Interim Removable Partial Dentures

Lec: prosthodontics د.حكمت جميل

Interim Removable Partial Dentures

An interim removable partial denture (RPD) is sometimes made prior to making a definitive removable partial denture. The patient may wear the interim RPD for a very short period or for a more extended period of years, depending on the situation. These various uses of interim prostheses for the partially edentulous mouth strive to achieve temporary goals with minimum time and expense. These prostheses are typically resin with wire retention and may include components to provide tooth support.

Interim prostheses may be indicated as a part of total treatment for the following:

1. Sake of appearance.Temporary improvement of esthetics after sudden loss of teeth, before sufficient healing has occurred to fabricate a permanent prosthesis (accidents, after extractions).

2. Maintenance of a space. Children - arches still growing, and a permanent prosthesis would not fit for long. Temporary space maintenance for missing teeth in esthetic areas (congenital, caries, trauma).

3. Reestablishment of occlusal relationships; Prevent extrusion, migration of adjacent/opposing dentition.

Interim removable partial dentures are used for the following reasons: (1) to establish a new occlusal relationship or occlusal vertical dimension; and (2) to condition teeth and ridge tissue for optimum support of the definitive removable partial denture that will follow.

4. Conditioning of teeth and residual ridges.

5. Interim restoration during treatment. Large pulps may preclude the use of fixed partial dentures until a later time.

6. Conditioning the patient for wearing a prosthesis.

A temporary restoration may be made to aid the patient in making a transition to complete dentures when the total loss of teeth is inevitable. Such a removable partial denture also may be considered a valid part of the treatment, because the patient is at the same time being conditioned to wear a

removable prosthesis. It should be considered strictly a temporary measure that provides the patient with a restoration for the remaining life of the natural teeth when further restorative treatment of those teeth is impractical or economically or technically impossible. This type of a removable partial denture may be worn for prolonged periods, in the meantime undergoing revision, modification to include additional teeth lost, or relining when such becomes necessary or advisable. The dentist should agree to provide such a removable partial denture only under the following conditions: (1) that a definite fee

for the treatment is appropriate and that the fee will depend on the servicing necessary; and (2) that when further wearing of the transitional denture is unwise and jeopardizes the health of remaining tissue, the transition to complete dentures will proceed.

7. Temporary improvement of esthetics after sudden loss of teeth, before sufficient healinghas occurred to fabricate a permanent prosthesis (accidents, afterextractions)

8. Transitional Denture: a removable partial denture used as a transition to a completedenture when:

a. all or some teeth need to be extracted but can’t be immediately (medicallycompromised patient).

b. patient is not psychologically prepared to loose all the teeth at one time

9. Treatment Denture: a removable partial denture used to improve a condition before adefinitive denture can be made. The types of treatment may include:

a. Tissue Conditioning

- papillary hyperplasia (massage, brushing, with or without surgery)

- acute inflammation (increase tissue adaptation and redistribute the stress)

- may use the existing denture or a new treatment denture may be made

b. Implant healing

- a treatment RPD may be necessary for esthetics and/or function

- an existing RPD or a new denture may be made

- a soft liner is placed so that the fixtures can heal unloaded

c. Alteration of Vertical Dimension / Occlusal Scheme

- important use to determine how the patient will react to the changes.

- may be required in order to use an occlusal splint

d. Surgical Splint

- after the removal of palatal tori, etc.

Appearance

For the sake of appearance, an interim removable partial denture may replace one or more missing anterior teeth, or it may replace several teeth, both anterior and posterior. Such a restoration is usually made of resin, which may be produced by a sprinkling method, by the visible light-cured (VLC) method, or by waxing, flasking, and processing with autopolymerizing or heat polymerizing resin

Space Maintenance

When a space results from recent extractions or traumatic loss of teeth, it is usually prudent to maintain the space while the tissue heals. In younger patients, the space should be maintained until the adjacent teeth have reached sufficient maturity to be used as abutments for fixed restorations, or so that an implant can be placed. In adult patients, maintenance of the space can prevent undesirable migration and extrusion of adjacent or opposing teeth until definitive treatment can be accomplished

Reestablishing Occlusal Relationships

Interim removable partial dentures are used for the following reasons: (1) to establish a new occlusal relationship or occlusal vertical dimension; and (2) to condition teeth and ridge tissue for optimum support of the definitive removable partial denture that will follow.

Interim removable partial dentures may be used as occlusal splints in much the same manner as cast or resin occlusal splints are used on natural teeth. When total tooth support is available, there is little difference between a fixed and a removable occlusal splint, except that a removable splint is likely to be left out of the mouth unless the patient is actually made more comfortable by its presence. This is usually true when the wearing of an occlusal splint alleviates a temporomandibular joint condition.

Conditioning the Patient for Wearing a Prosthesis

A temporary restoration may be made to aid the patient in making a transition to complete dentures when the total lossof teeth is inevitable. Such a removable partial denture also may be considered a valid part of the treatment, because the patient is at the same time being conditioned to wear a removable prosthesis. It should be considered strictly a temporary measure that provides the patient with a restoration for the remaining life of the natural teeth when further restorative treatment of those teeth is impractical or economically or technically impossible.

This type of a removable partial denture may be worn for prolonged periods, in the meantime undergoing revision, modification to include additional teeth lost, or relining when such becomes necessary or advisable. The dentist should agree to provide such a removable partial dentureonly under the following conditions: (1) that a definite fee for the treatment is appropriate and that the fee will depend on the servicing necessary; and (2) that when further wearing of thetransitional denture is unwise and jeopardizes the health ofremaining tissue, the transition to complete dentures will proceed.