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Principles of Denture Design (Introduction (What design works? (In RPDs,…
Principles of Denture Design
Introduction
What design works?
In RPDs, the main concern is that the prosthesis is partially supported by teeth and partially supported by soft tissues
Design for tooth-supported RPDs (KCl 3) usually straight forward
Challenge lies with KCl 1, 2 and somtimes 4
RPDs are intended to be placed into and removed from the mouth --> so they cannot be rigidly connected to the teeth and tissues --> hence they are subjected to movement in response to functional loads
One that considers the physiologic limits of the supporting structures
Clinicians must be aware of
Possible movements in relation to function
Design the denture to help control these movements
Movements lead to stress on abutment teeth and tissues
Dentures should be designed according to biomechanical properties
It is important to minimise and distribute potentially destructive forces by proper design and procedures
3 surfaces of the denture to be considered
Fitting surface
Occlusal surface
Polished surface
Our objective should be the perpetual preservation of what remains rather than the meticulous restoration of what is missing!!!
Forces that act on an RPD
Vertical (towards or away from tissues)
Horizonta (lateral and antero-posterior)
Rotational
Explain the factors which are to be considered when designing an RPD
All dentures must be constructured with proper
Extension
Retention
Stability
Support
Hygienic considerations
Other considerations
Masticatory function
Path of insertion
Appearance
Cost
Comfort and oral health
Considerations in choosing path of insertion
Aesthetics
Retention
Interferences
Guiding planes
Demonstrate how to approach RPD design systematically
OSCARR!!
O- Outline Saddle
Considerations
How many saddles
Flange or no flange
How many teeth do you want to replace
Saddle consists of BASE and TEETH
Denture Base
A part of a RPD which rests on the oral mucosa to which teeth are attached
Made of acrylic resin and/or colbalt chromium
If some/ all of the support is gained from the mucosa/ underlying bone, important to have maximum coverage by the base
Teeth
Reducing occlusal table of posterior teeth -- important for success of mandibular denture especially free-end saddle cases
Reductino can be achieved by using less teeth or narrower teeth-- force to underlying tissues will be reduced
S- Support
the saddle
All masticatory load placed on an RPD is eventually transmitted to the underlying bone
C- Connect
A- and
R- Retain
(indirect and direct)
R- Reciprocate
Refine the design
List all mouth preparations
Follow colour scheme stated in design sheet for lab
Importance of completing the design sheet
Helps clinician to have an overview of the denture he is making
A means of communication between dentist and dental technologist (design sheets also termed prescription form by some)
A means of communication between clinicians
Damage to RPDs can be reduced by
Well-designed, fitting RPD
Patient's good oral hygiene