FAILURES IN

REMOVABLE
PARTIAL
DENTURE
 Contents
• Introduction   
• Classification of failures in removable partial
dentures  
• Failures in diagnosis and treatment planning 
• Failures in mouth preparation  
• Failures in framework design  
• Failures in laboratory procedures  
• Failure in support for denture bases  
• Failures in occlusion
• Failure in patient-dentist relationship
• Conclusion 
• Bibliography
Introduction

Failure?
 . Classification
 
Mechanical failures
Failure of solder joints
Distortion
Occlusal wear
 
Changes in the abutment tooth
Periodontal disease
Problems with the pulp
Caries
Movement of the tooth
 
Design failures
Improper surveying
Improper component selection
 
Occlusal problems
 Failure of removable partial dentures
is due to inadequate:

1. Diagnosis and treatment planning

2. Mouth preparation procedures
3. Design of framework
4. Laboratory procedures
5. Support for denture bases
6. Occlusion
7. Patient-dentist relationship
 FAILURES IN DIAGNOSIS AND TREATMENT
PLANNING
jpd 2001
1) Improper diagnosis:

 Not making set of diagnostic casts for

each patient

 If discrepancy is seen between teeth and

the diagnostic casts and the definitive casts
 Making RPD’s using a 2-appointment
system:
one for diagnosis, definitive
impressions, mouth preparation procedures
and second for insertion of partial denture.

 Failing to remove debris and plaque from

the teeth before impression is made.
2) Surveying:

 Failure to use a surveyor during treatment

planning
 FAILURES IN MOUTH PREPARATION
PROCEDURES

1) Improper guide plane preparations:

2) To change height of contour:

 Improper positioning of the retentive

clasp arm and reciprocal clasp arm

 Retention and Stability of the prosthesis

affected.
 Inlays, Onlays and crowns:
3) Inadequate mouth preparation:

 Insufficient planning of the design of the

partial denture

 Episodes of pain or discomfort during

treatment procedure due to caries or defective
restoration.

 Failure to properly sequence mouth

preparation procedures
4) Rest and Rest Seat Preparation:

 Movement of the abutment tooth or sliding

of the prosthesis

-The forces transmitted from the

prosthesis to abutment teeth would occur
against the inclined plane.
 Occlusal rest Preparation in a multi-
surface Amalgam Restoration.

-Amalgam tends to flow when placed under

constant pressure or even excess preparation.
 FAILURES IN DESIGN OF FRAMEWORK

1) Tripoding:
 Metal frame work not fitting in the
patient.
-When technician not able to retripod
the master cast according to the desired tilt
of the dentist.
2) Design transfer to master cast:

 Clasp tip not engaging the undercut

 Abrasion of the master cast

3) Incorrectly located RPD components:
jpd 2001

 Incorrectly located major connector

 Incorrect use of clasp designs

 Use of clasps that are too broad in tooth
coverage and have too little consideration for
esthetics

 Flexible major connector

 Flexible clasp designs

4) Beading of the cast:

 Tissue blanching and inflammation or

ulceration seen when the beading on the cast
done too deep
5) Block out:

 Improper seating of the framework:-

-Block out not done properly permitting

rigid part of the framework to be placed in
undercuts.
 Framework that does not contact the tooth:-

Block out wax added above the height of

contour line or on the guiding planes and not
removed during shaping of wax.
6) Contouring of the block out wax:

 If the undercuts recreated in an attempt

to set a smooth layer of wax, the block out wax
is flamed with torch and over flaming would
result in undercuts.

 Framework is too retentive

- wax contouring is not correct, forming
a deep undercut.

 Hydrocolloid mold is torn when master

cast is removed.
7) Relief:

 Metal framework impinges on the soft

tissue.

-The thickness of the relief wax is too

thin
-The wax separated and lifted up from the
cast during duplication.
 FAILURES IN LABORATORY PROCEDURES

 
1) Poor cast-forming procedures:

 Cast is inaccurate: not a true

reproduction of the anatomy of the mouth.
2) Duplication:

 Block out and relief wax melted by reversible

hydrocolloid.

 Mold damaged during removal of the master

cast.
3) Refractory cast:

 Abraded refractory cast:-

Surface treatment of the cast not done
4) Waxing:

 Space exists between the upper border of

the lingual plate and tooth:-
Block out wax placed too high.
 Lingual or palatal plate connector too thin in
some areas.

 Displacement of the pattern wax from the

cast.
5) Failure of technician to follow the design
and written instructions:

 Improper seating of the framework.

6) Spruing

 Small particles of investment in the casting:-

-Sprue leads joined to main sprue on wax

pattern improperly.
-Sprue hole was enlarged by cutting with
knife, leaving roughened surface for metal to
flow over.
 Metal spilled when casting:-

-Sprue hole is too small for Bulk of metal.

-Sprue leads broken during investing
procedure

 Plaster inclusion in metal framework:-

-Sharp edges remaining in the cast, broken

due to the force of molten metal casted into
the mold.
 Internal mold deformations:-
-Constriction in the sprue lead

 Porosity in casting:-
-Improper spruing procedure

 Pattern failed to casting:-

-Pattern separated from crucible former
during investment
7) Investing:

 If the cast is dried with teeth up, white

materials would be deposited around the
teeth. This is due to deposition of salts which
form a positive layer that cannot be removed
without scraping and damaging the cast.

 Cracks in the cast

8) CASTING defects:-
jpd 2001
 Pitted casting

If the design is placed on the refractory

cast with a graphite pencil….

Contaminates…..

Burn out temperature…..

 Metal nodules and rough area on cast
framework

-Failing to use surface tension reducer

correctly on the waxed patterns would cause
air trap, when paint on investment flows

-If the surface tension, reducer is not

allowed to dry before applying the paint on
investment
• Incomplete casting and rough areas or fins in
casting

-W: P ratio….

-If paint on investment layer is too thin…

-If the paint on layer is too thick…..

 Porous cast frame work

If the mold moves in the casting machine

as the casting arm starts to spin, molten
metal sometimes may miss the sprue hole and
spill outside the mold.
 Incomplete casting

If the sprue hole faces upward during burn

out……

Casting temperature of metal….

 Warpage of the Frame work

The air pressure of the nozzle of air

abrasion machine is about 100 psi…..

If sufficient time is not allowed for the

metal to cool to room temperature in the
investment (quenching the mold)…..
 Nicks on the metal casting

Carelessly cutting off the sprue leads

Using the wrong mandrel in high spread

lathe…….
 Framework is too loose

Carelessly grinding the inside of

clasps….
 Fracture of the clasps

Removing too much metal from retentive

clasps ….

An improperly tapered clasp or one that

has thin places or nicks encourages breakage
by concentrating the strain….

Electro polishing for a longer time….

 Warpage of the framework

Abrasive rubber wheels and points can

build up heat in the framework very quickly

 Loose frame work

Polishing removes a definitive layer of

metal.
 Distorted frame work

Clasps and other parts of the frame

work can easily catch in the polishing wheel.
If they catch the framework they would be
pulled from operator hands and thrown. The
force usually distorts the framework and
injures the operator.
 Incomplete Casting of the Metal frame
work

-Metal too cold when cast…..

-Improper spruing ….
-Gas trapped in mold……
9) Mixing and packing acrylic resin:
jpd 2001

 Incompletely processed denture-

10) Deflasking and polishing the removable
partial denture:

 Distorted framework
 Increase in the vertical dimension
 Warpage of framework
 Scratches on the final metal framework
 Damaged denture teeth
 Distorted clasps

-Using a cloth wheel that was not broken

properly would result in damaged removable
partial denture or injure the operator.

-A new cloth wheel has strings of

material protruding from it.
 -The strings could tangle in the clasp or
other parts of removable partial denture and
snaps the removable partial denture from the
operator’s hands throwing it out with great
force.
 Scratches on the denture

-Course pumice leaves scratches…..

-It would be difficult to adequately polish

around the necks of denture teeth with a
cloth wheel or a lathe mounted bristle brush
without damaging the contours of the teeth.
 Dull appearance of the denture

Detergent alone would not adequately

remove polishing compound from the
removable partial denture.

The remaining residue would prevent the

removable partial denture from achieving the
luster.
11) Fitting the framework to the cast and
mouth:

 Framework too retentive on the

definitive cast.

 Frame Work not fitting exactly in the

mouth.
12) Finishing and polishing of framework:

 Polished surface is dull with fine

scratches
-Sequence of finishing steps not followed

 Major and minor connector over thinned

and flexible.
-Framework over thinned with abrasive
stones during finishing
 Clasps is nicked or notched

 Framework distorted
-Frame work caught in lathe during
finishing.
13) Fitting and adjusting the removable
partial denture to mouth :

 Failing to evaluate the denture borders

when placed intra-orally.

 Loss of retention and support.

 Soreness or Ulceration of soft tissue in

the patient’s mouth
 Increase in the vertical dimension of
occlusion

 Warpage of the RPD

-If the patient does not seat the
removable partial denture correctly, they may
warp the removable partial denture or be
injured by it.
-Warn the patient’s about the destruction
that would result if they bite on removable
partial denture to seat it.
 FAILURE IN SUPPORT OF DENTURE BASE

 Inadequate coverage of basal seat

tissues

 Failure to record basal seat tissues in

supporting form
 FAILURES IN OCCLUSION

1) Articulation:

Error in articulation of the cast

2) Face bow transfer:

 Alteration in the jaw relation

-Positioning the face bow on patient’s

face.
-Placement of the fork
 -Rocking of the record

-Trimming of the record or metal

showing through the record.

-Face bow transfer not done.

3) Correction of occlusal plane:

 Sensitivity of teeth or incipient caries-

after enameloplasty
4) Selecting and arranging teeth:

 Unable to interdigitate artificial teeth with

opposing natural dentition

 Insufficient space to set posterior tooth

replacement

 Anterior replacement teeth too short for

satisfactory esthetics
 Dentists failing to select type, shade and
mold of the denture teeth to be used
resulting in unaesthetic prosthesis not
accepted by patient.
FAILURE IN PATIENT-DENTIST RELATIONSHIP

 Failing to make a follow up appointment for

the patient

 Failure of dentist to provide adequate

dental health care information, including care
and use of prosthesis
 CONCLUSION
 
 “Good technique pays off” – these words are
not merely a motto to hang on the wall in the
laboratory but words that are to be followed.

 Shortcuts are risky attempts to save time by

modifying a proven procedure. They would
increase the chair time work required for
adjusting misfit dentures, dissatisfaction and
pain experienced by patients.
• To paraphrase an old saying, “the most
important step in making a removable partial
denture is the step being done correctly at
any given moment”.

• As someone well said, it is not how much

success we obtain, but how best we tackle
complex situations and failures, that
determine the skill of a clinician. No doubt,
failures are stepping stones to success but
not until their etiologies are established and
their occurrence is prevented.
 After all, as correctly said by Henry Ford,

“Failure is the opportunity to begin again,

more intelligently”
 
 BIBLIOGRAPHY

• Rudd W.R, Rudd D.K. Review of 243 errors possible

during the fabrication of removable partial denture:
Partial denture: I, II, III. J Prostet Dent 2001; 86:
251 -287.
• McCracken’s: Removable partial Prosthodontics.
Eleventh edition 2005
• Stewart’s Clinical Removable Partial Prosthodontics.
fourth edition
• A clinical overview of removable prostheses:3.
principles of design for removable partial denture
dent update 2002
• Internal porosity of cast titanium removable partial
dentures: influence of sprue direction on porosity in
circumferential clasps of clinical framework design
j prosthet dent 2002
• Pattern waxes and inaccuracies in fixed and
removable partial denture design
j prosthet dent 1997
• Surveying the removable partial denture : the
importance of guiding planes path of insertion for
stability
j prosthet dent 1997
WE SHOULD MEET THE MIND OF THE PATIENT
BEFORE WE MEET
THE MOUTH OF THE PATIENT