RPD Manual 11 - Removable Prosthodontics - Dalhousie University

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Interim Removable Partial Dentures Interim Removable Partial Dentures - 93 An interim removable partial denture (RPD) is sometimes made prior to making a definitive removable partial denture. The patient may wear the interim RPD for a very short period or for a more extended period of years, depending on the situation. Indications: 1. Large pulps may preclude the use of fixed partial dentures until a later time. 2. The clinical crowns may be short without any usable undercuts (in children or adolescents, the teeth may not be fully erupted). 3. Children - arches still growing, and a permanent prosthesis would not fit for long. 4. Temporary space maintenance for missing teeth in esthetic areas (congenital, caries, trauma) 5. Prevent extrusion, migration of adjacent/opposing dentition 6. Temporary time or financial constraints 7. Temporary improvement of esthetics after sudden loss of teeth, before sufficient healing has occurred to fabricate a permanent prosthesis (accidents, after extractions) 8. Transitional Denture: a removable partial denture used as a transition to a complete denture when: a. all or some teeth need to be extracted but can’t be immediately (medically compromised patient) b. patient is not psychologically prepared to loose all the teeth at one time 9. Treatment Denture: a removable partial denture used to improve a condition before a definitive denture can be made. The types of treatment may include: a. Tissue Conditioning - papillary hyperplasia (massage, brushing, with or without surgery) - acute inflammation (increase tissue adaptation and redistribute the stress) - may use the existing denture or a new treatment denture may be made b. Implant healing - a treatment RPD may be necessary for esthetics and/or function - an existing RPD or a new denture may be made - a soft liner is placed so that the fixtures can heal unloaded c. Alteration of Vertical Dimension / Occlusal Scheme - important use to determine how the patient will react to the changes (TMD) - may be required in order to use an occlusal splint d. Surgical Splint - after the removal of palatal tori, etc.
Interim Removable Partial Dentures - 94 Fabrication: 1. Make preliminary impressions 2. Pour diagnostic casts, survey, design a definitive partial denture 3. Optional Step (preferred) - Prepare guide planes, rest seats that will be used in the definitive RPD - Make new alginate impression, pour, survey, select path of insertion, tripodize 4. Maxillo-mandibular relations (facebow, occlusal vertical dimension, centric record if there are unstable contacts, protrusive record) 5. Articulate the casts 6. Draw design for interim partial denture Interim Partial Denture Design: Clasps (Wrought wire 0.02”) - Circumferential - Adams clasps - Ball clasps Bracing - the lingual/palatal acrylic of the RPD provides bracing through contact with the teeth at the heights of contour of the teeth Rests - wrought wire can be bent on itself and/or flattened and placed into the rest seats - acrylic may be used over cingulum rest seats - if longer term use is expected, cast rests and bracing arms can be embedded in the acrylic Major Connectors - Full palatal coverage increases strength and stability - Generally extend the denture to at least the first molar for stability - Retentive clasps are embedded into the acrylic major connector Prescription writing: 1. Mark any teeth to be extracted on the cast and write the teeth number on the prescription, draw a line where the cast to where the cast should be surgerized 2. Survey the cast and mark height of contour and retention areas (0.02”) 3. Indicate type of retentive clasp, rest and bracing. 4. Indicate where rests, retention arms and bracing are to be placed, state tooth # and surface 5. Draw the outline of the denture on the cast 6. Identify the shade and mould of teeth selected 7. State the type of occlusion required Laboratory Steps: To improve results, interim partial dentures should be sent to the lab for three distinct procedures: 1. Blockout & duplication of casts, fabrication of record bases & occlusion rims. The lab will return these for you to make jaw relations records and mount casts 2. Setting of teeth. The lab will return the partial dentures for a full wax try-in 3. At the final lab phase, the technicians will place retainers, scribe post dam, process
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Removable Partial Denture Manual Ro
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Table of Contents Table of Contents
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Table of Contents -iii Principles o
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Table of Contents - 2 4. poor progn
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Table of Contents - 4 F. Classifica
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Anatomy Tour - 6 Anatomy Tour for C
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Anatomy Tour - 8 ! Soft Palate ! Vi
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Anatomy Tour - 10 OTHER STRUCTURES:
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Preliminary Impressions - 12 6. Wra
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Surveying, Path of Insertion, Guidi
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Rests and Rest Seats - 24 A. Defini
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Rests and Rest Seats - 26 (d) The f
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Rests and Rest Seats - 28 Correct P
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Rests and Rest Seats - 30 2. The in
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Major Connectors - 32 Definition Ma
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Major Connectors - 34 3. Position -
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Major Connectors - 36 B. Full Palat
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Minor Connectors - 38 Definition Mi
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Minor Connectors - 40 The junction
Page 47 and 48: Minor Connectors - 42 When the dent
Page 49 and 50: Direct and Indirect Retainers - 44
Page 65 and 66: Denture Bases - 60 Advantages: Bead
Page 67 and 68: Denture Bases - 62 of the natural d
Page 69 and 70: Principles of Partial Denture Desig
Page 77 and 78: Design Session - 72 Classification
Page 85 and 86: Clinical Protocol, Final Impression
Page 87 and 88: Clinical Protocol, Final Impression
Page 89 and 90: Framework Adjustment - 84 Removable
Page 91 and 92: Framework Adjustment - 86 3. Silico
Page 93 and 94: Framework Adjustment - 88 after adj
Page 95 and 96: Jaw Relations, Altered Cast Techniq
Page 97: Jaw Relations, Altered Cast Techniq
Page 101 and 102: Coordinating Fixed and Removable Pr
Page 103 and 104: RPD Checklist - 98 7. Abutment Modi
Page 105 and 106: RPD Checklist - 100 16. Baseplate a
Page 107 and 108: Summary of Design Principles for Re
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RPD Manual 11 - Removable Prosthodontics - Dalhousie University

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