Removable Partial Denture
From WikiDent
Restorative treatment used to replace missing teeth, but is removable from mouth.
Indications
Article[1] states that projections from surveys suggest a possible decline in tooth loss but an associated increase of partial edentulism. Hopefully this is good for the future of prosthodontics. The article also attempted to identify evidence for proposed indications for RPD treatment.
Considered indications:
- Masticatory Function - research on SDA indicate no improvement if patient has 3 occluding pairs of posterior teeth.
- Nutritional Status - inconclusive
- Quality of Life/Tx Satisfaction - more significant improvement with the more teeth replaced
- Interactions between RPD and Oral Structures - increased risk for caries and periodontitis (not caused by RPD necessarily)
- TMD - no evidence RPD will prevent TMD
- Prophylactic Aspects - stabilize arch?...inconclusive
- Alternative Treatment Options - if possible, FPD treatment has better success. Other options: SDA concept, cantilevers, resin-bonded, implant.
- Contraindications - allergy???
No strong evidence exists for RPD recommendation. The more teeth missing the more possible benefit of an RPD. But RPD also increase complication of cleaning remaining teeth and risk of decay and periodontal disease.
Fit
The laboratory procedure for casting of a RPD framework is much more complex than that of a single crown. The fabrication of a refractory cast provides additional opportunity for casting error. A study[2] investigated the fit of RPD frameworks and found that less than 25% of the frameworks contacted the tooth where expected. Implication is that if rest is contacting only on marginal ridge than forces are not directed along root as planned. Careful evaluation and adjustment of fit recommended. Evaluation of fit can be accomplished by:
- Chloroform and rouge
- Fit Checker
- Disclosing Wax
