Kennedy’s classification of partially edentulous arches

 Facilitates recording of case histories

 Aids discussion between clinicians and
communication with technicians
 Helps clinicians to anticipate the basic type of RPD
design that is appropriate for each different patient
 Gives information about the number and distribution
of edentulous spaces
Kennedy Classification
 Class 1: Bilateral free-end
saddle.
 Class 2: Unilateral free-
end saddle.
 Class 3: Unilateral
bounded.
 Class 4: Anterior, across
the midline.
 All except class 4 have
modifications.
Kennedy class I
 Bilateral edentulous
areas are located
posterior to remaining
natural teeth
 Free end saddles (Distal
extension saddles)
Kennedy class I modifications
Kennedy class II
Kennedy class II modifications
Kennedy class III
Kennedy class III modifications
Kennedy class IV
Kennedy Classification
 Class 1: Bilateral free-end
saddle.
 Class 2: Unilateral free-
end saddle.
 Class 3: Unilateral
bounded.
 Class 4: Anterior, across
the midline.
 All except class 4 have
modifications.
 Support vs. Retention
 Support :  Retention:
Bracing
 Resistance to
displacement by
horizontal forces in
anteroposterior and
mediolateral directions
 Achieved by rigid
components of the
denture placed against
suitable vertical
surfaces on the teeth
and residual ridges
Reciprocation
 Reciprocation is the
resistance to lateral forces
applied to the abutment
tooth by the retentive clasp
arm as the arm is displaced
in an occlusal direction over
the bulbosity of the tooth
 Achieved by rigid
components on the opposite
side of the tooth to the
retentive arm
RPD Components
 Major connector
 Rests
 Direct retainers /
clasps
 Minor connectors
 Indirect retainers
 Denture bases in
conjunction with
prosthetic teeth
RPD Components – Major Connector
 Major connector joins the
components on one side of
the arch with those on the
opposite side
RPD Components – Minor Connectors
 Minor connectors join
the other components,
such as rests and clasp to
the major connector.
RPD Components – Clasps
 Clasp is a component of
an RPD that engages an
undercut on an
abutment tooth to resist
displacement of the
prosthesis away from
basal seat tissue
Clasps Types

 Occlusally approaching
clasp

 Gingivally approaching
clasp
RPD Components - Rests
 Rest: any component of a
partial denture on a
tooth surface that
provides vertical support

 Rest seat: the prepared

surface of an abutment
to receive the rest
Types of rests

 Occlusal rests

 Cingulum rests

 Incisal rests
Rests and Rests seats
RPD Components
 Major connector
 Minor connectors
 Direct retainers /
clasps
 Rests
 Denture bases in
conjunction with
prosthetic teeth
Definitions
 Rest: any component of a
partial denture on a
tooth surface that
provides vertical support

 Rest seat: the prepared

surface of an abutment
to receive the rest
Functions of rests

 Provide vertical support

 Maintain components in their correct position
 Protect the denture/abutment tooth junction
 Prevent overeruption of abutment tooth
 Provide indirect retention
Maintain components in their correct position
Protect the denture/abutment tooth junction
Prevent overeruption of abutment tooth
Rest seats
 Why are they prepared?

i. Create space for adequate thickness of a rest

ii. Produce a favourable tooth surface for support
iii. Prevent interference with occlusion
iv. Reduce the prominence of a rest
Create space for adequate thickness of
a rest
Produce a favourable tooth surface for support
Prevent interference with occlusion
Reduce the prominence of a rest
Types of rests

 Occlusal rests

 Cingulum rests

 Incisal rests
Occlusal rest seat
 Rounded triangular
shape with the apex
≥
towards the centre of the ≥ 2.5 mm
2.5
mm
occlusal surface
 Should be as long as it is
wide (at least 2.5 mm)
 Marginal ridge should be
reduced of
approximately 1.5 mm for
1.5 mm
adequate thickness of
rest
Occlusal rest seat
 The floor of the occlusal
rest seat should be apical
to the marginal ridge
and the occlusal surface
and should be concave,
or spoon shaped .
 The seat is broadest at
the marginal ridge and
tapers down into the
adjacent fossa (deepest *
area (*)
Occlusal rest seat
 The angle formed by
the occlusal rest and
the vertical minor
connector from which
it originates should be
less than 90 degrees
< 90°
Cingulum rest seat
 Mainly indicated for
upper anterior teeth
 Semilunar shape
 Prepared in enamel
above cingulum
 Should be prepared away
from the contact area
Incisal rest seat
 Mainly indicated for
lower anterior teeth
 Poor appearance
 unfavourable leverage
effect
So, consider augmentation
of cingulum by composite
and prepare cingulum rest
 Direct Retention
of RPD

Neuromuscular Inherent physical

Mechanical
control forces

Clasps Guide planes attachments

 Mechanical (1)

 Neuromuscular control (2)

 Inherent physical forces (3)

Mechanical – guide planes

 Path of insertion
 Direct Retention
of RPD

Neuromuscular Inherent physical

control Mechanical forces

Clasps Guide planes Attachments

Clasps: Definition
 Clasp is a component of
an RPD that engages an
undercut on an
abutment tooth to resist
displacement of the
prosthesis away from
basal seat tissue
Clasps: Types

 Occlusally approaching
clasp

 Gingivally approaching I
bar clasp
Clasps assemblies
Essential design criteria for effective
clasp assemblies
 Flexible retentive clasp arm

 Reciprocation

 Encirclement

 Support

 Passivity
Flexible retentive clasp arm

“The flexibility allows the arm to pass over the maximum bulbosity
of the tooth and into undercut”
 Reciprocation

❖ Reciprocation is the resistance to lateral forces applied to the

abutment tooth by the retentive clasp arm as the arm is displaced in
an occlusal direction over the bulbosity of the tooth
❖ Achieved by rigid components on the opposite side of the tooth to
the retentive arm
 Encirclement
Buccal
 An occlusally approaching *
clasp assembly should
engage more than half of
the circumference of the *
tooth *
 May be provided by three
widely-spaced points of Lingual
contact with the tooth in
gingivally approaching
clasp assemblies (*)
Support
 Passivity
 the retentive clasp arm
should exert no pressure
on the tooth until it is
activated by movement
of the denture in
function or on its
removal from the mouth
Comparison of occlusally and gingivally
approaching clasps - Length

The length of the gingivally

approaching clasp in not
restricted by the dimensions
of the clasped tooth, and
thus can be increased for a
greater flexibility
Comparison of occlusally and gingivally
approaching clasps - Appearance

Gingivally approaching clasps can be

more hidden and thus preferred for
anterior teeth
Comparison of occlusally and gingivally
approaching clasps - Hygiene

 The gingival
approaching clasps could
pose a greater risk of
periodontal problems
 Might also increase the
risk of root caries
Comparison of occlusally and gingivally
approaching clasps - Occlusion
 Occlusally
approaching clasps
might require tooth
reduction in order to
provide adequate
space
 Score (3:1) !!!

 Gingivally approaching  Occlusally approaching

clasps: clasps:
1. Length 1. Hygiene
2. Appearance
3. Occlusion
Problems and solutions – position of
undercut
Problems and solutions – shape of
sulcus
 Major and Minor Connectors

 Major connector joins the

components on one side of
the arch with those on the
opposite side.
 Minor connectors join the
other components, such as
rests and clasp to the major
connector.
Requirements for Major Connectors

A. Be rigid.
B. Protect the soft tissues.
C. Provide a means for placement of one or more
dentures bases.
D. Promote patient comfort.
A. Be rigid
 Rigidity:
➢Permits broads
distribution of
applied forces.
➢Enhance effectiveness
of other components
of the RPD.
 B. Protect the soft tissues

➢ Borders of a maxillary major

connector should be located
6 mm away from the free
gingival margins.
➢ Borders of a mandibular
major connector should be
located 3 mm away from the
free gingival margins.
 Cont …

➢Borders should run

parallel to the gingival
margins of the
remaining teeth.
➢Gingival margins must
be crossed at right
angle.
C. Provide a means for placement of
one or more dentures bases

➢Different major
connectors can be
used according to the
number and location
of edentulous spaces.
 D. Promote patient comfort
➢ Anterior border of a
maxillary major connector
should not end on the
anterior slope of a
prominent ruga.
➢ Borders of a maxillary
major connector should
cross palatal midline at
right angle.
 Cont …

➢Tori should be avoided

as much as possible.
➢Major connector should
exhibit smooth and
rounded contours and
angles.
 E. Provide a means for obtaining indirect
retention where indicated
 Indirect retainers are
required when the partial
denture is not supported at
each end of an edentulous
space
 Denture will rotate around a
fulcrum line but indirect
retainer can resist this
movement
Maxillary Major Connectors
1. Palatal bar.
2. Palatal strap.
3. Anteroposterior
palatal bar.
4. Horseshoe.
5. Anteroposterior
palatal strap.
6. Complete palate.
1. Palatal Bar

➢Narrow half oval with

its thickest point at
the center.
2. Palatal Strap

➢Consists of a wide
band of metal with a
thin cross-sectional
dimension.
 3. Anteroposterior Palatal Bar
➢ Anterior bar is flat and
similar to palatal strap in
cross section.
➢ Posterior bar is half oval
and similar to palatal bar
in cross section.
➢ The two bars are joined by
flat longitudinal elements
on each side of the palate.
 4. Horseshoe Connector
➢Consists of a thin band
of metal running
along the lingual
surface of the
remaining teeth and
extending 6 to 8 mm
onto the palatal
tissues.
 5. Anteroposterior Palatal Strap

➢Consists of two palatal

straps, each should be
at least 8 mm in
width.
 6. Complete Palate

➢Anterior border should be

kept 6 mm from gingival
margin or cover the cingula
of anterior teeth.
➢Posterior border should
extend to the junction
between the hard and soft
palate
Conclusions
 If the remaining teeth are periodontally involved, a
wide palatal strap or a complete palate is indicated.
 If a torus is present and is not to be removed,
anteroposterior palatal bar, anteroposterior palatal
strap, or horseshoe major connector may be used.
 Horseshoe major connector should not be
routinely because of the possibility of flexure.
 A palatal bar is very rarely indicated.
Mandibular Major Connectors
1. Lingual bar.
2. Sublingual bar.
3. Dental bar.
4. Kennedy bar.
5. Lingual plate.
6. Labial (or buccal
bar).
1. Lingual Bar
➢ Half pear shaped in cross
section.
➢ The broadest portion of
the bar is located at its
inferior border.
➢ Maximum cross-
sectional dimension is
oriented vertically.
➢ At least 8 mm of sulcus
depth must be present.
2. Sublingual Bar
➢ Maximum cross-
sectional dimension is
oriented horizontally.
➢ Needs special impression
technique.
➢ Needs less sulcus depth
than lingual bar.
3. Dental Bar

➢ Covers part of the lingual

surfaces of the anterior
teeth.
➢ Clinical crowns should
be long enough.
4. Kennedy Bar

➢ Consists of dental bar

and lingual bar.
➢ The upper bar (dental
bar) should present a
scalloped appearance.
 5. Lingual Plate
➢ Covers most of the lingual
surfaces of the teeth, the
gingival margin and the
lingual aspect of the ridge.
➢ Rigidity is achieved by
thickening the lower
border to a bar like section.
 6. Labial (buccal bar)
➢Runs across the mucosa
on the facial surface of
the mandibular arch.
➢Limited space and
increased length makes
it difficult to achieve
rigidity.
➢More effective when
used for short spans.
 Mandibular Major Connectors –
Comparison ( √ present, ? Uncertain, x absent)
Rigidity Hygiene Tolerance
Lingual √* √ √
bar
Sublingual √√ √ √
bar
Dental bar ? √ ?
Lingual √ x √
plate
Labial bar ? √ ?
Conclusions
 Lingual bar and sublingual bar are routinely used.
 Lingual plate can be used when there is
insufficient depth of sulcus, inoperable
mandibular tori, and for patient with high muscle
or high lingual frenum attachment.
 Lingual plate is also indicated when anterior teeth
have poor periodontal support and need
stabilisation.
 A labial ( buccal bar ) is rarely indicated.
 Minor Connectors
1. Minor connectors that
join clasp assemblies to
major connector.
2. Minor connectors that
join indirect retainers to
major connectors.
3. Minor connectors that
join denture bases to
major connectors.
4. Minor connectors that
serve as approach arms
for vertical bar type
clasps.
Minor connectors that join denture bases
to major connectors

 Open construction.
 Mesh construction.
Tooth supported vs Tooth-
mucosa supported
Differential support and movement –
resiliency of mucosa vs. rigidity of teeth
Design principles and considerations as related to type of support
▪ Saddles:
o The base extension
o The design of the occlusal surface
o The design of the polished surface
o The material for the impression surface
o The junction between saddle and abutment tooth
▪ Rests:
o Position of rests in relation to saddle
o The use of additional rests in distal extension saddle cases
▪ Direct retainers:
o Clasp design on most distal abutment (wrought occlusally approaching clasps and RPI)
▪ The need for indirect retention in distal extension saddle cases
▪ The need for larger major connector in distal extension saddle cases
Design principles and considerations
as related to type of support

 Saddles
 Rests
 Direct retainers
 Indirect retainers
 Major connectors
Design principles and considerations
as related to type of support - Saddles
 The base extension
 The design of the
occlusal surface
 The design of the
polished surface
 The material for the
impression surface
 The junction between
saddle and abutment
tooth
Saddles: The base extension
 Maximum coverage in  Maximum extension is not
distal extension saddles required in fully tooth
supported bounded
x √ saddles
 Saddles :
The design of the occlusal surface
x √
 Narrower and shorter
occlusal table in distal
extension saddles
Saddles: The design of the polished surface
 Polished
surface should
be shaped
correctly to
enhance
retention and x √
stability by
muscular
forces
 Place teeth in
neutral zone
Saddles: The material for the impression surface –
distal extension saddles (tooth-mucosa supported)

 Acrylic should be used in

distal extension saddle
dentures
 Saddles: The material for the impression
surface – bounded saddles (tooth supported)

 Metal can be used in

bounded saddle
dentures
 Advantageous when
interocclusal space is
reduced
 Saddles: The junction between saddle
and abutment tooth

 Open or closed design

 Open design is healthier
for gingiva
 Guide-surface philosophy
can be adopted with
closed design
 Closed design may be
required in an anterior
saddle for good aesthetics
Rests: position of rests in relation to saddle

 Tooth supported
(bounded saddles): rests
are placed adjacent to
saddles
Rests: position of rests in relation to saddle

 Tooth-mucosa
supported (distal
extension saddles): rests
are better to be placed
away from saddles
(mesial rests)
Rests: The use of additional rests in distal
extension saddles

 Support can be
augmented by placing
rests on more than one
tooth
 Direct retainers:
clasp design on most distal abutment

Rigid
Saddle
clasp

x
 Direct retainers: clasp design on most distal
abutment – wrought occlusally approaching clasps
Direct retainers:
clasp design on most distal abutment – RPI system
 R - Rest, placed
mesially on the most
 This is a design that distal abutment tooth.
permits the denture to More vertical loading,
rotate on the distal transmits less torque.
abutment tooth  P – Distal guide plate.
without causing any Designed so as not to
transmit torque to
damage to its abutment when saddle
supporting structures is loaded.
 I - I-bar. Disengages
tooth when saddle is
loaded.
Mesial
rest (R)

Gingivally approaching I Distal guide

bar (I) plate (P)
Saddle is not loaded Saddle is loaded
RPI system vs. a rigid occlusally
approaching clasp with a distal rest
Indirect retainers: The need for indirect
retention in distal extension saddles
(tooth-mucosa supported)

Fulcrum
line

Indirect
retainer
Connectors: The need for larger
connectors in distal extension saddles
(tooth-mucosa supported) dentures
 Sequence of designing
 Saddles
 Support
 Retention
 Bracing and reciprocation
 Major connectors
 Indirect retention
 Review of completed design
Example
 Kennedy class II
 A gap exists between LR6
(46) and the mesially tilted
LR8 (48)
 On LR6 (46) the suitable
undercut is on the
mesiolingual aspect of the
tooth
 No sulcus undercut or high
frenal attachment in the area
around LL4 (34)
 Good depth of lingual sulcus
 Interocclusal space is reduced
Saddles and tooth support
 Spaced meshwork for acrylic
impression surface
 A narrow occlusal table
 Closed design
saddle/abutment junction
 Maximum extension of
denture base
 Mesial occlusal rest on LL4
(34)
 Occlusal rests on LR4 (44),
LR6 (46), and LR8 (48)
Retention, Bracing, and reciprocation
 A gingivally approaching
clasp to be used on LL4 (34)
 RPI system
 An occlusally approaching
clasp to be used on LR6 (46;
the retentive tip will engage
the mesiolingual undercut)
 Minor connectors
 Reciprocal arm on LR6 (46)
 Fully extended flanges
 Guide plates on LR6 (46)
and LL4 (34)
Major Connector and indirect retention

 Lingual or sublingual bar

 Occlusal rest on LR4
(44) will provide indirect
retention
Design prescription
Completed framework
 Altered Cast Technique
 A technique whereby the cast
is altered so that the saddle
areas are replaced
 Achieved by taking an
impression of the saddle areas
using an acrylic tray attached
to the framework
 Mainly applied to free end
saddle cases
 Advantages

 Reduce rotation of a free-

end saddle denture
 Eliminates some casting
inaccuracies
 Improve the impression
of the saddle area
 Maintain occlusal contact
between both natural &
artificial dentition
 Procedure
 The framework is designed
and cast as normal
 Ask the lab for a removable
tray for an altered cast
impression
 Check and adjust the
framework inside the
patient mouth
 Cont …
 Fix the tray to the
framework using cold
cure acrylic
 Take the altered cast
impression using light
bodied silicone
impression (or?)
 Cont …
 In the lab, the saddle area
of the cast is removed
away.
 The framework is placed
on the teeth of the cast
 Cont …
 The impression is boxed
in
 The impression is
poured, this pour
joining with the
remaining original cast
to give a new improved
cast of the saddle area
 Surveying
 Surveyor: an instrument allows
a vertical arm with different
attachments to contact with
the teeth and the ridge to
identify parallel surfaces and
undercuts
 Attachments:
• Analysing rod
• Graphite marker
• Undercut gauge
• Trimming knife
Attachments ..
Attachments …
Concepts
 Guide surfaces: Two or more parallel axial surfaces on
abutment teeth.
 Path of insertion:
• This is the path which follows the greatest number of
parallel surfaces of the teeth.
• This path is chosen by using an analysing rod in a surveyor
• This the only path along which the denture may be
inserted or removed
 Path of displacement:
• The path along which the denture would naturally be
displaced
• It assumed to be at right angle to the occlusal plane
Surveying
 Determine the best
path of insertion.
 Surveying
 Identify undercut
areas of the teeth that
may be used for
retention.
 Survey cast in the path
of displacement.
 Depth of undercut

 This is the distance

between a rod which is
parallel to either path of
insertion or path of
displacement and the
surface of the tooth
 Depth of undercut is
measured by undercut
gauge
Simple machines found in RPDs
Lever
 lever is a rigid bar
supported somewhere
along its length
(fulcrum)and the lever
can move around the
fulcrum
 used to transmit force, as
in raising or moving a
weight at one end by
pushing down on the
other
 Class I, II, and III
Class I

Class II

Class III
Class I lever
 Fulcrum lies in the
center, Resistance is at
one end and force at the
other
 Found in class I and II
Kennedy RPDs
 Most destructive and
should be avoided
Class II lever
 Fulcrum is at one end
effort at the opposite end
and resistance in the
center
 Class I and II Kennedy
RPDs
 Altering the fulcrum
position and resultant
clasp movement can
disallow harmful
engagement of abutment
Class III lever
 Fulcrum is at one end,
resistance at opposite
end & effort is in the
centre
 Found in class III and IV
Kennedy RPDs
 Least destructive
Class I

Class II

Class III
 Rest-
fulcrum
point (F)

Effort (E)

Rigid clasp-
Resistance (R)

Cantilever class I lever

Solutions and
alternative designs?
 Best
Solution

Implants can be used to address the effect of lever by

providing rigid element at the unsupported end (distal
end) which will disallow movement into supporting
tissues
 Rest-fulcrum Changing the rest
point (F)
position (fulcrum
point) will change
lever class form I to II

Rest-fulcrum Rest-fulcrum
point (F) point (F)

E E

R
R
 Effort arm

Clasp-
Resistance
(R2)

Clasp- Rest-fulcrum
Resistance point (F)
(R1)
Resistance
Resistance arm 1
arm 2

When the effort arm is longer than the resistance arm,

mechanical advantage favours the effort arm,
proportionately to the difference in length of the two
arms -Importance of cross arch stabilisation
 Inclined plane
 Forces against an
inclined plane may
result in deflection
of that which is
applying the forces
(denture) or may
result in movement
to the inclined plane
(tooth), neither of
these is desirable
Inclined plane
 An angle greater
than 90 degrees fails
to transmit occlusal
forces along the
supporting vertical
axis of the abutment
tooth. This also
permits slippage of
the prosthesis away > 90°
from the abutment,
which can result in < 90°
orthodontic-like
forces being applied
to an inclined plane
on the abutment,
with possible tooth
movement
Movement in relation to Sagittal plane – Rotation around a fulcrum line
passing through the most posterior abutments when the denture base
moves vertically toward or away from the supporting tissues and
residual ridges
Movement in relation to Frontal plane – Rotation around longitudinal axis
formed by the crest of the residual ridge
Movement in relation to Horizontal plane – Rotation around vertical axis near
the centre of the arch
Movement in relation to Sagittal plane – Rotation around a fulcrum line
passing through the most posterior abutments when the denture base
moves vertically toward or away from the supporting tissues and
residual ridges
Movement in relation to sagittal plain
 Movement of distal extension saddle
towards mucosa will depend on: quality
of mucosa, accuracy and extent of
denture base, applied load
 Rotation occurs about fulcrum line: an
axis through the most posterior
abutments
 This axis may pass through occlusal
rests or any other rigid portion of a direct
retainer assembly located occlusally or
incisally to the height of contour of the
primary abutments
 Fulcrum line is the centre of rotation as
the distal extension base moves toward
the supporting tissue when an occlusal
load is applied
Movement in relation to sagittal plain
 Movement of distal extension
saddle away from mucosa will be
resisted by the retentive clasp arms
on distal abutments, stabilising
minor connectors, and indirect
retainer
 Indirect retainer is a vertical support
elements of the framework anterior
to the distal abutments
 Indirect retainers should be placed
as far as possible from the distal
extension base, affording the best
possible leverage against lifting of
the distal extension base
Movement in relation to Frontal plane – Rotation around longitudinal axis
formed by the crest of the residual ridge
Movement in relation to frontal plane
 Rotation is about a longitudinal
axis as the distal extension base
moves in a rotary direction
about the residual ridge
 Rotation can cause undue
stresses to the side of the
supporting ridges and shifting
of the denture bases
 Rotation is resisted by the
rigidity of major and minor
connectors and their ability to
resist torque
Movement in relation to Horizontal plane – Rotation around vertical axis near
the centre of the arch
Movement in relation to horizontal plane
 Rotation is about an
imaginary vertical axis
located near the centre
of the dental arch
 Movement is resisted by
reciprocal arms and
minor connectors in
contact with tooth
vertical forces (Bracing
components)
Articulators
Simple hinge articulator
Average value articulator
Arcon vs. non arcon articulators
Semi-adjustable non-arcon
Semi-adjustable arcon
Fully adjustable articulator
Facebow
Arbitrary facebow
Kinematic facebow
References
 McCracken's Removable Partial Prosthodontics , 12th ed:
Alan B. Carr and David T. Brown (Chapter 10, Principles of
Removable Partial Denture Design )
 A Clinical Guide To Removable Partial Denture Design:
Davenport et al. (Chapter 4 ; Saddles)
 A Clinical Guide To Removable Partial Denture Design:
Davenport et al. (Chapter 5 ; Support)
 A Clinical Guide To Removable Partial Denture Design:
Davenport et al. (Chapter 6 ; Retention)
 A Clinical Guide To Removable Partial Denture Design:
Davenport et al. (Chapter 10 ; A system of design)
 Handout
Thank you