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7/29/2019 Scr.1 - Removable Partial Dentures
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Remavable artial denture
Hebah ra3d ramadneh
3essam el-3alam
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Removable Partial DenturesInthissemesterwewilltalkaboutremovablepartialdenture,whichis moredifficultthancompletedenturebecauseitssmallerandneedotherstepstobe
done. isaprosthesisthatreplacesoneormoremissingteeth.(not
allteeth)
Inpartialprosthodonticswehave2types:1-interimprosthodontics(Interim (transitional)) :( , , )***Itsalmost(notalways)madebyacrylic(looklikecompletedenture),ithasclasps .
2-diffinitiveprosthodontics(permanent):thefinalone
***ithasmetalframeworkitsusuallymadeofcobaltchromiumwhichisverystrongmaterial(notcorrodeeasily)&itsbiocompatibleforthetissueinthemouth.
wecanalsousenickelchromium itsastrongmaterial,butitsstillhasproblemwiththetissueinthemouth,5%ofpeoplehasnickelsensitivityso,wetrynottousenickelindentistry.
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NOTE:_weusechromiumtoprotectthecobaltmaterialbecausechromiumisfastertoreactwithoxygen._Inthelabwewillmakemetalframeworkdenture.Intheclinicyouwillmeetdifferentcaseswithdiferentmissingteethso,itsdifficulttodescribeeachcasetothetechnicianssowehavedifferentclassificationsystemsweredesigned,andtheseweredoneinNorthAmerica .Theclassificationsystemthatyouhavealreadybeenfamiliarwithis
with .DrKennedyproposedthisclassification90yearsago,Kennedysclassificationhassomedeficienciesand
thatswhyMr.Applegatecamealongandmadesomemodifications. Wehavedifferentclassesinkennedysclassification:
*class-I:themostmissingteeth,theanteriorteethispresentbuttheposteriorteethislost.wecandescribeitasbilateraldisextension( Bilateral edentulous).itcanbeupperorlowerbutinbothside(bothsidemissing).
*class-II:insteadofhavingmissingteethinbothside,wehavemissingteethinoneside,itsunilateraldisextension, Unilateral edentulous(onesidemissing).
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*class-III:wehavespacedmissingteeth,thatmeanmissingteethintheanteriorandposteriorpartofthemouthwecalleditboundspaced( ).itsaUnilateralareaboundedbyanterior&posteriornaturalteeth.
*class-IV:itsjustlikeclass-IIIbutitsspecial,itbilateralcrossthemidline.
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Applegatesmodifications:thefirstoneisspacemodification:
youhaveadditionalspace,ithasnothingtodowiththenumberofmissingteeth,itdealwiththenumberofmissingspace.EXs:-ifyouhavepatientwithkennedysclass-Iandhemisshiscentralincisoryou
calleditkennedysclass-Imodification-1 .ifthispatientalsolosthislateralincisorinthesamesidewealsocalleditkennedysclass-Imodification-becauseitsdealwithnumberofspacesnotthenumberofthemissingteeth.- ifyouhavepatientwithkennedysclass-IandhemisshiscanineandlateralincisorintheRtandintheLf,wecalleditkennedysclass-Imodification-1-2
***WECOUNTTHESPACESNOTTHEMISSINGTEETH***
-NOTE:Thereis modificationspacein ).OnlyClassI,II,IIhasmodificationspace.becauseI take the most posterior edentulous area and the anterior spacebecomes a modification.
In Ihave edentulousspace,thereisamistakeintheslidesitsnotbilateralitsjustunilateral(oneedentulousarea,itcanbe2butithas
differentname),nowifthisspacecrossesthemidlineitbecomes .
Sometimesthereareothermissingspaces,notthetypicalformthatKennedytalkedabout.ForexampleifIhaveatooth
Remember this:
Class I . 2 edentulous areasClass II.1 edentulous area.
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missinghere(thestarinthepicture),whatshouldIcallit??ThereisanApplegatesrulesaysthatIalwayschoosethe posterioredentulouspart,theonethatisthemostposterioristhedistalextension,whichisKennedy'sclassII,whatshouldIcalltheotherspace(hereitsthestar)??ApplegatesaidthatifIhaveanadditionaledentulousareaIdontcaretothenumberofteeth,itcouldbeoneortwo,andeachadditionalmissingspaceiscalleda
,notaccordingtothenumberofmissingteethbutaccordingtotheboundedspaces.Sothisis .TheotherproblemwithKennedy'sclassesis,hereIhave ,whatifIhaveteethmissing,herethestarsinthepicture>>>
Itakethe edentulousareaandtheanteriorspacebecomesa EventhoughitcrossesthemidlinewhichisanotherruleofApplegate(Thereis modificationspacein ).ClassI,II,IIIcanhaveamodification,itscommonsense,ifIhaveclassIVmodificationI(whichcanthappen)itshouldbeclassIIIanyway,hereismyexplanationanyedentulousareaotherthantheoneinclassIVwillbeforsureintheposteriorpartbecauseclassIVshould
crossthemidlinewhichmeansthatitsanteriortoanyedentulousareasandasApplegatesaidthatwechoosethemostposterior,soifIhaveanyadditionaledentulousareawithclassIVitwilltransformtoamodificationinsteadofaclassbyitself.
Nowwewilltalkabout3rdmolar:
manypeoplebornwithout3
rd
molarsowecantincludeitinourcalcification(if the third molar is not included in my design, its not included in theclassification ) .
SometimesthereareteethinthemouththatIdontuseinmydesign.WhatifItellyouthatthisupper3 rdmolarhasnolower3 rdmolarsousuallyinApplegate
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modificationyouwillseethatifthethirdmolarisnotincludedinmydesign,itsnotincludedintheclassificationsoifImnotusingthe3 rdmolar,thisbecomesaunilateralextensionofedentulousareawhichis
Now this is true for 3rd
and 2nd
molar, unless I give you specific information then youhave to take specific default, now again lets go to Applegates rules.
1-Classification should follow rather than precede extraction:If a patient come to you and has a periodontal disease extract the teeth
then make the classification, or imagine the patient without that tooth or teeth.
2- If 3rd molar is missing & not to be replaced, it is not considered in theclassification.
3-If the 3rd molar is present and to be used as an abutment, it is considered in theclassification.
4-If the second molar is missing and not to be replaced, it is not considered in theclassification.
5-The most posterior edentulous area determines the classification.6-Edentulous areas other than those determining classification are called
modification spaces.
7-The extent of the modification is not considered, only the number.8-There is no modification space in Class IV.
If I delete this molar it becomes class II
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***Nowletustalkaboutveryimportantissue,whichisaboutforcesaffectthedenture,thesupportedtissue,. -Naturalteethconnectedwiththebonebyperiodontalligament(2-4mm),so,itcanmovearound0.5mminalldirection.-Inthecompletedenture,itsfixedonasofttissueabovethebonesotheboneresolvedbutthestoryisthesameinallpartofthemouthso,thepatientcompensatewiththesecondition.-inthepartialdenturetheproblemis:itssupportbysofttissueandteeth
so,thetoothwhichlocateattheendoftheboundedspacewillaffectedbymoreforce,moreloadbecausethemotionandrotationwillbearounditandwithtimeitwillbelost,BUTourjobistomaintainthehealthytissuewhichisexistthere.So,ifyouhaveteethinonepartofthemouthandnoteethintheotherpartthenyouhaveabigproblem
so,nowwehaveothertypeofcalcificationwhichdependontheloaddistreputionandsupportform:***inthecompletedenturewehave or
(alldenturesupportedbytissue).***inthemetalframeworkpartialdenturewehave3story(accordingtokenndysclasses):1-class-III&class-IV(shortspan),wehaveteethinbothsideofboundedspacesowehave . weremovepartofenamelbutnotreachthedentinethenweputthepartialdentureaboveit.2-class-I&class-II,wehavetoothinthefrontandtissueinthebackso;wehave .Andthisistheproblembecausewhenthepatientmasticatehewillcompressthetissueandputmoreloadonthetooth,,,so,nowadaysmostofourstudyistoreducetheseforceandloadtomaintaintheremainingstructureinthemouth.3-Acrylicandinterimpartialdentureandaretissue WHY?Becausetheacrylicmaterialisweakerthanmetalso,itwillruptureif
weputitabovehardpart(tooth)andbymetalwecanmakethinextensionbutbyacrylicwecantso,itslikethecompletedenture(NOtoothsupported).DONEBY:hebahramadneh! ! !!
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