INTRODUCTION AND
CLASSIFICATION OF
REMOVABLE PARTIAL
DENTURES
KEERTHANA R
 The branch of prosthodontics concerned with the replacement
of teeth and contiguous structures for edentulous or partially
edentulous patients by artificial substitutes that are readily
removable from the mouth. (GPT8)
REMOVABLE
PROSTHODONTICS
 REMOVABLE PARTIAL DENTURE is defined as any
prosthesis that replaces some teeth in a partially dentate arch.
It can be removed from the mouth and replaced at will – also
called as partial removable dental prosthesis. ( GPT 8).
TYPES OF
RPD
Acrylic partial
dentures
TYPES
Cast partial
dentures
• Clasp retained
• Attachment
retained
Tooth supported
RPD
A partial denture that
receives support from
the natural teeth at
each end of the
edentulous spaces
Based
on
support
Tooth-Tissue
Supported RPD
The denture base that
extends anteriorly/
posteriorly and is
supported by teeth at
one end and tissue on
the other end – distal
extension partial
dentures.
INTERIM DENTURE
• Enhance the esthetics, stabilization and/or function for a limited
time
• Later replaced by definitive prosthesis
TRANSITIONAL DENTURE
TEMPORARY
RPD
• An interim denture in which artificial teeth are added as natural
teeth lost
TREATMENT DENTURE
• Used for the purpose of treatment or conditioning of tissue
• Post surgery
 Abutment: Any tooth or a portion of a tooth that serves to support
and/or retains prosthesis.
 Retainer: The fixation device, or any form of attachment applied
directly to an abutment tooth and used for fixation of the prosthesis.
TERMINOLOGIES
RELATED TO RPD
 Retention: Quality of denture which resist the vertical forces of
displacement.
 Support: The resistance to displacement towards the basal tissue or
underlying structures.
 Stability: Quality of the prosthesis which resists displacement by
functional, horizontal and rotational forces.
 Cross arch stabilization: Resistance against dislodging forces
obtained by using a partial removable dental prosthesis design that
uses natural teeth on the opposite side of the dental arch from
edentulous space to assist in stabilization.
COMPONENTS OF RPD
COMPONENTS
OF RPD
a.
b.
c.
d.
e.
f.
g.
h.
Major connector
Minor connector
Rest
Retentive arm
Reciprocal arm
Denture base
Replaced teeth
Indirect retainer
 Long span edentulous situation
 Trauma cases (extensive tissue and bone loss)
INDICATIONS
FOR RPD
 Immediate gratification to the patient
 Atraumatic tooth replacement
 Abutment tooth are not periodontally sound
 Generalised poor periodontal status
 Young patient (adolescent)
CONTRAINDICATIONS
FOR RPD
 Patient’s preference
 Patient who lack dexterity to insert prosthesis
 Mentally and Physically challenged patients
 Patients who do not care to maintain oral hygiene
 Non ambulatory patients
EXTRAORAL FACTORS
INTRAORAL FACTORS
 Distal extension cases
 Age
FACTORS
DETERMINING
SELECTION OF
RPD
 Sex
 General health
 Occupation and economic
status
 Patient desires and attitude
 Time factor
 Long edentulous span
 Reduced periodontal support
 Cross arch stabilization
 Excessive residual ridge
resorption
 Aesthetics
 Immediate replacement of teeth
 Obturation of defects
 Alteration of vertical dimension
 Poor prognosis for complete
dentures
ADVANTAGES
Advantages
and
disadvantages
 Less Cost
 Relatively easy to construct
 Easy to modify (e. Additions
to denture)
DISADVANTAGES
 Weak material
 Non-rigid
 Must be bulky for strength
 High potential for damage to
soft tissues
CLASSIFICATION OF
PARTIALLY
EDENTULOUS ARCHES
 Help in communication
 To formulate a good treatment plan
NEED FOR
CLASSIFICATION
 To anticipate the difficulties that commonly occurs
 To design a denture according to occlusal load
 To create an order from innumerable possible combination of
teeth present and edentulous spaces
 Allow visualization
REQUIREMENTS
OF
CLASSIFICATION
 Allow differentiation between tooth supported and tooth-tissue
supported partial dentures.
 Serve as a guide to the type of design to be used
 Be universally accepted.
KENNEDY‘S CLASSIFICATION
Edward Kennedy in 1923
Based on the relationship of the edentulous spaces to the abutment teeth
 CLASS I-Bilateral edentulous areas located posterior to the remaining natural teeth.
 CLASS II-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 crossing
the midline.
APPLEGATE‘S MODIFICATIONS
Dr. O C Applegate in 1960
Based on the Capability of the abutment tooth
. CLASS V-Kennedy’s Class III edentulous space in which the
anterior abutment (eg. Lateral incisor) is not suitable for the
support.
. CLASS VI-Kennedy’s Class III edentulous space in which
teeth adjacent to the edentulous space are capable of total
support of the required prosthesis.
APPLEGATE’S RULES
Rule 1: classification should follow rather than precede
extractions 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 the third molar is present and is to be used as an
abutment, it is considered in the classification.
Rule 4: if the second molar is 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.
 Rule 6: edentulous areas other than those, which determine the classification, are referred to
as modification spaces and are designated by their number.
 Rule 7: the extend of the modification is not considered, only the number of edentulous areas.
 Rule 8: there can be no modification areas in class IV. Because any additional edentulous
space will definitely be posterior to it and will determine the classification.
MERITS
 Simple and universally
acceptable
 Easy to communicate
 Permits visualization
 Type of support can be
determined
 Number and location of
edentulous spaces can be
determined
 Provides design for each class
DEMERITS
 Does not assess the choice,
number, location and
condition of the abutment
teeth.
 Assessment of the hard and
soft tissue status not
possible.
 Does not indicate the
position of individual tooth.
 Does not permit assessment
of occlusion.
CUMMER’S CLASSIFICATION
Cummerin 1930
Based on Number and position of direct retainer
 CLASS I-DIAGONAL: 2 diagonally opposite teeth are chosen as abutment teeth for the attachment of
direct retainer.
 CLASS II- DIAMETRIC: 2 diametrically opposite teeth are chosen as abutment teeth for the attachment
of the direct retainers
 CLASS III-UNILATERAL: one or more teeth on the same side chosen as abutment teeth for the
attachment of the direct retainers.
 CLASS IV-MULTILATERAL: three or more teeth are chosen as abutment teeth for the attach-ment of
the direct retainers, disposed in a triangular or quadrilateral
MERITS
 Helps in design
 Allows analysis of support
available
DEMERITS
 Edentulous area has no
representation
 Number or class of teeth not
elaborated
BAILYN’S CLASSIFICATION
Bailyn in 1928
Based on support- tooth borne, tissue borne or combination
He divided all removable partial dentures into:
1. Anterior restorations (A) where saddle areas (denture bases) are
anterior to the first bicuspids.
2. Posterior restorations (P) where saddle areas (denture bases) are
posterior to the cuspids.
These were divided into three classes:
Class I: Bounded saddle, replacing not more than three teeth - tooth
supported.
Class II: Free end saddle, no posterior abutment-tooth-tissue supported.
Class III: Bounded saddle, replacing more than three teeth - tooth-tissue
supported.
The designations could be AI PII, AII PI, AI PII depending on the combination
of available edentulous spaces
MERITS
 First to emphasize the
importance of support
DEMERITS
 No immediate visualization
of partially edentulous arch.
 No representation of
individual teeth involved
NEUROHR`S CLASSIFICATION
Neurohr in 1939
Based on the type of support
Class I : Tooth bearing
Unilateral or bilateral case falls under this class when there are teeth present
posterior to all spans and when there are no more than four teeth missing in
any space
VARIATIONS
VARIATION I : Missing posteriors
predominate
VARIATION 2: Missing anteriors
predominate
A) Posterior teeth are missing ,anteriors
are present
A) Anterior teeth are missing and
posterior are present
B) Posterior teeth are missing and some
anteriors are also missing
B) Anterior teeth are missing and some
posteriors are also missing
Class II: Tooth and Tissue Bearing
A unilateral or bilateral partial denture situation falls under this classification
when there are no teeth posterior to one or more spans or when there are more
than four teeth (including a cuspid) in one or more spans.
Division I: When there are no teeth posterior to one or more spans:
Variation 1: Missing posteriors
predominate:
Variation 2: Missing anteriors
predominate:
A. Posterior teeth are missing, anteriors
are present
A. None
B. Posterior teeth are missing, and some
anteriors are also missing
B. Anterior teeth are missing and some
posteriors are also missing
Division II: Has teeth posterior to all spans, but there are more than four
teeth missing (including a cuspid) in one or more spans.
Variation 1: Missing posteriors
predominate:
Variation 2: Missing anteriors
predominate
A. None
A. Anteriors missing, posteriors are
present
B. Posterior teeth are missing, and
some anteriors are also missing
B. Anterior teeth are missing, and
some posteriors are also missing
Class III – Tissue bearing complete dentures
MERITS
DEMERITS
 Classifies on the basis of
length of span, hence
provides an idea about
support required.
 Complexity
 Defines the dominant
edentulous area of concern
 No representation of
individual teeth
 Does not provide the location
of edentulous span- side,
quadrant, etc.
MAUK’S
CLASSIFICATION
Mauk in 1942
Based on
1.number, length and
position of spaces
2.number and position of
remaining teeth
1.
Class I: Bilateral posterior spaces and teeth remaining in a
segment in the anterior region
2.
Class II: Bilateral posterior spaces and one or more teeth at the
posterior end of one space
3.
Class III: Bilateral posterior spaces and one or more teeth at
the posterior end of both spaces
•
•
•
Class IV: A unilateral posterior space with or with out teeth at the posterior end of
the space. The arch is unbroken on the opposite side
Class V: An anterior space only. The posterior part of the arch is unbroken on
either side
Class VI: Irregular spaces around the arch. The remaining teeth are single or in
small groups
MERITS
DEMERITS
 Differentiates between
unilateral and bilateral cases
 No clear representation with
respect to multiple
edentulous spans
 Differentiates between tooth
supported and tooth+tissue
supported edentulous spans.
 Number of teeth missing per
span not described
 No representation of
individual teeth involved
GODFREY'S CLASSIFICATION
Dr. R J Godfrey 1951
Based on location and extent of edentulous space
CLASS A: Tooth borne edentulous span in the anterior region
of the jaw.
CLASS B: Tooth & tissue borne edentulous span in the
anterior region of the jaw
CLASS C: Tooth borne edentulous span in the posterior region
of the jaw
CLASS D: Tooth and tissue borne edentulous Span in the
posterior region of the jaw.
MERITS
 Differentiates between
anterior and posterior
edentulous spaces
 Differentiates tooth and
tissue supported edentulous
spans
DEMERITS
 No description about
unilateral/bilateral
edentulous situation
 Quadrant wise location not
provided
 No representation of number
or type of teeth missing in
the edentulous span
BECKETT’S CLASSIFICATION
 Class I: Saddles (denture bases) that are entirely tooth supported
with sound abutment teeth.
 Class 2: Saddles that are entirely mucosa supported. These may
be of two types:
Beckett in 1953
Based on
1. The quality of abutment
support
2. The magnitude of
occlusal support.
3. The harmony of the
occlusion.
4. The quality of the
mucosa and residual ridge.
 1. Free end saddle.
 2. Bounded saddle where the length of the saddle or condition of
the abutment teeth contraindicates a tooth-borne saddle.
 Class 3: Saddles that are tooth-borne but abutment teeth are not
capable of providing total support.
MERITS
DEMERITS
 Anteroposterior location of
saddle not specified.
 Kind of support, quality of
support specified for every
individual edentulous span.
 Quadrant wise location not
provided.
 No representation of exact
number or type of teeth
missing in the edentulous
spans.
FRIEDMAN’S CLASSIFICATION
 A:Anterior edentulous space
 B:Bounded posterior edentulous space
 C:Posterior free ended or cantilever edentulous space
 Each of these is further Sub classified into:
Friedman in 1953
Based on
Location of edentulous
space
 1. Single missing tooth
 2. Two or more continuous missing teeth
DEMERITS
MERITS
Simplicity
• Quadrant wise location not
provided.
• No specification about unilateral or
bilateral case
• No representation of exact number
or type of teeth missing in the
edentulous spans
AUSTIN LIDGE CLASSIFICATION
 Anterior space or spaces (A)
 Posterior space or spaces (P)
 Bilateral spaces (Bi)
DEMERITS
Austin and Lidge in
1957
Based on
Position of teeth
MERITS
1.First to classify in a
unilateral & bilateral
perspective
2.Provision for
visualisation
1.Quadrant not
defined
2.No representation
of exact number or
type of teeth
missing in the
edentulous spans
SKINNER’S CLASSIFICATION
CLASS I
Skinner in 1957
Based on relationship
of the abutment teeth
to the supporting
residual alveolar ridge
Abutment teeth located both
anterior and posterior to
denture bases, spaces may be
unilateral or bilateral.
CLASS II
Abutment teeth located
posterior to the denture base.
CLASS III
Abutment teeth located
anterior to the denture base,
spaces may be unilateral or
bilateral
CLASS IV
Denture bases located both
anterior and posterior to
abutment teeth, may be
unilateral or bilateral.
CLASS V
Abutment teeth are unilateral in
relation to denture base.
MERITS
 Defines the relation of the
abutment teeth to the
edentulous space in an
anteroposterior and saggital
plane, providing an idea
about the support available.
DEMERITS
 Quadrant not defined
 No representation of exact
number or type of teeth
missing in the edentulous
spans.
SWENSON CLASSIFICATION
 CLASS I: Arch with one free end denture base
 CLASS II: Arch with two free end denture bases
 CLASS III: Arch with edentulous space posteriorly on one or both
the sides, but with teeth present anteriorly or posteriorly to each
space.
Swenson in 1963
Based on location of
edentulous space in
relation to the abutment
teeth
 CLASS IV: Edentulous space located anterior to the remaining
natural teeth.
 Subdivisions : Anterior(A) , Posterior(P) and Anterior&Posterior
(AP)
MERITS
 Classifies on the basis of
support available and allows
for anteroposterior design to
be visualised
DEMERITS
 Criteria for dominant and
subdivided edentulous space
not described.
 No representation of exact
number or type of teeth
missing in the edentulous
spans.
Diagnostic criteria for evaluating for classification
1) Location and extent of the edentulous areas
2) Condition of abutments
ACP
Classification
3) Occlusion
American college of
Prosthodontics 2002
Each criteria is subdivided into
4) Residual ridge characteristics
CLASS I – Ideal or minimal compromised
CLASS II – Moderately compromised
CLASS III- Substantially compromised
CLASS IV – Severely compromised
MERITS
DEMERITS
. Provides a clear description of
. Edentulous areas have no
quality of support ,condition of
edentulous foundation
individual representation with
respect to location of tooth
. Demarcates between shorter
and longer edentulous span hence
classifying the kind of support
required