可摘局部义齿设计及病例讨论（46页）.ppt

如何设计RPD？ Designing RPD’s Planning sequence for RPD patients Diagnostic assessment and preliminary impressions Diagnostic casts mounted in centric relation Draw the ideal RPD design (on paper) Survey the study casts and determine the most advantageous position (MAP) of the designed RPD path of insertion and withdrawal Revise and finalize the RPD design Designing RPD’s Planning sequence for RPD patients Diagnostic casts mounted in centric relation Designing RPD Frameworks Draw the ideal RPD design (on paper) There are no classic designs. Any design is a product of diagnosis, treatment planning Abutment, arch and occlusal criteria The application of design principles and philosophy A knowledge and appreciation of RPD biomechanics RPD Design Sequence Rests Major Connectors Minor Connectors Denture Base Connectors Retainers Mandibular DesignIssues of concern Proximal Plates – include 2.0 mm of mucosal coverage. Reduce if visible and non-esthetic. It should be fabricated of metal The metal is easily cleaned and does not harbor oral microorganisms Basic Problem of previous designs Acrylic resin at the tooth tissue junction Acrylic resin is porous and harbors oral bacteria and accumulation of plague Space at tooth tissue junction Impaction of food into the space Hypertrophy of tissue into the space (arrow) Mandibular DesignIssues of concern Minor Connectors to Rests - The vertical components to the rests should be at least 5.0 mm apart to reduce food entrapment. Consider lingual plate if closer. Denture Base Connectors – Retention of the resin saddle. Must be short of movable tissues. Should have relief. Allow spot metal seating check on master cast. Connectors are placed toward the lingual to prevent impingement Mandibular RPD Design  Issues of concern The major connectors may not impinge upon movable soft tissues such as frenum, or vestibular areas. Superior horizontal components must be clear of marginal gingival tissu