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NOVEMBER 2004
ESSENTIALS OF PARTIAL
DENTURE DESIGN
All partial dentures have two things in common. First,
they must be supported by oral tissues. Second, they
must be retained against reasonable dislodging forces.
If a tooth, which may be used for the support of the
partial denture, remains at each end of each edentulous
span, then the appliance is a tooth-borne, removable
bridge type of prosthesis (Fig. 1). Three components
are necessary. These are: the connectors, the retainers,
and the bracing or stabilizing components.
The partial denture that does not have the advantage
of tooth support at each end of each edentulous space
still has support, but in this instance, the support comes
from both the teeth and the underlying ridge tissues,
rather than from the teeth alone (Fig. 2). This is a composite support, and the prosthesis must be so fabricated
as to coordinate the resilient support rendered by the
edentulous ridge and the more stable support offered
by the abutment teeth.5-10 The three essentials
the connectors, retainers, and stabilizing componentsmust be even more carefully designed and
executed because of the movement of tissue-supported
denture base areas. In addition, provision must be
made for three other essentials.
First, the best possible support must be obtained
from the resilient ridge tissues. This is accomplished by
the impression technique more than by the partial denture design, although the amount of area covered by the
partial denture is a contributing factor in such support.
Second, the method of direct retention must take
into account the inevitable tissueward movement of
the free-end denture bases under the stresses of mastication and occlusion. Direct retainers must be designed so
THE JOURNAL OF PROSTHETIC DENTISTRY 409
Fig. 1. A removable partial denture which is entirely toothsupported through the medium of occlusal rests on each
abutment tooth. (Kennedy Class III.)
that some flexing or stress-breaking under occlusal loading will occur instead of transmitting torsion directly to
the abutment teeth.
Third, the partial denture having one or more freeend denture bases must be so designed that movement
of the unsupported and unretained end away from the
tissues will be prevented or minimized. This is often
referred to as indirect retention, and is best described
in relation to an axis of rotation through the occlusal
rest areas of the principle abutments. However, retention from the partial denture base itself can frequently
be made to prevent this movement of the denture base
away from the tissues and, in such instance, may be spoken of as direct-indirect retention.
The remainder of this article will deal with the proper
design and the frequent violations of the principles involved in each of the essentials named.
OCCLUSAL RESTS
The support of the partial denture by the abutment
teeth is dependent upon the alveolar support of those
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Fig. 5. Anterior and posterior palatal bars as major connectors in an upper partial denture design.
MAJOR CONNECTORS
The proper form and location of a lingual bar is
presumably well known to every dentist. Does your technician know and conform to these principles? Do you
insist that certain principles are not violated, or do you
accept whatever violations he incorporates into his design? A little review of these principles will do no harm.
The lingual bar should be properly located in relation
to gingival and moving tissues, and it should be of sufficient bulk to be nonflexing, tapered superiorly with the
necessary half-pear cross-section form, and with sufficient, but not excessive, relief over the tissues.
Frequently, we find lingual bars located high against
delicate tissues, sometimes with insufficient relief, but
more frequently with excessive relief and of some nondescript strap or half-round form. A still more prevalent
violation of principle is in the lack of the rigidity so necNOVEMBER 2004
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Fig. 11. A, The anatomic or static form of the edentulous ridge as recorded with a hydrocolloid impression material. B, The
functional form of the same edentulous ridge as recorded with a wax that is fluid at mouth temperature, such as Kerrs Korecta
wax No. 4. The denture base areas of the master cast have been repoured as in Fig. 12.
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Fig. 12. The master cast after the ridge portion has been cut
away. The cut surfaces are scored for retention, and the wax
impression is attached to the remaining part of the cast. The
remaining part of the cast is soaked, and the ridge area is
repoured with a new mix of stone.
STABILIZING COMPONENTS
The stabilizing or bracing components of the partial
denture framework are those rigid components that
assist in stabilizing the denture against horizontal
413
RIDGE SUPPORT
The support for the tooth-borne partial denture or
the tooth-borne modification space comes entirely
from the abutment teeth by means of occlusal rests.
Support for any free-end denture base comes primarily
from the resilient soft tissues overlying the residual alve414
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Fig. 15. A, The outline form of the denture framework has been carefully drawn in pencil on the surveyed master cast. The
laboratory technician has only to duplicate this design in his casting so that when the casting is placed on the master cast it
matches the penciled outline. B, The framework design is drawn on a chart with colored pencils. Labels and written instructions
are used to supply the specific details.
INDIRECT RETAINERS
Any strut placed anterior to the fulcrum line is mistakenly considered to be an indirect retainer. An indirect
retainer can function only to assist in preventing the
rotational movement of a free-end denture base away
from the tissues when the indirect retainer is placed as
far anteriorly from the fulcrum line as adequate tooth
support permits.15, 17 It must be placed in a prepared
rest in an abutment tooth that is capable of withstanding
the stresses placed upon it (Fig. 13). An indirect retainer
cannot function correctly on an inclined tooth surface,
nor can a lower incisor tooth be used for this purpose.
Either canine or premolar teeth must be used for this
purpose, and the rest seats must be prepared in those
415
teeth as carefully as the preparation for any other occlusal rest. Where canine teeth are used, incisal rests or cingulum rests are acceptable for indirect retainers,
provided a definite seat can be obtained.
It should be remembered also that indirect retainers
serve a second purpose in partial denture design. This
purpose is that of occlusal rest support for major connectors. A long lingual bar or an anterior palatal bar is
thereby prevented from settling into the tissues.
Indeed, even in the absence of a need for indirect retention, such auxiliary support is sometimes indicated.
It should be remembered also that, contrary to common usage, a secondary lingual (Kennedy) bar or a lingual plate does not in itself act as an indirect retainer.
Resting on inclined tooth surfaces as they do, they serve
more as orthodontic appliances than as support for partial dentures. Terminal rests at each end of these lingual
plates should be used to stabilize the dentures and prevent movement of the teeth contacted. If such rests
are used, they alone are the indirect retainers, and they
function equally well without the added bar or plate.
The use of a lingual plate is indicated where the lower
anterior teeth are subject to calculus formation or are
weakened by periodontal disease (Fig. 14). Calculus
may then form on the plate instead of forming on the
teeth. Experience with the lingual plate has shown that
the underlying tissues do remain healthy and that there
are no harmful effects to the tissues from the metallic
coverage.
However, one precaution must be taken. Adequate
relief must be provided where the bar or plate crosses
the gingival margins and the adjacent gingivae. This
should be accomplished by using at least a 0.002 gauge
tin-foil blockout in these areas, in addition to a wax
blockout of the gingival crevice.
It does not seem that there are any advantages to
be had from the use of the Kennedy bar that are not
enhanced by the use of a lingual plate. There are times,
however, when the lingual plate would show through
interproximal embrasures of the teeth, and, for esthetic
reasons, the Kennedy bar would be preferred. The decision as to when to use the Kennedy bar or the lingual
plate and its design should be made by the dentist rather
than by the laboratory technician and should be clearly
indicated by the dentist on the cast.
BLOCKOUT OF UNDERCUTS
The decision as to where to use blockout wax should
be made by the dentist from his survey of the master cast.
Twenty-eight gauge wax, in addition to a wax blockout
of the tissue undercuts, is usually sufficient to relieve the
lingual bar connectors. Two or three-thousandths
gauge tin foil should be used over all gingival crossings,
in addition to blocking out the gingival crevice. Any
less relief than this will cause tissue impingement when
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SUMMARY
I have attempted to excuse the shortcomings of the
commercial dental laboratory by pointing out the responsibilities of the dentist for biologic partial denture
design and his frequent failure to provide the laboratory
technician with casts of properly prepared mouths and
adequate prescriptions for him to follow. By prescription I am referring to penciled outlines (Fig. 15,A), diagrams (Fig. 15,B), and written instructions prepared by
the dentist for the dental technician.13 Now I must also
make a statement regarding the responsibilities of the
commercial dental laboratory in the hope that they, too,
may find some motivation for improving their services.
In the average commercial dental laboratory today,
mass production is an economic necessity. It is augmented by the use of stereotyped designs and plastic pattern forms. Added to this, the salary level of the skilled
dental laboratory technician is not high by todays economic standards, and the training facilities for dental
VOLUME 92 NUMBER 5
MCCRACKEN
0022-3913/$30.00
Copyright 2004 by The Editorial Council of The Journal of Prosthetic
Dentistry
REFERENCES
1. DeVan MM. The nature of the partial denture foundation: Suggestions for
its preservation. J Prosthet Dent 1952;2:210-8.
2. Christensen G. Partial denturesA benefit or a menace? Aust J Dent 1945;
49:102-7.
NOVEMBER 2004
doi:10.1016/j.prosdent.2004.08.001
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