do you recommend a retentive clasp (as shown in the design) in a pier abutment situation? theoretically, no retentive components except the rests, or did I get it wrong sir?
Thanks Professor for these amazing videos! I have an exam tomorrow in designing RPDs and I think I can now ace it because of your simplified explanations!! God bless you
Professor Paul, if you have time, could you please explain why the stops "occlusal rests" are added to the strengthened above the caps, for metallic support to the male part of locator attachments? Why not incorporate them directly into the strengthener bar, so the strengthener and processing caps are directly over the implants and centred on the ridge instead of having occlusal stops out labially?
@@valyamertarchyan9560 I add the contact stops to the caps to dissipate the occlusal forces under function. This will reduce any chance of stress fractures. Clients biting force is increased with no propreoception of force due to the elimination of perio ligaments in the edentulous state. Additionally the caps are cured to the frame and used in bite registrations and try-ins as a more secure position for those spots. And serves as a verification jig thus eliminating any surprises at the insertion appt. Thank you for your interest. Regards Paul
Hello Professor Paul, I appreciate the excellent videos and explanations you've provided. They are an incredible source for students and anyone with an interest in removable prosthodontics. Thank you! I have two questions regarding the case. I would appreciate your feedback. As I understand, you maintained the existing minimum overjet and overbite of 13 and 12 while incorporating them into the immediate interim complete upper denture setup. I agree that a minimum overbite is advantageous for the stability of the complete denture, but I'm unclear about the necessity of a minimum overjet (in the case shown in the videos, I believe there is contact between the upper and lower anterior teeth in CO). Am I correct in assuming that having an overjet helps achieve balanced occlusion in protrusive movements? What is the rationale behind the decision to maintain a minimum overjet in this case setup? Also, having contact between lower natural and upper artificial teeth won't there be a risk of developing a flabby or fibrous ridge because of the contact between the lower natural teeth and the upper denture teeth? My second question relates to the midline in cases involving a combination of natural or partial denture teeth against an upper complete denture. If the upper midline, determined by facial symmetry, does not match the midline of the lower natural teeth, which one should be prioritized in selecting the midline for the upper denture to achieve the best possible esthetics?
Thank you for your question and interest. I would follow the maxillary always for midline. I would maintain OJ in CO to minimize hyper occlusal contacts in function. I thought I maintained OJ in video. 1.2,1.3 to be extracted. Regards Paul
@@DentureAdventure I apologize, it seems I'll need to watch the video again😊 (which I've already done twice because it's interesting). By the way, I've been spending 90% of my time on Denture Adventure instead of studying for exams. It is awesome✨! Thank you for your time and answers.
Dear professor paul, Thank you for this amazing video. But i had a question about a patient with extensive class IV Kennedy ( they don’t have teeth 12,11,21,22,23,24,25). How can we compensate for loss of lateral guidance when we don’t even have premolars ?and do we put double Akers on tooth 17,18 or 16,17? I am so confused about general design of this RPD i would appreciate it so much if you could help me.
Thank you for your question and interest. This I would categorize as one of the most challenging for stability. Clasp posterior teeth as anterior and posterior as possible. Maintain minimum OB and OJ. Additionally major connector as far posterior as possible for indirect retention. Basically reverse class 1 in design. Regards Paul K
Dear Professor Paul, I have a question regarding the last design you presented in the video on mandibular long-span class IV, where only teeth 37 and 47 are present. I noticed that you used a ring clasp with a mesial retentive clasp, which is the same technique we learned in our class. However, I have a question that has been on my mind for a while now. Why can't we use distal buccal or lingual undercuts for retention? I think these distal clasps could serve as both direct and indirect retainers. As we use a distal occlusal rest, which serves as an indirect retainer but also prevents the distal retentive clasp from moving towards the tissue during rotation movement of the denture around the fulcrum line, preventing impingement of the soft tissues. Please correct me if I am wrong. Also, please note that in my past life,😊 I was a dentist, so it's quite possible that my thinking is incorrect😊. Thank you.
Thank you for your interest. Engaging the mesial undercuts would promote the retentive clasps to rotate into the undercuts. The reverse would provide no retention or no further retention as the rotation of the prosthetic would move these retentive clasps towards the tissue in theory. However by placing auxillary rests as you mentioned this would minimize the rotation. This value of rotation would be inherent on length of the guide planes, depth of undercut ,height of clinical crowns, type of antagonist dentition, alveolar bone height, type of saliva and occlusal scheme among others. This theory was based on studies by Prof.Dr. Markxor and is valuable in the education setting. Practically, I would see this type of endentulism treated with an acrylic partial denture foregoing any vertical stop which would exercise this theory for sure with a mesial buccal engaging wrought wire clasp anticipating this denture to be transitional in nature. Best of luck in your studies.
Hello Professor Paul, I have been watching your partial design videos for a year now, and I recently realized that they were created by the professor who teaches in the classroom next to mine. It's amazing to have such a great resource available. Thank you for providing this opportunity to learn.🙂 Thank you, Kyle(your student) for directing me to your "The Denture Adventure" channel!
Hi Dr. Paul, thanks for such a great series. would it be possible to share a copy of these worksheets? revising the basics of RPD design through these would be very helpful for me. thanks so much. cheers.
This would depend on a few factors. Generally on a free end we would favor the mesial occlusal rest on the terminal abutment adjacent to the free end. If a tooth bound posterior modification exists we would favor the surface adjacent to the edentulous space. If an anterior modification is present, it would be prudent to close off these guide planes as well as all guide planes to food impaction. This would improve patient satisfaction and compliance in wearing removable prosthetics.
Thank you so much for the video Please why wasn’t RPI system used since it’s class 1 And I don’t understand why the last maxillary design is class 1 when it has just one free end
Good question ! I guess it would depend on the severity of the cross-bite. Classic would be 1st bicuspid class 1 with minimal overjet. 1st molar end to end in transition. 2nd molar cross-bite. Merci PK
Hi Juliette, Thank you for kind words. My hope is that we all take responsibility in designing our frameworks rather than letting a third party decide for us. For those that do, awesome. Continue being awesome practitioners. For those that don’t, never too late to start. PK
Please can you explan me the third design of maxillary why it's class 1 ?? we study in kennedy classification the class 1 the anterior are found but the posterior free end bilateral
Thank You for your question. The third design has a bilateral fee end. According the Applegate's rule #5 the posterior edentulous areas supercede the anterior edentulous space. Therefore in would be Kennedy class I modification 1. Hope that helps. PK
@@DentureAdventure you're welcome, but the appreciation is well deserved. I've been searching something like this channel for a long time as I'm still young(ish) and finding an informative gem like this, that covers all the various laboratory steps, from the surveying to the trimming, regarding this branch of the dental technology which fascinates me a lot, is uncommon over here on YT. And I searched a lot. I also like the name of the channel, which I consider spot on as watching these videos feels like watching a proper start to finish adventure, which is what our job, at last, is. My best regards, dear sir, keep up the good work. Greetings from Italy.
What if the missing teeth are 11,21,22 and 23, should we put an indirect retainer, if so where can we put it? And what type of rest shall i use? Thank youu
Typical answer. It depends. Assuming the anterior edentulous is small and retention of posterior teeth is adequate indirect retention would most likely not be needed. If the space has a large width and flat vaulted palate with not so much posterior retention then a open palate design would help in minimizing rotations.
Hi Lule, Abutments for direct retainers are those teeth adjacent to the edentulous areas. Also could be categorized as primary abutments. If primary abutment teeth are guarded or compromised then prognosis would not be as favourable and possible secondary abutments utilized to anticipate possible future tooth loss. It would be better dentistry to address the health and longevity of abutments prior to treatment. Avoiding this I believe to be iatrogenic dentistry. Thank you for your comments.
