INTRODUCTION
PROSTHESIS
Is an artificial replacement of an absent part of the human body
DENTULOUS PATIENT
Patients having a complete set of natural teeth
EDENTULOUS PATIENTS
Patients having all their teeth missing
PARTIALLY EDENTULOUS PATIENTS
Patients having one or more but not their entire natural teeth missing
REPLACEMENT OF MISSING TEETH - 3 basic ways
•Fixed bridges
•Removable partial dentures
•Dental implants
REMOVABLE PARTIAL DENTURE I
Removable dental prosthesis (appliance) replacing one or more natural teeth and associated oral structures
It can be removed and replaced in the mouth by the patient.
ABUTMENT
A tooth, a portion of a tooth, or that portion of a dental implant that serves to support and/or retain prosthesis
&
FREE END/DISTAL EXTENSION EDENTULOUS AREA (SADDLE)
An edentulous area, which has an abutment tooth on one side only.
BOUNDED EDENTULOUS AREA (SADDLE)
An edentulous area, which has an abutment tooth on each end
OBJECTIVES OF RPDs
1. Preservation of the Remaining Tissues
A- Preservation of the health of the remaining teeth.
B- Prevention of muscles and TMJ Dysfunction.
C-Preservation of the residual ridge.
D- Preservation of the tongue contour and space.
·
f
Replacement of lost teeth prevents migration of teeth into the edentulous area following the loss of natural
dentition.
·
Consequences of tooth loss
- Reduction in masticatory efficiency and avoidance of certain foods because of chewing problems
- Food impaction
- Effect on aesthetics
- Effect on speech
- Attrition of the remaining dentition
- Development of temporomandibular disorders in some cases
- Effect on patient’s psychology and self-esteem
- Effect on the neutral zone
·
Normal masticatory cycle
2. Restore the Continuity of the Dental Arch to Improve Masticatory Function
3. Improvement of Esthetics, and Providing Support to the Para-oral Muscles, Lips & Cheeks
4. Enhance psychological comfort
Restoration of anterior teeth improves and restores appearance.
·
5. Restoration of Impaired speech
Dento-labial F,V
Linguo-dental sounds
Linguo-alveolar sounds L, n, t, d....
ADVANTAGES OF RPD OVER FPD
1- RPD constructed for any case whilst FPD are confined to short spans bounded by healthy teeth and with
a normal occlusion.
2- Cheaper than fixed partial denture
3- They are more easily cleaned
4- They are more easily repaired
5- No tooth reduction is required
6- Presence of denture flange improves the esthetic outcome.
PROBLEMS ASSOICATED WITH IMPROPER DESIGNED PARTIAL DENTURES
1- Stagnation of food causes tooth decay
2- Induce stresses on abutment teeth and tissues --> PM destruction
--> Inflammation
--> Bone resorption
3- Improper occlusion cause T.M.J. disorders.
4- Ill fitting denture --> Inflammation, ulceration ,gingival recession, bone resorption.
5- Sensitivity from acryl
INDICATIONS FOR RPDs
1- No abutment tooth posterior to edentulous space (Free end edentulous area).
2- Long edentulous bounded span, too extensive for fixed restoration
3- Periodontally weak teeth not sufficiently sound to support fixed- partial denture
4- With excessive loss of residual bone, the use of labial flange or need to restore lost tissues.
With excessive loss of residual bone, space
is seen under the pontic
5- After recent extraction, usually done only to improve esthetics, or for patient satisfaction
6- Need of bilateral bracing (cross arch stabilization)
7- Young age (less than 17 years have a high pulp horn)
8- Enhancing esthetics in anterior region, due to presence of flange supporting Lips and Cheek
9-Economic considerations, attitude and desire of the patient
CONTRAINDICATIONS OF RPDs
• Whenever fixed restorations can be successfully used.
• When prognosis of remaining natural teeth is doubtful (Grade III mobility)
• Poor oral hygiene & high caries susceptibility.
• Lack of patient cooperation.
TYPES OF RPDs
Depending on denture base material
i
[Link] metal-based RPD
[Link] acrylic RPD
Permanent RPD
Temporary RPD
COMPONENTS OF RPDs
Denture Base
Artificial Teeth
Supporting Rests
Retainers: Direct retainers & Indirect Retainers
Connectors: Major Connectors & Minor Connectors