1 Objectives and Classification Pd Fayad

8/8/2019 1 Objectives and Classification Pd Fayad

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OBJECTIVES AND CLASSIFICATION

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Andrews Bridge

The combination of a fixed dental prosthesis incorporating a bar with a

removable dental prosthesis that replaces teeth with the bar area, usually

used for edentulous anterior spaces. The vertical walls of the bar may

provide retention for the removable component. By James Andrews.

Gillett Bridge

Eponym for a partial removable dental prosthesis utilizing a Gillett clasp

system, which was composed of an occlusal rest notched deeply into the

occlusal axial surface with a gingivally placed groove and a circumferential

clasp for retention. The occlusal rest was custom made in a cast restoration.

MORA Device

Acronym formandibular orthopedic repositioning appliance, a type

of removable dental prosthesis with a modification to the occlusal surfaces

used with the goal of repositioning.

Angle of Gingival Convergence

According to Schneider, the angle of gingival convergence is located

apical to the height of contour on the abutment tooth. It can be identified by

viewing the angle formed by the tooth surfaces gingival to the survey line

and the analyzing rod or undercut gauge in a surveyor as it contacts theheight of contour.

Continuous Gum Denture

An artificial denture consisting of porcelain teeth and tinted porcelain

denture base material fused to a platinum base.

Fulcrum Line

It is an imaginary line, connecting occlusal rests, around which a partial

removable dental prosthesis tend to rotate under masticatory forces. The

determinants for the fulcrum line are usually the cross arch occlusal rests

located adjacent to the tissue borne components.

Semi precision Rest

A rigid metallic extension of a fixed or removable dental prosthesis that

fits into an intracoronal preparation in a cast restoration.


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Nesbit Prosthesis

Eponym for a unilateral partial removable dental prosthesis design, that

De. Nesbit introduced in 1918.

Resilient Attachments

An attachment designed to give a tooth borne/soft tissue borne

removable dental prosthesis sufficient mechanical flexion, to withstand the

variations in seating of the prosthesis due to deformation of the mucosa and

underlying tissues without placing excessive stress on the abutments.

CONSEQUENCES OF TOOTH LOSS

1- A loss of ridge volumeboth height and widthcan be expected

Bone loss is greater in the mandible than the maxilla, more pronounced

posteriorly than anteriorly, and it produces a broader mandibular arch while

constricting the maxillary arch.

2- Alteration in the oral mucosa

The attached gingiva of the alveolar bone can be replaced with less

keratinized oral mucosa, which is more readily traumatized.

3- Aesthetic impact

Facial features can change Secondary to altered lip support and/orreduced facial height as a result of a reduction in occlusal vertical dimension.

4- Reduction in masticatory efficiency

It is the ability to reduce food to a certain size in a given time frame. It

has been shown that there is a strong correlation between masticatory

efficiency and the number of occluding teeth in dentate individuals.

5.T.M.J.dysfunction

6. Tipping, migration, rotation and superimposition of remaining teeth.

7.Altered speech


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Partial Dentures:

Partial dentures are appliances restoring one or more but not the whole

set of natural teeth . These Appliances maybe in form of:

I- Fixed partial prosthesis ( bridge ):

An appliance which restores one or more missing teeth it is permanently

cemented to the neighboring natural teeth and cannot be removed by the

patient.

II- Removable partial prosthesis:

An appliance which restores missing teeth and the associated oral

structures for a partially edentulous patient " it can be removed by the patient .

Removable partial dentures may restore :

(a) Bounded edentulous area : which has an abutment tooth on each end.

(b) Free end edentulous area : which has an abutment tooth on one side

only . Partial dentures restoring free end cases are called distal- extension

partial dentures.

III- Partial over dentures : Partial over dentures are removable partial

dentures that are constructed to overly and gain additional support

from either :

Natural teeth that are reduced in height and contour or :

Implants inserted in the edentulous areas .

IV- Removable partial Dentures for Maxillo facial Defects :

These are removable prostheses restoring tissue defects which are

either developmentally or traumatically acquired. They are usually

retained by clasps on the remaining natural teeth.


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Types of removable partial dentures :

( 1 ) Unilateral partial dentures : Partial dentures which restore teeth on one

side of the arch without being extended to the opposite side

( 2 ) Bilateral partial dentures : partial dentures restoring missing teeth and

extended on both sides of dental arch .

According to retention to natural teeth

a- Extra coronal retention

b- Intracranial retention

According to material

-Metallic - acrylic -flexible

OBJECTIVES OF REMOVABLE PARTIAL DENTURES

1- Preservation of the Remaining Tissues:

The primary purpose of RPD is the preservation of the health of the remaining

tissues.

A- Preservation of the health of the remaining teeth.

The loss of teeth leads to migration, tilting or drifting of the

remaining natural teeth into the edentulous spaces (Fig.1-3), such

movements leads to unequal distribution of load on the remaining

teeth. In addition to food impaction in the interstitial spaces leading to

caries and /or gingivitis.

B- Prevention of muscles and TMJ Dysfunction.

Absence or movements of posterior teeth may cause:

A- Changes in the pattern of mandibular closure (Fig.1-4).

B- Change in the vertical and horizontal relations of the

mandible and maxilla. Consequently muscles and TMJ Dysfunction

may arise.


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C-Preservation of the residual ridge.

By preventing rapid bone resorption which may happen due to

lack of function.

D-Preservation of the tongue contour and space.

2 Restore the Continuity of the Dental Arch to Improve Masticatory

Function:

A reduction of the number of teeth leads to a decrease in the chewing

efficiency and greater effort on the digestive organs leading to digestive

disorders, accordingly replacing lost teeth will greatly improve the chewing

capability of the patients, distribute the load over the entire arch and improve

the balance over the whole masticatory system.

3- Improvement of Esthetics, and Providing Support to the Paraoral

Muscles, Lips and Cheeks:

Teeth and the alveolar ridge give support to the musculature of the lips

and cheeks. Non-replacement of the missing teeth gives the patient a senile

appearance characterized by nose-chin approximation and wrinkles aroundthe lips. Missing teeth can be replaced with predictable results using partial

denture.

4- Restoration of Impaired speech:

Anterior teeth play an essential role in phonetics, particularly in the

production of labio and linguo-dental sound. Loss or wrong position of

anterior teeth and subsequent alveolar ridge resorption can result in phonetic

impairment.

Proper replacement of artificial teeth in relation to the lip tongue and alveolar

ridge also the proper contouring of dentures help in restoration of speech

defects.


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5- Enhance psychological comfort:

Partial dentures should restore and correct the appearance for the

psychological benefits of the patient, by providing socially acceptable

esthetics. A comfortable prosthesis will encourage and help in patient

rehabilitation .

INDICATIONS FOR REMOVABLE PARTIAL DENTURES

1. No abutment tooth posterior to edentulous space (Free end edentulous

area)).

2.After recent extraction, usually done only to improve esthetics, or for

patient satisfaction.

3.Long edentulous bounded span, too extensive for fixed restoration.

4.Periodontally weak teeth not sufficiently sound to support fixed- partial

denture.

5. With excessive loss of residual bone, the use of labial flange or need to

restore lost tissues.

6. Need of bilateral bracing (cross arch stabilization).after periodontal

diseases treatment ,fixed prosthesis provide only antero-posterior

stabilization only not mediolateral .7. Enhancing esthetics in anterior region, by the use of translucent

artificial teeth instead of dull fixed partial denture pontic.

8. Young age (less than 17 years).

9. Geriatric patients

10. Immediate replacement.

11.Economic considerations,attitude and desire of the patient.

12.Physical problems.

13. Unfavorable maxillo-mandibular relation.

Contraindication

1- Large tongue.

2- Mentally retarded.

3- Poor oral hygiene.


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ADVANTAGES OF REMOVABLE PARTIAL DENTURE OVER FIXED

PARTIAL DENTURE:

1- They can be constructed for any case whilst fixed P.D. are confined to

short spans bounded by healthy teeth and with a normal occlusion.

2- Cheaper than fixed partial denture.

3- They are more easily cleaned.

4- They are more easily repaired.

5- No tooth reduction is required.

Disadvantages of a Removable Partial Denture:

1- It can cause caries: by harboring food debris in close contact with the

natural teeth a partial denture may promote caries. This will depend on

several factors, chief of which are:

a) The age of the patient, up to the age of 25 years caries susceptibility is

greatest, there after it tends to decrease.

b) The oral hygiene of the patient.

c) The design of the denture: this is all important because well designed

dentures will cause for less damage to the mouth than those of through

less design.2- It can damage the supporting tissues of the teeth: removable partial

dentures may cause damage to the gum margins by:

a) Fitting too closely into the gingival tissues: through and causing

mechanical injury to it.

b) Allowing food to pack down between the denture and the teeth.

3- It may loosen the natural teeth by leverage: clasps which grip the teeth

too tightly or indirect retainers which are badly placed may cause excessive

stresses to be induced in the natural teeth .

4- It can cause traumatic damage to the palate.

5. Clasps can be unesthetic, particularly when they are placed on visible tooth

surfaces.


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HAZARDS OF IMPROPERLY DESIGNED PARTIAL DENTURES

An improperly designed and constructed partial denture may adversely

affect the tissues in the following manner:

1- Stagnation of food around component parts of partial denture in contact

with tooth surfaces that are not readily cleanedcauses tooth decay .

2-Induce stresses on abutment teeth and tissues. If these stresses exceed the

physiologic limits of tissue tolerance, pathologic and destructive changes may

occur:

a) Excessive stresses on abutment teeth cause periodontal membrane

destruction, pocket formation, mobility, and even loss of these teeth.

b) Inflammation, ulceration and gingival recession may occur due to

excessive stresses and undue coverage of tissues with the restoration.

Inadequate denture support due to inadequate stoppers, this causes

displacement of the restoration towards the tissues causing gum stripping.

c) Stresses may also causebone resorption and loss of the bony foundation

necessary to support the prosthesis.3- Improper occlusion of teeth or the presence of premature contact may cause

T.M.J. disorders.

PHASES OF PARTIAL DENTURE SERVICE

1- Education of patient: the process of informing a patient about a health matter

to secure informed consent, patient cooperation, and a high level of patient

compliance. Patient education should begin at the initial contact with the

patient and continue throughout treatment.

2- Diagnosis, treatment planning, design, treatment sequencing, and mouth

preparation.

3- Support for Distal Extension Denture Bases.


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4- Establishment and Verification of Occlusal Relations and Tooth

Arrangements.

5- Initial Placement Procedures.

6- Periodic Recall.

REASONS FOR FAILURE OF CLASP-RETAINED P.D.

Diagnosis and treatment planning

1. Inadequate diagnosis

2. Failure to use a surveyor or to use a surveyor properly during treatment

planning

Mouth preparation procedures

1. Failure to properly sequence mouth preparation procedures

2. Inadequate mouth preparations, usually resulting from insufficient planning of

the design of the partial denture or failure to determine that mouth preparations

have been properly accomplished

3. Failure to return supporting tissue to optimum health before impression

procedures

4. Inadequate impressions of hard and soft tissue

Design of the framework

1. Failure to use properly located and sized rests

2. Flexible or incorrectly located major and minor connectors

3. Incorrect use of clasp designs4. Use of cast clasps that have too little flexibility, are too broad in tooth

coverage, and have too little consideration for esthetics

Laboratory procedures

1. Problems in master cast preparation

a. Inaccurate impression

b. Poor cast-forming procedures


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c. Incompatible impression materials and gypsum products

2. Failure to provide the technician with a specific design and necessary

information to enable the technician to execute the design

3. Failure of the technician to follow the design and written instructions

Support for denture bases

1. Inadequate coverage of basal seat tissue

2. Failure to record basal seat tissue in a supporting form

Occlusion

1. Failure to develop a harmonious occlusion

2. Failure to use compatible materials for opposing occlusal surfaces

Patient-dentist relationship

1. Failure of the dentist to provide adequate dental health care information,

including care and use of prosthesis

2. Failure of the dentist to provide recall opportunities on a periodic basis

3. Failure of the patient to exercise a dental health care regimen and respond torecall

CLASSIFICATION OF PARTIALLY

EDENTULOUS ARCHES

Need for classification:

1- To differentiate between different partial denture.2- It facilities writing or speaking about partial denture designs and referral or

prescription writing to the laboratory thus facilitating communication.

3- To formulate good treatment plane.

4- To anticipate difficulties commonly to occur for each class.

Requirements of an Acceptable Classification:

Classifications are importantto facilitate communicationbetween the dentist

and the laboratory technician. Acceptable classification should satisfy the

following requirements:

1.Permit immediate visualization of the type of partially edentulous arch.

2.Permit immediate differentiationbetween bounded and free extension

partial dentures.

3. It should be universally accepted.


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4. Serve as guide to design used.

Classifications

Several methods of classification based on various factors have

been proposed.

A- Classification According to the Extent of the Removable

Partial Denture:

1- Unilateral RPD (Removable Bridge): which restore missing teeth on one

side of the arch without being extended to the other side. This unilateral

design provides least amount of tooth preparation and least amount of tooth

and soft tissue contact.

For unilateral removable partial denture to be successful:

1. clinical crown of abutment tooth must be long enough to

resist rotational forces.

2. The buccal and lingual surfaces of the abutment tooth

must be parallel to resist tipping forces.

3. Retentive undercuts should be available on both the

buccal and lingual surfaces of each abutment.

* Unilateral removable partial dentureshould be used with caution. as

the chance of the denture becoming dislodged and aspirated is too great.

Bilateral RPD: which restore missing teeth and extended on both sides

of the dental arch.

B- Cummer's classification :

This classification mainly based upon various the position of

the direct patner of the finished restoration . The direct retainer

may be diagonally, diametric, unilaterally or multilaterally placed.

This classification describes the restored rather than the unrestored

arch, so it is of line value because it follows denture design .


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C - Bailyn classification :

Bailyn,s classification is based on the support afforded to the

denture by the tissues . the restorations may be :

o Tissue born prosthesis : the denture is enterily supported by

the mucosa and the underlying bone .

o Tooth born prosthesis : the denture is entirely supported by

abutment teeth .

o Tooth tissue supported prosthesis : the denture is supported

bu both abutment teeth and moucosa.

D- Fridman's classification :

Fridman classified partial dentures in to :Group A for anterior restoration

Group B- For bounded posterior restoration

Group C- For posterior free end restoration (c= cantilever) .

E - Osborne and Lammie (1974)

Class I: Denture supported by mucosa and underlying bone

Class II: Denture supported by teeth

Class III: Denture supported by a combination of mucosa and tooth-

borne means.

Class IV: Denture supported by implants.

F.Beckett and Wilson

Class I: Bounded saddle and the abutment cant support the saddle

Class II: Free end saddle

A. Tooth and tissue support

B. Tissue support

Class III: Bounded saddle and the abutment can support the saddle


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Skinner's Classification

He introduced the classification in 1959. He said that about 1,31,072

combinations of partially edentulous arches are possible.

His classification is based on the relation of the edentulous arches to the

abutment teeth.

Class I: Abutment teeth are present anterior and posterior to the edentulous

space. It may be unilateral or bilateral.

Class II: All the teeth are present posterior to the denture base which

functions as a partial denture unit. It may be unilateral or bilateral.

Class III: All abutment teeth are anterior to the denture base which

functions as a partial denture unit. It may be unilateral or bilateral.

Class IV: Denture bases are located anterior and posterior to the remaining

teeth, and these may be unilateral or bilateral.

Class V: Abutment teeth are unilateral in relation to the denture base, and

these may be unilateral or bilateral.

H- Kennedy's Classification:

Dr. Edward Kennedy proposed this classification in 1923. This is themost popular classification. It is based on locations and number of

edentulous areas.

Class I: Bilateral edentulous areas (free-end saddles) located posterior to the

remaining natural teeth.72%

Class II: A unilateral edentulous area (free-end saddle) located posterior to

the remaining natural teeth.14%

Class III: A unilateral edentulous area with natural teeth remaining both

anterior and posterior to it.8,5%


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Class IV: A single, but bilateral (crossing the midline ), edentulous area

located anterior to the remaining natural teeth.3%

Applegate later added two classes

Class V: A unilateral edentulous area with natural teeth remaining both

anterior and posterior to it but the anterior abutment is not suitable for

support.

Class VI: A unilateral edentulous area with natural teeth remaining both

anterior and posterior to it with abutments capable for total support.

FISET'S ADDITIONS

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

Class IX A partially edentulous situation in which functional and cosmetic

requirements or the magnitude of the interocclusal distance require the useof a telescoped prosthesis (partial or complete).The remaining teeth are

capable of total or partial support for the prosthesis.

Class X A partially edentulous situation in which the remaining teeth are

incapable of providing any support. If the teeth are kept to maintain

alveolus integrity, the arch must be restored with an OVERDENTURE

which is a complete denture supported primarily by the denture foundation

area


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The numeric sequence of the classification system is based on the

frequency of occurrence of each class. Class I being the most common While

class IV is the least common. This classification was then modified by

Applegate .

Why a unilateral edentulous area is considered as class II?

Because it include features of both class I and class III especially if

modification is present.

Advantages

1- It is the most widely used method of classification of the partially

edentulous arches.

2- It is simple and can be easily applied to nearly all partially

edentulous bases.

3- It permits immediate visualization of the partially edentulous arch

and permits a logical approach to the problems of design.

Applegate has provided the following eight rules governing the

application of the Kennedy system.

Applegate's Rules for Applying the Kennedy Classification:

Rule (1) : Classification should follow rather than precede any

extraction of teeth that might alter the original classification.

Rule (2) : If the third molar is missing and not to be replaced, it is not

considered in the classification.

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 (that is,

the opposing second molar is also missing and is not to be replaced ), it is not

considered in the classification.

Rule (5) : The most posterior edentulous area or areas always determine

the classification.


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Rule (6) : Edentulous areas other than those determining the classification

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

Rule (7) : The extent of the modification is not considered, only the

number of additional edentulous areas.

Rule (8) : There can be no modification areas in Class IV arches. Any

edentulous area lying posterior to the "single bilateral area crossing the

midline" would instead determine the classification.

Class IV Partial dentures especially those having long edentulous areas

are considered mesial extension bases. They require the same denture design

principles as class I partial dentures.

ACP classification system for partial edentulism J Prosthodont 2002;11:181-193.

Prosthodontic Diagnostic Index ( PDI )

The American College of Prosthodontists (ACP) has developed a classification

system for partial edentulism based on diagnostic findings. This classification

system is based on diagnostic findings. Four categories of partial edentulism

are defined, Class I to Class IV, with Class I representing an uncomplicatedclinical situation and class IV representing a complex clinical situation. Each

class is differentiated by specific diagnostic criteria.

Diagnostic Criteria

1. Location and extent of the edentulous area(s)

2. Condition of abutments

3. Occlusion

4. Residual ridge characteristics.

Class I

This class is characterized by ideal or minimal compromise in the

location and extent of edentulous area (which is confined to a single arch),


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abutment conditions, occlusal characteristics, and residual ridge conditions.

All 4 of the diagnostic criteria are favorable.

1. The location and extent of the edentulous area are ideal or minimally

compromised:

The edentulous area is confined to a single arch.

The edentulous area does not compromise the physiologic support of the

abutments.

The edentulous area may include any anterior maxillary span that does

not exceed 2 incisors, any anterior mandibular span that does not exceed

4 missing incisors, or any posterior span that does not exceed 2 premolars

or 1 premolar and 1 molar.

2. The abutment condition is ideal or minimally compromised, with no

need for preprosthetic therapy.

3. The occlusion is ideal or minimally compromised, with no need for

preprosthetic therapy; maxillomandibular relationship: Class I molar and

jaw relationships.

4. Residual ridge morphology conforms to the Class I complete

edentulism description.

Class II

This class is characterized by moderately compromised location and

extent of edentulous areas in both arches, abutment conditions requiring

localized adjunctive therapy, occlusal characteristics requiring localized

adjunctive therapy, and residual ridge conditions.

1. The location and extent of the edentulous area are moderately

compromised:

Edentulous areas may exist in 1 or both arches The edentulous areas do

not compromise the physiologic support of the abutments.

Edentulous areas may include any anterior maxillary span that does not

exceed 2 incisors, any anterior mandibular span that does not exceed 4

incisors, any posterior span (maxillary or mandibular) that does not exceed


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2 premolars, or 1 premolar and 1 molar or any missing canine (maxillary or

mandibular).

2. Condition of the abutments is moderately compromised:

Abutments in 1 or 2 sextants have insufficient tooth structure to retain or

support intracoronal or extracoronal restorations.

Abutments in 1 or 2 sextants require localized adjunctive therapy.

3. Occlusion is moderately compromised:

Occlusal correction requires localized adjunctive therapy.

Maxillomandibular relationship: Class I molar and jaw relationships.

4. Residual ridge morphology conforms to the Class II complete


Class III

This class is characterized by substantially compromised location and

extent of edentulous areas in both arches, abutment condition requiring

substantial localized adjunctive therapy, occlusal characteristics requiring

reestablishment of the entire occlusion without a change in the occlusal

vertical dimension, and residual ridge condition.

1. The location and extent of the edentulous areas are substantiallycompromised:

Edentulous areas may be present in 1 or both arches.

Edentulous areas compromise the physiologic support of the abutments.

Edentulous areas may include any posterior maxillary or mandibular

edentulous area greater than 3 teeth or 2 molars, or anterior and posterior

edentulous areas of 3 or more teeth.

2. The condition of the abutments is moderately compromised:

Abutments in 3 sextants have insufficient tooth structure to retain or

support intracoronal or extracoronal restorations.

Abutments in 3 sextants require more substantial localized adjunctive

therapy (ie, periodontal, endodontic or orthodontic procedures).

Abutments have a fair prognosis.


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3. Occlusion is substantially compromised:

Requires reestablishment of the entire occlusal scheme without an

accompanying change in the occlusal vertical dimension.

Maxillomandibular relationship: Class II molar and jaw relationships.

4. Residual ridge morphology conforms to the Class III complete


Class IV

This class is characterized by severely compromised location and

extent of edentulous areas with guarded prognosis, abutments requiring

extensive therapy, occlusion characteristics requiring reestablishment of

the occlusion with a change in the occlusal vertical dimension, and residual

ridge conditions.

1. The location and extent of the edentulous areas results in severe occlusal

compromise:

Edentulous areas may be extensive and may occur in both arches.

Edentulous areas compromise the physiologic support of the abutment

teeth to create a guarded prognosis.

Edentulous areas include acquired or congenital maxillofacial defects. At least 1 edentulous area has a guarded prognosis.

2. Abutments are severely compromised:

Abutments in 4 or more sextants have insufficient tooth structure to

retain or support intracoronal or extracoronal restorations.

Abutments in 4 or more sextants require extensive localized adjunctive

therapy.

Abutments have a guarded prognosis.

3. Occlusion is severely compromised:

Reestablishment of the entire occlusal scheme, including changes in the

occlusal vertical dimension, is necessary.

Maxillomandibular relationship: class II division 2 or Class III molar and

jaw relationships.


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4. Residual ridge morphology conforms to the class IV complete


Other characteristics include severe manifestations of local or systemic

disease, including sequelae from oncologic treatment, maxillomandibular

dyskinesia and/or ataxia, and refractory patient (a patient who presents with

chronic complaints following appropriate therapy).


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Implant-Corrected Kennedy (ICK) Classification System for

Partially Edentulous Arches Journal of Prosthodontics 17 (2008) 5025

Guidelines for the new classification system

The new classification system will follow the Kennedy method with

the following guidelines:

(1) No edentulous space will be included in the classification if it will be

restored with an implant-supported fixed prosthesis.

(2) To avoid confusion, the maxillary arch is drawn as half circle facing up

and the mandibular arch as half circle facing down. The drawing will appear as

if looking directly at the patient; the right and left quadrants are reversed.

(3) The classification will always begin with the phrase "Implant-Corrected

Kennedy (class)," followed by the description of the classification. It can be

abbreviated as follows:

(i) ICK I, for Kennedy class I situations,

(ii) ICK II, for Kennedy class II situations,

(iii) ICK III, for Kennedy class III situations, and

(iv) ICK IV, for Kennedy class IV situations.

(4) The abbreviation max for maxillary and man for mandibular can

precede the classification. The word modification can be abbreviated as mod.

(5) Roman numerals will be used for the classification, and Arabic numerals

will be used for the number of modification spaces and implants.

(6) The tooth number using the American Dental Association (ADA) system is

used to give the number and exact position of the implant in the arch. (Note:

other tooth numbering systems such as Federation Dentaire Internationale

[FDI] can be used, as can the tooth name. The ADA system was used by the

authors because of familiarity).


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Universal numbering system table

Permanent Teeth

upper left upper right

16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1

17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

lower left lower right

(7) 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 (#).

(8) 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.

(9) A different name, ICK Classification System, is given to this classification

system to be differentiated from other partially edentulous arch classification

systems.


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ICK I (#2, 15).

ICK I (#2).

ICK I mod 3 (#18, 22, 28, 31).

ICK II (#2).

ICK II mod 1 (#21, 26, 30).

ICK III mod 3 (#23, 26).

ICK IV (#6, 11)


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Component Parts of removable partial dentures

Denture bases.

Artificial teeth .

Supporting rests.

Connectors: Major connectors

Minor connectors

Retainers : Direct retainers

Indirect retainers

These components may provide one or more of the following functions:

1-Support:

a. The resistance of a denture to tissue ward movement.

b. Adequate and wide distribution of the load to the teeth and mucosa.

2- Retention: The resistance of a denture to vertical displacement force (to

move away from its tissue foundation)).

3- Indirect retention: The resistance of denture rotationaway from the

tissues about an axis.

4- Bracing: The resistance of a denture to lateral forces.

5- Reciprocation: The resistance of lateral forces on the abutment during

insertion and removal of the removable partial denture .

Reciprocation is required as the denture is being displaced occlusally

whilst thebracingfunction,comes into play when the denture is fullyseated.

6- Stability: The resistance of a denture to tipping movement.

Tipping movement: Vertical rotation around a line parallel to ridge crest

(twisting of the denture base)

1 Objectives and Classification Pd Fayad

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