Assessment of existing RPDs and the decision to repair or prescribe a new prosthesis:

Question 1

Successful removable partial dentures:

Maintenance:

Answer 1

Removable partial denture patients should follow a maintenance program, being recalled at 6-months intervals. The minimal professional services to be rendered at these times are

1. Checking of physical integrity and adjustment of partial framework (a clasp may break, and the patient is either not aware of it or doesn’t consider it important
2. Loss of alveolar bone support resulting from rotation at the fulcrum in the distal extension dentures
3. Loss of occlusal contacts
4. Reduction of vertical dimension with pressure on anterior teeth (this is particularly damaging when a lower distal extension partial denture opposes a complete denture
5. Evidence of excessive pressure under connectors
6. Labial migration of lower anterior segment with impingement of lingual bar on mucosa (this may require remaking the denture)
7. Tongue or cheek biting and other pernicious habits
8. Impingement of peripheral boarders of denture base mucosa.
9. Once a year also include a minimal radiographic examination of abutments, endodontically and periodontically treated teeth, and posterior teeth

All minor corrections should be made, including relining, if necessary

Question 2

It is the position of the American College of Prosthodontists (ACP) that removable complete and partial dentures should be evaluated for replacement when at least one of the following conditions occurs:

Answer 2

1. If chronic irritation (inflammation) exists beneath the denture bases (including but not limited to epulis fissuratum, oral ulcerations, or treatment-resistant Candida-related denture stomatitis). (Caveat: The list is not intended to be all-inclusive, but rather key examples of “red flags” signaling that a denture should be replaced).
2. If denture adhesives are required for the patient to eat, or to retain the dentures socially (i.e., when the dentures will not remain in place by themselves), or when adhesives must be used more than once daily.
3. If the patient will not, or cannot, wear the removable prostheses.
4. If the removable prostheses have degraded sufficiently to lead to prosthesis instability, loss of retention, loss of esthetics, loss of support, inability to eat, or if the prostheses or prosthetic teeth are discolored, cracked, broken, or missing.
5. If the teeth supporting a removable partial denture or overdenture are lost.
6. If the prosthesis has been in function for more than 5 years.