Partially Edentulous arches classification

1. Partially Edentulous arches classification Dr Balendra pratap singh Assistant Professor Department of Prosthodontics

2. INTRODUCTION

3. CONTENTS • Need for Classification • Requirements of an acceptable method of classification. • Various types of Classification. • Critical evaluation • Summary • Conclusion • References

4. NEED FOR CLASSIFICATION • Ease of communication between dentist and laboratory personal. • Facilitates case history recording and immediate visualization of the edentulous arches • Formulate a good treatment plan • Formulate basic design principles which might be applied to similar situations. • Anticipate the difficulties commonly to occur for that particular design.

5. REQUIREMENTS OF AN ACCEPTABLE METHOD OF CLASSIFICATION: • Allow visualization of the type of partially edentulous arch • Permit immediate differentiation between the tooth-supported and the tooth and tissue supported removable partial denture • Universally accepted • A guide to the type of design to be used

6. Various Types of Classification • Cummer’s Classification. 1920 • Kennedy’s Classification. 1925 • Bailyn’s Classification. 1928 • Neurohr’s Classification. 1939 • Mauk’s Classification. 1941 • Wild’s Classification. 1949 • Godfrey’s Classification. 1951 • Friedman’s Classification. 1953 • Beckett’s Classification. 1953 • Craddock’s Classification. 1954

7. Austin-Lidge Classification. 1957 • Skinners Classification. 1957 • Wilsons Classification.1960 • Watt’s Classification. 1958 • Applegate Classification. 1960 • Avant’s Classification. 1960 • Swenson’s Classification. 1963 • Fiset,s Classification. 1973 • Costa’s Classification. 1974 • Osborne Classification. 1979 • ACP Classification. 2002

8. Kennedy’s classification: In 1925 Dr. Edward Kennedy of New York.. This system is based on the relationship of the edentulous spaces to the abutment teeth. It is a positional or anatomical classification.

9. Class I : Bilateral edentulous areas located posterior to the remaining natural teeth. Highest incidence in mandible • Class II : A unilateral edentulous area located posterior to the remaining natural teeth

10. Recognize the Classification?

11. Class III : A unilateral edentulous area bounded anteriorly and posteriorly by remaining teeth • Class IV : An edentulous area located anterior to the remaining natural teeth. A single but bilateral (crossing the midline) edentulous area

12. Recognize the classification?

13. Modifications • They were indicated according to the number of such areas not by their extent, like Class III mod 2

14. Advantages: • It permits immediate visualization of the partially edentulous arches. • It permits a logical approach to the problems of design. • It gives a definite treatment plan. • Differentiates between bounded saddle and free end saddle. • Simplicity.

15. Disadvantages: • Did not explain the length of the edentulous span or number of missing teeth- only provide number of modification spaces. • Not enough consideration about the condition of teeth and the remaining supporting structures. • No distinction between modification spaces which occur in the anterior segment to those of posterior segment.

16. Applegate’s classification Oliver C. Applegate 1960, provide a modification of Kennedy’s system. • This system is based on the number, location and condition of abutment teeth or manner of achieving support.

17. Class V : Teeth bound the edentulous area anteriorly and posteriorly but anterior bounding tooth is not suitable as abutment. (not strong enough for rest, direct retainer) (as the lateral incisor). It is basically a class III situation where anterior abutment cannot be used for any support.

18. Class VI : An edentulous situation in which the boundary teeth are capable of total support of the required prosthesis. This situation hardly requires any tissue support. The abutments are capable of providing total support. • Additional edentulous areas are designated by letter A and P. • A : Anterior segment of the arch. • P : Posterior segment of the arch is bounded by remaining teeth.

19. Applegate’s rules: • Rule One: Classification should follow rather than precede extractions that might alter the original classification. • Rule Two: If the third molar is missing and not to be replaced, it is not considered in the classification. • Rule Three: If the third molar is present and is to be used as an abutment, it is considered in the classification. • Rule Four: If the second molar is missing and is not be replaced, it is not considered in the classification.

20. Rule Five: The most posterior edentulous area or areas always determine the classification. • Rule Six: Edentulous areas other than those, which determine the classification, are referred to as modification spaces and are designated by their number.

21. Rule Seven:The extent of the modification is not considered, only the number of additional edentulous areas are considered. • Rule Eight: There can be no modification areas in class IV. Because any additional edentulous space will definitely be posterior to it and will determine the classification.

22. References • Applegate O.C. : Essentials of Removable partial denture prosthesis. 1st edition, 1965. • Avant W.E. : The universal classification for removable partial denture situations. J. Prosthet. Dent. 1966; 16: 533-540. • Davenport J.C., Basker R.M., Heath J.R. and Ralph J.P. : A color atlas of removable partial dentures. 1st edition, 1988. • David M. Watt and A. Roy MacGregor: Designing partial dentures. • Eugene Costa: A simplified system for identifying partially edentulous dental arches. JPD, 1974, 639-645. • Friedman J.: The ABC classification of partial denture segments. JPD, 1953, 517-524.

23. Kratochvil F.J. : Partial removable prosthodontics. 1st edition, 1988. • McGivney G.P., Carr A.B.: McCracken’s Removable partial prosthodontics. 10th edition, 2001. • Miller E.L. : System for classifying the partially edentulous arch. J. Prosthet. Dent. 1970; 24: 25-40. • Skinner C.N. : A classification of removable partial denture based upon the principles of anatomy and physiology. J. Prosthet. Dent. 1959; 9: 240-45. • Stewart K.L., Rudd K.D. and Kuebker W.A. : Clinical Removable partial prosthodontics. 2nd edition, 2001. • Thomas J. McGarry:Classification system for partial edentulism, Journal of Prosthodontics, 2002 Sep;11(3):181-93.

24. Multiple choice questions

25. Q1. If tooth number 47 in below mentioned cast is part of Removable partial denture then this condition of partial edentulous state is classified as? • Class 1 2. class 2 • 3. Class 1 mod. 1 4 class 2 mod 2

26. Q2. If tooth number 48 in below mentioned cast is NOT part of Removable partial denture then this condition of partial edentulous state is classified as? • Class 1 2. class 2 • 3. Class 1 mod. 1 4. class 2 mod 2

27. Q3. If tooth number 18 in below mentioned cast is part of Removable partial denture then this condition of partial edentulous state is classified as? • Class 1 2. class 2 • 3. Class 1 mod. 1 4. class 2 mod 2

28. Q4. If tooth number 28 in below mentioned cast is part of Removable partial denture then this condition of partial edentulous state is classified as? • Class 2 mod. 2 2. class 2 mod. 1 • 3. Class 3 mod. 1 4. class 3 mod. 2

29. Q5. According to Kennedy, all partially edentulous arches are classified into • 1. 6 types • 2. 4 types • 3. 2 types • 4. 3 types

30. Q6. Keeping in mind that all teeth are healthy, how do classify this? • Class 4 2. class 3 mod. 1 • 3. Class 4 mod. 1 4. class 3 mod. 2

31. Q7. This RPD is classified as • Class 1 mod 1 2. class 2 mod. 2 • 3. Class 1 mod. 2 4. class 2 mod. 1

32. Q8. If you need some adjustment in this RPD, which type of RPD you tell to Lab? • Class 1 2. class 3 • 3. Class 2 4. class 1 mod. 1

33. Q9. You have found this RPD in clinic, how do you describe it? • Class 2 mod 2 2. class 3 mod 2 • 3. Class 4 mod 3 4. class 1 mod. 2

34. Q10. This RPD is classified as • Class 4 mod 2 2. class 3 mod 2 • 3. Class 4 mod 1 4. class 2 mod. 2

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