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Minimizing stresses induced by RPD

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Mohammed M Fouad
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 BY
Dr. Mohammed M. Fouad
Prof of prosthodontics
Faculty of Dentistry
Mansoura University
 Stresses induced by Removable Partial denture:
 Introduction.
 The stresses in RPD can be divided as
 Mechanical principles applicable in RPD.
 Induced stresses to be recognized.
 Factors influencing magnitude of stresses transmitted to the abutment
teeth.
 Minimizing of stresses induced by RPD regarding:
A. Reducing the masticatory load.
B. Type of supporting tissues.
C. Improvement of support for distal extension dentures using endosseous dental
implants.
D. The design of each component.
 Consequence of greater stresses induced by partial denture.

14/10/2017 Prof. Dr Mohammed M Fouad 2

 Introduction

14/10/2017 Prof. Dr Mohammed M Fouad 3

What is stress?
 An internal force that resists an externally
applied load or force. GPT.
Different types of stresses are:
 Compressive stress
 Tensile stress
 Shear stress

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  The ability of living things to tolerate force (to be stressed)
is largely dependent upon the magnitude or intensity of
the force.
 It is the bone that provides support for a removable partial
denture(i.e., the alveolar bone by way of periodontal
ligament and the residual ridge bone through its soft
tissues)
 If destructive forces can be minimized, the physiologic
tolerance of the supporting structures are not exceeded
and pathologic changes do not occur.

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  When a removable partial denture will be constructed,
the control of potentially damaging forces is the primary
goal of removable partial denture design.

 It is important for the dentist to consider the direction

,duration and frequency of the force application as well as
the magnitude.

 Blindly done, the removable partial denture can act as a

potentially destructive device which could induce more
harm than the good it was intended for.

14/10/2017 Prof. Dr Mohammed M Fouad 66

The stresses in RPD can be
divided as:
 Vertical
1. Displacing stresses.
2. Dislodging stresses.
 Horizontal
 Torsional

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 Displacing stress
Those forces which are the
result of stresses along the
long axis of the teeth in a
crown to apex direction and
the relatively vertical stresses
on the ridge mucosa. These
are the least harmful and are
born well if within
physiologic limits.

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 Dislodging stress
 These are the forces which
tend to lift the partial
denture from its rest
position. Reciprocal
dislodging action occurs
when wide edentulous
spaces are interrupted by
few teeth thus inviting an
antero-posterior or lateral
tilt of prosthesis.

14/10/2017 Prof. Dr Mohammed M Fouad 9

 Horizontal stress
They originate as a
component of rhythmic
chewing stroke. These
forces are effective in
mesio-distal and
buccolingual direction.
These lateral stresses are
most damaging.

14/10/2017 Prof. Dr Mohammed M Fouad 10

 Torsional stress
It is a twisting rotational type of
force. It’s a combination of
vertical and horizontal force.
Torsion is noted most frequently
where a long segment acts upon
the first abutment it engages.
Where the ridge mucosa has
higher resiliency torque is
higher. Torque applies rotation
about a fixed point.

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 Mechanical principles
applicable in RPD

14/10/2017 Prof. Dr Mohammed M Fouad 12

 Mechanical principles applicable in RPD:

 Lever principle: When subjected to intraoral forces, a

removable partial denture can perform the actions of
lever.

 Inclined plane principle: It should be borne in mind that

the success of a removable partial denture lies in
avoiding these to the greatest extent possible.

 Snowshoe principle: This principle is based on

distribution of forces to as large an area as possible.
14/10/2017 Prof. Dr Mohammed M Fouad 13
Principles Of Lever
 A lever is a rigid bar that
rests on a fulcrum (a fixed
point). The farther the
force is from the fulcrum,
the easier it is to work the
lever
 As a rule, the longer the
extension base, the greater
the potential for damaging
loads to be generated on
the opposite side of the
fulcrum line.
 There are 3 classes of lever:

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First class lever

 Most efficient type.

 E.g. Distal extension
removable partial denture.

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Second class lever
 Less efficient.
 With a class-2 lever, the
fulcrum is at one end,
the effort is at the other
end and the resistance
is in the middle.
 As indirect retention in
removable partial
denture.

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Third class lever
 Least efficient.
 The fulcrum is at one end
and the effort is applied
between the fulcrum and
the resistance.
 Rare in partial dentures.
 TMJ muscles and teeth
act as a class III lever

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Inclined Plane principle:
 Forces against the inclined
plane may result in
deflection of that which is
applying the force or may
result in the movement of
the inclined plane .
 Neither of these results are
desirable
 E.g Cingulum rest seat on
cuspids

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 Inclined plane
 Inclined plane
Forces against an inclined
plane may result in
deflection of that which
is applying the forces or
may result in movement
to the inclined plane,
neither of these is
desirable.

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 Snowshoe principle:
 This principle is based on
distribution of forces to as
large an area as possible.
Like in a snow shoe which
is designed to distribute
forces on the entire base
area of the shoe, a partial
denture should cover
maximum area possible
within the physiologic
limits so as to distribute
the forces over a larger
area.

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Induced stresses to be
recognized

21
Stress resulting from appliance inaccuracies

 Orthodontic stress

 Malocclusion

 Impingement of subbasal

structures.

22
Stress from interference to appliance insertion

 Intermittent disturbance of tooth alignment .

 Contacting rigid area of a removable prosthesis

passes over the surface bulge of the abutment
tooth.

23
Gingival impingement by the removable
appliance:

 Gingivae most susceptible to injury by any

pressure induced by a removable prosthesis.

24
 Stress on a sloping tooth surface for the
support of an abutment occlusal rest.
 Seen while using cuspid tooth for abutment

services with steep lingual surface.

 Appliance slips as occlusal load is applied which

can cause gingival irritation.

25
 Stress resulting in the impingement by
a major connector:

 Trauma from flexing

 Trauma from lateral appliance movement

 Trauma from connector settlement.

26
 Factors influencing
magnitude of stresses
transmitted to the abutment
teeth

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Factors influencing magnitude of stress transmitted to the
abutment:
1. Length of edentulous span.
2. Type of support.
3. Quality of ridge support and type of mucosa.
4. Qualities of clasp
 Clasp flexibility.
 Clasp design and amount of tooth contact.
 Length of the clasp.
 Material used for clasp construction.
5. Abutment tooth surface.
6. Occlusal harmony.
7. Possible movements taking place.
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 1-Length of edentulous span:-
 The longer the edentulous
span  the longer the
occlusal table the greater
the leverage force
transmitted to the abutment
teeth.
 Try retaining posterior teeth
to prevent this problem.

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 2-Type of support.
Difference between tooth supported and
tissue supported prosthesis
 Tooth supported:-
 Class 3,class 4
 Derive support from teeth
 The movement potential is less
because the teeth provide resistance
to functional loading.
 single universal design can be
followed for teeth supported
prosthesis
 The denture base is made up of
metal bases.
14/10/2017 Prof. Dr Mohammed M Fouad
 Tooth-Tissue supported:-
 Seen in class1 and class2 cases.
 Tissue  maximum amount of
support (tissue provides primary
support and teeth provide
secondary support).
 Too much tissue movement because
of the dynamic state of the tissue.
 Multiple complex design have to
followed.
 Denture base  acrylic resin
30
3-Quality of ridge support and type of mucosa:-
 Large well rounded ridges  better
stress distribution.
 Tall broad ridge  longer denture
flange  withstand lateral forces.
 Small thin, knife like ridges are very
poor.
 Thickness and health of the
mucoperiosteum also influence the
loads transferred to abutment teeth:
 2 mm thick healthy mucosa  bear greater
functional loads.
 Thin friable, flabby mucosa are very poor in
withstanding stresses.

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 4- Qualities of clasp :-

A-Clasp flexibility:
 A flexible clasp transmits less
load to the tooth structure.
 Wrought wire clasp is most
commonly used.
 It has tendency to produce very
high amount of lateral stress.
 But not indicated in cases with
poor ridges as it cannot with
stand lateral stresses leading to
heavy stresses on the ridges.

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B-Clasp design and amount of tooth contact:-

 It should be passive(doesn't
apply force on the teeth
while it is seated on the
teeth).
 So complete seating of
prosthesis is mandatory.
 Reciprocal arm should
designed that it lies in the
above the height of
contour.

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C-Length of the clasp:

 A longer clasp is more

flexible.
 And a curved path than
a straight path on the
tooth surface will
provide more flexibility

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D-Material used for clasp construction:-

 Co cr alloys based clasp

apply more force on the
abutment teeth than gold
based alloy.
 So thinner diameter co cr
clasp can be used to reduce
the amount of force
applied.

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5-Abutment tooth surface:-

 The surface of a gold crown or restoration gives

more frictional resistance to clasp arm movement
than the enamel surface of the tooth.

 Hence greater stress is exerted on a tooth restored

with gold than on a tooth with intact enamel.

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6-Occlusal harmony:-

 It plays an important role.

 Deflective contacts should
be avoided.
 Prosthesis opposing natural
dentition face more forces
than from a natural
dentition.
 Occlusal force should be
directed to middle of
residual alveolar ridge 
closer to the abutment.

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7-Possible movements taking place:

 tooth tissue supported RPD  Greatest movement .

 Most common movement taking place  rotational
movement.
 Rotational movement  different planes, in a
dynamic complex way.
 This movement is based :-
1. Quality of tissue,
2. Amount of functional load applied and
3. Also on the quality of the denture base.
 Usually there are three types of rotational movements
taking place:

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 First rotation
 Axis of rotation  in horizontal
plane (Supportive and retentive
fulcrum lines). Extend through the
distal abutments.
 Rotation of denture in sagittal
plane(towards or away from ridge)
 Greatest magnitude of all
movements.
 Not necessarily damaging as
rotation is in apical direction.

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The horizontal fulcrum lines:
1. RM around the primary fulcrum
line (toward the tissue): It is
controlled by the supporting
ridge.
2. RM around the secondary
fulcrum line (away from the
tissue): Result from the pull
action (of sticky food),
overextended denture borders
and gravity on maxillary
prosthesis. Indirect retainer
control this movement.

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 Second fulcrum line  sagittal plane.
 It extends from the distal abutment
occlusal rest to the crest of the ridge
 Class I situation  two such lines, one
on each side of the arch.
 Rotational movement occurs in the
frontal plane or faciolingual
direction(rocking movement of
denture)
 Lesser magnitude
 Induces horizontal stress on the
abutment.
 It is moderately damaging.

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 The third fulcrum  midline just
lingual to anterior teeth.
 Fulcrum line  vertically

 Rotational movement in the horizontal

plane (ie, the flat, arcuate movements
of the prosthesis).
 The force resulting from this
movement is almost entirely
horizontal.
 Forces can be extremely damaging
and should receive significant attention
during the design process.

14/10/2017 Prof. Dr Mohammed M Fouad 42

 Minimizing of stresses induced
by RPD

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Minimizing of stresses induced by RPD
regarding:
A. Reducing the masticatory load.
B. Type of supporting tissues.
C. Improvement of support for distal extension
dentures using endosseous dental implants.
D. The design of each component.

14/10/2017 Prof. Dr Mohammed M Fouad 44

 A- Minimizing of stresses
induced by RPD regarding
Reducing the masticatory load

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 A. Reducing the masticatory load.
a) Necessary with; Heavy bite, Long span and Poor bone
factor.
b) Achieved by the following:
 Reducing occlusal table: Using narrow teeth and
Placing the artificial teeth on the anterior two-thirds of
the saddle.
 Harmoniums occlusion:
 Simultaneous stable tooth contact in centric occlusion
or relation, Freeing of occlusion in eccentric and
Avoiding interlocking cusps.
14/10/2017 Prof. Dr Mohammed M Fouad 46
 B- Minimizing of stresses
induced by RPD regarding type
of supporting tissues

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Distributing stresses of RPD between teeth and tissue
(In Free end saddles):

Three design concepts

are available includes:
1. Stress equalization.
2. Physiologic basing.
3. Broad stress
distribution.

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1-Stress equalization (stress
breaker):
 A device or design that
is used to allow a
limited movement
between the saddle and
the direct retainer to
equalize the disparity of
vertical movement
between the tooth and
mucosa and hence
reduce lateral and
tipping forces on
abutment teeth.

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Indications for the use of the stress breaker:
1. In distal extension removable partial
denture.
2. Length of edentulous span is long.
3. Weak abutment teeth.
4. Well-formed residual alveolar ridges.
5. Highly compressible mucous membrane.
6. When internal attachments are employed in
distal extension cases.
7. Good economic.

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 Disadvantages of stress breaker:
1. It is accompanied with increased ridge
resorption.
2. Reduces the effectiveness of indirect retainer.
3. Difficult construction.
4. Easily distorted and difficult to repair.
5. Expensive.

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 2-Physiologic basing:
 To equalize the disparity of vertical
movement between the tooth and
mucosa, the physiologic basing is
produced either by displacing the ridge
mucosa during the impression-making
procedure or by relining the denture
base after it has been constructed.

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Advantages of Physiologic basing:
1. Intermittent base movement has physiologically
stimulating effect on the underlining bone and
soft tissue.
2. The simplicity of design because of the minimal
retention requirements.
3. Minimal direct retention used, the looseness
the clasp (combination clasp with wrought wire
retentive arm) will reduce the functional forces
transmitted to the tooth.

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 Disadvantages physiologic basing:
1. The denture isn’t well stabilized against lateral
forces because of minimum number and flexibility
of direct retainer.
2. Because the artificial teeth are always slightly above
the occlusal plane when the denture isn’t in
function, there will always be slightly premature
contacts between the opposing teeth and the
denture teeth. This is an uncomfortable sensation
for many patients.
3. It’s difficult to produce effective indirect retention
because of the vertical movement of the denture
and the minimal retention of the direct retainer.
14/10/2017 Prof. Dr Mohammed M Fouad 54
3-Broad stress distribution:
 The advocates of this school believe that
excessive trauma to the remaining teeth and
the residual ridge can be prevented by
distributing the force of occlusal among
many teeth (multiple clasping) and as much
of the available soft tissue area as possible
(maximum tissue coverage) may
physiologically simulate them to a state of
health.

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 Advantages broad stress distribution:
1. Occlusal forces are distributed on many teeth.
2. Lateral forces may be distributed over as many teeth as
possible.
3. Multiple Clasping constitutes a form of removable
splinting.
4. Broad stress distribution partial denture doesn’t require
relining as frequently as other types because the residual
ridge doesn’t bear as much the occlusal load.

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 Disadvantages broad stress distribution:
1. Great amount of tooth and tissue coverage and the
increased bulk, may cause the prosthesis to be less
comfortable to the patients.

2. Increased amount of tooth coverage by multiple

clasping will cause cares. This is prevented by good
oral hygiene and fluoride rinses..

14/10/2017 Prof. Dr Mohammed M Fouad 57

The effectiveness of tissue support
depends on the following factors:
1) The quality of the residual ridge.
2) The extent to which the residual ridge will be covered by
the denture base .
3) The type and accuracy of the impression: Use altered cast
impression technique for mandibular distal extension
RPD’s.
4) The accuracy of the denture base.
5) The design characteristics of the component parts of the
partial denture framework.
6) The anticipated occlusal load.

14/10/2017 Prof. Dr Mohammed M Fouad 58

In Entirely Tooth Supported Prosthesis (class III RPD):

 In class III RPD, forces are directed

within the long axes of the
abutments and support is gained
entirely from the periodontal
ligaments of individual teeth.
 Therefore limited movement is
possible, and this movement can
result in non-axial loading of the
abutment teeth during function.
 Weak abutment teeth may need
splinting

14/10/2017 Prof. Dr Mohammed M Fouad 59

The effectiveness of tooth support depends on
many factors:
1. Periodontal health.
2. Crown and root morphologies.
3. Crown-to-root ratio.
4. Bone index area (how the tooth has responded to
previous stress)
5. Location of the tooth in the arch.
6. Length of edentulous span.
7. The opposing dentition.

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 C- Minimizing of stresses
induced by RPD regarding
improvement of support for
distal extension dentures using
endosseous dental implants

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Enhancing and improvement of support for
distal extension dentures using endosseous
dental implants.
Advocates of this school of partial denture
design believe that all rotational movements
of distal extension denture base are
eliminated by reconstituting the missing
distal abutment using endosseous implant.

14/10/2017 Prof. Dr Mohammed M Fouad 62

Enhancing and improvement of support using
endosseous implants and converting the design
to one of the following treatment options:
 Bilateral fixed bridge connecting two endosseous implants.

 Bilateral fixed bridge connecting endosseous implant and

tooth.

 Telescopic denture using remaining natural teeth and/or

implants.

 Removal partial (implant and / or tooth) overdenture.

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 Implant-supported fixed partial dentures are the
ideal treatment option for partially edentulous
patients.

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 When additional surgery is not a possible option,
an implant-assisted removable partial
overdenture (IARPOD) can be planned as a
reliable treatment for distal extension ridges .

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Fewer implants (cost-effective ) inserted under the distal
extension denture base will:

1. Improve support,
2. Enhance retention and
stability,
3. Preserve the residual
ridge,
4. Reduce the stress
applied on the
abutment teeth, and
5. Eliminate the need for
un-esthetic clasps.

14/10/2017 Prof. Dr Mohammed M Fouad 66

 D- Minimizing of stresses induced
by RPD regarding the design of each
component

14/10/2017 Prof. Dr Mohammed M Fouad 67

Direct retainers:-
 The retentive clasp arm should

provide adequate retention with

least forces on abutment tooth.

 This can be done by:

1. providing retention from other

components of denture as:

• Adhesion cohesion.

• Frictional grip.

• Neuromuscular control.

2. The support and stability of the

prosthesis also may be improved.

14/10/2017 Prof. Dr Mohammed M Fouad 68

 3. The spatial distribution of retentive clasps is more important
in minimizing stresses by direct retention than the number of
clasps.

The following configurations can be followed while determining

clasp position:
 Quadrilateral configuration:- it is used in class 3 situation
with modification space.

 Tripodal configuration:- class 2 modification 1

 Bilateral configuration.

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  Quadrilateral configuration:-
1. Class 3 with modification space.
2. Clasp assembly on both abutment teeth adjacent
to edentulous space.
3. In case of absence of modification space clasp
assembly anteriorly and posteriorly are given on
the dentulous opposite arch.
 Tripodal configuration:-
1. Class 2 with modification space.
 Clasp present adjustment to the edentulous
space.
 On the modification space side clasp on both the
abutment teeth.
2. If modification is absent clasp placed as far
anteriorly and posteriorly on the teeth.
 Not as effective as quadrilateral configuration
but better in class 2 cases.
 bilateral configuration:-
1. Class 1 situations.
2. Provides least stress reduction.

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4. Clasp design:-

a) Cast circumferential clasp:-

 Class 2 and class 1 cases clasp assembly
involving disto-occlusal rest and retentive tip
involving mesiofacial undercut is prevented.
 Terminal end of such clasp  tipping forces on the
abutment teeth.
 A clasp that originates from the mesioocclusal rest
and engages the distofacial undercut or a reverse
circulate clasp should be used.

b) Vertical projection clasp:-

 T clasp or modified t clasp can be used on an
abutment adjacent to the distal extension space.
 It is used when the a distofacial undercut is seen
on the abutment.
 It is not indicated in case of mesiofacial undercut.
 I clasp is better used involving mesiofacial
undercut and mesioocclusal rest seat.
 It apply the least stress on abutment teeth.

14/10/2017 Prof. Dr Mohammed M Fouad 71

c. Combination clasp:-
 Used when a distal extension is presented
with a mesiofacial undercut.
 Flex more and in multiple spatial planes.

 Combination of both cast and wrought

wire is used.
 Wrought wire is used as the retentive arm
and cast metal is used as the reciprocal arm
 More flexible and produces less stress on
the abutment.

14/10/2017 Prof. Dr Mohammed M Fouad 72

c. Combination clasp (Stress breaker action):

 Used when a distal extension

is presented with a mesiofacial
undercut.
 Flex more and in multiple
spatial planes.
 Combination of both cast and
wrought wire is used.
 Wrought wire is used as the
retentive arm and cast metal is
used as the reciprocal arm
 More flexible and produces
less stress on the abutment.
Modified T-bar clasp (A clasp with Stress breaker like-action):
Reverse circlet clasp (Interproximal circlet clasp):

14/10/2017 Ass. Prof. Dr Mohammed M. Fuad 75

5. Position of the retentive third:

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RPI clasp (A clasp with Stress breaker like-action):

 This design concept was

proposed to accommodate
functional movement in
denture while changing the
fulcrum line.
 RPI stand for rest proximal
plate I bar

14/10/2017 Prof. Dr Mohammed M Fouad 77

RPA Clasp Design (a clasp with Stress breaker like-action) :
It is a modification of RPI where instead of I bar Aker clasp is used.

14/10/2017 Prof. Dr Mohammed M Fouad 79

 Modification of RPA clasp

 A modification of RPA
clasp can be done by using
wrought wire clasp instead
of Aker clasp to minimize
stresses on abutment
tooth.
6. Splinting of abutment teeth:-
 Tooth with decreased periodontal support can be splinted together
 It stabilizes the abutment in a mesio-distal direction.
 splint extends anteriorly beyond the canine the stabilization effect
is present even in faciolingual direction.
 On of the most common consideration for fixed splinting is lone
standing abutment adjacent to distal extension edentulous space.
 Such a tooth can get damaged due to rotational forces.
 Fixed splinting in this situation serves the purpose.

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  Splinting by removable prosthesis
doesn’t made if fixed splinting is
possible.
 The splinting consists of clasping
more than one tooth on each side of
the arch and using additional rests for
increased support.
 Not all clasps to be retentive.

 Prepared guiding planes may provide

additional horizontal stability.
 results in decreased mobility.

 Cross arch stabilization

14/10/2017 Prof. Dr Mohammed M Fouad 82

• Rest and rest seats:-
 Rest seats are essential as they transmit force
vertically along the long axis of the teeth.

 Rest seats prevent formation of any lateral

stresses.

 Rest seats should be designed in such a way

that they are less than 90 degrees to the path
of insertion.

 Thus helping the rest to grab the tooth

securely and prevent its migration.

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 In tooth born RPD Rests are placed adjacent to edentulous space (both ends).

 In tooth-tissue born saddle RPD support comes primary from soft tissue overlying

the ridge and secondary from abutment end of the denture base through rest.

 Occlusal rest seats should be rounded and some amount of space should be present

between the rest and rest seat to allow free movement as a movement of ball and

socket joint.

 Mesial rest preferred.

 Distal rest preferred when:

• abutment is rotated (limited access for minor connector to mesial)

• plunger cusp/heavy centric contact on mesial

• large restoration on mesial.

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• Indirect retention
 It prevents tissue away
rotation of free end
removable partial dentures
(Class I, II & IV) .
 It is located on the opposite
side of the retentive fulcrum
line as far as possible.
 Class 3 situation usually
doesn’t need a indirect
retainer as there is no lever
effect.

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14/10/2017 Prof. Dr Mohammed M Fouad 86
 • Major connectors:-

 Major connector must be rigid and not impinge

on the gingival tissue.
 Major connector must cover maximum area to
dissipate the occlusal forces falling on it.
 In maxilla a palatal full coverage major connector
is more preferred as it contacts all palate and
many remaining teeth with a palatal plate thus
helps in dissipating the forces.
 In mandible the lingual plate major connector Is
most preferred because it covers the whole
lingual surface of anterior teeth.
 Thus distributing the forces to all the teeth.
 It is particularly helpful in splinting periodontally
weakened teeth.
 It also provides rigidity and cross arch
stabilization.

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• Minor connector
 Minor connectors should be:

1. Rigid except that assist to approach bar type clasps which is

flex.

2. Positioned to enhance cleanliness and comforted.

3. Not interfere with the placement of the artificial teeth.

4. Part of minor connector that crosses the gingival must be

relieved.

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  The guide plate plays a very important role in dissipating functional
stresses because of its close adaptation to the abutment teeth.
 This minor connector helps in two major functions.

 It provides a single path of insertion.

 Improved stability by providing increased resistance to

horizontally directed forces
 Additional guide plates can be incorporated on other teeth to help
dissipate the lateral stresses falling on the single tooth.

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• Denture bases:-
 Maximum tissue coverage by denture base is
needed for:
 Reducing the load per unit area to minimize ridge
resorption.
 Better bracing from labial, lingual and buccal
flange.
 Overextension of denture base should be avoided.
 Accurate adaptation of denture base is necessary
for proper retention of denture base.
 The external polished surface of the denture
should be contoured properly in order to aid in
retention of the dentures.
 Unless a need for later relining is anticipated, the
denture base may be made of metal, which has
several advantages.

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 Resistance of the saddle to anteroposterior movement:
 Forward movement of upper denture can be resisted by:
1. Anterior natural teeth.

2. Anterior slope of the hard palate.

3. Covering tuberosity.

4. Using of posterior abutment.

 Backward movement of lower denture can be resisted by:

1. Steep sloping of retromolar region.

2. Mesial occlusal rest.

3. Clasp that utilizes the mesiobuccal undercut for retention

4. Embrasure hooks

5. Molar teeth.

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• Occlusion:-
 Reduce the occlusal load through:
1. Using narrow teeth (reduce buccolingual width of the teeth)

2. Using small teeth and reduce its number.

3. Set the artificial teeth in the anterior two third of the saddle.

4. Reduction of cusp height.

5. Sharp cusps or ridges and sluiceways (escaping of food from occlusal

table) for masticatory efficiency with maximum force of cutting the
food.

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• Occlusion:-
 Achieving harmonious occlusion through:
1. Simultaneous stable tooth contact in centric occlusion or
relation.

2. Freeing of occlusion in centric and eccentric.

3. No use of steep cusp inclination (avoid interlocking cusp)

4. Artificial teeth set over the crest of the ridge or slightly lingual to
it.

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Consequence of greater stresses
induced by partial denture

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Consequence of greater stresses induced
by partial denture:
 Abutment teeth:
 Orthodontic movement.
 Malocclusion.
 Residual ridge:
 Inflammation.
 Edema of residual ridge mucosa.
 Resorptive loss of adjacent alveolar process.

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references
 Mc crackens removal partial denture. 11th edition.
 Stewarts clinical removable prosthodontics. 3rd edition
 Maxillary ridge rehabilitation with obturator
prosthesis ijcd dec 2013 2(6).
 Beumer J, Curtis TA, Firtell DN. Maxillofacial
rehabilitation, prosthodotics and surgical
considerations.

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 Thank you

14/10/2017 Prof. Dr Mohammed M Fouad 97

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