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Lecture 7: Design Sequence For Rpds

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Lecture 7: Design

Sequence for RPDs


Karen L. Faraone, D.D.S., M.A.
Department of Restorative Dentistry
General Goal: To understand
the basic principles and sequence
of designing RPDs
Objectives:

• to understand the necessity of mounting the diagnostic casts on an


articulator prior to RPD design
• to understand surveying and tripoding of the diagnostic cast
• to understand the sequence for selection of components for a RPD
I. Observe the mounting of the
diagnostic casts on an articulator
A Evaluate existing occlusion on natural teeth
B Evaluate plane of occlusion
C Evaluate interarch distance
Diagnostic Mounting

Supereruption of molar:
Plane of occlusion is poor:
possibilities include
possibilities include tuberosity
enameloplasty, crown, elective
reduction & enameloplasty of #18 ,
endo. & crown, extraction to
extraction #18, complete maxillary
correct plane of occlusion
denture
Diagnostic Mounting

Problems with the plane of occlusion must be


addressed prior to partial denture fabrication.
Diagnostic Mounting

Severe plane of occlusion problems - both cases would most likely


need a complete maxillary denture and mandibular partial denture.
Diagnostic Mounting

? ?
II. Survey the diagnostic casts

A Establish most favorable path of draw


using analyzing rod
1 Generally, occlusal plane is at a zero degree tilt
2 Guide planes as parallel as possible
3 Retentive areas - may need to tilt cast to evenly
distribute
4 Minimize tissue undercuts where possible
B Indicate height of contour with carbon
marker
C Measure clasp tip undercuts using
undercut gauges
1 indicate in red pencil
2 determine need for “prepared retention”
D Place tripod marks on cast
Establish most favorable path of
draw using the analyzing rod
Measure clasp tip undercuts using undercut
gauges and indicate in red pencil
Place tripod marks on the cast
Indicate height of contour with a
carbon marker
III. Rest location
A Located on all teeth adjacent to edentulous areas
B Be aware of interferences from opposing occlusion
C Be aware of fulcrum lines and the need for indirect retention
D In general, rests are located on the side of the tooth that is
immediately adjacent to an edentulous area
1. Example: tooth #30 is missing
DO rest on #29
MO rest on #31
2. Exception: distal extensions have
MO rests on primary
abutments
Rest location

Rests #20 MO & #28 MO Rule: distal extensions


have MO rests on primary abutments
Rest #21 MO Rule: be aware of fulcrum lines and
the need for indirect retention
IV. Proximal Plate location
A Located on all proximal surfaces adjacent to edentulous
areas - extends buccally and lingually just short of the line
angles and occlusally to the marginal ridge
B Draw 1 mm. wide “foot”

Proximal Plate
Foot
Foot

The foot moves the acrylic- metal finish line away from the
gingival margin leaving smooth metal against the gingival
margin rather than a “rough” junction of materials.
V. Minor Connector location
A Draw from rests and proximal plates toward location of
major connector
B Must have 5+ mm. space between vertical components
C Joins major connector at 90 degree angle
D Crosses gingival margin at 90 degree angle
Minor Connectors

5 mm. 5 mm.

4 mm. 4 mm.
VI. Major Connector
A Consider Kennedy classification
B Consider length of edentulous span
C Consider periodontal status
D Consider quality of supporting bone
E Consider occlusion and excessive muscular force
F Maxillary major connectors
1 borders must be at least 6 mm. from gingival margins
2 borders must pass thru valleys of rugae where possible
G Mandibular major connectors
1 borders are at least 4 mm. from gingival margin
2 lingual plate when distance between gingival margin and sublingual sulcus is less
than 8 mm.
Major Connector
Major Connector
Major Connector
Major Connector
Major Connector

Acute Angle

The major connector ends in an acute angle - this allows the


acrylic to meet it at an obtuse angle. Bulk of acrylic is necessary
for strength.
VII. Design the direct retainers
and reciprocation
A. There is an even total number of clasps - generally
one clasp on each side or two clasps on each side
B. Retentive clasp tip must end on a predetermined
undercut
1. Should be minimum necessary to resist reasonable
dislodging forces
2. .010” for cast clasps on incisors and premolars
3. Up to .020” for cast clasps on molars
4. Need more retention for wrought wire clasps - at least .
020”
C. Outline all clasp arms in blue, indicating precise
width, taper, and relationship to survey lines and the
gingival margins
D. Problem situations:
1. Kennedy Cl. I (bilateral distal extension)
a. I-bar located on each primary abutment in midbuccal or mesiobuccal
b. If tooth or tissue undercuts preclude use of an I-bar, then use wrought
wire alternative
2. Kennedy Cl. II (unilateral distal extension) - be aware
of creating a potentially damaging lever when clasping anterior to the
fulcrum line
Clasp location

I-bar is located midbuccally - it The I-bar should end one tooth width
contacts the tooth at the posterior to primary abutment in
predetermined .010” undercut and what would be an interproximal area.
extends occlusally for 1.5 to 2.0 This aids is setting the artificial
mm. Drawing should indicate the teeth.
precise width and taper of clasp.
VIII. Design the retentive mesh
or lattice
A. 3 mm. ovoid tissue stop on mandibular
distal extension
1. Located in 2nd molar area
2. Stop needed for jaw relations and processing
B. Do not cover retromolar pad or
tuberosity with acrylic retention mesh or
lattice
Design the acrylic retention
lattice or mesh

Bilateral acrylic retention lattice covers the distal extensions to


the 2nd molar area where it ends with the tissue stop. The
retromolar pad should not be covered with lattice. The lattice
joins the major connector 1.5 to 2.0 mm. superior to the depth of
the major connector.
Interference between RMP and
Tuberosity

These examples demonstrate why we do not cover the RMP or


tuberosity with acrylic retention lattice or mesh. Frequently there
is less than 3 mm. of space remaining between the RMP and
tuberosity. Lattice and mesh must be enveloped in acrylic - so
wherever it is placed, you commit to 1.5 mm. of acrylic above and
below the mesh plus the thickness of the metal itself.
Why is a tissue stop unnecessary
on a maxillary RPD framework?
…because the maxillary major
connector is intimately adapted to
the palate so in effect it acts as a
very large tissue stop.

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