Removable partial dentures or RPDs, replace one or more natural teeth in the upper or lower jaw. Partially edentulous patients choose this denture when they cannot have a bridge or dental implants.
This dental prosthesis is called removable partial denture because you can insert and remove it without dentist help.
A partial denture may have a plastic or metal base. Clasps or precision attachments connect the removable denture to your teeth. Precision attachments are generally more esthetic than clasps. Removable partial dentures with precision attachments cost more than those with clasps.
Sometimes happen the dentist has to put crowns onto your residual teeth before to connect the prosthesis. The reason is they are too weak to support a partial denture by them self.
Kennedy classification of partially edentulous arches
In the dentistry field dentists classify edentulous patients based on the teeth they still have in the mouth. The most used way is the Kennedy classification defined by Dr. Edward Kennedy in 1923 in New York.
Here is how it works.
Kennedy class I
Edentulous areas located posterior to the natural teeth.
Kennedy class II
Unilateral edentulous area posterior to the remaining teeth.
Kennedy class III
Unilateral edentulous area with natural teeth remaining bough anterior and posterior to it.
Kennedy class IV
Bilateral (across the midline) edentulous area located anterior to the remaining teeth.
Plastic framework based
Denturist can build removable partial denture on a plastic base. In other words, the base or framework holds the false gums and the prosthetic teeth. The difference is the wearer comfort, the prosthesis cost and durability.
Usually the plastic type is used for temporary need: during healing, periodontal therapy or implants placement. It is easy for your tongue to flip the removable denture out or to move it from its location; that’s why the plastic type is called “flipper”. In some very rare cases this dental prosthesis can last years but you should know it is not recommended.
Metal framework based
Long-lasting removable partial dentures are built on a metal framework: Vitallium, Chrome, Cobalt or gold alloy.
Partial dentures are made up of three main elements. First the metal support structure (also called framework). Second the fake flange which has the double task of restoring the appearance and hide the underlying metal. The third part are the prosthetic teeth.
Let’s say your partial denture has to make up for the lack of teeth in both the right and left of the upper arch. In this case the partial denture will have the palatal bar that follows the arch of the palate.
When, instead, the teeth to be replaced are located in the lower arch, the metal bar passes under the tongue and for this is called lingual bar.
The bar ensures greater stability to the whole prosthetic device once placed in the patient’s mouth.
The metal structure of all partial denture is connected to natural teeth through metal hooks. They embrace the dental elements through visible claps or using invisible precision attachments.
Partial dentures with precision attachments
To improve the aesthetics of partial denture, claps can be replaced with precision attachments. In this case, the natural teeth have to be encapsulated otherwise they are not able to support the masticatory loads. This type of dental prosthesis is called combined restorations (crowns + removable denture with precision attachments).
Partial dentures with claps
Claps are used to firmly connect the partial denture to the remaining natural teeth. The aesthetic result is not the best you can get because, they are visible to people you will talk to.
Moreover, despite being the most affordable choice, they make hard to keep the oral hygiene.
Removable dentures on implants
Implant-supported single crowns and fixed partial dentures are alternatives to RPD. In some cases there are a lot of problems designing the right removable dental prosthesis.
If you are missing several teeth on one side of the mouth and there is no support for the prosthetic device, the removable denture will be unstable. To solve this problem, your dentist can place one or two implants in your jawbone. Implants will offer the right support to the removable partial denture. Retention can be customized based on the patient desire and unsightly clasps hided.
Partial dentures may cause periodontal disease and tooth decay
Recent researches indicate that partial denture wearers suffer more decay and gum disease than non-partial denture wearers. Let’s see why it happens.
RPDs have claps that attach directly to the remaining teeth. Those hooks allow bacterial plaque to accumulate more than usual. Plaque inflames the tissue, cause gum disease (gingivitis) and tooth decay.
It is very important to keep bough, residual teeth and denture clean. It is not an hard task because you can remove the partial denture from your mouth. Be sure to remove every small food pieces from the gum line and between teeth. Also brush your partial denture as well as the palatal and the lingual bar.
The positive side is that: if you keep your mouth healthy and the partial denture is well-made, it can be an aesthetic and functional alternative to more expensive dental prosthesis.
Maintenance and care
Partial dentures need a meticulous daily care after every meal.
First remove the prosthesis. Proceed to clean it with a soft bristles toothbrush and a mild toothpaste. Do not use a whitening toothpaste, it can ruin the color of teeth.
In the days immediately following delivery, you should wear your new partial denture as long as possible.
The more time you wear the prosthesis the more quickly your mucosa and facial muscles get used to the foreign body.
Wearing the prosthesis as long as possible allows the dentist to identify spots to be modified to provide you with more comfort.
When the partial prosthesis is not in the mouth it is good to keep it in a safe place. Protected it from accidental falls with a slightly damp cloth. Excessive dehydration may cause deformations.
How much do removable partial dentures cost ?
Let’s say that partial dentures cost varies according to the number of dental elements to be replaced and the number and type of claps or attachments.
Indicatively:
The price of the single denture with two claps is about 550 dollars;
The price of each resin tooth set on the framework is 45 dollars;
The cost of each additional hook is $90;
The relining cost of partial dentures is about 100 dollars.