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RPD SUPPORT

SUPPORT: Means To Bear. RPD Support: Ability of RPD to:


- Bear occlusal forces / stresses. - Resist tissue-ward displacement / sinking. Influenced by: - Ridge, DST & Teeth Conditions. - Denture Design Feature.

RPD SUPPORT

RPD SUPPORT: Mucosa Support:


Mucosa & bone underneath not made to support RPD. A given force displace mucosa 10-times > than the: - amount of tooth-intrusion into its socket. Recovery of displaced mucosa: visco-elastic as to: - purely elastic recovery of PDL. Upon load removal: Mucosa recovers in 72 Hours: - compared to PDL recovering instantaneously. Mucosa underneath a denture remain deformed. Cortical bone underneath firm mucosa provide: - good support & stable foundation. > Support potential: U-shaped ridge (Height & width).

RPD SUPPORT

RPD SUPPORT: Mucosa Support:


Upper RPDs: Wider tissue coverage by RPD base. Palatal Plate provide better support. - Good Areas: Hard palate, tuberosity. Saddles & Support & RPD Design for a: - DES & Post. Bounded Spaces in the same upper arch: - Recommended design: Horse-shoe design RPD. Saddles Extension on Bounded space side: -1/3 area b/w ridge crest & midline of palate. Saddles Extension for Free-ended space: - 2/3 1/2 area b/w ridge crest & midline of palate. Lower K-I & K-II RPDs: FES / DES RPDs: Base extended to E.O.R / Buccal Shelf.

RPD SUPPORT

RPD SUPPORT RPD SUPPORT:Mucosa Support (Contd):

RPD SUPPORT

RPD SUPPORT: Every RPD (Dyer 1972): Utilize design principles of Spoon denture: - a space maintainer & RPD in children: - replacing missing upper anterior teeth. Best example of mucosa-supported RPD. Design features: Denture base well-away from FGMs. Denture base on displaceable palatal mucosa: - pin-damming / food-lines carved (seal). - Base sealed on lateral NV bundles. Posterior border extended upto Ah line.

RPD SUPPORT

RPD SUPPORT: Every Design RPD (Contd):


Point contact with natural teeth: - located near the occlusal surface. - leaving easily self-cleaning space below: - contact points b/w natural & denture teeth. OI Free Occlusion in CR & Excursions. Use teeth narrow BL dimensions if multiple saddles. Incorporate labial flange for A-P bracing of RPD. Incorporate metal wire or acrylic distal posts: - on last erupted teeth in arch for P-A bracing. Adams Clasps OR No Clasps .

RPD SUPPORT

RPD SUPPORT: Lower FES RPDs: Differential support problem. Mesially teeth provide support for DEB of RPD. Distally DEB of RPD supported on mucosa. Mucosa more displaceable than PDL of teeth. Such RPD if made on cast made of impression: - recorded in muco-static imp. material will: - be unstable during function b/c of mucosa: - yielding under load & causing sinking of RPD. Tilting forces & torque on premolar abutments. Damage their PDL and lead to their loss.

RPD SUPPORT

RPD SUPPORT: Lower FES RPDs: 3-ways to solve problem of differential support: 1. Chair-side / Intra-oral Reline of RPD: - Done at the RPD insertion stage using: - close mouth impression technique &: - Hi Mol. Wt intraoral self-cure resin. 2. Flexible / Stress-breaker connection in RPD: - allows independent movements of: - tooth-borne & tissue-borne parts of RPD. Technically difficult approach. Skills not available universally. RPD distortion & Tissue impingement.

RPD SUPPORT

RPD SUPPORT: Lower FES RPDs: Solving problem of differential support (Contd):
3. Recording Controlled displaced state of tissues by: - Altered Cast Impression Procedure (ACIP) to: - fabricate a Stable, Well-fit & Rigid RPD. ACIP (Applegate 1959): 2-Step Procedure: 1. Impression Step: Fabricate metal FWK & Try in mouth. Add temporary acrylic bases with its fitting surface: - relieved from ridges by 0.25mm relief spacer. Controlled displaced state of mucosa obtained by: - painting molten wax (Kerr. Correcta wax No.4): - using a camel hair brush. (Contd)...

RPD SUPPORT
RPD SUPPORT: Lower FES RPDs (Contd): Solving problem of differential support (Contd): Upon each layer of wax, FWK is inserted in mouth. FWK held stationary & pressed in place by; - firmly holding it thru lingual major connector. No pressure on temporary bases. Continue painting molten fluid wax on fit surface until: - even, smooth & glossy fitting surface obtained. 2. Cast-altering step: Done on master cast on which FWK was tried / fitted. FES areas of cast cut with frit-saw (wire saw). Fit Trayed FWK to altered cast (No FES parts). Add new FES areas to cast by pouring stone mix.

RPD SUPPORT
RPD SUPPORT: Lower FES RPDs (Contd): Solving problem of differential support (Contd): When set, remove temporary bases from cast. Add wax bases & occlusal rims to FWK. Register MMR & face-bow transfer records. Establish occlusion on articulator. Prepare waxed-up RPD for trial. On Trial, accomplish final wax-up & seal RPD on: - new altered cast. Invest, de-wax, pack mould and process / finish RPD. Fit RPD in mouth. Review & Recall visits.

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