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Classification systems of

Partially Edentulous Arches

BY
R.SUNIL
2nd MDS

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Contents

 Introduction

 Requirements of classification

 Various Classification systems

 Conclusion

 References

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Introduction

• Any classification that gives too much information especially diagnostic


and prognostic, destined to have limited acceptance.

• Recognizing this various authors tried to simplify their classifications to


understand the partially edentulous arches.

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Requirements Of An Acceptable System Of Classification

• Allow visualization of the type of partially edentulous arch.

• Permit differentiation between the tooth supported and the tooth and tissue
supported partial dentures.

• Serve as a guide to the type of design to be used.

• Universally acceptable.

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Need For Classification

 Ease of communication between dentist and laboratory personal.

 Facilitates case history recording and immediate visualization of the


edentulous arches.

 Formulate a good treatment plan

 Formulate basic design principles which might be applied to similar


situations.

 Anticipate the difficulties commonly occurring for that particular design.


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Classification systems

• Cummer’s classification system 1920


• Kennedy’s classification system 1923
• Bailyn’s system 1928
• Neurohr’s system 1939
• Mauk’s system 1941
• Wild 1949
• Godfrey 1951

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Classification systems

• Beckett’s system 1953


• Friedman’s system 1953
• Craddock- 1954
• Swenson classification system 1955
• Wilson- 1957
• The Austin-Lidge classification system 1957
• Watt - 1958

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Classification systems

• Skinner’s system 1957

• Applegate-Kennedy’s system 1960

• William Avant 1966

• Osborne & Lammie- 1974.

• Costa- 1974

• ACP classification - 2004

• ICK Classification-2008
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Kennedy's Classification System 1923

• Based on the relationship of the edentulous spaces to the abutment teeth.

• Class I – Bilateral edentulous area located posterior to the remaining


natural teeth.

• Class II – Unilateral edentulous area located posterior to the remaining


natural teeth.

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• Class III – Unilateral edentulous area with natural teeth remaining both anterior and
posterior to it.

• Class IV – A single but bilateral (Crossing the mid-line) edentulous area located
anterior to the remaining natural teeth.

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Applegate’s Rules

• RULE 1- Classification should follow rather than precede any extraction of


teeth that might alter the original classification.

• RULE 2- If a third molar is missing and not to be replaced, it is not

considered in the classification.

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• RULE 3- If a third molar is present and is to be used as an abutment, it is
considered in the classification.

• RULE 4- If a second molar is missing and is not to be replaced, it is not considered


in the classification.

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• RULE 5- The most posterior edentulous area always determines the
classification.

• RULE 6- Edentulous areas other than those determining the classification


are referred to as modification spaces and are designated by their number.

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• RULE 7- The extent of the modification is not considered, only the number
of additional edentulous areas are considered.

• RULE 8- There can be no modification areas in class IV arches.

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Advantages of Kennedy’s classification

• Permits immediate visualization, & allows easy distinction between tooth


& tissue supported prosthesis.

• This permits a logical approach to the problems of design.

• It makes possible the application of sound principles of partial dentures


design.

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Disadvantages of Kennedy’s classification

• The condition of teeth and remaining supporting structures not considered.

• No distinction between modification spaces which occurs in the anterior to


those of posterior segment.

• Did not explain the length of the edentulous span or number of missing
teeth - only provides number of modification spaces.

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ACP classification 2004

• Based on 4 diagnostic criteria: location and extent of edentulous area,


abutment conditions, occlusal characteristics and residual ridge conditions.

• Class I – Ideal or minimally compromised

• Class II – Moderately compromised

• Class III – Substantially compromised

• Class IV – Severely compromised

McGarry TJ, Ahlstrom RH, Koumjian JH: Classification system for partial edentulism. J Prosthodont
2004;11:73-82 17
ACP classification system offers the following
potential benefits

• Improved professional communication.

• An objective method for patient screening in dental education.

• Improved interoperator consistency.

• Improved diagnostic consistency.

• Standardization for research purpose.

• Organized method for decision making to send for referral.

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ICK Classification 2008

• ICK I, for Kennedy class I situations,

• ICK II, for Kennedy class II situations,

• ICK III, for Kennedy class III situations,

• ICK IV, for Kennedy class IV situations.

Johany S: ICK Classification System for Partially Edentulous Arches. J Prosthodont


2008;17:502-7.
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Guidelines for the classification system

• No edentulous space will be included in the classification if it will be restored with


an implant-supported fixed prosthesis.

• Roman numerals will be used for the classification, and Arabic numerals will be
used for the number of modification spaces and implants.

• The classification of any situation will be according to the following order: main
classification first, then the number of modification spaces, followed by the number
of implants in parentheses according to their position in the arch preceded by the
number sign (#).

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• The maxillary arch is drawn as half circle facing up and the mandibular
arch as half circle facing down.

• The classification can be used either after implant placement to describe


any situation of RPD with implants, or before implant placement to indicate
the number and position of future implants with an RPD.

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Examples for Kennedy class I situations

ICK I (#2, 15) ICK I (# 17, 22, 32)

ICK I mod 1 (# 19, 25, 30) ICK I mod 2(# 18,22, 26,31) 22
Examples for Kennedy class II situations
ICK II (#2) ICK II (#2, 7 )

ICK II mod 2 (#24, 29,) ICK II mod1 (#21, 26, 30 ) 23


Examples for Kennedy class III situations
ICK III (# 6)

ICK III mod 3 (# 23, 26) ICK III mod 1 (# 6, 11)

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Examples for Kennedy class IV situations

• ICK IV (# 6,11) ICK IV (#19,22)

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Cummer's Classification System 1920

Based on Number & position of direct retainers .


Class I-Diagonal- Two retainers diagonally opposite one another.
Class II-Diametric- Two retainers diametrically opposite one another.

Miller EL: Systems for classifying partially dentulous arches. J Prosthet Dent 1970;24(1):25-40 26
Class III-Unilateral- Two or more direct retainers on the same side.

Class IV-Multilateral- Three direct retainers in a triangular relationship.

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Bailyn's System 1928

Based on whether the prosthesis is tooth borne, tissue or a combination of the two

A - anterior edentulous areas

P - posterior edentulous areas

I-abutment teeth present at each extremity of a saddle area, span not more than
3 teeth

II-tooth support at 1 extremity only of saddle area.

III-tooth support at both extremities of the saddle, span of more than 3 teeth.

Miller EL: Systems for classifying partially dentulous arches. J Prosthet Dent 1970;24(1):25-40 28
Class P I Class P II

Class P III Class A III

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Class A I P II Class P I P II

Class AI PII PIII

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Advantage:

• Was the first to emphasize the importance of support to partial denture by


the remaining tissue.

Disadvantage:

• Does not give immediate visualization of partially edentulous arch.

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Mauk's System 1942

Based on

1. The number, position and length of the spaces.

2. The number and position of the remaining teeth.

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• Class I – has bilateral spaces and teeth remaining in anterior segment.

• Class II – has bilateral posterior spaces and one or more teeth at the
posterior end of the one space.

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• Class III – bilateral posterior spaces and one or more teeth at the posterior
end of both space.

• Class IV – unilateral posterior space with or without teeth at the posterior


end of the space.

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Class V – Has anterior space only.

Class VI – Has irregular spaces around the arch.

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Wild’s classification in 1949

• Class I- Interruption of dental arch (bounded).

• Class II- Shortening of dental arch(free end).

• Class III- Combination of 1 and 2.

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Godfrey’s System 1951

Based on the location and extent of the edentulous spaces where teeth are
to be replaced. No sub divsions or modifications for the main classes.

Class A – has tooth borne denture bases in the anterior part of the mouth.

Class B – has mucosa borne denture bases in the anterior part of the
mouth.

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Class C – has tooth borne denture bases in the posterior part of the mouth

Class D – has mucosa borne denture bases in the posterior part of mouth

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Beckett's System 1953

Based on whether the denture base is

 Class I Tooth-borne

 Class II Tissue-borne

Class III Inadequate abutments to support

 A combination of the two.


Miller EL: Systems for classifying partially dentulous arches. J Prosthet Dent
1970;24(1):25-40 39
Tooth borne Tissue borne

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Inadequate abutment support Combination of A &B
Friedman's System (ABC) 1953

• Based on three essential segment types occurring either as discrete or as


continuous segments.

Based On Boundaries Of The Spaces

• A - Anterior tooth bounded space.

• B - Bounded posterior space.

• C - Cantilever.

• Combination of A-B-C spaces.


Friedman J: The ABC classification of partial denture segments. J Prosthet Dent 1953;3:517-24. 41
A - Anterior tooth bounded space. B- Bounded posterior space.

C- Cantilever. Combination of A-B-C spaces. 42


Craddock in 1954

• Class I- Saddles supported at both ends by substantial abutment teeth.

• Class II- Vertical biting forces applied to denture resisted entirely by soft
tissue.

• Class III- Tooth supported at only one end of the saddle.

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Swenson’s classification system 1955

• Class I – An arch with one free end denture base.

• Class II – an arch with two free end denture bases.

Miller EL: Systems for classifying partially dentulous arches. J Prosthet Dent
1970;24(1):25-40 44
• Class III – an arch with an edentulous space posteriorly on one or both
sides of arch but with teeth present anteriorly and posteriorly to each
space.

• Class IV – an arch with an anterior edentulous space and with five or more
anterior teeth missing.

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SWENSON IA SWENSON IP SWENSON IAP

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Austin-Lidge Classification 1957

• Based on the position of missing teeth.

• In this system the letter

• A designates an anterior space.

• P designates a posterior space.

• AP-both anterior and posterior spaces

Miller EL: Systems for classifying partially dentulous arches. J Prosthet Dent
1970;24(1):25-40 47
Class A 1 – a missing anterior tooth on one side only.

Class A 2 – anterior teeth missing on both right and left sides.

Class P 1 – Posterior teeth are missing on one side only.

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• Class P 1 Bi- Posterior teeth are missing on one side

• Class P2 – Posterior teeth missing on both sides.

• Class A1P1- Anterior and posterior teeth missing on one side only.

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AP A2P2

A2P
AP2

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Watt in 1958

Stated that there are three possible methods of supporting partial denture.

• Entirely tooth borne.

• Entirely tissue borne.

• Partially tooth borne and partially tissue borne.

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Skinner's System 1959

• Based on Quality and degree of support from the abutment teeth and
residual ridge.

• Class1- Abutment teeth located both anterior and posterior to the


edentulous space, it may be unilateral or bilateral.

• Class2- All teeth posterior to the denture base, may be unilateral or


bilateral

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• Class3- All abutment teeth anterior to the denture base, may be unilateral
or bilateral.

• Class4- Denture bases located both anterior and posterior to the remaining
teeth, may be unilateral or bilateral.

• Class5- Abutment teeth unilateral in relation to the denture base.

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Applegate- Kennedy's System 1960

• Class1- all remaining teeth are anterior to bilateral edentulous regions.

• Class II- the remaining teeth of either the left or right are edentulous
regions.

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• Class III- the edentulous space is bounded by teeth which enable to give
support.

• Class IV- the remaining teeth bound the edentulous area posteriorly on
both right & left of the midline.

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• Class V- an edentulous area where teeth bound both anteriorly &
posteriorly but anterior one cannot give support.

• Class VI- same as class V but the anterior tooth can give the
support( entirely tooth borne)
 

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Fiset’s modification

• Class VII :-A partially edentulous situation in which all remaining natural
teeth are located on one side of the arch, or of the median line.

• Class VIII :-A partially edentulous situation in which all remaining natural
teeth are located in one anterior corner of the arch

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• Class IX : Functional and cosmetic requirements or the magnitude of the
interocclusal distance require the use of a telescopic prosthesis (partial or
complete). The remaining teeth are capable of total or partial support for
the prosthesis.

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• Class X :- remaining teeth are incapable of providing any support. to
maintain alveolus integrity, restored with an overdenture which is
supported primarily by the denture foundation area.

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William Avant 1966

• Class I :- This replaces one or more posterior teeth on one side of the
arch, mesial to most distal abutment tooth

• Class I-F :- This replaces one or more posterior teeth on one side of the

arch, terminating in a free end.

Avant WE: A universal classification for removable partial denture situations. J Prosthet
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Dent 1966;16:533-9.
• Class II :- this replaces one or more posterior teeth both sides of the arch,
mesial to most distal abutment tooth on both sides

• Class II-F :- this replaces one or more posterior teeth both sides of the
arch, terminating in free ends on both sides

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• Class III :- this replaces one or more anterior teeth

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Osborne & Lammie in 1974

Classification based on support of a denture.

• Class 1 - Mucosa borne.

• Class 2 - Tooth borne.

• Class 3 - Combination of 1 and 2.

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Costa 1974
Class A

Class L

Class T

Costa E: A simplified system for identifying partially edentulous dental arches. J Prosthet
Dent 1974;32:639-45. 64
Classification of unconventional partial
dentures
Unconventional partial denture

Based on condition of remaining teeth Based on support Based on material used

Telescopi c bri dge Light polym er ised partial dentur e

Periodontally Endodontica One to three Cu sil Implant Flexible Non metal


comprosmised lly treated teeth missing denture supported rpd denture clasp dentureCobalt chromium
A n d re w s b rid g e

Swami PR, Sanyal P, Sam SM. Classification of unconventional removable partial denture. Int J Oral Care Res
2018;6(1):S77-83. 65
Guide plane RPD Swing lock RPD

Nesbit denture 66
Removable partial overdenture
Cu-sil denture Implant supported RPD

Andrew’s bridge 67
Telescopic denture
Non metal clasp RPD
Flexible RPD

Light polymerised RPD


Coblat chromium RPD

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Conclusion

• No single classification can completely describe about the condition of the


partial edentulism.

• A classification system should help you to immediately visualise the


partially edentulous arch.

• Such systems should be adapted and used for better understanding of the
condition of the edentulous arch.

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References

• Miller EL: Systems for classifying partially dentulous arches. J Prosthet


Dent 1970;24(1):25-40.

• Stewart KL, Rudd KD, Kuebker WA. Clinical removable partial


prosthodontics. 2nd edition, pp – 1-18.

• Costa E: A simplified system for identifying partially edentulous dental


arches. J Prosthet Dent 1974;32:639-45.

• Friedman J: The ABC classification of partial denture segments. J Prosthet


Dent 1953;3:517-24. 70
References

• Avant WE: A universal classification for removable partial denture


situations. J Prosthet Dent 1966;16:533-9.

• Johany S: ICK Classification System for Partially Edentulous Arches. J


Prosthodont 2008;17:502-7.

• McGarry TJ, Ahlstrom RH, Koumjian JH: Classification system for partial
edentulism. J Prosthodont 2002;11:181-193.

• Swami PR, Sanyal P, Sam SM. Classification of unconventional


removable partial denture. Int J Oral Care Res 2018;6(1):S77-83. 71

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