• Minor connectors/proximal plate:

  • Metal coverage needs to extend 2mm from the tooth to the tissue junction

  • 3mm of opening on mandibular

• Major connectors:

  • Posterior: minimum 8mm width

  • The posterior palatal metal connector should NOT extend beyond the vibrating line

  • Lingual bar: 3mm away from the gingival margin

    • Usually choice whenever possible

    • Width: 4-5mm

• Denture Base Connectors:

  • Located on the crest and lingual side of ridge (more room for denture teeth)

  • Limit the posterior extension to 1/2-2/3rds the length of the distal edentulous span

  • 1mm space underneath for acrylic

• Retainers: usually I-bar

  • 90 degrees up

  • Contact area: 1mm above gingival margin

  • 5-7mm in length

  • Bottom portion should be above height of contour (HOC) of ST

  • Passive retainer: placed above the tooth HOC

  • Active retainer: placed below the tooth HOC

  • C-Clasp retainers: usually NOT indicated

    • IF Soft tissue undercut is undesirable

    • Usually used in toothe borne RPDs (on molars) when esthetics are not priority

      • • Never put C-clasp on abutment adjacent to extension base (like premolar)

• Rests:

  • Discussed more in Appointment 2 box

  • Always choose Mesial rests in Distal extension base

• Axis of Rotation:

  • A line going from rest to rest near the location of the 2 active retainers

  • All other retainers away from this axis should be passive

1) Place Dx on surveying table and position occlusal plane parallel to surveyor base

2) Use diagnostic rod to check parallelism of guiding plane, evaluate Height of Contour (HOC) and soft tissue (ST)

3) Use 0.01 undercut gauge to check retention

• Ideal retention is cervical 1/3-2/3rds of tooth

• Excessive retention requires tooth alteration to lower the HOC

• Lack of retention can be managed by: creating a "dimple", enameloplasty, or crown

  • • Dimple: wide, oval-like undercut

4) Carbon rod and metal sleeve to mark HOC

5) Tripod to chosen MAP: 3 horizontal lines w/ the 0.03" undercut gauge

• Further apart, the better

Prior to appointment: make sure you finalize RPD paper design and upload it into your chart by having the Cashier scan it.

End of appoint: will have Dx casts and Tx plan

1) Go through ATP to finalize treatment plan

2) need to draw RPD designs (PreTP) on Dx Casts, Survey to determine MAP and Tripodize to index MAP

3) Finalize RPD paper design at Genius-Prosth Consult and get signature, upload it into your chart by going to the Cashier at UCLA Clinic

General Do's and Don'ts of Rests:

• Rest must be positive and spoon shaped: does NOT allow RPD to slide off

• Within enamel

• Depth=1.25-1.5mm

• Diverges at marginal ridge

• No sharp margins/line angles, no undercuts

• Rest should NOT be on cusp tip

Indications for Survey Crown:

1. Caries on any surface

2. Teeth proclination resulting in difficult path of insertion

3. Canines with flat cingulum making it difficult to develop positive rests

4. Possible significant dentin exposure if rests were made

5. To restore a badly broken down tooth

6. To re-establish proper occlusal plane

7. To provide proper rests

8. To provide adequate retentive undercuts when inadequate contours exist on key RPD abutment

Purpose: to capture more hard and soft tissue once framework is received, protects abutment teeth by providing 2-3 times more mucosal support and minimizing denture movement

1. Place casting on master cast

2. A single layer of baseplate wax is placed over edentulous area to provide space for impression material

3. Reseat RPD framework on master cast and confirm adaption of rests/major connectors

4. Remove wax from denture base connector area to provide mechanical lock of acrylic to the metal

5. Apply tray acryllic/triad of uniform thickness, make sure to apply vaseline before curing!!

6. Acrylic trays are trimmed and polished

7. Make 2-3mm space at the vestibular area for border molding

8. THEN make physiological adjustments (REFER TO APT 3)

9. Now, acrylic tray will be connected to framework using Pattern Resin or Duralay AFTER adjustments are made in patient's mouth

10. Check connected tray's peripheral extensions

11. Border molding is performed and cut back 0.5mm thickness to allow room for impression material

12. Create VENT HOLES near the finish line for escape of excess impression material

13. Take impression using Light body rubber base or light body PVS, applying a thin layer

    • Keep fingers over the rests and connectors, not on extension area

14. Trim the excessive impression material at the metal finish line on the tissue surface

15. Remove edentulous area of master cast, and seal RPD framework w/ connected impression on it, secure with sticky wax on major connectors, minor connectors and retainers (NOT rests)

    • Only metal will touch the cast

    • Start the initial cut 1-2mm distal to abutment next to edentulous area

    • Create retention grooves or notches on the cut surfaces

      • Do not extend it to the gingival portion of abutment tooth

16. Impression and cast are beaded and boxed to be poured in vacuum-mixed stone

    • • Master cast=green stone

      • Altered cast=yellow stone

After this appointment: have Record bases and wax rims

1. Coat the framework with Occlude spray on tooth contacting areas and try to seat the framework

   • Alternatively: can use gold rouge and chloroform

2. Simulate movement: 1 finger on rest of Major Connector anterior to axis of rotation & 1 finger on the denture base connector distal to the axis of rotation

   • Burned out area means binding to the tooth

3. Adjust with carbide burs and high speed grinding stones

   • Do NOT adjust retainers before consulting w/ instructor

4. Stop adjusting when=

   • Cast moves easily with the rest at the axis of rotation, rolling smoothly in rest seat w/o lifting

   • Abutment tooth is not torquing/moving

5. NOW make wax rims and record base

   • Record base:

     1. 1. Need to be made if NOT sufficient number of teeth to support occlusion

        2. Most cases are required: example=distal extension

        3. Needs to be thin

After this appointment: need to mount and festoon

1. Take VDO evaluation and determination

2. Horizontal relationship evaluation and determination

3. Take Facebow record

4. Wax rims: need to be reduced until it reaches existing Centric Occlusion/VDO

   • • Mark Facial midline, upper lip line, and smile line

5. Take Jaw Relation Record

   • ZOE engages into the V notches

   • Confirm by hand-articulating and comparing OB and OJ to in-mouth

6. Protrusive Position Record

   • When anterior teeth are edge to edge contact or 3-6mm protrusive from centric

   • Adjust condylar inclinations

7. Teeth selection and shade, gingival shade selection

8. (Anterior appointments:) Determine flange extension length and discuss w/ your patient

9. After appointment: mount casts and set up teeth

   • Place more important teeth first: 1M, 2M, 1PM, 2nd PM

After appointment: finish festooning and lab prescription

1. Verify and confirm VDO and horizontal position

2. Subjective and objective evaluations of esthetics

3. Gingival shade taking

4. Get Esthetic approval by patient on Axium

5. After try in apt: grind away the record base material on bottom side of base connectors

   • Make sure intaglio is clear, no flashes/sharps

6. Complete festooning, seal periphery with wax and blend to the land of the cast

7. On Lab work authorization:

   • Procession with ___color___ upon discussion w/ lab tech

   • Finish and polish processed RPD

   • Hydrate the prosthesis