**THE UNIVERSITY OF WESTERN AUSTRALIA** Oral Health Centre of Western Australia ## Removable Partial Denture: Clinical and laboratory steps Dr Matsubara   Oral Health Centre of Western Australia Dr Matsubara Clinical photo showing a gloved hand holding a metal framework of a removable partial denture. The image is overlaid with the title 'Removable Partial Denture: Clinical and laboratory steps'. Clinical photo showing a gloved hand holding a complete removable partial denture with artificial teeth. The image is overlaid with the title 'Removable Partial Denture: Clinical and laboratory steps'. # **RPD** **The University of Western Australia | Oral Health Centre of Western Australia** ## Initial appointment: Clinical examination * Presenting complaint and its history * Medical history (medications) * Dental history (previous prosthesis) * Patient expectations ## Oral examination * TMJ and MoM * Occlusion * Vitality of strategic teeth * Periodontal assessment of abutment teeth * Assessment of soft tissues * Study models on articulator #### Patient History and Expectations - Presenting complaint and its history - Medical history (including medications) - Dental history (previous prosthesis) - Patient expectations #### Clinical Assessment - TMJ and Muscles of Mastication (MoM) - Occlusion - Vitality of strategic teeth - Periodontal assessment of abutment teeth - Assessment of soft tissues - Study models on articulator # Study Models The University of Western Australia Oral Health Centre of Western Australia ## **RPD** | **CLINIC** | | **LAB** | | :--- | :--- | :--- | | Upper and lower preliminary impression | ⟶ | Upper and Lower Cast | | Mounting of study models on semi-adjustable articulator | ← | Base & Rim | | | **MMR** | If required |   #### Clinical and Laboratory Workflow 1. **Preliminary Impressions (Clinic)**: Upper and lower preliminary impressions are taken. 2. **Cast Fabrication (Lab)**: Creation of upper and lower casts. 3. **Base and Rim Construction (Lab)**: Fabrication of base and rim if required for Maxillo-Mandibular Relationship (MMR). 4. **Articulation (Clinic)**: Mounting of study models on a semi-adjustable articulator. Clinical photo showing a semi-adjustable articulator with upper and lower dental study models mounted on it, demonstrating the mounting of study models as described in the workflow. Clinical photo displaying two dental casts (upper and lower) with pink base material and red rim material applied, illustrating the 'Base & Rim' stage of the RPD study model process. Almost 40 terabytes of data from this streaming site   Almost 40 terabytes of data from this streaming site Clinical photo showing the recording of centric relation using a leaf gauge. The image displays a patient's anterior teeth with an orange bite registration material placed between the upper and lower arches. A blue stack of leaf gauges is inserted into the incisal edge space between the central incisors to measure the occlusal vertical dimension (OVD). The caption below identifies this as 'Leaf gauge'. Visual figure displaying a set of stacked leaf gauges fanned out against a white background. The gauges are thin, semi-transparent plastic strips used for measuring small distances. One specific leaf is marked with the number '56'. The caption below indicates that each leaf has a thickness of 200 µm. # RPD ## Study Models Willis bite gauge Calipers Compass    #### Measurement Tools for Study Models - Willis bite gauge - Calipers - Compass Labelled diagram showing dental study models: a Willis bite gauge and calipers against a blue background. Clinical photo of a patient's profile with a Willis bite gauge positioned to measure facial distance. Procedure image showing gloved hands using a compass to measure the distance between the nose and chin on a patient's face. # RPD ## Study Models **OVD = RVD – Freeway space**   #### Vertical Dimension Calculation OVD = RVD – Freeway space Schematic diagram illustrating the relationship between Overdenture Vertical Dimension (OVD), Restorative Vertical Dimension (RVD), and Freeway space. The diagram shows two opposing jaw profiles with dotted shading representing tissue. A dashed line indicates the freeway space at the bottom, a shorter vertical arrow labeled 'OVD' measures the occlusal clearance above it, and a longer vertical arrow labeled 'RVD' spans from the same baseline to the occlusal plane. Text annotation reads 'OVD = RVD – Freeway space'. This visual demonstrates how to calculate OVD based on anatomical measurements. Clinical photograph showing a patient’s face in profile during an oral health assessment. A black rectangular device, likely a facebow or measurement tool, is positioned against the cheek near the mouth. The skin displays redness and small lesions, possibly indicating dermatological conditions relevant to prosthetic planning or study model fabrication. The image supports practical application of concepts like OVD and RVD by showing real-world clinical context. RPD **The University of Western Australia** | Oral Health Centre of Western Australia ## Study Models ### Phonetics tests / speaking method * Sibilant phonemes: S sound * 2-3 mm between incisors (closest speaking space) #### Phonetics Tests and Speaking Method - Sibilant phonemes: S sound - 2-3 mm between incisors (closest speaking space) RPD ThE UNIVERSITy OF WESTERN AUSTRALIA | Oral Health Centre of Western Australia Study Models Diagnostic workup • Simulate the teeth position • Wax-up crowns and changes on the occlusal plane • Plan survey crowns Prof Hotinski RPD   #### Diagnostic Workup Objectives - Simulate the teeth position - Wax-up crowns and changes on the occlusal plane - Plan survey crowns Clinical study model showing diagnostic workup for RPD. Two views of dental casts with red wax-up simulating teeth position and occlusal plane changes. Left view shows anterior-posterior perspective; right view shows lateral occlusion. Caption 'Prof Hotinski' below. Close-up photo of a partial denture framework on a cast, showing pink acrylic base with metal clasps engaging abutment teeth. Demonstrates survey crown planning or final prosthesis design. **RPD** **LYC** RPD Survey and Design -> Mouth preparation - Another study model - Endodontic treatment - Periodontal treatment - Direct restorations - Guiding planes - Rest seats - **Survey crowns** Oral Health Centre of Western Australia THE UNIVERSITY OF WESTERN AUSTRALIA RPD   #### Mouth Preparation Sequence Following RPD Survey and Design, mouth preparation includes: - Another study model - Endodontic treatment - Periodontal treatment - Direct restorations - Guiding planes - Rest seats - Survey crowns Clinical photo showing a dental study model (white plaster) with a metal surveyor tool positioned against the tooth structure. This image illustrates the 'LAB' phase of RPD Survey and Design, demonstrating how contours are analyzed on a physical replica. Clinical photo showing an intraoral view of a tooth being prepared by a dentist. A high-speed handpiece is cutting into the tooth surface, illustrating the 'CLINIC' phase of Mouth preparation. This visual corresponds to the text list including Endodontic treatment, Guiding planes, and Rest seats. ### `RPD` **The University of Western Australia Oral Health Centre of Western Australia** #### Clinical Process for RPD (Removable Partial Denture) | Stage | Location | Description | Related Procedures/Notes | | :--- | :--- | :--- | :--- | | **CLINIC** | Clinic | **Mouth preparation** | Prepares the teeth for the denture. | | **LAB** | Laboratory | **Special tray** | Special tray (On Duplicate Study Model) is fabricated. | | **CLINIC** | Clinic | **Final Impression** | **Final Impression**<br>Elastomeric impression | | --- | --- | --- | | **Conventional workflow** | | (Special tray process) | | | | | | | | | **Master Model** | | | | | | | **Need to send:** | | | | | - Master model & bite reg | | | | | - Study model with framework design | | | | | - Lab slip (location and type of clasp, rest location, teeth being replaced, tooth shade) | | <br> **RPD** | | | | | | Acrylic partial denture | | **Need to send:** | | | | | - Master model | | | | | - Bite registration | | | | | - Lab slip (location of clasp, teeth being replaced, tooth shade) | | | Co-Cr partial denture | | |  #### Clinical and Laboratory Requirements | Stage | Location | Description | Notes | | :--- | :--- | :--- | :--- | | **CLINIC** | Clinic | Mouth preparation | Prepares teeth for the denture | | **LAB** | Laboratory | Special tray | Fabricated on duplicate study model | | **CLINIC** | Clinic | Final Impression | Elastomeric impression | #### Laboratory Submission Requirements **For Co-Cr Partial Denture (Conventional Workflow):** - Master model and bite registration - Study model with framework design - Lab slip (clasp location/type, rest location, teeth replaced, tooth shade) **For Acrylic Partial Denture:** - Master model - Bite registration - Lab slip (clasp location, teeth replaced, tooth shade) Flowchart diagram illustrating the clinical and laboratory workflow for an RPD (Removable Partial Denture). The process starts at the 'CLINIC' with 'Mouth preparation', moves to the 'LAB' for a 'Special tray (On Duplicate Study Model)', then returns to the 'CLINIC' for a 'Final Impression' using elastomeric impression material. This is labeled as the 'Conventional workflow'. The flow continues downwards to a 'Master Model'. From the Master Model, two branches emerge: one leading to an 'Acrylic partial denture' and another to a 'Co-Cr partial denture'. Below each branch, specific items 'Need to send' are listed (e.g., Master model & bite reg, Lab slip details). | DIAGRAM TITLE | RPD | | :--- | :--- | | **TOP ROW - LOGOS** | **THE UNIVERSITY OF**<br>**WESTERN**<br>**AUSTRALIA**<br>*(Logo: University of Western Australia Swan)* | | | **Oral Health Centre**<br>*(Logo: Stylized Scroll)*<br>**of Western Australia** | | **MAIN FLOWCHART** | **CLINIC** | | | **[ Box ]** Mouth preparation | | | **[ Box ]** Master Model | | | **[ Box - Red Border ]** Acrylic partial denture | | | **[ Box ]** Mount the models<br>on articulator | | | **[ Box ]** Tooth setting | | | **[ Box ]** Denture try-in | | | **[ Box ]** Processing | | | **[ Box ]** Insertion | | **CENTER SECTION** | **LAB** | | | **Special tray**<br>*(study model)* | | | **Conventional workflow** | | **RIGHT COLUMN (CLINIC)** | **[ Box ]** Final Impression | | | Elastomeric impression |   #### Workflow Summary 1. **Clinic:** Mouth preparation 2. **Lab:** Special tray (from study model) 3. **Clinic:** Final Impression (Elastomeric) 4. **Clinic:** Master Model 5. **Clinic:** Acrylic partial denture path: - Mount models on articulator - Tooth setting - Denture try-in - Processing - Insertion Flowchart diagram illustrating the 'Conventional workflow' for RPD. It shows a sequence starting at CLINIC (Mouth preparation), moving to LAB (Special tray/study model), and returning to CLINIC (Final Impression/Elastomeric impression). The diagram includes red arrows indicating the process flow. Detailed procedural diagram showing steps from Master Model to Insertion. Includes text boxes: Acrylic partial denture (red border), Mount models on articulator, Tooth setting, Denture try-in, Processing, Insertion. Visual elements include photos of a cast with pink base, intraoral view of teeth in denture, close-up of acrylic partial denture, and final insertion photo. ```mermaid graph TD subgraph LAB1 [LAB] A[Special tray<br/>study model] end subgraph CLINIC1 [CLINIC] B[Mouth preparation] C[Final Impression<br/>Elastomeric impression] end A --> C B --> C C -- "Conventional workflow<br/>Impressions<br/>Study model with framework design<br/>Lab prescription" --> D[Master Model] D --> E[Co-Cr partial<br/>denture] E --> F[Survey<br/>Block out undercuts] F --> G[Cast Co-Cr framework] G --> H[Framework try-in] H --> I[Mounting of Master<br/>model on Articulator] I --> J[Tooth setting] J --> K[Denture try-in] K --> L[Denture processing] L --> M[Insertion] ```  #### Detailed Co-Cr Workflow 1. **Initial Steps:** Special tray (Lab) and Mouth preparation (Clinic). 2. **Impression:** Final Elastomeric impression (Clinic). 3. **Master Model:** Created from impressions, study model with design, and lab prescription. 4. **Framework Fabrication:** - Survey and block out undercuts - Cast Co-Cr framework 5. **Clinical Integration:** - Framework try-in - Mounting of Master model on Articulator - Tooth setting - Denture try-in 6. **Finalization:** - Denture processing - Insertion Flowchart diagram illustrating the RPD (Removable Partial Denture) workflow. The chart is divided into sections labeled 'CLINIC' and 'LAB'. It begins with 'Mouth preparation' in the clinic, followed by 'Final Impression' using an elastomeric impression. The process then moves to the lab for creating a 'Master Model', which leads to the fabrication of a 'Co-Cr partial denture'. Subsequent steps include surveying, blocking out undercuts, casting the Co-Cr framework, framework try-in, mounting the master model on an articulator, tooth setting, denture try-in, denture processing, and finally insertion back at the clinic. Logos for The University of Western Australia and Oral Health Centre of Western Australia are present in the top right corner. **RPD** **Elastomeric Impression for framework fabrication** Thickness of the custom try border = 2-3mm Watch the video "Partial Custom Try"    #### Elastomeric Impression Specifications - Used for framework fabrication. - Thickness of the custom tray border: 2-3mm. Clinical photo showing a yellow custom tray with visible border thickness. Caption below indicates 'Thickness of the custom try border = 2-3mm'. Clinical photo displaying an elastomeric impression material in cross-section, showing layered structure with green outer layer and pink inner core. Clinical photo of a red-and-white elastomeric impression taken from a patient's mouth, demonstrating proper border extension for framework fabrication. **RPD** **THE UNIVERSITY OF WESTERN AUSTRALIA** **Oral Health Centre of Western Australia** # Elastomeric Impression for framework fabrication  Elastomeric Impression for framework fabrication Clinical photo showing an elastomeric impression of a maxillary arch for RPD framework fabrication. The purple base material covers the palatal vault and gingival margins, while the orange addition silicone captures detailed tooth anatomy. **RPD** **THE UNIVERSITY OF** **WESTERN AUSTRALIA** Oral Health Centre of Western Australia **Beading and Boxing the impression to pour up the master model** **Watch the video “Beading and Boxing”**   #### Master Model Preparation - Beading and Boxing the impression to pour up the master model. Procedure image showing a pair of hands performing the 'Beading' step on a dental impression. A blue border (bead) is being applied to the periphery of a purple/red impression material using a black instrument. Procedure image showing the 'Boxing' step completed on a dental impression. The impression material (purple/red with blue occlusal detail) is seated inside a red wax or plastic tray box. **RPD** **MASTER MODEL** Duplicate the master model Surveying Block out undercuts #### Master Model Processing - Duplicate the master model - Surveying - Block out undercuts # RPD ### **The University of Western Australia | Oral Health Centre of Western Australia** **Duplication of master model after the block out of undercuts and reliefs** **Investment model for the framework fabrication** <div style="text-align: center;"> | | | | :--- | :--- | | | | </div> <!-- Video Icon --> ****Watch the video "Duplicating"**    #### Investment Model Preparation - Duplication of master model after the block out of undercuts and reliefs. - Creation of the investment model for framework fabrication. Clinical photo of a blue silicone duplicating mold (Dentaurum brand) containing an impression of the dental arch. Product shot of 'Wirosil' silicone duplicating material packaging and bottles (BEGO brand). Clinical photo showing two plaster models: one is a duplicate cast with visible reliefs and undercuts, and the other appears to be the original master model. RPD Waxing the RPD framework (on investment model)    #### Framework Waxing - Waxing the RPD framework on the investment model. Schematic diagram of an upper dental cast showing the placement of a Removable Partial Denture (RPD) framework. The image displays a wire outline representing the metal framework and red markings indicating clasps engaging with specific teeth. Clinical photo demonstrating the waxing process of an RPD framework on an investment model. A blue wax structure covers the anterior teeth and connects to a red wax retentive clasp assembly extending posteriorly over the alveolar ridge. Close-up clinical photo of the posterior section of the waxed RPD framework. It highlights the detailed construction of the red retentive arm and blue major connector/wax base in relation to the tooth anatomy. # RPĐ **THE UNIVERSITY OF WESTERN AUSTRALIA** | Oral Health Centre of Western Australia ## Casting of RPD framework Spruing Sprue Burnout technique McCracken's Removable Partial Prosthodontics     #### Casting Procedures - Spruing and sprue placement - Burnout technique - Reference: McCracken's Removable Partial Prosthodontics Clinical photo labeled 'Spruing' showing a red cylindrical sprue attached to a dental cast. A black arrow points to the connection area labeled 'Sprue', illustrating the spruing process for an RPD framework. Photo showing the application of investment material around a dental model and sprue during the casting preparation phase. Photo showing a completed white investment ring (flask) containing the invested dental cast and sprue, ready for burnout. Photo labeled 'Burnout technique' showing an investment flask being placed inside a furnace using tongs, demonstrating the burnout step in the casting process. # RPD ## Casting of RPD framework   Casting of RPD framework Clinical photo showing a dental wax pattern (wax-up) of an RPD framework mounted on a green impression tray. The wax structure is light blue/white with a central cylindrical sprue hole, demonstrating the pre-casting stage. Clinical photo showing the cast metal framework of an RPD after casting and removal from the mold. The metallic structure features a horseshoe-shaped retentive clasp assembly and rests against a dark background. **RPD** Casting of RPD framework **McCracken’s Removable Partial Prosthodontics**    Casting of RPD framework (Reference: McCracken’s Removable Partial Prosthodontics) Clinical photo showing the first step of casting an RPD framework: 'Blockout of the master cast'. The image displays a dental model (master cast) with specific areas blocked out using material to prevent investment material from entering undercuts. Clinical photo showing the second step: 'Wax pattern on investment model'. A wax pattern of the metal framework is attached to the cast for casting purposes. Note the central hole in the base of the model. Clinical photo showing the third step: 'Cast framework on the duplicated master cast'. The final metal framework has been cast and is shown fitted onto a duplicate cast of the patient's dentition. **RPD** **FRAMEWORK TRY-IN** **Assessing the Cast framework off the model** * Defects on the tissue side of the framework, * Check for abraded areas on the master cast; * Assess the smoothness of the framework; * Check for adequate thickness.  #### Extra-oral Framework Assessment Assessing the cast framework off the model: - Check for defects on the tissue side of the framework. - Check for abraded areas on the master cast. - Assess the smoothness of the framework. - Check for adequate thickness. Clinical photo of a metallic Removable Partial Denture (RPD) cast framework placed on a dental stone model. The image serves to visually demonstrate the assessment criteria listed in the text, such as checking for defects on the tissue side and verifying adequate thickness. The University of Western Australia | Oral Health Centre of Western Australia **RPD** **FRAMEWORK TRY-IN** **Assessing the Cast framework on the master model** * **Verify** if the framework follows the design that you created * **Check** the seating of the framework on the master model * **Check** for proper adaptation and placement of clasps * **Check** the ease of framework removal   #### Framework Assessment on Master Model - **Verify** if the framework follows the created design. - **Check** the seating of the framework on the master model. - **Check** for proper adaptation and placement of clasps. - **Check** the ease of framework removal. Clinical photo showing a metal cast framework seated on a lower dental master model. The framework includes clasps and rests adapted to the teeth, demonstrating the 'seating' and 'adaptation' steps mentioned in the text. Close-up clinical photo of a specific clasp assembly on a master model. This view illustrates the detailed check for 'proper adaptation and placement of clasps' as described in the slide instructions. - **RPD** # FRAMEWORK TRY-IN ## Assessing the Cast framework in the mouth * Seating of the framework in the mouth: **PASSIVE SEATING** * Fully seated on rest seats with clasps in the correct position * Retention and stability * Relationship with soft tissue    #### Intra-oral Framework Assessment - Seating of the framework in the mouth: **PASSIVE SEATING**. - Ensure it is fully seated on rest seats with clasps in the correct position. - Evaluate retention and stability. - Evaluate relationship with soft tissue. Clinical photo showing a metal RPD framework being inserted into the mouth. The image demonstrates the 'seating of the framework' process mentioned in the text, viewed through a dental mirror to show the clasp engaging with the tooth. Clinical photo of an upper jaw (maxilla) displaying a cast framework try-in. The metal framework is seated on the natural teeth, illustrating the assessment of retention and stability as described in the bullet points. Clinical photo of a lower jaw (mandible) showing a cast framework try-in. This visual aids in assessing the relationship between the framework and soft tissue, as well as verifying that clasps are in the correct position. **RPD** Framework adjustment The UNIVERSITY OF WESTERN AUSTRALIA | Oral Health Centre of Western Australia     Framework adjustment Clinical intraoral photograph showing a metal framework clasp (retainer) engaging an abutment tooth. The framework is coated with green impression material or baseplate wax to demonstrate the fit against the gingival tissue and tooth surface. Close-up procedural image demonstrating a specific adjustment step on a dental cast. A gloved hand holds the model while a red arrow points to a sharp edge of the green wax framework where it contacts the occlusal surface, indicating a point for grinding or smoothing. Close-up photo of a dental instrument tip applying pressure to a sharp corner of the green framework on a cast, illustrating the mechanical removal of excess material. Intraoral view showing the adjusted framework seated on the patient's gums. This image serves as a post-adjustment comparison to show how the retainer fits after the modification shown in the other panels. RPD Framework adjustment **THE UNIVERSITY OF** **WESTERN** **AUSTRALIA** Oral Health Centre of Western Australia    Framework adjustment Clinical photo showing an intraoral view of a lower dental arch with a metal framework being adjusted. A gloved hand is visible on the left side, holding or manipulating the appliance near a molar tooth. Close-up clinical photo of a metallic partial denture framework held by gloved hands. The framework includes blue modeling compound (likely impression material) applied to specific areas for adjustment or fit-checking purposes. Intraoral clinical photo showing the insertion or adjustment of a lower removable partial denture (RPD). Gloved fingers are positioning the metal framework over the patient's teeth and gingival tissues. **RPD** # Framework adjustment • Minor connectors • Reciprocating arm • 2/3 Retentive arm Never the final 1/3 of the Retentive arm   #### Components for Adjustment - Minor connectors - Reciprocating arm - 2/3 of the Retentive arm **Note:** Never adjust the final 1/3 of the Retentive arm. Schematic diagram of a removable partial denture (RPD) framework showing metal arms. Red boxes highlight specific areas: one on a minor connector and another on the retentive arm. The diagram illustrates the structural components relevant to framework adjustment. Clinical photograph of a cast dental model with an RPD framework in place. Blue material highlights the path of insertion or occlusal surfaces. A red arrow points to a specific area of the framework, likely indicating a site for adjustment as per the slide title 'Framework adjustment'. RPD # Framework adjustment Occlusion interferences  #### Occlusal Adjustments - Identification and removal of occlusion interferences. Clinical photo showing an intraoral view of the lower left quadrant with a metal framework in place. The image demonstrates occlusion interferences during framework adjustment for an RPD (Removable Partial Denture). Visible are natural teeth and the metallic structure of the denture framework. The complete OCR text for the provided PDF page is as follows, inclusive of all header, body, and footer information. This includes the University of Western Australia branding, "The Oral Health Centre of Western Australia", the page title "Maxillo-mandibular relationship", and the subtitle "Mount master model". ```markdown # RPD | Maxillo-mandibular relationship | | The University of Western Australia | |:---|:---|:---| | **Mount master model** | | The Oral Health Centre of Western Australia | * Add acrylic base to saddle region * Connected to the framework * CI I, II, extensive IV ```       #### Mounting the Master Model - Add acrylic base to saddle region. - Connect base to the framework. - Applicable for Kennedy Class I, II, and extensive IV. Clinical photo of a maxillo-mandibular relationship model showing an upper dental arch with metal framework and acrylic base added to saddle region. The black wire mesh indicates the framework connected to the teeth. Clinical photo of a master model for RPD (Removable Partial Denture) preparation, showing CI I, II, extensive IV classification. The model displays prepared tooth areas outlined in black ink on the cast. Clinical photo showing pink acrylic base material applied to the saddle region of a master model, demonstrating the addition step before final framework connection. Clinical photo of a partially completed RPD framework with metal components and some acrylic base material visible, illustrating intermediate construction stage. Clinical photo showing transparent or semi-transparent acrylic base material formed over the saddle region of a master model, demonstrating the mounting process for RPD fabrication. Clinical photo of a completed RPD framework with clear acrylic base attached, showing the final mounted structure ready for clinical use or further processing. IMG text: RP D Maxillo-mandibular relationship Mount master model Cl I, II, extensive IV **RPD** **The University of Western Australia | Oral Health Centre** of Western Australia Maxillo-mandibular relationship Mount master model CI I, II, extensive IV     #### Maxillo-mandibular Relationship Mount master model for Kennedy Class I, II, and extensive IV. Clinical photo showing a lower dental cast with an RPD (Removable Partial Denture) framework and pink acrylic flange. Next to it is the detached denture component with metal clasps, illustrating the 'Mount master model' step for CI I, II, extensive IV cases. Clinical photo of a mounted maxillo-mandibular relationship setup. Shows an upper cast with a denture base and a lower cast with teeth and RPD clasps, demonstrating how the models are positioned relative to each other. Close-up clinical photo of the occlusal view of the upper jaw cast showing the arrangement of artificial teeth on the denture base within the mount. Close-up clinical photo showing two blue-colored wax or material blocks connected by a metal bar, likely representing part of the RPD framework or mounting apparatus. The University of Western Australia | Oral Health Centre of Western Australia Maxillo-mandibular relationship        Maxillo-mandibular relationship Clinical photo showing an upper removable partial denture (RPD) framework with metal mesh clasps and acrylic base, placed on a dental cast. The image demonstrates the fit and design of the prosthesis against the maxillary arch. Intraoral clinical photo of an upper RPD in situ, showing the metal framework adapted to the patient's palate with visible clasps engaging abutment teeth. Demonstrates functional placement within the oral cavity. Photo of an upper RPD with red wax or soft liner material applied over the metal framework on a cast. Likely used for evaluating occlusal contacts or comfort during fabrication. Lateral view of an upper RPD on a cast, showing the metal framework extending posteriorly with pink acrylic base. Illustrates the depth and contour adaptation to the maxillary ridge. Intraoral photo showing an upper RPD with a metal clasp engaging a natural tooth and pink acrylic base seated against the gingiva. Demonstrates the relationship between the prosthesis and adjacent dentition. Frontal intraoral photo showing an upper RPD with purple articulating paper marks indicating occlusal contact points between the prosthesis and lower teeth. Highlights the maxillo-mandibular relationship during function. Occlusal view of an upper RPD with purple articulating paper showing contact areas along the buccal cusps and posterior regions. Used to evaluate occlusion and vertical dimension in relation to the mandible. **RPD** **Altered Cast Technique** **The University of WESTERN AUSTRALIA** Oral Health Centre of Western Australia **Mandible CI I and II** **Prof Hotinski photos** #### Indications for Altered Cast - Mandible Kennedy Class I and II. # Altered Cast Technique ## Altered cast impression technique - Use putty for border molding and light body material to copy the free end saddle ridge - Finger pressure is applied only to the rest, never the free end saddle area (tray) - Ask the patient to make the movements with the tongue and retract the cheeks to copy the soft tissues in function (always keep the finger pression to avoid dislodgement of the framework. - Framework must remain stable until the complete set of impression material. Feit. JADA 199 #### Altered Cast Impression Technique - Use putty for border molding and light body material to copy the free end saddle ridge. - Apply finger pressure **only** to the rest; never apply pressure to the free end saddle area (tray). - Patient movements: Ask the patient to move the tongue and retract cheeks to capture soft tissues in function. - Stability: Maintain finger pressure until the impression material is completely set to avoid framework dislodgement. (Reference: Feit. JADA 199) RPD Maxillo-mandibular relationship Arranging teeth and waxing the denture base.  #### Laboratory Procedures - Arranging teeth and waxing the denture base. Clinical photo showing the arrangement of teeth and waxing of a denture base. The image displays dental casts with artificial teeth positioned in the maxillary and mandibular arches, demonstrating the maxillo-mandibular relationship during RPD fabrication. **RPD** **Maxillo-mandibular relationship** **Try-in** • Evenness of occlusal contact • Occlusal vertical dimension • Appearance • Relationship to the neutral zone **THE UNIVERSITY OF WESTERN AUSTRALIA** **Oral Health Centre of Western Australia**   #### Try-in Evaluation Criteria - Evenness of occlusal contact - Occlusal vertical dimension - Appearance - Relationship to the neutral zone Clinical photo of a lower removable partial denture (RPD) try-in. The image shows the metal framework and teeth of the prosthesis seated in the patient's mouth. Visible are the clasps engaging the abutment teeth and the occlusal surfaces of the artificial teeth. This visual demonstrates the 'Relationship to the neutral zone' mentioned in the text. Clinical photo of an upper and lower RPD try-in showing maxillo-mandibular relationship. Both arches contain prosthetic teeth with visible clasps. The image allows for assessment of the 'Evenness of occlusal contact', 'Occlusal vertical dimension', and 'Appearance' as listed in the text.   Anatomical cross-section diagram of the oral cavity illustrating maxillo-mandibular relationships. Labeled structures include: Maxilla (upper jaw), Cheek (buccal region), Potential denture space (central void between jaws), Tongue (floor of mouth), and Mandible (lower jaw). The image demonstrates how these anatomical features relate to each other in the context of denture placement. Comparative schematic showing two scenarios labeled 'Correct' and 'Wrong'. It illustrates the relationship between teeth (represented by white shapes) and surrounding soft tissue (pink/red gradient areas). The 'Correct' side shows proper alignment with balanced forces, while the 'Wrong' side depicts misalignment or improper positioning relative to the vertical dashed line dividing the sections. # Processing the denture **RPD** THE UNIVERSITY OF WESTERN AUSTRALIA Oral Health Centre of Western Australia Watch the video "Denture processing"     Processing the denture Clinical photo of a denture base with artificial teeth and metal clasps (RPD components) attached to a dental cast. Step in denture processing showing the waxed-up denture framework inside a flask mold filled with plaster or stone. Step in denture processing showing the denture base material (pink acrylic) set within the flask mold after removal of excess material. Step in denture processing showing the opened flask revealing the processed denture base on one side and the metal framework embedded in wax on the other side. RPD insertion RPD insertion RPD Project **RPD insertion** Defects on the denture base Voids, porosity Oral Health Centre of Western Australia The University of Western Australia     #### Inspection at Insertion - Check for defects on the denture base. - Inspect for voids and porosity. Clinical photo showing a pink denture base held by metal clasps. A thin metal probe is inserted into a visible void on the surface of the denture base, demonstrating porosity or incomplete filling. Clinical photo of a pink denture base with a curved metal probe pressing against it. The image highlights a defect area where the material appears porous or has a void, illustrating poor adaptation or fabrication issues. Close-up clinical photo of a pink denture base showing surface irregularities, including white discolorations and cracks. These defects may indicate material failure, wear, or manufacturing flaws affecting fit and function. Clinical photo displaying the occlusal view of a pink denture base with artificial teeth. Visible are multiple small circular pores on the underside of the base, indicating porosity that could compromise structural integrity and retention. **RPD** **RPD insertion** **Defects on the denture base** 1 – Sharp projections and acrylic nodules 2 – Sharp edges 3 – Overextension into bony undercuts **PAIN**  #### Common Base Defects Causing Pain 1. Sharp projections and acrylic nodules 2. Sharp edges 3. Overextension into bony undercuts Labeled diagram of a denture base showing defects causing pain. Labels: 1 points to sharp projections and acrylic nodules on the ridge; 2 points to sharp edges; 3 points to overextension into bony undercuts. Text annotations include 'RPD insertion', 'Defects on the denture base', and 'PAIN' with downward arrow. **RPD** **RPD** **RPD insertion** **Adjustment of the saddles** THE UNIVERSITY OF WESTERN AUSTRALIA | Oral Health Centre of Western Australia   Adjustment of the saddles Clinical photo showing a blue impression material on a dental cast with metal clasps, demonstrating the adjustment of saddles during RPD insertion. Close-up clinical photo of a dental handpiece adjusting an RPD saddle against gum tissue and teeth, illustrating the insertion process. # RPD **THE UNIVERSITY OF WESTERN AUSTRALIA** **Oral Health Centre of Western Australia** Denture is not well adapted to the alveolar ridge * Reline of the denture base Mandibular class I and II Pick up impression    #### Management of Poor Adaptation If the denture is not well adapted to the alveolar ridge (specifically Mandibular Class I and II): - Reline of the denture base - Pick up impression Clinical photo of a 'Pick up impression' (likely zinc oxide eugenol) applied to the interior surface of a denture base. The image demonstrates the material being used for relining the denture. Clinical photo showing a mandibular removable partial denture in situ. It illustrates a flabby ridge area and a metal clasp on an abutment tooth, demonstrating poor adaptation to the alveolar ridge as described in the text. Photo of a mandibular denture base with pink acrylic resin and blue/white border material (likely a reline material or impression compound). This visual represents the 'Reline of the denture base' procedure mentioned in the text. | RPD | | --- | | Occlusal contacts are inadequate | | | | • Open bite in the edentulous area (teeth are bellow the occlusal plane) | | • High OVD (teeth are too high) | | Bite registration | | Pick-up impression |     #### Management of Inadequate Occlusal Contacts **Clinical Findings:** - Open bite in the edentulous area (teeth are below the occlusal plane) - High OVD (teeth are too high) **Corrective Procedures:** - Bite registration - Pick-up impression Clinical photo of an upper dentition showing inadequate occlusal contacts. The image demonstrates an open bite in the edentulous area where teeth are below the occlusal plane, and indicates high OVD (over vertical dimension) as teeth appear too high. Clinical photo of a side view of dentition showing similar occlusal issues, illustrating how teeth are positioned too high relative to the opposing arch. Procedure image labeled 'Bite registration'. Shows a dental cast with purple articulating material representing the bite registration process, demonstrating how occlusal relationships are recorded for RPD fabrication. Procedure image labeled 'Pick-up impression'. Shows a dental cast with white impression material surrounding teeth, demonstrating the pick-up impression technique used in RPD fabrication. ```mermaid graph TD subgraph Clinic C1[Clinical Examination<br/>Occlusal analysis<br/>Alginate impressions (upper and lower)] C2[Facebow record<br/>Maxillo-Mandibular Relationship] C3[Mouth preparation<br/>Survey Crowns (if required)] C4[Final Impression] C5[Framework try-in] C6[MMR with base and rim attached<br/>to the framework<br/>Alter cast technique (if required)] C7[Denture try-in] C8[Denture insertion] end subgraph Laboratory L1[Upper and lower Study models] L2[Duplicate Study models] L3[Base & Rim<br/>(If required)] L4[Mounting of models on articulator] L5[Diagnostic Assessment<br/>Diagnostic workup/wax-up] L6[Survey of Study model<br/>& Design of framework] L7[Special tray<br/>(on Study model)] L8[Beading and Boxing<br/>Master Model] L9[Duplicate Master Model<br/>(Processing model)] L10[Survey of Master model<br/>Block out Undercuts on Master model<br/>Duplicate block out model - Investment model] L11[Cast Framework<br/>(on Investment model)] L12[Mount Master Models on articulator<br/>(Cross Mount Processing Model)] L13[Tooth setting] L14[Denture processing] end C1 --> L1 L1 --> L2 L1 --> L3 L3 --> C2 C2 --> L4 L4 --> L5 L5 --> L6 L2 -.-> L6 L6 --> C3 L6 --> L7 C3 --> C4 L7 -.-> C4 C4 --> L8 L8 --> L9 L8 --> L10 L10 --> L11 L11 --> C5 C5 --> C6 C6 --> L12 L9 --> L12 L12 --> L13 L13 --> C7 C7 --> L14 L14 --> C8 ```  #### Comprehensive Workflow Summary **Clinical Stages:** 1. Examination, occlusal analysis, and alginate impressions. 2. Facebow record and Maxillo-Mandibular Relationship (MMR). 3. Mouth preparation and survey crowns. 4. Final Impression. 5. Framework try-in. 6. MMR with base/rim and Altered Cast technique (if required). 7. Denture try-in. 8. Denture insertion. **Laboratory Stages:** 1. Study model fabrication and duplication. 2. Base and rim construction. 3. Articulator mounting and diagnostic wax-up. 4. Survey and framework design. 5. Special tray fabrication. 6. Master model beading, boxing, and duplication. 7. Framework casting on investment model. 8. Tooth setting and denture processing. Flowchart diagram illustrating the 'Workflow for Co-Cr RPD' (Cobalt-Chromium Removable Partial Denture). The diagram is split into two columns: 'Clinic' on the left and 'Laboratory' on the right. It details a step-by-step process starting with Clinical Examination and Alginate impressions in the Clinic, leading to Study models and Diagnostic Assessment in the Laboratory. Subsequent steps include Mouth preparation, Final Impression, Beading and Boxing of the Master Model, Cast Framework, Framework try-in, Denture try-in, and finally Denture insertion. Arrows indicate the sequence of actions and data flow between clinic visits and laboratory processing stages. # THE UNIVERSITY OF WESTERN AUSTRALIA Oral Health Centre of Western Australia Thank you Oral Health Centre of Western Australia Thank you [^1]: Original PDF page 1: [[L9 Clinical Sequence for RPD.pdf#page=1|L9 Clinical Sequence for RPD, p.1]] [^2]: Original PDF page 2: [[L9 Clinical Sequence for RPD.pdf#page=2|L9 Clinical Sequence for RPD, p.2]] [^3]: Original PDF page 3: [[L9 Clinical Sequence for RPD.pdf#page=3|L9 Clinical Sequence for RPD, p.3]] [^4]: Original PDF page 4: [[L9 Clinical Sequence for RPD.pdf#page=4|L9 Clinical Sequence for RPD, p.4]] [^5]: Original PDF page 5: [[L9 Clinical Sequence for RPD.pdf#page=5|L9 Clinical Sequence for RPD, p.5]] [^6]: Original PDF page 6: [[L9 Clinical Sequence for RPD.pdf#page=6|L9 Clinical Sequence for RPD, p.6]] [^7]: Original PDF page 7: [[L9 Clinical Sequence for RPD.pdf#page=7|L9 Clinical Sequence for RPD, p.7]] [^8]: Original PDF page 8: [[L9 Clinical Sequence for RPD.pdf#page=8|L9 Clinical Sequence for RPD, p.8]] [^9]: Original PDF page 9: [[L9 Clinical Sequence for RPD.pdf#page=9|L9 Clinical Sequence for RPD, p.9]] [^10]: Original PDF page 10: [[L9 Clinical Sequence for RPD.pdf#page=10|L9 Clinical Sequence for RPD, p.10]] [^11]: Original PDF page 11: [[L9 Clinical Sequence for RPD.pdf#page=11|L9 Clinical Sequence for RPD, p.11]] [^12]: Original PDF page 12: [[L9 Clinical Sequence for RPD.pdf#page=12|L9 Clinical Sequence for RPD, p.12]] [^13]: Original PDF page 13: [[L9 Clinical Sequence for RPD.pdf#page=13|L9 Clinical Sequence for RPD, p.13]] [^14]: Original PDF page 14: [[L9 Clinical Sequence for RPD.pdf#page=14|L9 Clinical Sequence for RPD, p.14]] [^15]: Original PDF page 15: [[L9 Clinical Sequence for RPD.pdf#page=15|L9 Clinical Sequence for RPD, p.15]] [^16]: Original PDF page 16: [[L9 Clinical Sequence for RPD.pdf#page=16|L9 Clinical Sequence for RPD, p.16]] [^17]: Original PDF page 17: [[L9 Clinical Sequence for RPD.pdf#page=17|L9 Clinical Sequence for RPD, p.17]] [^18]: Original PDF page 18: [[L9 Clinical Sequence for RPD.pdf#page=18|L9 Clinical Sequence for RPD, p.18]] [^19]: Original PDF page 19: [[L9 Clinical Sequence for RPD.pdf#page=19|L9 Clinical Sequence for RPD, p.19]] [^20]: Original PDF page 20: [[L9 Clinical Sequence for RPD.pdf#page=20|L9 Clinical Sequence for RPD, p.20]] [^21]: Original PDF page 21: [[L9 Clinical Sequence for RPD.pdf#page=21|L9 Clinical Sequence for RPD, p.21]] [^22]: Original PDF page 22: [[L9 Clinical Sequence for RPD.pdf#page=22|L9 Clinical Sequence for RPD, p.22]] [^23]: Original PDF page 23: [[L9 Clinical Sequence for RPD.pdf#page=23|L9 Clinical Sequence for RPD, p.23]] [^24]: Original PDF page 24: [[L9 Clinical Sequence for RPD.pdf#page=24|L9 Clinical Sequence for RPD, p.24]] [^25]: Original PDF page 25: [[L9 Clinical Sequence for RPD.pdf#page=25|L9 Clinical Sequence for RPD, p.25]] [^26]: Original PDF page 26: [[L9 Clinical Sequence for RPD.pdf#page=26|L9 Clinical Sequence for RPD, p.26]] [^27]: Original PDF page 27: [[L9 Clinical Sequence for RPD.pdf#page=27|L9 Clinical Sequence for RPD, p.27]] [^28]: Original PDF page 28: [[L9 Clinical Sequence for RPD.pdf#page=28|L9 Clinical Sequence for RPD, p.28]] [^29]: Original PDF page 29: [[L9 Clinical Sequence for RPD.pdf#page=29|L9 Clinical Sequence for RPD, p.29]] [^30]: Original PDF page 30: [[L9 Clinical Sequence for RPD.pdf#page=30|L9 Clinical Sequence for RPD, p.30]] [^31]: Original PDF page 31: [[L9 Clinical Sequence for RPD.pdf#page=31|L9 Clinical Sequence for RPD, p.31]] [^32]: Original PDF page 32: [[L9 Clinical Sequence for RPD.pdf#page=32|L9 Clinical Sequence for RPD, p.32]] [^33]: Original PDF page 33: [[L9 Clinical Sequence for RPD.pdf#page=33|L9 Clinical Sequence for RPD, p.33]] [^34]: Original PDF page 34: [[L9 Clinical Sequence for RPD.pdf#page=34|L9 Clinical Sequence for RPD, p.34]] [^35]: Original PDF page 35: [[L9 Clinical Sequence for RPD.pdf#page=35|L9 Clinical Sequence for RPD, p.35]] [^36]: Original PDF page 36: [[L9 Clinical Sequence for RPD.pdf#page=36|L9 Clinical Sequence for RPD, p.36]] [^37]: Original PDF page 37: [[L9 Clinical Sequence for RPD.pdf#page=37|L9 Clinical Sequence for RPD, p.37]] [^38]: Original PDF page 38: [[L9 Clinical Sequence for RPD.pdf#page=38|L9 Clinical Sequence for RPD, p.38]] [^39]: Original PDF page 39: [[L9 Clinical Sequence for RPD.pdf#page=39|L9 Clinical Sequence for RPD, p.39]] [^40]: Original PDF page 40: [[L9 Clinical Sequence for RPD.pdf#page=40|L9 Clinical Sequence for RPD, p.40]] [^41]: Original PDF page 41: [[L9 Clinical Sequence for RPD.pdf#page=41|L9 Clinical Sequence for RPD, p.41]] [^42]: Original PDF page 42: [[L9 Clinical Sequence for RPD.pdf#page=42|L9 Clinical Sequence for RPD, p.42]] [^43]: Original PDF page 43: [[L9 Clinical Sequence for RPD.pdf#page=43|L9 Clinical Sequence for RPD, p.43]] [^44]: Original PDF page 44: [[L9 Clinical Sequence for RPD.pdf#page=44|L9 Clinical Sequence for RPD, p.44]] [^45]: Original PDF page 45: [[L9 Clinical Sequence for RPD.pdf#page=45|L9 Clinical Sequence for RPD, p.45]] [^46]: Original PDF page 46: [[L9 Clinical Sequence for RPD.pdf#page=46|L9 Clinical Sequence for RPD, p.46]]