Assessment of the Partially

Dentate Patient

Dr. Graham Quilligan

 Objectives
 To understand the need for tooth replacement
 To recognise that there a number of methods for
replacing missing teeth
 To recognise the indications for Removable
Partial Dentures
 To undertand the limitations of fixed
bridgework
 To understand the sequence of clinical stages
Treatment options for the Partially Dentate

• Fixed prostheses
– Bridgework (Conventional & Resin Bonded)
– Implant retained fixed prostheses
• Removable Partial Dentures (acrylic/co-cr)
• Functionally orientated treatment planning
(Shortened Dental Arch)
• Controlled progression to complete dentures
(Transitional dentures)
Replacement Options for the Partially
Dentate
• Length of edentate span
Replacement Options for the Partially
Dentate
• Soft Tissue and bone loss
Replacement Options for the Partially
Dentate
• Why not use bridgework?
Replacement Options for the Partially
Dentate
• Spacing
Replacement Options for the Partially
Dentate

• Diastema
Replacement Options for the Partially
Dentate
• Alignment
 Replacement Options for the Partially
Dentate

• Unrestored Abutments
Replacement Options for the Partially Dentate

• Prognosis for remaining teeth

Partial Denture Design

A systematic approach
 Planning

 Patient input
 Previous history
 Assessment of Abutment teeth
– Radiographs
 Dental Examination
– Caries
– Periodontal disease
– Occlusal considerations
Removable Partial Dentures

 Tissue borne
 Tooth borne
 Tooth and Tissue borne
 Kennedy Classification
 (1-4, modifications)
Preliminary Impressions
Preliminary Registration
Removable Partial Dentures

 Preliminary casts
 Mount Preliminary casts (preliminary
registration required)
 Survey casts to identify undercuts
– Tooth
– Tissue
Surveyor
 Surveyor
 Coloured lead and Analysing Rod
– Survey at Path of Natural Displacement (table
horizontal)
– Tilt cast and survey again (preferably different
colour lead)
– Identify areas of undercut
 Use undercut gauge to measure depth
– Decide on clasp tip position and material
Surveyed cast
A system of design
 Outline saddle areas
 Path of insertion
 Support
 Retention
– Direct
– Indirect
 Bracing
 Connectors
Outline saddle areas
Path of insertion
Support
Occlusally Approaching clasp
Gingivally Approaching clasp
 Depth of Undercut
 <0.25mm – wrought or cast
 0.25-0.5 mm – wrought gold, stainless steel
or elongated cast cobalt chrome
 >0.5 – wrought only
 Connectors
 Major Connectors
– Join saddles together

 Minor Connectors
– Join Clasps/Rests to Major Connectors
Major Connectors
 Bars
– Lingual – 8mm
– Sub Lingual -6mm or less
– Buccal
– Palatal (Anterior/Middle/Posterior)
 Plates
– Lingual
– Palatal
Connectors
Connectors
 Tooth Preparations

 Rest Seats
 Guide Planes
 Lowering of survey lines
 Create undercuts
– Addition of composite
– Dimple cavity in enamel
– Surveyed Crowns
Rest Seat Preparation
Guide Planes
Creating Undercuts
Creating Undercuts
 Prescription Sheets

 Transfer of design – draw outline

carefully
 Describe principle features
– Position of rest seats
– Clasp design (inc. materials)
– Connector Design
 From tooth try in to finish
 BLOCK OUT UNWANTED
UNDERCUTS!
 Aftercare

 Keep your designs simple

 Cleaning instructions
 Ongoing maintenance
 Reading Material
 “A clinical guide to removable partial denture design” Author -
Davenport, J. Basker, R., Heath, J. et al Publisher – MacMillan
(BDJ Series)

 “A clinical guide to removable partial dentures” Author -

Davenport, J. Basker, R., Heath, J. et al Publisher – MacMillan
(BDJ Series)

 “Removable Partial Dentures” Author – Jepson, NJA,

Quintessence Publishing co.