I

PRACTICE

prosthetics

5
A system of desig n
s n

J. C.

Davenp ort,1 R. M.

Basker,2 J. R. Heath,3 J. P. Ralph, an! P"#. $lant%,5

In th&s part, -e -&ll !&s'+ss
Design sequence Design example

Th&s ! o* nents !es&,n an! &n!&'ates 'o))+n&'ate! art&'le (+&l!&n &nto an ho- the !eta&ls o* 'learl. to the !ental !es'r& , RPD te'hn&'&an. (es a 'o)po e**e't&ve the !es&,n 'an (e )etho
Reviewing the designs Design prescriptio

t wi ll alr ea dy be ap pr ec iat ed

th at an R P D is th e su m of

a of the series design to the dental impornum we describe atechnician. tant stages of method of It must of course be surveying the ber building these remembered that the cast and of components design sequence is selecting a com into a design but one stage of the path of pone and emphaoverall treatment plan insertion. nts. size the for a partially eden!he In importance of tulous patient and is following this clearly underta en after two part detailing the completing the alle"amples sequence.
has two bounded

illus #. $addles. trate %. $upport. how &. Retention. to '. (racing and appl reciprocation. y ). *onnector. the +. Indirect retention. basi ,. Review of c completed design. !o help with

different identification- colours the various RPD components are illustrated in

. prin cipl es of design using the following

Ex ple am 1 Fig.
.
1*

Example 1
This maxillary arch

edent areas on the right edentulous teeth have Tooth !" disto& area on the small #$"% is buccally ulous side and a distal left. The crowns. rotated extension

E ; Leeds als %#& University of mer 2Pro and "rust, Leeds, *anchester, and itus fess onsu UK; onsultant in Prof or ltant '#onorary !estorative esso of !esearch Dentistry, entral r, Den in *anchester Uni tal !estor (ello), #ealthcare "rust, vers Pros ative University ity theti Dentis of *anchester *anchester, UK; of cs, try, +(ormerly onsultant in Bir !estorative Uni Leeds &enior min "each Lecturer in Dentistry, Leeds gha vers m, ity ing !estorative "eaching #os$itals %#& "rust and UK of #os$it Dentistry,

&enior linical Lecturer, University of Leeds and #onorary .isiting Professor, entre for Dental &ervices &tudies,

Unive onsultant in lic0:com !E(E!EED rsity Prosthetic of Dentistry, (aculty of P7PE! < British /or0, 2dontology, Dental /or0, University of UK; *almo, &)eden =ournal 1 Prof * orres$ondence 2666; 1>?3 essor to3 1 .ictoria !oad, 1>@A1?6 of #ar4orne, Prost Birmingham B15 hetic 678 Denti email3 stry, 9ohn:daven$ort;4tc

/epublished ed parts1 p+(l&'at& in the in the ons0 (D01 boo s 7 All the have been linical parts included 8uide to which /together !emova4l comprise with a e this series number Partial /which of Dentures will be unpublish +I$(2 3-

43')55)441 and 7 linical 8uide to !emova4 le Partial Denture Design

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$ el up a lo po is no +t has d w rt Saddl requireme been d 1 /re es nt for a decid le a d1 and ed to labial s n Fi suppo use a flange at 9close / d g. rt y s 2 There R8#18%. d9
desig A t e oblem totally C a loa s tooth& li di d associ supporte ni st fro ated d2 c al al e m with additional G xt a differe support ui e m ntial must be d n axi suppo gained e llar rt are from to si y not so palatal R o R mar:e coverage e n < d here m s D as o a v d ca they a dl n are in bl e be the e wi dis mandi P tri ble. a th bu Rest rti a te seat al m d prepar e wi ation e si nt al del is u re y planne r st ov d for e . er the th three e - e teeth. si o ha /s it is g w rd not n e pal possib to v s er at le to u 2 e ma:e p a th this p s e dentur or pr e th

n as the The for short saddl all clinical e thr crowns must ee offer be sa limited fully dd prospects exten le for clasp ded in s retention. the

distal w exten or: saddle requi sion will be s to red. edent reque enabl To ot ulous sted e h area. for the them su ,pace two to be d poster reline pp d ort mesh ior when is

t d on R; o #1;%2 R" b #1"% and e !" #$"%. g *ecause a !" #$"% is i rotated2 a n mesial rest e would be

very visible tooth. This 1 and conflicts with R unsightly. advice given The occlusal elsewhere in rest is our *D0 therefore publication placed on the 1 distal aspect of the

R" #1"% n of R e te to e n nti obtain and !" the t 1 o clasp #$"%%. dent Thus ure eFn n i +t retenti supplem base entary into ti g is on retention the from o. must be left pr n ! only obtained bucc ac / three by wide al g tic teeth palatal sulcu r R ab # R; coverage s and e e le #1;%2 2 full

n d by d contact th with the e guide lef surfaces t which tu will be b prepared er on the os abutmen ity t teeth. /s 2 a most extensio arou n of the

un sio ble to bony only der buc use a under reas cut cal gingiv cut in onab on aspec ally the le R t2 a appro buccal alter ; 9ring9 achin sulcus nativ #1; clasp g . /s e2 % is is a clasp an wrou situ suitab on occlus ght ate le R" ally gold d desig #1"% appro wire on n. +t is becau aching has its not se of clasp been me possi a is the chos

en xibility for occlusally d be the short approaching 9 ca clasp arm to clasp is to be reciprocatir us function used here e it efficiently. also. po /s a on /blue1 ss prominent (racing Fig. " es fraenum #racing se precludes a s gingivally and suf approaching and reciprocati fici clasp on on ent !" #$"%2 a +t has been fle wrought gold

of all retent ive arms2 thus provi ding cross &arch recipr ocatio n

*t pa ate saddle o o lat away from n r al from moving n a the occlusall e n co anteri y. The or ma>or c d ve teeth clasp t i ra and axis is o n ge from sited r d by the through / ir th sensit R; b e e ive #1;% and l c area !" a t co aroun #$"%. c r nn d the The
e ec 1 t tor e papill a e is a to n n ne prom d ti ed ote i o ed hygie n n . ne -

incisiv mesial occlusal rest on R" #1"% will be the indirect and retainer d =o ir w tolera to resist e or ev nce tothe c th er2 the displacin t e it frame g force wor:. r re is +t is e a po nec t s ssi ess e bl ary n o e to ti n to pla n o s :e ep n gi th for indi Fv e i e an rect ret g n ter enti . ior on al $ bo to re rd pre a er ven of t Cd th the o y2 e n w pa dist n id lat al exten e al sion e c pl

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prost heti cs
stage2 treatment should plan be has drawn and that been to proved on chec: completed a proforma to that be the necessary. the to design provisional provide easy design reference the four should principles be that have con or satisfies Design prescription Rigi / provisional R<D design2 produced at the initial treatment planning completed any other -aving and restorative been updated shown treatment in the the promote design is of being any continued it is changes carried important oral out. in health the to 1nce review treatment #this the result dlight nect Fig% while & reviewed esign prescription to
.

Fig. cast. 'confirmed will The esign improve use The of prescription dental resulting aclarity. different include technician definitive technician details coloured with of with the R<D the lead will the retentive materials design be to final as:ed that impression. prescription clasps used to tobe construct inon used. the The survey R" is+n given a #1"% this prescription cobalt and case to the chromium the !"must dental #$"% being casting made from 7.( mm wr o ught gold wire The design should also be drawn on the surveyed master
. .

Fig. ( planning )*e completed +rame,orfr amewor: 6areful and clear prescription result in the required metal
gap ts ")% has the tilte !R #" extension edentulous area. Example $ en )arch This mandibular a siall unilateral distal !R # and Fig. . betwe Example 2 me y / exis
01

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clus on $ aFs req al th di p uir table e dga ed will di be st l. c to used al e1 to su s/e en redu rfa d abl r e the of / y e the load !! eSt sa fallin " l aa ddl g on #8 the "%. ld odi e tissu n to es of w l 1 ei be the eden asn reli tulou ne n gd s damfoll area ce ce

2 R 3 2 R

sd ng / u s alv clos psh eol ed puwar desi opo res gn r pr orp will be t o: tio used n. / / to r r wnar provi t e ill ro de d/b w recip 1 e oc rocat
ion

ne owi .

Tp t op h ot oe hrt s sfoa ur d

d ll l be e ga in w ed i fr

o e us #8 ea ble su s m si al "%. te m pp a al rest Th st uc ort d ao on e po os for dl c !!" m cl gr ssi a the e

i hieve sd by exten ading cthe

dentur pear& f e shape u base d pad onto and to the the

th e ar ch it

is to e ph can rests im sp suppo r ebe have po re rt so osprodu been rta ad that a si ced2 place nt th stable t sthus d on

!R" #""%2 !R) #")% and

!R( #"(%. The occlu sal

rests e the teeth. s on the gap Rest c molar betwe seat a s en the prepa bridg two ration e

R ei en1 entio di al te io s eno/g Fig. t n st ex ns n a t t nre 11 R eThe

.

dle will caref shap e dbe ully ed to m u

all a iv appro csto be !!" clasp one onent the m t o gi all achin l pused #8"%. will of the s R<+ and o w ng y g a on This be comp for syste the th mi r nnect t r ugh bucc braci arm !R) and tissu t hothe al ng on #")% to the es of h e e no co ors2 d g h

( ai g d p oati /b e1 g. 2 # aing recip ion a rcnan reci r con lu Fi 1 r cand rocat !ater

* oc ar. pos c f !R) oni Thi sibl t r #")% nne s e in i o ne co the v n ecn nn emb e t rasu ct t ect res i o t od or bet n f or e will wee d t h rap be n ie /nt rigi the r bdh d teet e c l an h so c l ai i d that t a will cnn av the re s
nti 1i h co ewo r: o ar e veris n a neli ag well fo x dc e toler r i ated th t i r g the by e neu gin the di dt a giv pati st ent. al i el al ma rns rgi T ex et u ns. h te e ns c Th o io il t e ccn o r c thr lu sa nu ee n of s p a s s i n g t h r o u g h ! ! " # 8 " % a n d

dt oid

fram te

e t s mi eTf no nho r t e co r nn i r ect oea ors n s will

s d al dl re e st b o ec n a ! us Re " it F u be #" is i i b pla "% p gsli ce wi os . nd ll iti 1s as pr o g !u un o n u obt vi e f rus d d a f ive e w l ef ell i ly C b as fe in

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dental Example +n technician this instance 1.prescription a the clearly casting proforma will be then constructed as described in for cobalt chro mi u on m as all o whole y labelled Design prescription Fig. 1" esign The design is reviewed described in =ig. ) and given to the

Fig. 1$ esign prescription dictates is wise to shape draw the and outline location of of the the connector sublingual the .evertheless2 cast to avoid any it mis uthe n der st a ndin g a bout its requironbar. The shape of the lingual sulcus2 faithfully recorded on the cast2

Fig. m et 1& al fr )*e a mecompleted w or : 6areful planning and clear +rame,orprescription again result in the required
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