D R . M O H A M E D O S M A N B A B I K I R

B D S . G B O I . M S C

Phases of partial denture services

Introduction

• There are six phases in RPD construction.

• These phases are correlated and not separated from each other

Six Phases Of Partial Denture Service

1. Education of Patient

2. Diagnosis, Treatment Planning, Design, Treatment Sequencing, and Mouth Preparation

3. Support for Distal Extension Denture Bases

4. Establishment and Verification of Occlusal Relations and Tooth Arrangements

5. Initial Placement Procedures

6. Periodic Recall

1. Patient education

The dentist and the patient share responsibility for the

ultimate success of a removable partial denture.

Preservation of the oral structures, it’s one of the

primary objectives of prosthodontics treatment, will

be compromised without the patient's cooperation in

oral hygiene and regular maintenance visits.

Patient education should begin at the initial contact

with the patient and continue throughout treatment.

1. Patient education

The removable partial denture is often doomed to

limited success if the patient fails to exercise proper

oral hygiene habits or ignores recall appointments.

A patient will not usually retain all the information

presented in the oral educational instructions. For this

reason, patients should be given written suggestions to

reinforce the oral presentations.

2.Diagnosis, Treatment Planning, Design, Treatment

Sequencing, and Mouth Preparation

Treatment planning and design begin with medical and dental histories and good diagnosis.

2.Medical history

A full medical history must be recorded.

Some specific medical condition can be contraindicate or may result in difficulties to wear or use a denture such as:

Drug induced xerostomia

Radiotherapy.

Sjogren syndrome

Epilepsy.

Neurological condition(Parkinson disease).

2.Dental history

Also a full dental history must be recorded.

• The state of the residual dentition is a good indicator for past oral care.

Present and previous denture history is also important, and may provide useful evidence for the design of replacement.

2.Diagnosis

Patient complaints is the key to reach the diagnosis.

Complaints may come in several form such as : toothache , facial pain, difficulty in eating, deterioration of appearance or dissatisfaction with RPD.

Radiographs & study casts aids in diagnosis

2.Examination

The complete oral examination must include both clinical and radiographic interpretation of :

(1) caries

(2) the condition of existing restorations.

(3) periodontal conditions

(4) responses of teeth – vitality test - (especially for abutment teeth)

(5) residual ridges

2.Examination

Additionally, evaluation of the occlusal plane, the arch form, and the occlusal relations of the remaining teeth must be meticulously accomplished by clinical visual evaluation and diagnostic mounting of the study cast.

2.Examination

After a complete diagnostic examination has been accomplished and a removable partial denture has been selected as the treatment of choice, a treatment plan is sequenced and a partial denture design is developed.

2.Surveying the Diagnostic Cast

Surveying the diagnostic cast is essential to effective

diagnosis and treatment planning.

used to determine the relative parallelism of two or more

surfaces of teeth or other part of cast of the dental arch .

2.Mouth preparations

• Following the development of a comprehensive

treatment plan including the design for the RPD an

appropriate sequence of mouth preparation procedures

should be completed.

• This may include surgical, periodontal, endodontic, or

orthodontics therapy in addition to restorative

treatment and abutment tooth modification.

2.Surgical Preparation

Grossly displaceable soft tissue covering basal seat areas and hyperplasic tissue should be removed to provide a firm denture foundation.

Mandibular tori should be removed if they will interfere

with the optimum location of a lingual bar connector or

a favorable path of placement.

Any other areas of bone prominence that will interfere

with the path of denture placement should be removed

also.

2.Periodontal preparation

Periodontal disease and plaque control :

• Home care instruction and professional hygiene recall

system should be implemented

• Hyperplastic tissue may require surgical reduction in

order to expose more of the clinical crown and

improve abutment tooth contour.

2.Restorative preparation

1.Removal of caries.

2.Replacement of defective restoration.

3.Restoration of structurally compromise teeth.

4.Occlusal plane modification.

5.Correction of malocclusion.

6.Correction of unacceptable abutment tooth not corrected

through enamel modification.

2.Endodontic preparation

Non-vital teeth should be endodontically treated.

2.Modification of abutment tooth

Objectives:

1. Develop an acceptable path of placement.

2. Improve esthetics.

3. Enhance comfort .

4. Promote favorable biomechanical properties:

a. retention.

b. Stability (bracing).

c. Support.

2.Orthodontic Preparation

Occasionally, orthodontic movement of malposed teeth

for a better removable partial denture design.

3.Support for Distal Extension Denture Bases

For distal extension removable partial denture, load or

forces must be distribute between the residual ridge –

distal extension- and neighboring abutments, to

decrease forces on the adjacent abutments.

4.Establishment and Verification of Occlusal Relations

and Tooth Arrangements

• Recording and verification of occlusal relationships and

tooth arrangement are important steps in the construction

of a partial denture.

• The harmonious occlusion established from the

articulated study casts. It is essential in treatment planning

because it can determine the sufficient space to locate the

denture components without occlusal interferences .

4.Establishment and Verification of Occlusal Relations and Tooth Arrangements

Therefore the final jaw relations should not be recorded

until the denture framework have been constructed and

returned to the dentist, then the fit of the framework to

the abutment teeth and opposing occlusion can be

verified and corrected.

5.Initial Placement Procedures

Include adjustments to the RPD and for review of

instructions given to the patient to optimally maintain

oral structures and the provided restorations.

6.Periodic Recall

• Done by the dentist through recall appointments for periodic evaluation of the responses of oral tissue to restorations and of the acceptance of the restorations by the patient.

• Periodic re-evaluation of the patient is critical for early recognition of changes in the oral structures to allow steps to be taken to maintain oral health.

• The patient should return to the clinic within 24 hours, this period is sufficient to allow detection of initial signs of most post insertion complications.

• The Patient must also be advised about the future care of the mouth to ensure health and longevity of the remaining structures.

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