The Rpd Redemption: Renaissance of the Removable Partial Denture

18 INTERNATIONAL DENTISTRY SA VOL. 9, NO. 5 Modern RPDs need to redeem the unfavourable reputation of their predecessors. They need to be able to hold their own in terms of comfort, aesthetics and function while safeguarding oral health. To achieve this, RPDs require both considered prosthodontic treatment planning and careful design. Most RPD frameworks are designed in the dental laboratory without the benefit of relevant clinical preparation, information or input (Schwarz and Barsby 1980, Basker et al 1988, Dullabh et al 1993, Lynch and Allen 2003). If the clinician is not in charge this is at best a biomechanical exercise; at worst a supervised route to further dental decline. To treat RPD design as a purely biomechanical exercise ignores the importance of making sure that the RPD follows hygienic principles to interfere as little as possible with plaque control, and does not damage the oral tissue (Öwall et al 2002). The Adult Dental Health Survey (1998) (Kelly et al 2000) projects a decline in tooth loss but also a rise in partial edentulism. Where there is no aesthetic compromise a shortened dental arch (SDA) is an acceptable and functional option (Armelini and von Fraunhofer 2004). If an SDA is not possible, the first choice for both patient and dental professional is probably a fixed option (fixed partial denture, FPD). In most instances however, the FPD will probably come at a significantly higher cost and involve more complicated/invasive treatment. It therefore seems fair to suggest that the profession can expect a need for RPDs for many years to come. RPDs are automatically less attractive by dint of being ‘removable’. Unless they conform to open/hygienic principles in a well-maintained mouth they are also known to make the dentition more at risk from caries and periodontal disease