Clinical Guideline 20 Version 1

Valid to: March 2017

Provision of Removable Partial Dentures

Purpose
Evidence-based clinical guidelines are intended to provide guidance, and are not a standard
of care, requirement, or regulation. However, the application of clinical guidelines in
publicly-provided oral health services allows for consistency to occur across large patients
cohorts with a variety of oral health clinicians.
This clinical guideline details the procedure that should be followed to ensure uniform
assessment of all patients in which this treatment is to be provided.

Guideline
Clinical considerations
Clinical considerations for the provision of removable partial dentures (RPDs) and the type
of RPD to be provided will be determined by a comprehensive oral examination that
considers the patients;

Oral hygiene status

Remaining dentition

Location of remaining dentition

Periodontal health status

Carious lesions

Status of intra oral mucosa

Residual alveolar ridge and associated resorption

Tori

Occlusion

Existing prosthesis

Age/special needs/dexterity

Occlusal vertical dimension

Diagnosis and treatment planning

It is generally understood acrylic dentures worn over an extended period of time tend be
detrimental to overall oral health as they need to cover a greater area of oral mucosa to
maintain adequate strength (2). Many are often exclusively mucosa supported resulting in
vertical movement during mastication. These are the primary factors in the detrimental
effects of long term use of acrylic RPDs
Information obtained during the comprehensive oral examination will inform the diagnosis
and treatment planning options available.
Treatment planning options will include:

No provision of RPD treatment (1)

Provision of an interim RPD (2)

Provision of a transitional RPD (3)

Provision of definitive RPD (4)

Provision of a treatment RPD (5)

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1: No provision of RPD treatment

Indications: Would a fixed restoration be better for this patient?
Patient content with aesthetic appearance
Patient content with masticatory function
Existing tooth migration/over eruption minimal over a sustained period
Small edentulous areas distal of second pre-molar when asymptomatic
2: Provision of an interim RPD treatment (1)
An interim RPD is primarily indicated where the patients age, health or lack of time
precludes a more definitive treatment. Interim RPDs are predominantly produced from
acrylic resin unless the interim treatment is required for an extended period of time.
Indications: Inadvertent loss of an anterior tooth (Trauma)
Young patients where accident, undetected rapid caries requiring
extraction or hereditary partial andontia
Elderly patients where health, age and mobility are of concern
3: Provision of transitional RPD treatment

(2)

A transitional RPD is primarily indicated where the patient requires a functional prosthesis
as treatment continues in transition, as the patient loses remaining symptomatic dentition.
Transitional RPDs are constructed from acrylic resin in order to facilitate the addition of
acrylic teeth during this transition. A transitional RPD is used during transition to the
definitive treatment.
Indications: Poor oral hygiene
Periodontally involved dentition with poor prognosis
Advanced carious lesions
Dental health awareness of patient is limited
4: Provision of definitive RPD treatment

(3)

A definitive RPD is typically defined as one that incorporates a cast metal framework. A
definitive RPD is primarily indicated where the patient requires treatment to restore the
occlusion or aesthetics of a partially edentulous area and presents with good oral health
status and good oral health awareness.
Indications: Good oral hygiene
Good periodontal health
Suitable abutment teeth to support RPD
Presence of tori (acrylic denture not possible)
Insufficient space in the edentulous area for acrylic denture
Occlusal parafunctional habits
It is generally understood that a definitive RPD with a cast metal framework provided in the
right conditions will result in a longer lasting prosthesis that is less likely to be detrimental
to the overall oral health of the patient.(5)

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5: Provision of a treatment RPD treatment

(1)

A treatment RPD is typically defined as an RPD that used as a vehicle to provide a

temporary course of treatment. Treatment RPDs are most commonly constructed using
acrylic resins.
Indications: Carrier of tissue treatment material where traumatized tissues are
present
To restore or increase vertical dimensions (4)
To provide splinting following immediate extraction or other surgical
corrections in the oral cavity
Follow-up
All patients provided with a removable partial denture should be provided with a
comprehensive list of instructions for the use of their RPD. Patients should be informed that
minor adjustments may be required if the patient experiences problems with fit, function or
comfort/tolerance. Removable partial dentures generally require a level maintenance that
exceeds that of fixed restorations. A definitive RPD constructed with a cast metal
framework that is supported by edentulous ridges and abutment teeth will require relining
or rebasing over time. Patients with a definitive RPD should ideally present for an oral
health check-up annually. In the absence of an annual oral health check-up a patient who
has been provided with a definitive RPD should be advised to seek a review according to
the current DHSV public oral health waiting list guideline (6).
Patients provided with an interim RPD, a transitional RPD or a treatment RPD will be
followed up in line with the treatment plan as required.

Definitions
Nil

Revision date
March 2017

Approved by
Director of Clinical Leadership, Education
and Research

Policy owner
Clinical Leadership Council

Date approved
March 2014

References and related documents

(1) Stewart. Rudd. Kuebker; Clinical Removable Partial Prosthodontics, 2nd edition, Ishiaku
EuroAmerica Inc, 1992.
(2) John D. Jones/Lily T. Garcia; Removable Partial Dentures A Clinicians Guide, 1st edition,
Wiley-Blackwell, 2009
(3) Dr Sybille K Lechner/Prof A Roy MacGregor; Removable Partial Prosthodontics, a caseorientated manual of treatment planning, 1st edition, Wolfe publishing, 1994
(4) Journal; Quintessence International, Volume 43, Number 5, May 2012; Safety of
increasing vertical dimension of occlusion: A systematic review. Dr Jaafar Abduo, BDS,
DClinDent. Associate Professor in Prosthodontics, Faculty of Dentistry, University of
Western Australia.

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(5) The Journal of Prosthetic Dentistry; Survey of partial removable dental prosthesis
(partial RDP) types in a distinct patient population. Deo K. Pun, DMD, MS,a Michael P.
Waliszewski, DDS, MsD,b Kenneth J. Waliszewski, DDS, MS,c and David Berzins, PhDd
Marquette University, Milwaukee, Wis
(6) Dental Health Services Victoria. Waiting List Guidelines - Oral Health Program. October
2011, pp 11.

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