INTRODUCTION,

CLASSIFICATION &
BIOMECHANICS
of
PARTIALLY
EDENTULOUS
arches
DR. ANUSHA SINGH
CONTENTS:

 Indication against use of FPD

 Indication for RPD
 Parts of RPD
 Steps in the treatment of an RPD patient
 Advantages and disadvantages of RPD
 Requirements of an acceptable classification
 Classifications
 mechanical principles applicable in removable prosthodontics
 forces acting on partial dentured
 Causes of failure of RPD
 Conclusion
 References
The art and science of replacing absent body
parts is termed prosthetics , and any
artificial part is called a prosthesis.

The term prosthesis and appliance are often

confused & interchangeable.

Appliance is correctly used only to refer to a

device worn by a patient in the course of
treatment, such as a orthodontic appliance,
surgical appliance.
 PROSTHODONTICS

FIXED REMOVABLE MAXILLOFACIAL

complete Partial

extracoronal Intacoronal
REMOVABLE PARTIAL DENTURE

 ‘‘ Any prosthesis that replaces some teeth in

a partially dentate arch . It can be removed
from mouth and placed at will.’
- GPT 8
 INDICATIONS AGAINST USE OF FIXED
PARTIAL DENTURES
 Youth Patient
large dental pulps and
lack of clinical crown height.

 Advanced Age
Reduced life expectancy and
Frequently failing general health contraindicate the
expensive and tedious dental procedures
 Long edentulous span

 Excessive loss of bone

As they are unable to support a fixed prosthesis and it is
necessary to provide support for the lips or cheek or to
obtain proper tooth position for the artificial tooth
 INDICATIONS FOR RPD

 Long edentulous span :contraindicates use of fixed partial

denture

 No abutment tooth posterior to edentulous space

 Reduced periodontal support of remaining teeth: loss of

bony support so unable to support a fixed prosthesis.

 Need for cross-arch stabilization: The fixed partial denture can

provide excellent an anterioposterior stabilization but limited lateral,
or buccolingual, stabilization.
 Physical or emotional problem of the patient :The
lengthy preparation and construction for fpd can be tiring

 Esthetics of primary concern in replacement of

multiple missing anterior teeth :Three-dimensional denture
tooth on a denture base may have a more lifelike appearance than
some pontics

 After recent extraction : teeth immediately following extraction

are replaced with temporary removable partial dentures that can
be relined as resorption occurs.

 Patient desire :To avoid operative procedures on sound,

healthy teeth and for eco­nomic reasons.
 ADVANTAGES OF RPD
 Does not sacrifice sound healthy tooth
 Economic

 Easier to repair

 A properly designed partial denture will assist in support of existing

teeth

 help to balance bite. This means better chewing and a healthier jaw
joint.

 Add support to the cheeks & lips.

 existing natural teeth extracted for any reason, new teeth can be
added
 DISADVANTAGES OF RPD
 Low patient acceptance.

 The clasps sometimes show when the patient

smiles.

 The bar across the palate interferes with taste. It

may feel bulky and may cause the patient to gag
at first.
 food collects under it during eating. It should be
removed from the mouth and cleaned after every meal
and at night.

 As the partial is repeatedly taken in and out, it can wear

anchor teeth and loosen them.

 Caries may develop under clasp component especially if

patient fails to keep the prosthesis and abutment clean.
 PARTS OF A REMOVABLE PARTIAL
DENTURE

The components of a removable partial denture are:

1. Major connector
2. Minor connector
3. Rest
4. Direct retainer
5. Indirect retainer
6. Denture base
7. Artificial tooth replacement
 MAJOR CONNECTOR
Def: The major connectors connect the parts of the prosthesis
located on one side of the arch with those on the opposite
side. All other parts of the partial denture are attached to it
either directly or indirectly.

Properties:
 Be rigid
 Provide vertical support and protect the soft tissues
 Provide a means of obtaining indirect retention where
indicated
 MINOR CONNECTOR
 
 Def: The connecting link between the major connector or
base of a rpd and the other units of the prosthesis, such as
clasp assembly, indirect retainers, occlusal rests, or cingulum
rests.

 Functions :
 To transfer functional stress to the abutment teeth.
 To transfer the effect of the retainers, rests, and the
stabilizing components to the rest of the denture.
 REST
 A rest is a rigid extension of a partial denture that contacts a
remaining tooth (or teeth) to dissipate functional forces.
 
 DIRECT RETAINER

 
 A clasp or attachment placed on an abutment
tooth for the purpose of holding a removable
denture in position.
 INDIRECT RETAINER

 
 A part of RPD which assists the direct retainers in
preventing displacement of distal extension
denture bases by functioning through lever action
on the opposite side of the fulcum line.
 DENTURE BASE AND TOOTH REPLACEMENTS

 Denture base is the part of the denture that

forms the tissue surface of the denture over the
edentulous area.
o helps to distribute the forces acting on the
denture over the entire residual ridge.
o It holds the tooth replacements in position.

 Tooth replacements reproduce the contour and

function of the missing teeth.
PARTIAL DENTURE SERVICE DIVIDED INTO SIX
PHASES

first phase patient education.

second phase diagnosis, treatment planning,

design of the partial denture framework,
treatment sequencing, and execution of mouth
preparations.

third phase provision of adequate support for

the distal extension denture base.

fourth phase establishment and verification of

harmonious occlusion
fifth phase involves initial placement
procedures and a review of instructions given
the patient to optimally maintain oral
structures and the provided restorations.

sixth phase follow-up services 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.
FIRST PHASE:
Patient education

 "The process of informing a patient about a health

matter to secure informed consent, patient
cooperation, and a high level of patient compliance.“

 give written suggestions to reinforce the oral

presentations.
SECOND PHASE: diagnosis , treatment
planning n mouth prep.

 thorough medical and dental histories.

 The complete oral examination including both clinical and

radiographic interpretation
 Evaluation of the occlusal plane, the arch form, and the
occlusal relations of the remaining teeth accomplished
by clinical visual evaluation and diagnostic mounting.

 The surveyor is instrumental in diagnosing and guiding

the appropriate tooth preparation and verifying mouth
preparation
THIRD PHASE: provision of
support for distal extension

 primary supporting area should be recorded

or related under some loading so that the
base may be made to fit the form of the ridge
when under function.

 distal extension base must be made as equal

to and compatible with the tooth support as
possible.
 FOURTH PHASE:
 For the distal extension base, however, jaw
relation records should be made only after
verifying the fit of the framework to the
abutment teeth and opposing occlusion
FIFTH PHASE :

 occurs when the patient is given possession of the

removable prosthesis.

 occlusal harmony be ensured

 the processed bases must be reasonably perfected to fit

the basal seats.

 ascertained that the patient understands the

suggestions and recommendations given by the dentist
 SIXTH PHASE: Periodic recall

 Periodic re-evaluation of the patient is critical .

 These examinations must monitor the condition of

the oral tissue, the response to the tooth
restorations, the prosthesis, the patient's
acceptance, and the patient's commitment to
maintain oral hygiene.

 6-month recall period is adequate for most patients,

CLASSIFICATION
Need for classification:

Formulate a good treatment plan

Anticipate difficulties for the design

Communication

Designing according to occlusal load

REQUIREMENTS
1. Allow visualization of the type of partially
edentulous arch being considered

2. Permit differentiation between tooth-supported

and tissue-supported partial dentures

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

4. Be universally acceptable
 CUMMER’S CLASSIFICATION

 Proposed by Cummer in 1920

 First professionally recognized classification

 Based upon choice of number and position of direct

retainer
 CLASS I
 Partially dentulous arch in which two diagonally
opposite teeth are chosen as abutment for direct
retainers with an indirect retainer as auxillary
attachment
 CLASS II
 Partially dentulous arch in which two diametrically
opposite teeth are chosen as abutments for
attachment of direct retainer with an indirect
retainer as auxillary attachment
 CLASS III
 Partially dentulous arch in which one or more teeth
on the same side are chosen as abutments for
attachment of direct retainer with or without indirect
retainer
 CLASS IV
 Partially dentulous arch in which three or more
teeth are chosen as abutments for attachment of
direct retainer without use of indirect retainer
KENNEDY CLASSIFICATION
 Dr.Edward Kennedy (1925)

 Most widely used

 Original classification contains 4 classes based on

relationship of edentulous spaces to abutment teeth
 Class I
 Bilateral edentulous areas located posterior to the
remaining natural teeth (most common)
 CLASS I I
Unilateral edentulous area located posterior to the
remaining natural teeth
 CLASS III

Unilateral edentulous area with natural teeth both

anterior and posterior to it
 CLASS IV

Single,bilateral edentulous area located anterior to the

remaining natural teeth (least common)
Dr. O.C. Applegate (1960) modified Kennedy
classification by including 2 more classes:

CLASSV
Edentulous area bounded anteriorly and posteriorly by
natural teeth but in which anterior abutment (lateral
incisor)is not suitable for support
CLASS VI
Teeth adjacent to the space are capable of total support
of required prosthesis
APPLEGATES RULES
RULE 1
Classification should follow rather than precede any
extractions 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.
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 .

RULE 5
The most posterior edentulous area/areas always
determine the classification.
RULE 6
Edentulous areas other than those determining the
classification are referred to as modifications 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.
BAILYN’S CLASSIFICATION
Proposed by Bailyn
Based on whether the prosthesis is tooth-borne,
tissue-borne ,or a combination of the two.

RPD

ANTERIOR(A) POSTERIOR(P)

Saddle areas anterior Saddle areas posterior

to First premolar to canine

SUB-DIVISIONS:

CLASS I :Bounded Saddle(not more than three teeth

missing. Tooth-supported

CLASS II: Free end saddle(there is no distal abutment

tooth). Tooth Tissue-supported

CLASS III: Bounded saddle (more than three teeth

missing ). Tooth Tissue-supported
MAUK’S CLASSIFICATION
 By Mauk in 1942

 Based on :
- number and position of the remaining
teeth
- number ,length and position of the
spaces
 CLASS I
Bilateral space with
no teeth posterior to it

CLASS II
Bilateral space with
teeth present posterior
to one space
 CLASS III
Bilateral space with
teeth present posterior
to both spaces

CLASS IV
Unilateral posterior
space with or without
teeth posterior to it
 CLASS V
Anterior space with
Unbroken posterior
arch

CLASS VI
Irregular spaces around
the arch
BECKETT’S SYSTEM
 Proposed by Beckett in 1953

 3 classes

 Based on whether the denture base is tooth-borne,

tissue-borne or a combination of the two

 Widely used in Australia

CLASSI
Saddles(denture bases )
which are tooth-borne

CLASS 2
saddles(denture bases)
which are mucosa-borne


 CLASS 3
inadequate abutments
and mucosa to support
the saddle
 FRIEDMAN’S SYSTEM

 Introduced by Friedman in 1953

 Based on three segments types :

‘A’ Anterior space
‘B’ Bounded posterior space
‘C’ Cantilever
‘A’ anterior space

‘B’ bounded posterior

space
 ‘C’ Cantilever
Posterior free –end space

‘C-A-B’space
CRADDOCK CLASSIFICATION
 By Craddock in 1954

 CLASSI : saddles supported on both sides by

substantial abutment teeth
 CLASSII: vertical biting forces applied to denture
resisted entirely by soft tissues
 CLASSIII: tooth –supported at only one end of the
saddle
SKINNER’S SYSTEM
 Given by C.N Skinner in 1957

 Based upon the relationship of the abutment teeth

to the supporting residual alveolar ridge

 Classified into 5 classes

 CLASSI
Teeth present both
anterior and posterior
to denture base

CLASS II
RPDs –teeth are
posterior
to denture base
 CLASS III
abutment teeth are
related anterior to
denture base

CLASS IV
denture base both
anterior and posterior
to remaining teeth
CLASS V
abutment teeth are
unilateral to denture base
WATT etal CLASSIFICATION
 IN 1958

Based on type of support derived

1. Entirely tooth-borne: denture rests on abutment
teeth
2. Entirely tissue-borne: denture rests on soft tissue
3. Partially tooth-borne and Partially tissue-borne:
rest both on tissue and teeth
APPLEGATE-KENNEDY SYSTEM
By O.C Applegate in 1960

Is a modification of Kennedy classification

Based on :
- ability of boundary teeth to supply abutment facilities
for the partial denture
-the location of the edentulous spaces in relation to the
teeth which remain
 CLASS I
All remaining teeth are anterior to bilateral edentulous
space
Most frequently occurring
Mandible(highest incidence)
 CLASS II
Remaining teeth of either right or left side are anterior to
unilateral edentulous ridge
 CLASS III
Edentulous space bounded by teeth both anteriorly and
posteriorly
 CLASS IV
Edentulous space lies anterior to the remaining teeth which
bound it both to right and left of median line
 CLASS V
-Edentulous space bounded anteriorly and posteriorly by
teeth but the anterior boundary tooth not suitable for
abutment service
-Mostly in maxillary arch
 CLASSVI
Edentulous space bounded anteriorly and posteriorly by
teeth and where boundary teeth are capable of total
support
SWENSON CLASSIFICATION
Proposed by Swenson and Terkla

4 classes based on relationship of edentulous spaces

to abutment
 CLASS I
Arch with one free end
denture base

CLASS II
arch with two free end
denture base
 CLASS III
Edentulous space posteriorly
on one or both sides but
with teeth present anteriorly
and posteriorly to each space

CLASS IV
anterior edentulous space
with 5 or more anterior
teeth missing
COSTA’S CLASSIFICATION
 By Eugene Costa in 1974 (Romania)

 Based on describing the partially edentulous spaces

 Terminologies used
Anterior- edentulous space in anterior dental arch
Lateral- edentulous space bounded both mesially
and distally by remaining teeth
Terminal- edentulous space not bounded distally
by remaining teeth
 Spaces identified starting from right to left
‘A’ Anterior

‘L’ Lateral

‘T’ Terminal
OSBORNE-LAMMIE system
 Proposed in 1974

-CLASS I: mucosa-borne
-CLASSII: tooth-borne
-CLASSIII: combination of I & II
WILD’S CLASIFICATION
3 classes:
 CLASS I –Interruption of dental arch(bounded)

 CLASSII-Shortening of dental arch(free end)

 CLASS III-Combination of I & II

Not well known in English literature

MC GARRY CLASSIFICATION
Developed by
The American College of Prosthodontists(ACP) in
2002 ,McGarry et al

Based on diagnostic finding and treatment planning

 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), abutment
conditions, occlusal characteristics, and residual ridge
conditions.
 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.
 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.
 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.
20.ICKClassification System
Sulieman S. Al-Johany, & Carl Andres , 2008

partially edentulous arches incorporating implants placed

or to be placed in the edentulous spaces for an RPD

The classification begins with the phrase "Implant-Corrected

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

(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.
BIOMECHANICAL CONSIDERATIONS
Biomechanics basically deals with application
of mechanical principles to biological tissues.
 designing an RPD should be based on thorough
understanding of the various forces that will act
on RPD : direction and magnitude of these forces,

 one can select the components of the RPD and

position them to counteract, control or minimize
these stresses, without compromising the health.
An understanding of simple machines should enhance our
rationalization of the design of R.P.D’s to accomplish the
objective to preserve oral structures.
Machines can be divided into 2 general categories:
 simple and
 complex.
The six simple machines are: lever, wedge, screw, wheel and axle,
pulley and inclined plane.
 
 ‘lever’ and ‘inclined plane’ deserve most of
our attention in designing a R.P.D.
Mechanical principles applicable in
Removable Prosthodontics
 Lever principle

 Inclined plane

 Snowshoe principle

 L beam effect
 Lever: A simple machine consisting of a rigid bar
pivoted on a fixed point and used to transmit
force, as in raising or moving a weight at one
end by pushing down on the other.

 The support point of the lever is called the

fulcrum,

 Fulcrum line of a removable partial denture:

(GPT-8): a theoretical line around which a
removable partial denture tends to rotate
 Three classes of levers (based on location of
fulcrum, resistance and direction of effort
(force).
Class I
Class II
Class III
Class I lever

Fulcrum lies in the centre,

Resistance is at one
end and force at the other.
 This type of lever can occur in patients with distal extension
partial dentures.

 The Direct retainer will be - Fulcrum,

 Effort end lies on the point- Area where the artificial teeth are
located

 Load is the region of the Anterior end of the major connector.

 Using AN ADDITIONAL REST (INDIRECT RETAINER) TO

SHIFT THE FULCRUM LINE PREVENTS LEVER ACTION IN
THESE DENTURES.
 A cantilever is a beam supported at only one end and can act
as a first class lever. A cantilever design should be avoided.

When force is directed against Cast circumferential direct retainer

unsupported beam, cantilever can act
as a first class lever.
Mechanical advantage is in favour of
effort arm
engages mesiobuccal undercut and is
supported by disto occlusal rest. If
rigidly attached to abutment it may
impart detrimental first class lever force
to abutment
Mesial rest concept for distal extension
removable partial denture

 Distal occlusal rest: Gingival extremity of

denture base adjacent to posterior abutment
tends to move in an arc towards the tooth
Mesial rest
 Mesial rest is to alter the fulcrum position and
the resultant clasp movement,

 disallowing harmful engagement of the

abutment tooth
Bar type of retainer, minor
connector contacting guiding plane
on distal surface of premolar, n
mesio occlusal rest used to reduce
cantilever force when denture
rotates towards residual ridge
Tapered wrought wire retentive arm,minor
connector contacting guiding plane on the
distal surface of premolar, and mesio occlusal
rest.
This design is applicable when distobuccal
undercut cannot be found or created or
when tissue undercut contraindicates placing
bar type retentive arm.
Class II lever

Fulcrum is at one end effort

at the opposite end and
resistance in the centre.
 This type of lever action occurs in indirect
retention of a rpd.

 when a displacing force tends to lift a denture from one

end(effort), the anterior most point of the major connector
will act as the axis of rotation (fulcrum), the intermediate
zone of the denture, which is lifted by the force, will form the
resistance of the lever.
Class III lever

Fulcrum is at one end,

resistance at opposite
end and effort is in the centre. this type of
lever action does not occur in partial
dentures.
 Inclined plane

Forces against an inclined plane may result in

•deflection of that which is applying the forces or

•
•may result in movement to the inclined plane,

• neither of these is desirable.

 If angle greater than 90 degrees

Forces not along long axis

Slippage of prosthesis away

from the abutment

Orthodontic like forces

Abutment severely tilted

 Snowshoe principle

This principle is based

on distribution of
forces to as large an
area as possible.

A partial denture should cover maximum area possible

within the physiologic limits so as to
distribute the forces over a larger area.
 L beam effect :
 This principle is applicable to the antero-posterior
palatal bar or strap major connector.

 In this component there are two bars /strap lying

perpendicular to each
other.
 The ant. and
post. bars are joined
by flat longitudinal elements
on each side of the lateral
slopes of the palate.

 The two bars lying in two different planes produce a

structurally strong L beam effect that gives excellent rigidity to
the prosthesis.
FORCES ACTING ON PARTIAL DENTURE

 Distal extension rpd will rotate when force is directed on the

denture base.

 Differences in displaceability of the periodontal ligament of

the supporting abutment teeth and soft tissue covering the
residual ridge permit this rotation.

 This rotation is in combination of directions rather than

unidirectional
 1. Fulcrum on horizontal plane:

 Extends through the principle abutments.

 Rotational movement of the denture in the sagittal plane.

 Greatest in magnitude n most damaging
Force on abutment
mesio-apical or disto-apical

(greatest vector in
apical direction)
 a) Denture base moves away from
supporting tissues:

Counteracted by:
direct retainer and indirect retainer
 b) Denture base moves towards the
supporting tissues:

Counteracted by:

• Occlusal rest
• Tissues of supporting ridge
 2. Fulcrum on the sagittal plane:

extends through the occlusal rest on the terminal

abutment and along the crest of the residual ridge on
one side of the arch

• Less in magnitude but can be damaging

 Counteracted by:

 Rigidity of major and minor

connector and their ability
to resist torque.

 Close adaptation of the

denture base along the
lateral slopes and the
buccal slopes of the palate
and ridge.

 Direct retainer design

  3. Fulcrum located in midline just lingual to the
anterior teeth (fulcrum is vertical)

Rotational movement of denture in horizontal plane

or
flat circular movements of the denture
 Counteracted by :

 Stabilizing
components
(reciprocal arm and
minor connector)

 Rigid major connector

 close adaptation of
denture base
CAUSES OF FAILURE OF CLASP RETAINED PARTIAL DENTURES:
 
Diagnosis and treatment planning
1. Inadequate diagnosis
2. Failure to use a surveyor properly during treatment planning
Mouth preparation procedures
1. Failure to properly sequence mouth preparation procedures
2. Inadequate mouth preparations
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 designs
4. 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 c. Incompatible impression
materials and gypsum products
2. Failure to provide the technician with 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
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 to recall
CONCLUSION
A removable partial denture designed and fabricated
so that it avoids the errors and deficiencies listed is
one that proves the partial denture can be made
functional, esthetically pleasing, and long lasting
without damage to the supporting structures. The
success or failure of a partial denture will depend
more than anything else upon the design used. The
design should conform to the requirement.
BIBLIOGRAPHY
1.Mc Cracken;Removable Partial Prosthodontics 11th edn.

2.Stewart; clinical removable partial prosthodontics 2nd edn.

3. Miller EL: Systems for classifying partially dentulous arches. J

Prosthet Dent 1970;24:25-40   
.
4.Applegate O.C: The Rationale of Partial Denture Choice J
Prosthet Dent 1960;10:891-907

5. Skinner C: A classification of removable partial denture based

upon the principles of anatomy and physiology. J Prosthet
Dent 1959;9:240-246  
 6. Costa E: A simplified system for identifying partially
edentulous dental arches. J Prosthet Dent 1974;32:639-645
 
7. McGarry TJ, Nimmo A, Skiba JF, et al : Classification system for
partial edentulism. J Prosthodont 2002;11:181-193

9 . Avant: universal classification for removable partial denture

situations .J prosth dent 1960;16:533
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