75% of RPD frameworks don’t fit perfectly.

- Active clasps cause orthodontic movement and

should be adjusted to be passive. Incomplete
seating might also cause discomfort, damage soft
tissues and supporting bone
- Adjust soon after fabrication, without denture base
- Check accuracy of the framework as designed
The design as drawn and then executed in the metal framework.
- Framework should fit master cast. If it does not,
probably will not fit intraorally
- Framework should cause no abrasion on the cast
Rest seats should be fully seated
All retentive, reciprocal arms, proximal plates,
superior portion of lingual plates and all maxillary
major connectors should be contacting the casts
(spaces will collect debris causing caries and gingival
irritation).
 Major & minor connectors:
. Should have adequate distance from abutments (hygiene)
. Proper proportions (rigidity, hygiene)
. Adjust or have lab adjust or remake framework
. Minor Connectors should have butt joint finish lines slightly
undercut for acrylic resin and also of sufficient thickness.
. 1mm relief over saddles for acrylic
- Clasps have uniform taper

No Taper
Finish and Polish
- Framework should be highly polished
- No pits, nodules, scratches or sharp edges (stress
concentration and might injure mucosa).
Reduction can be undertaken with
. Heatless stones
. Diamond burs
. E-Cutter burs.
. Coarse stones
Shofu coral stones
Carborundum disks
Polishing can be undertaken with:
. Carborundum points & wheels
. Final polish - Shofu brown & green points

Use care!
- Incomplete seating of framework is a common
problem (usually binding on abutments)
- For adjustment use an indicating medium
. Aerosol Sprays (Occlude)
. Disclosing Wax
. Silicone
Aerosol sprays
. Thin, accurate and not easily displaced
But
. Can dissolve in saliva
. Difficult to remove
. Can’t tell how far from seating
(2D)
Disclosing Wax
. Sets immediately
. Inexpensive
. Shows how far from seating (3D)
But
. Can stick to teeth
. Can be distorted
- Adjust areas of significant show-through.
Completely remove wax with metal particles.
Repeat until full seating
Silicone indicating medium
. Three dimensional
. Minimal distortion
But
. More expensive
. Sets relatively slowly (~ 2 min)
. Can tear or pull off the
framework
. Use minimal amount (expense)
. Cover all components contacting the abutments
. Mark contacts with dampened red pencil
. Remove silicone material
. Adjust marked areas
Initial Assessment of framework fit:

- ‘How does the framework feel?’

- No pulling or wedging (Active engagement of
abutment teeth)
- Overall comfort of the framework
- Determine if casting fits similarly on the cast and
intraorally. If not, final impression is inaccurate
and a new impression should be made
Areas of abrasion on master cast may indicate areas
of binding
Place indicating medium

Align the framework, place

pressure over rests. No pressure
over saddles. Check for ‘show-
through’. Repeat

x x
. Differentiate between normal & abnormal contacts
e.g: Guiding planes normally have long vertical areas of
contact . Broad areas of severe show-through may
indicate binding
. Avoid excessive force that might cause bending
. Avoid heat generation (could melt the acrylic)
. Retentive tip of direct retainers normally have show-
through areas, but eliminate active clasp retention
Most common interferences
that prevent complete
seating:
.Under rests
. Rigid portions of direct retainers
. Interproximal portions of lingual
plates
. Interproximal minor connectors
. Shoulder areas of embrasure
clasps
- After adjustment is completed, a
thin even layer of indicating
medium is applied results in
greyish hue from underlying
metal. Complete seating with
gliding sensation and no grating
or snapping
Detected using pressure-indicating paste
. Apply a thin layer with streaks. Place with moderate
pressure
. Areas of show-through should be relieved while
remaining streaks indicate no contact
. Maxillary major connectors have broad even palatal
contact
 No tissue contact

The metal framework tried in the mouth to verify the fit.

Notice that the underside of the framework in the areas
where teeth are to be placed is not in contact with the
tissue.
- RPDs are fabricated on unmounted casts. So, occlusal
interferences usually present
- Occlusal vertical dimension should be unchanged
- Centric and eccentric contacts should be identical with
or without the framework
- With highly polished metal, articulating paper marks
poorly. So, check opposing occlusal contacts or slightly
roughen framework with air abrasive or rubber
impregnated abrasive
- Adjust individually opposing frameworks, then adjust
them together
- Eliminate interferences between the frameworks
- If occlusal rest thickness is ≤ 1.5 mm after adjustment,
rests will be subject to fatigue and possible fracture
- May require additional tooth preparation and remake
- Last resort - occlusal reduction of opposing teeth
- Adjust minor interferences caused by retentive arms.
Reduce opposing cusp - last resort
- With heavy contacts: Lower height of contour and
remake
- Don’t relieve claps (alters flexibility and fracture
resistance)
Corrected (Modified) Cast Technique
- The difference in compressibility between the denture
bearing mucosa and the periodontal ligament of the
abutment teeth will cause the free-end saddle to sink
under occlusal load and RPD to rotate about the
support axis
- Reduces the support differential between ridge and
abutments by obtaining a compressive impression
mimicking functional loading.
- Provides a more accurate relationship between
abutments & ridge
- Improves load distribution and denture stability
- Corrects peripheral adaptation
- Class I & II RPDs
- Framework most likely to be adjusted in the future
(need for relining and rebasing)
- Extensive Class III & IV cases
- Tooth mobility + compressible mucosa
- Less necessary in maxilla
- Ensure well-fitting framework on the cast
- Place relief over ridge (1 mm wax relief)
- A custom acrylic impression tray is fabricated over the
framework
- Check seating of the framework on the cast. If not
seated, remove, repeat tray construction (rests fully
seated, tissue stop contacts cast, metal adjacent
abutment contacts cast, no resistance as framework
seated).
- Check peripheries of the tray (2-3 mm short of
vestibular)
- No displacement when cheeks and lips are pulled or
when the patient activates tongue
- Border moulding is undertaken to simulate final denture
border
- Before making the impression, ensure tray is well
retained by framework
- Remove wax spacer
- Coat tray with adhesive and wait for 10-15 minutes
- Polyvinyl siloxane (light or medium body) or zinc-
oxide eugenol can be used.
- Carefully load tray and make sure no material is
under rests, guiding plates, max. major connector,
etc.
- Seat the framework applying pressure over rests. No
pressure should be applied on saddles or
unoccluding teeth (Fulcruming or tissue
compression). This might cause spring back and
lack of tissue contact.
- Remove the impression and inspect it:
. Absence of voids
. Minimal show-through
. The impression must cover supporting tissues
. Framework is fully seated.
- Modify small errors or retake impression
Send to the laboratory. Residual ridge is sectioned from
the original cast
- Ensure no contact between impression & cast
- Place retentive grooves in cast
- Sticky wax in place
- Box the impression ensuring water tight seal
- Seal retainer, major & minor connector borders
- Pour new ridge areas in different color stone
- If tray is added carelessly, it can alter passive
relationship between framework and teeth
- Excess impression material under framework, might
cause incomplete seating
- If inadequately sealed, stone over teeth, can’t articulate
model
- An alternative procedure involves rebasing the
completed denture by applying zinc-oxide eugenol
impression on the acrylic fitting surface of the relevant
saddles and taking an impression while the denture is
being seated by pressure on the rests. This might
disrupt the evenness of the occlusal contacts in the
saddle area by creating premature contacts posteriorly.
Jaw relation registration
•To establish and maintain a harmonious relationship with all oral
structures and to provide a masticatory apparatus that is efficient and
esthetically acceptable.
•To ensure that all the effects of occlusal loading be distributed as
evenly as possible to all supporting structures capable of receiving the
force
* To best control the undesirable effects of rotational or torquing forces
on the prosthesis.

*To prevent any deflective contacts of the teeth during centric or

eccentric closures as these can produce pathological changes in the
supportive structures or in the neuromuscular mechanism that controls
mandibular movement.
 Jaw Relation Records

 * Vertical Jaw Relations:

Rest Vertical Dimension „RVD‟
Occlusion Vertical Dimension „OVD‟
* Horizontal Jaw Relations:
Centric Relation
Centric Occlusion
Eccentric Relations
Protrusive relation
Lt & Rt Lateral relations
* Face bow Registration.
 Vertical Jaw Relation
The vertical distance between
two selected points, one on
the fixed (maxilla) and one
on the movable member
(mandible).
Rest Vertical Dimension (RVD)
Is the distance measured when
the mandible is in the rest
position.

Occlusal vertical Dimension

(OVD)
Is the distance measured when
the occluding rims or teeth are
in contact.
 Inter-occlusal Distance (FWS)

The distance between the occluding surfaces of maxillary and

mandibular teeth when the mandible is in the rest position.
For a complete denture patient, it is the difference between RVD
and OVD.

RVD – OVD = 4 mm
o
In natural dentition it ranges from 2-4 mm in the premolar
area
If stable occlusal contacts are provided by the remaining natural teeth, the
existing OVD and CO relation should be recorded.

For the patients whom one of the arch is edentulous or whom the opposing
teeth do not provide stable occlusal contacts, OVD has to be measured
as follows,
RVD – OVD = 3 - 4 mm
Normally the OVD of a partially edentulous patient
is provided by the opposing natural teeth contact
and it should not be changed.

Unless,
1. Symptoms of diminished OVD exist such as tired
aching muscles, unexplained pain in the head and
neck region, shortened nose-chin distance
(appearance of premature aging).
2. Excessive Free way Space or ‘over-closure’ of the
jaws.
Wearing of the teeth does not mean that OVD should be increased –
unless the free-way space is greater than 4mm.
1. Confirm the loss of vertical dimension by taking history, cephalometric
examination, and the presence of excessive free-way space.

2. Increase the existing OVD temporarily by fabricating an acrylic resin

occlusal overlay appliance in maximum intercuspation, ensuring
that 4mm of freeway space must exist.
3. Restore the desired OVD permanently with the help of fixed and
removable prosthesis (made simultaneously) only after the
physiologic response of the patient to this appliance is positive.
Centric Relation
‘the most retruded position of the mandible to maxilla at an established OVD’.

It is a bone to bone relation that is repeatable by the patient. It remains constant

throughout life & during its recording cuspal relation of the teeth is not
considered.
 What to Record – C.R or C.O

In more than 90% of people, C.O is 0.1 - 2mm in front of the CR.
 What to Record – C.R or C.O
Centric Occlusion should be recorded whenever a patient
requiring a partial denture has cusps on remaining natural teeth
that can guide the mandible back to this position,

otherwise,
C.R should be recorded, e.g., for distal extension RPD, or when the
opposing arch is edentulous.
- Most accurate method requires use of stabilized occlusal
rims. After carefully verifying the fit and occlusion of
the RPD framework intra-orally and after performing
the altered cast procedure, an auto-polymerizing
acrylic resin base is usually attached to the framework
saddle areas. A base-plate wax base may also be
formed. Rims should be placed just out of contact.
A wax occlusion rim is then placed
over the resin base, while
considering the width and
height dimensions of the natural
missing teeth.
Clinical Procedure:

1. The framework with the attached record block is

first tried in the mouth for reconfirming the fit of
framework.
2. The height of the wax occlusion rims are so
adjusted intra-orally that 1mm of space exists
between the opposing teeth & the rims.
- Three widely separated tripod points of occlusal contacts are
necessary to relate the 2 casts accurately. These contact points
may be tooth to tooth or tooth to interocclusal recording material

A stable orientation of the opposing casts may exist if sufficient

teeth remain and in these patients no interocclusal relation
recording is necessary.
For the patients whom one of the arch is edentulous or
whom the opposing teeth do not provide stable
occlusal contacts, OVD has to be measured as follows,
RVD – OVD = 3 - 4 mm
The recording medium (wax or ZnO paste) is then placed on the
mandibular wax rims while V notches are cut in the upper rim
- the patient is then guided in the desired C.O or C.R position.
Care must be taken to avoid any pressure being applied on the soft
tissue under the record bases to avoid any inaccuracies.
is an instrument used to record the spatial relationship of the maxilla
to some anatomic reference (transverse horizontal axis) and then
transfer this relationship to an articulator.
The steps of making this record can vary depending on
the type of face-bow & articulator being used,
however, following are the basic steps,
Preparation of the face-bow / bite fork.
Orientation of face-bow to articulator.
Mounting the maxillary cast to articulator.
 - Strive for “Occlusal
Harmony”
- Examine the pre-
treatment occlusion
- Design partial before
considering occlusal
schemes
 Place clasps so they
do not affect existing
occlusion

Davies, SJ et. al. BDJ 2001, 191:9:491-502

 - If a physiologic state exists, maintain
maximum intercuspation.

- Bilateral simultaneous contacts should be

established in the restored occlusion.

- Multiple points of posterior occlusal contact

improve chewing efficiency & decrease the
potential for wear

- Do not alter existing occlusal scheme except to

remove a pathologic process.
 - If lateral guidance is needed, strive for
canine guidance.
 Select if canines are present and sound

 Helps to reduce lateral forces

 Promotes a more vertical chewing cycle

 Allows for greater selection of occlusal

morphologies

Ivanhoe JR, Plummer KD. J Dent Clan N Am 48 (2004) 667-683

 - Establish group function or unilateral balanced
occlusion if canines are missing or week.

- Do not permit Nonworking contacts on natural

teeth unless they oppose a CD in balanced
occlusion
 - No single occlusal scheme will work for every
patient

- Selection of an occlusal scheme is multifactorial

- There is currently no evidence to support one

occlusal scheme over another

- Emphasis should be placed on protecting the

natural dentition rather than correcting the
edentulism