CONCEPTS OF

DESIGNING
REMOVABLE
PARTIAL DENTURE
PROSTHESIS
-Presented by
Dr. Gaurav Kharbanda
 Great controversy continues to exist as
to what constitutes correct design and
adequate support for the free-end or distal
extension removable partial dentures. The
method for using and equalizing support from
the edentulous ridge and remaining teeth
remains the main issue. The different
methods used have given rise to various
design philosophies.
 There are 3 basic underlying approaches to
distributing the forces acting on a partial denture,
between the soft tissue and the teeth.
1.Stress equalization
2.Physiologic basing
3.Broad stress distribution
STRESS EQUALIZATION

Emphasizes that the resiliency of the tooth

secured by the periodontal ligament in an apical
direction is not comparable to the greater
resiliency and displaceability of the mucosa
covering the edentulous ridge. Due to this, forces
are transmitted to the abutment teeth as the
denture bases are displaced in function.
It is the belief of this school, that a rigid
connection between the denture bases and the
direct retainer on the abutment tooth is
damaging and that some type of stress director
or stress equalizer (a flexible or movable joint
between teeth and metal frame work so that the
base can move independently of the clasp) is
essentially to protect the vulnerable abutment
teeth.
Advantages:
1)This design usually calls for minimum direct
retention because the denture base operates
more independently than a conventional
denture.

2)Internal attachments for retention of a stress

broken prosthesis are widely used.
Theoretically at least the stress director
eliminates the tipping on the tooth, thus
preventing bone resorption about the tooth.
3)Intermittent pressure against the mucosa caused
by the movement of the denture base has a
massaging effect on the underlying bone and
soft tissue. Thus it is claimed, minimizes tissue
change and reduces the necessity of relining
and rebasing the denture to compensate for
tissue changes as is required for most distal
extension partial dentures.
Disadvantages

1.The stress director is comparatively fragile.

2.Its lack of ability to prevent damaging lateral
stresses from occurring on the edentulous ridge
can result in rapid resorption of bone and settling
of the denture. If sufficient thickness of metal is
used in the hinge to prevent lateral movement,
the prosthesis becomes heavy, bulky and
annoying to the patient.
3.Its construction is complex and costly.
4.It requires constant maintenance and may be
difficult or impossible to repair
5.Of the 3 schools of thought the stress breaker
school has the least advocates, appealing
mostly to the more sophisticated or
experienced practitioner.
PHYSIOLOGIC BASING

This philosophy of design believes that

equalization can best and most simply be
accomplished by some form of physiologic basing
or lining of the denture base. This is produced
either by depressing or displacing the ridge
mucosa during the impression making procedure
or by relining the denture base after it has been
constructed.
The reason for displacing the mucosa during the
impression procedure is to record the soft tissues
in their functioning form and not anatomic form
so that the denture base formed over displaced
tissue will adapt more readily to the depressed
tissue and will be better able to withstand the
force generated.

Hence the artificial teeth of the removable

partial denture constructed from a tissue
displacing impression will be positioned above
the plane of occlusion when the denture is in the
mouth and not in function. To permit the vertical
movement of the partial denture from the rest
position to the functional position, the direct
retainers must be designed with minimal
retention and their number should be limited.
ADVANTAGES:
1.The intermittent base movement that occurs
when occlusal loads are applied and removed
has a stimulating effect on the underlying bone
and soft tissue, thus reducing the frequency to
reline or rebase the prosthesis.
2.Simplicity of design and construction due to
minimal retention requirements.
3.The looseness of the clasp on the abutment
tooth reduces functional forces transmitted on
the tooth and hence aids in their preservation.
Disadvantages

1.The denture is not well stabilized against lateral

forces due to minimum number and flexibility of
the direct retainers.
2.The residual ridge receives a greater proportional
amount of force than the abutment teeth. Many
critics believe that the tooth with its periodontal
ligament is better able to withstand lateral forces
than the residual ridge. The load of supporting the
denture is limited to a few teeth instead of being
shared by a number of teeth as in other
philosophies.
3.As artificial teeth are always slightly above the
occlusal plane when the denture is not in function,
there will always be slight premature contacts
between the opposing teeth and the denture teeth
when the mouth is closed, resulting in an
uncomfortable sensation for many patients and
may result in a sense of insecurity.
4.It is difficult to produce effective indirect retention
because of the vertical movement of the denture
and the minimal retention of the direct retainer. By
the time the indirect retainer engages a rest seat to
prevent the denture base from being dislodged, the
direct retainer would have lost contact with the
abutment tooth.
Broad stress distribution:

Advocates of this school believe that

excessive trauma to the remaining teeth and
residual ridge can be prevented by distributing the
forces of occlusion over as many teeth and as
much of available soft tissue areas as possible.
This is accomplished by the use of additional rests,
indirect retainers, clasps and broad coverage
denture bases.
Advantages:
o The forces of occlusion are reduced on any one
tooth or area of the ridge and hence will never
exceed the physiological limit of the teeth with no
resultant resorption of the alveolar bone.
o Multiple tooth contacts by direct retainers,
additional rests and minor connectors can be
planned so that lateral forces can be distributed
over as many teeth as possible.
o Clasps used constitute a form of removable
splinting especially when fixed splinting is not
indicated due to a guarded prognosis for economic
reasons.
o Proponents believe prosthesis is easier and less
expensive.
o No flexible components so less danger of
distorting the denture and less subject to
breakage.
o Due to increased stability, this partial denture
doesn’t require relining as frequently as other
types because residual ridge doesn’t bear as
much of the horizontal load.
Disadvantages
Greater amount of tooth and soft tissue coverage
and increased bulk may cause the prosthesis to
be less comfortable and less accepted by patients
compared to other simpler designs.
Due to increased amount of tooth surface, mouth
must be kept meticulously clean. With today’s
increased awareness and currently available aids,
this factor may not be as critical as it might once
have been thought.
If certain principles are applicable for the solution of
given conditions, the same principles will be operative
in another instance showing repetition of these
conditions. If this is found not to be true, it indicates that
something less than basic principles are being applied.
The first concept of design should follow or
accompany the preliminary survey when oral changes
are being planned.
Final design should be determined at the time of
final survey, when it is possible to measure the mouth
preparation changes that have actually been
accomplished.
The design should be decided by the
prosthodontist who planned/executed the mouth
preparation for only he can know the oral conditions.
Tooth-tissue supported removable partial dentures
Class I:
In class I, the abutment teeth are situated
anterior to edentulous areas. This type receives
support from soft tissues and the remaining teeth.
The different nature of the available support
requires careful consideration when designing the
removable partial denture.
Principles for Class I Removable Partial Dentures
(Bilateral Distal Extension)
For Class I
1.Clasps
 2 clasps on each terminal tooth are
sufficient.
 For distobuccal undercut a vertical projection
clasp is indicated
 For mesiobuccal undercut wrought wire
clasp.
 Reciprocal arm should be rigid. Can also be
a. For Class II
1. Clasps
 Usually 3 clasps are designed.
 The distal extension side can be designed
similar to Class I
 The tooth supported, or modification side
should have two retentive clasps:one as far
posterior and one as far anterior as esthetics
permit. If modification space is present it is
usually most convenient to clasp either side
abutment.
 Reciprocal arm should be rigid. Can also be
replaced with lingual plate.
For Class I and II
2. Rests
 For maximum possible support.
 Designed for direction of stress in a
direction along the long axis of the tooth.
 Should always be placed on the tooth
adjacent to the edentulous area.
For Class I and II
3. Indirect Retention
 Location: as far anterior to the fulcrum line
 2 indirect retainers for Class I situation, and
1 on the on the opposite side as the
edentulous area in Class II is sufficient.
 Lingual plate with rest seats is an efficient
retainer.
For Class I and II
4. Major Connector
 Must be rigid and not impinge on soft
tissue.
 Maxillary: support from hard palate
whenever possible.
 Mandibular: lingual plate for increased
rigidity, indirect retention and elimination of
areas of food impaction.
For Class I and II
5. Minor Connector
 Rigid
 Positoned to enhance comfort, cleanliness,
and placement of artificial teeth.
For Class I and II
5. Minor Connector
 Rigid
 Positoned to enhance comfort, cleanliness,
and placement of artificial teeth.
For Class I and II
6. Occlusion
 Centric relation and occlusion should
coincide.
 Artificial teeth should be positioned to
reduce stress.
 Positoned to enhance comfort, direction of
stress along long axis, and efficiency of
mastication.
For Class I and II
7. Denture Base
 Broad coverage for equal stress
distribution.
 Borders should not interfere with the
functional movements of the tissues.
 Selective pressure technique is indicated
for edentulous space.
b. For Class III
1.Clasps
 Quadrilateral positioning is ideal.
 Type of clasp is not critical.
 Selection depends on considerations for
tooth, esthetics.
 Bracing arm should be rigid.
b. For Class III
2. Rests
 Should be placed on the adjacent
abutments.
 Should support the major connector

3. Indirect Retainers
 Usually not required
For Class III
4. Major Connector and Minor Connector
 Requirements same as Class I

5. Occlusion
 Requirements same as Class I.
For Class III
6. Denture Base
 Functional impression is not neccesary
 Extent of coverage should be determined
by appearance, comfort and avoidance of
food impaction.
c. For Class IV
1.Clasps
 Quadrilateral positioning is ideal.
 Location should be as anterior as possible
adjacent to edentulous area and as far
posterior to the fulcrum line as possible.
 Type of clasp is not critical.
 Selection depends on considerations for
tooth, esthetics.
c. For Class IV
2. Major Connector
 Rigid and broad coverage. E.g. maxillary
palatal coverage.
3. Indirect Retainer
 Should be located as far posterior to the
fulcrum line as possible.
PROBLEMS OF DESIGN
Some problems of design are recurrent in more
than one group of partial denture situations.
Number and location of the modification space
will determine how much trouble may result:
• If the modification space is in anterior part
of the arch, the path of insertion from the
right or left angulations is impossible.
• An additional edentulous space bounded
by teeth will mean more opposing proximal
surfaces with the increased possibility of
interference to the insertion of the finished
restoration.
• When host teeth are not replaced, it is likely
that those remaining will have migrated out of
normal alignment. Hence the modification
space becomes either larger or smaller than
the original tooth. This makes the placing of a
substitute quite difficult. It also results in
frequent fracturing of the substitute from
modification of the frame work