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Making Predictable
Removable
Prosthodontics
With Traditional and
Digital Techniques
Quyen Pham, DDS
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Removables
Making Predictable Removable
Prosthodontics With Traditional
and Digital Techniques
Quyen Pham, DDS
ABSTRACT
In recent years, technological
advances have facilitated the
development of CAD/CAM and
decreased the inaccuracies of
conventional techniques. However,
removable denture design has
employed the same traditional
procedures for more than 50 years
despite the many risks of errors.
Digital removable denture design
software is relatively new. This
article will explain the traditional
removable denture device process
and compare it with this new digital
option, which has proven to be
relatively efficient and facilitates the
standardization of clinical results.
LEARNING OBJECTIVES
• Distinguish different
designs and components of
removable devices.
• Determine the sequence of
steps in making removable
devices.
• Use CAD/CAM imaging
techniques in creating
removable devices.
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I
n recent years, technological advances have facilitated the de-
velopment of CAD/CAM and decreased the inaccuracies of
conventional techniques.1 Digital systems have been integrated
into the fabrication of inlays, onlays, crowns, fixed partial den-
tures, implant abutments/prostheses, and maxillofacial prostheses.2
However, removable denture design has employed the same tradi-
tional procedures for more than 50 years despite the many risks of
errors. Digital removable denture design software is relatively new.
This article will explain the traditional removable denture device
process and compare it with this new digital option, which has
proven to be relatively efficient and facilitates the standardization
of clinical results.
More than 36 million Americans are edentulous, and about
90% of edentulous people have dentures.3 Dentures are also a
common and popular restorative dentistry treatment for people
who have just partial tooth loss. One goal of dental reconstruction
is to regain durable function and esthetics that are as similar to
natural teeth as possible. For an edentulous patient, a variety of
treatment options can be considered, including mucosa-supported
removable dental prostheses (RDP), implant-retained RDP, fixed
detachable prostheses, and metal-ceramic fixed dental prostheses.
Each treatment option has unique advantages and limitations with
respect to space, implant distribution, and implant number.4-7
Patient management plays an important role in the process of
creating removable prosthetics. From the beginning, during the
patient consultation, communication is crucial. It is important to
listen to what motivates the patient. For example, is the patient
more concerned with function or esthetics? The answer may help
determine which material to use. Concerning denture quality,
patients are generally more satisfied with customized skeletal
dentures for retention, masticatory efficiency, and esthetics be-
cause they prefer not to see classic wire hooks.8
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It is also important to discuss alternative treat-
ment plans and options with a patient, such as
All-on-4® (Nobel Biocare, nobelbiocare.com) or
an overdenture. The main disadvantage of these
treatments is cost. For older patients, partial
edentation therapy with partial dentures is often
required.9 Many elderly patients live on a fixed
income, so a large expense may not fit within
their budget. Conservative treatments such as
dental implants are expensive. Consequently,
their use is limited in lower socioeconomic
groups, in whom the highest rates of tooth loss
occur.10-12 Conventional removable prosthodontic
treatments, therefore, continue to outnumber
implant tooth replacements in general practice.13
PARTIAL DENTURE COMPONENTS
The important steps in making partial dentures
involve forming rest seats, picking the correct
type of partial allocation, and taking a good im-
pression. A partial denture consists of a handful
of parts. There are major and minor connectors,
denture bases, artificial teeth, and direct and
indirect retainers. A major connector is the main
body of a denture, which provides rigidity and
unites all the parts of the denture. A minor con-
nector joins together all other parts of a denture
to the major connector. A denture base is the part
that is adapted to the soft tissues in the region of
missing teeth and is used to support the artificial
teeth. Artificial teeth replace the missing teeth.
Direct retainers, often clasps, are the parts of
the denture that prevent it from falling out of
the mouth. Indirect retainers prevent the denture
from shifting during eating or talking. Rests are
indirect retainers.
Rests
A rest seat is a small projection of metal that
rests on a chewing surface of a natural tooth
from the main frame of the body of the denture.
A rest seat has many functions. It is important to
place a rest seat because it prevents partials from
rocking, shifting, or rotating when eating and
talking. It also prevents open bite. Furthermore,
4 CDEWORLD.COM | VOLUME 6 • NUMBER 148
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it helps maintain a level of clasp engagement
with tooth surfaces. Placement of a rest requires
that a small amount of enamel is removed from
the tooth structure using a small dental bur.
This creates a space so that the metal projec-
tion from the denture rests on the tooth. This
way the patient should not feel a high bite when
biting the teeth together. Rests are important
because without them, a denture base would
rest entirely on an edentulous ridge, causing all
the load created during chewing to fall on the
bone within the edentulous ridge. That type of
denture support is called mucosal support and
may result in a faster rate of resorption of the
edentulous ridge, which is ultimately detrimental
to the ridge. A tooth support is when a rest is
placed on a tooth on each side of the gap so that
the load of mastication is shared between the two
teeth. A tooth and mucosal support combined
are used when a rest can only be placed on one
tooth; then the load is shared between the natural
tooth and the ridge.
Placing a rest seat is normally a quick proce-
dure. There are occlusal rests, cingulum rests,
and incisal rests. Occlusal rests are placed on one
or both sides of a molar or premolar. Cingulum
rests are placed on an upper incisor or a canine,
resting on the cingulum of the tooth. Incisal rests
are placed on lower incisors, where preparation
of a cingulum rest may penetrate beyond the thin
enamel. A cingulum rest is the least esthetic type
of rest because it can be seen from the front.
To optimize partial denture design, retention
and function, the author always places rest seats
on abutment teeth. The author also takes a closer
examination of abutment teeth for wear. If they
are too worn down, the author recommends
crowns before the impression to restore the tooth
to its ideal anatomy.
Frameworks
Acrylic resin framework removable partial den-
tures (RPDs) are far more common than cast
metal framework RPDs.14 Long-term studies on
acrylic resin framework RPDs are lacking, but
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A variety of treatment options can be considered,
including mucosa-supported removable dental prostheses
(RDP), implant-retained RDP, fixed detachable
prostheses, and metal-ceramic fixed dental prostheses.
they continue to be used frequently.15,16 Because
they lack the strength and established design
principles of cast metal framework RPDs, al-
ternative RPD frameworks have been shown
in some studies to have reduced longevity and
significant periodontal consequences.17
A metal framework works best when esthet-
ics are not the patient’s primary concern. The
advantages to a metal framework for RPDs are
the ability to adjust the clasps if the partial is
too loose or too tight, the lower costs, and the
assistance from plates and clasps in creating
retention. Disadvantages can include a metallic
taste and discomfort. Flexible partials are a more
esthetically pleasing alternative. The advantages
include the cosmetics, lack of metallic taste, and
how thin and flexible they are. The disadvan-
tages include cost, that the plate does not create
retention, that not everyone is a candidate, and
that they can be hard to adjust. Combination
partials are good for retention and esthetics,
although some patients still complain about a
metallic taste. A unilateral partial can be used
to reserve space for a bridge or implant later.
From the author’s experience with digitally
fabricated frameworks versus conventionally fab-
ricated frameworks, digitally fabricated frame-
works tend to have a tighter and more consistent
fit from patient to patient. With conventionally
fabricated frameworks, the author sometimes
faces challenges with partials not fitting in the
patient’s mouth even though they fit perfectly in
the model. This situation can occur because of
poor impression techniques, impression distor-
tions, and improper pour-up of the models.
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THE TRADITIONAL DENTURE EXPERIENCE
In the traditional denture creation process, the
first visit is critical because that is when perhaps
the most crucial step is taken: the impression. A
well-made impression will save a dentist from
complications later. The consistency of the mix-
ture used must be precise (Figure 1). The mixture
must be given enough time to set. After the im-
pression is taken, the mixture should be poured
immediately. The second visit is when the most
time will likely be spent with the patient. This is
when the patient’s vertical dimension of occlu-
sion (VDO), vertical dimension of rest (VDR),
midline, and smile line are measured (Figure
2), in addition to a bite registration being taken.
During the third visit, the artificial teeth are
tried in and occlusion checked. Occlusion is one
of the most important factors affecting denture
stability (Figure 3). Vertical forces on the denture
base lying over the resilient tissue will produce
lever forces on the denture. Vertical forces acting
outside the ridge crest will produce tipping of
the denture. The clinician should ensure the fit
is comfortable and tight. The fourth visit is when
the denture is delivered (Figure 4). Any final
adjustments are then made, and the dentures are
polished. Reline protocol dictates that patients
should come in a few times after the denture
delivery. Reline can be performed in-office or
sent to a laboratory.
DIGITALLY DESIGNED DENTURES
Advancements in CAD/CAM technology can
now be used for the fabrication of removable den-
tures, including milling and rapid prototyping.18
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1 2

3 4
Fig 1 through Fig 4. The traditional denture experience. At the first visit, the impression is taken (Fig 1). At the second visit, measurements
are taken of the patient’s VDO, VDR, midline, and smile line (Fig 2). At the third visit, occlusion is checked; vertical forces on the denture base
lying over the resilient tissue will produce lever forces on the denture, whereas vertical forces acting outside the ridge crest will cause the
denture to tip (Fig 3). At the fourth visit, the dentures are delivered to the patient (Fig 4).

CAD/CAM technology refers to digital design
and manufacture. CAD software recognizes
the geometry of an object, and CAM software
is used for the manufacture. CAD/CAM has
been used for several years for the fabrication
of inlays, onlays, crowns, fixed partial dentures,
implant abutments/prostheses, and maxillofacial
prostheses.19 Now it can be used to make fixed
restorations and removable dentures as well.20-
22
During CAD, impressions of the edentulous
maxilla and mandible or existing dentures are
subjected to laser scanning.23 Unlike the tradi-
tional method where a wax pattern is made on
a definitive cast, a digital RPD is designed on
a computer. Additionally, cone-beam computed
tomography, a special type of x-ray equipment
used when regular dental or facial x-rays are not
sufficient, can be used for the modification of
previous dentures.20
Digitally designed dentures can be used in
lieu of conventional denture design with im-
pressions, but intraoral digital impressions can
also be taken when traditional impressions are
not an option. For example, digitally designed
dentures are a possibility for patients with severe
gag reflexes who cannot tolerate a traditional im-
pression. Digital imagery for dentures provides
better accuracy, fewer chairside adjustments,
comfort for the patient, and overhead savings
(Figure 5 and Figure 6). As with any new tech-
nique, there is a learning curve for the dental
practice to be comfortable and successful with
this process. Many intraoral scanners are on the
market to help with digital dentures.
The commercial manufacturers of removable
complete dentures with CAD/CAM employ a
gadget for transferring the maxillomandibular
relation (MMR) to a digital articulator and final-
izing the dentures completely with CAD/CAM.
There are two options for MMR transfer during

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5 6
Fig 5 and Fig 6. CAD/CAM imaging of upper (Fig 5) and lower jaw (Fig 6).
complete prosthesis fabrication using CAD/CAM:
1) the MMR can be transferred using conventional
impression and transfer techniques or 2) one of
the system kits on the market can be used, such as
the AvaDent® (AvaDent Digital Dental Solutions,
avadent.com) system kit or the Dentca™ (Dentca
CAD/CAM Denture, dentca.com) system kit.24,25
As few as two clinical appointments are
required for the manufacturing of removable
complete dentures using these system kits. In
the first appointment, impressions are recorded
using special trays provided in the system, the
jaw relation is recorded using an anatomical
measuring device, and the occlusal vertical
dimension is determined using conventional
methods. Then the centric relation is recorded
and teeth are selected. The last step of the first
appointment is the delivery of the final impres-
sion to the manufacturer. The manufacturer
will define and mark the denture borders using
the system’s computer software. Then the teeth
will be virtually set and the prosthesis base
milled from traditional denture resin material.
A trial denture can be prepared if requested. In
the second clinical appointment, the dentures
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are delivered and adjustments are made as
needed, often very similarly to conventional
prosthesis delivery.25
There are also just a few steps for the manu-
facturing of partial prosthesis frameworks with
CAD/CAM. First, dental casts are prepared us-
ing a conventional impression method or digital
impression. For conventional impression tech-
niques, casts are then scanned using a digital
scanner. The path of insertion of the RPDs is
defined digitally, and then the shape of the com-
ponents of the framework is designed 3-dimen-
sionally by dentists or laboratory technicians.
Based on this design, a 3D pattern is printed
using rapid prototyping, with a resin that can
be eliminated. The pattern subsequently un-
dergoes investment, elimination, and casting,
thereby completing the fabrication of a digital
RPD framework.26,27 Finally, the digitally de-
signed metal RPD frameworks are produced.28
A digital denture fabrication method has vari-
ous advantages over conventional methods. In
particular, the scan data can help determine
the best path of insertion and removal and can
control the undercut amount through digital
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computation in a more straightforward and ac-
curate way than conventional surveying. The
author finds that Kennedy Classification I and
II are the most difficult cases. With no poste-
rior teeth for support, the partial tends to lift,
causing a food trap and discomfort for patients.
The use of digital impressions and design for
removable prosthodontics is still in its relative
infancy. The future of this technology is very
bright. As with any new technology, the early
adopters will have frustration as the software
for design evolves.
CONCLUSION
By simplifying the denture-making process, digital
denture design is increasing efficiencies for den-
tists, laboratories, and patients. Although several
digital denture design systems are now available
on the market, their use by dental practitioners and
technicians remains marginal.29,30 Too few clinical
studies have evaluated the accuracy of a digitally
generated RPD intraorally. Although the learning
curve is steep, clinicians and laboratory technicians
would benefit from adopting this digital practice
into their repertoire; it is likely to become the stan-
dard of care for RPDs.
REFERENCES
1. Bohner LO, Neto PT, Ahmed AS, et al. CEREC chair-
side system to register and design the occlusion in restor-
ative dentistry: a systematic literature review. J Esthet
Restor Dent. 2016;28(4):208-220.
2. Ahlholm P, Sipilä K, Vallittu P, et al. Digital versus con-
ventional impressions in fixed prosthodontics: a review. J
Prosthodont. 2018;27(1):35-41.
3. American College of Prosthodontists. Facts and figures.
ACP website. https://www.gotoapro.org/facts-figures/.
Accessed April 8, 2019.
4. Sadowsky SJ. Treatment considerations for maxillary
implant overdentures: a systematic review. J Prosthet
Dent. 2007;97(6):340-348.
5. Slot W, Raghoebar GM, Vissink A, et al. A systematic
review of implant-supported maxillary overdentures after
a mean observation period of at least 1 year. J Clin Peri-
odontol. 2010;37(1):98-110.
8 CDEWORLD.COM | VOLUME 6 • NUMBER 148
PEER-REVIEWED
2 CDE CREDITS
6. Schnitman PA. The profile prosthesis: an aesthetic fixed
implant-supported restoration for the resorbed maxilla.
Pract Periodontics Aesthet Dent. 1999;11(1):143-151.
7. Weinberg LA. The biomechanics of force distribution
in implant-supported prostheses. Int J Oral Maxillofac
Implants. 1993;8(1):19-31.
8. Bolat M, Bosînceanu DN, Baciu ER. Partial dentures:
successes and failures. Romanian Journal of Oral Reha-
bilitation. 2017;9(4):93-96.
9. Bilhan H, Erdogan O, Ergin S, et al. Complication rates
and patient satisfaction with removable dentures. J Adv
Prosthodont. 2012;4(2):109-115.
10. Burt BA, Ismail AI, Morrison EC, Beltran ED. Risk
factors for tooth loss over a 28-year period. J Dent Res.
1990;69(5):1126-1130.
11. Eklund SA, Burt BA. Risk factors for total tooth loss
in the United States; longitudinal analysis of national data.
J Public Health Dent. 1994;54(1):5-14.
12. Dolan TA, Gilbert GH, Duncan RP, Foerster U. Risk
indicators of edentulism, partial tooth loss, and prosthetic
status among black and white middle-aged older adults.
Community Dent Oral Epidemiol. 2001;29(5):329-340.
13. Janus CE, Hunt RJ, Unger JW. Survey of prosthodon-
tic service provided by general dentists in Virginia. J Pros-
thet Dent. 2007;97:287-291.
14. Lewandowska A, Speichowicz E, Owall B. Remov-
able partial denture treatment in Poland. Quintessence Int.
1989;20(5):353-358.
15. Allen PF, Jepson NJ, Doughty J, Bond S. Attitudes and
practice in the provision of removable partial dentures. Br
Dent J. 2008;204(1):E2.
16. Walmsley AD. Acrylic partial dentures. Dent Update.
2003;30(8):424-429.
17. Zlatarić DK, Celebić A, Valentić-Peruzović M. The
effect of removable partial dentures on periodontal health
of abutment and non-abutment teeth. J Periodontol.
2002;73(2):137-144.
18. Bilgin MS, Baytaroğlu EN, Erdem A, Dilber E. A re-
view of computer-aided design/computer-aided manufac-
ture techniques for removable denture fabrication. Eur J
Dent. 2016;10(2):286-291.
19. Miyazaki T, Hotta Y, Kunii J, et al. A review of dental
CAD/CAM: current status and future perspectives from
20 years of experience. Dent Mater J. 2009;28(1):44-56.
20. Kanazawa M, Inokoshi M, Minakuchi S, Ohbayashi
SEPTEMBER 2019

PEER-REVIEWED
N. Trial of a CAD/CAM system for fabricating complete
dentures. Dent Mater J. 2011;30(1):93-96.
21. Busch M, Kordass B. Concept and development of a
computerized positioning of prosthetic teeth for complete
dentures. Int J Comput Dent. 2006;9:113-120.
22. Goodacre CJ, Garbacea A, Naylor WP, et al. CAD/
CAM fabricated complete dentures: concepts and clini-
cal methods of obtaining required morphological data. J
Prosthet Dent. 2012;107(1):34-46.
23. Kawahata N, Ono H, Nishi Y, et al. Trial of duplica-
tion procedure for complete dentures by CAD/CAM. J
Oral Rehabil. 1997;24(7):540-548.
24. Sirirungrojying S, Srisintorn S, Akkayanont P. Psycho-
metric profiles of temporomandibular disorder patients in
southern Thailand. J Oral Rehabil. 1998;25(7):541-544.
25. Sülün T, Akkayan B, Duc JM, et al. Axial condyle
morphology and horizontal condylar angle in patients
with internal derangement compared to asymptomatic
volunteers. Cranio. 2001;19(4):237-245.
9 CDEWORLD.COM | VOLUME 6 • NUMBER 148
PEER-REVIEWED
2 CDE CREDITS
26. Eggbeer D, Bibb R, Williams R. The computer-aid-
ed design and rapid prototyping fabrication of remov-
able partial denture frameworks. Proc Inst Mech Eng H.
2005;219(3):195-202.
27. Williams RJ, Bibb R, Rafik T. A technique for fabri-
cating patterns for removable partial denture frameworks
using digitized casts and electronic surveying. J Prosthet
Dent. 2004;91(1):85-88.
28. Han J, Wang Y, Lü P. A preliminary report of design-
ing removable partial denture frameworks using a spe-
cifically developed software package. Int J Prosthodont.
2010;23(4):370-375.
29. Schwindling FS, Stober TA. Comparison of two digi-
tal techniques for the fabrication of complete removable
dental prostheses: a pilot clinical study. J Prosthet Dent.
2016;116(5):756-763.
30. Kattadiyil MT, AlHelal A. An update on computer-
engineered complete dentures: a systematic review on
clinical outcomes. J Prosthet Dent. 2017;117(4):478-485.
SEPTEMBER 2019
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Removables
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Making Predictable Removable Prosthodontics

With Traditional and Digital Techniques
Quyen Pham, DDS

1. What percentage of edentulous people have dentures? 6. What are the advantages to a metal framework for
A. about 90% removable partial dentures?
B. about 10% A. the ability to adjust the clasps if the partial is too loose
C. about 50% or too tight
D. about 25% B. the lower costs
C. the help from plates and clasps in creating retention
2. Which of the following are an important step in
D. all of the above
making partial dentures?
A. making rest seats 7. In the traditional denture creation process, the first
B. picking the correct type of partial allocation visit is critical because that is when perhaps the most
C. taking a good impression crucial step is taken: what is it?
D. all of the above A. measurements for the VDO, C. occlusion is checked
VDR, midline, and smile line D. all of the above
3. What is a major connector?
B. the impression
A. the main body of a denture, which provides rigidity and
unites all the parts of the denture 8. Which special type of x-ray equipment can be used for
B. the part that is adapted to the soft tissues in the region the modification of previous dentures when regular
of missing teeth and will be used to support the artificial dental or facial x-rays are not sufficient?
teeth a. rapid prototyping c. cone-beam computed tomography
C. the part of the denture that prevents the denture from b. mammography d. fluoroscopy
falling out of the mouth
9. Which of the following are an option for MMR transfer
D. the part of the denture that prevents it from shifting
during complete prosthesis fabrication using CAD/CAM?
during eating or talking
A. The MMR can be transferred using conventional
4. What is the function of a rest seat? impression and transfer techniques.
A. It prevents partials from rocking, shifting, or rotating B. One of the system kits on the market can be used.
when eating and talking. C. both A and B
B. It prevents open bite. D. neither A nor B
C. It helps maintain a level of clasp engagement with tooth
10. What is the first step in the manufacturing of partial
surfaces.
prosthesis frameworks with CAD/CAM?
D. all of the above
A. Dental casts are prepared using a conventional
5. Which is the least esthetic type of rest? impression method or digital impression.
A. occlusal C. incisal B. Casts are scanned using a digital scanner.
B. cingulum D. none of the above C. The path of insertion of the removable partial dentures
is defined digitally.
D. A 3D pattern is printed using rapid prototyping.

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or AGD endorsement. The current term
TO TAKE THE QUIZ, VISIT of approval extends from 1/1/2017 to
CDEWORLD.COM/EBOOKS/CE/148 12/31/2022. Provider #: 209722.

10 CDEWORLD.COM | VOLUME 6 • NUMBER 148 SEPTEMBER 2019

 “Pacific Dental Services has supported me
in every stage of my career. I previously
worked in private practice and have found
the mentorship, modern technology and
predictability of advancing my career to be far
superior with the support from PDS.”

JAMIE TOOP, DDS

PDS®-supported Practice Owner

Dentist

Freedom to care.
Support to succeed.
A solid platform to see
your career thrive.

Pacific Dental Services®-supported practices are

looking for talented dentists who are passionate about:

Ownership opportunities with a balanced lifestyle

Clinical Excellence in a patient-centric environment
Being on the forefront of modern dentistry Today, PDS supports more than 700
practices, with career opportunities
available in 21 states.

TO LEARN MORE,
EMAIL: Info@pacden.com
OR VISIT: PacificDentalServices.com