Lingual rest seats
a. Cingulum rest seats
Indication: Anterior teeth
Advantages:
-Favorable mechanical leverage
-Favorable esthetic
Disadvantages:
-Requires prominent cingulum to minimize tooth
modification
-Sharp internal line angles may compromise rest adaptation
V- 4. Rest seats
3- Lingual rest seats
a. Cingulum rest seats
Dimensions:
-Faciolingualy: Conacave V or U
-Mesiodistally: Inverted V or U
-Prepared with a cylindrical bur
Fig. 13. Lingual cingulum rest seats
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V- 4. Rest seats
3- Lingual rest seats
b. Ball rest seats
Indication: Anterior teeth
Advantages:
-Favorable mechanical leverage
-Favorable esthetic
- Does not require a prominent cingulum
Disadvantages:
-Tooth preparation may extend through dentoenamel
junnction which may necessitate restoration
V- 4. Rest seats
3- Lingual rest seats
b. Ball rest seats
Dimensions (Resembles small occlusal rest seat)
- Apically inclined
- Marginal ridge reduction required
- Rounded internal form
- Prepared with round bur
Fig. 13. Lingual ball rest seats
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Restoration on abutment teeth
A. Correction of unacceptable abutment tooth contours
B. Dentine exposure during tooth modification
Restoration on abutment teeth
A. Correction of unacceptable abutment tooth contours:
1. Composite resin:
- Bonded composite resin may be used to improve tooth
contours but should not be used in force bearing area.
- May be used to establish the lingual wall of a rest seat.
- May be used to increase depth of undercut.
Fig. 14. The lingual wall of the rest seat may be developed by
bonding composite to the enamel
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Restoration on abutment teeth
2. Cast metal and metal ceramic restoration for abutment teeth:
a. May provide ideal contours.
b. Metal preferred in force bearing areas such as rest seat.
c. Ledged cast restoration.
-Improve stability.
-May improve support and retention
Fig. 15. Cast metal and metal ceramic restoration for abutment teeth
Restoration on abutment teeth
B. Dentine exposure during tooth modification:
1. Indication for restoring exposed dentine:
- Sensitivity
- Caries susceptibility.
2. Restoration:
- Amalgam.
- Composite resin.
- Cast metal
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Thank you
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