Removable partial denture with functional retention (RPDwFR): Presentation of the technique

OBJECTIVES Tooth loss can cause chewing and speech difficulties that greatly affect people’s overall health and quality of life. Currently, there is strong evidence among dentists who perform prosthetic planning limited to osseointegrated implants, excluding removable prostheses from the rehabilitation options. Removable partial dentures (RPDs) are widely used in clinical practice and are still considered a viable and conservative alterna­tive for the rehabilitation treatment of patients who require replacement of missing teeth, resulting in satisfactory functionality and aesthetics for them. Moreover, dental preparations for RPDs are considered minimally invasive and the clinical time required for this treatment is less than for implant rehabilitation. RPDs are often held in place by clasps, which may compromise oral hygiene and encourage plaque retention increasing potentially the risk of development of caries and periodontal disease especially in the abutment teeth used to support the prosthesis. Metal clasps can cause considerable aesthetic discomfort for the patient, and esthetic issues are pivotal in patient’ satisfaction leading to underuse and subsequent rehabilitation failure. The aim of this study is to evaluate the introduction in daily clinical practice of a removable partial denture with functional retention (RPDwFR), which has a mucous support with active and passive re­tention. Moreover, this type of RPD’s design is characterized by the absence of clasps, a key role to increase patient’s compliance. MATERIALS AND METHODS The subjects in this study were patients with partial edentulism who have been rehabilitated with RPDs through RPDwFR design which was performed in order to refine active retention (referred to the guide planes and proximal plates), increase the passive one through an adequate extension of the prosthetic base and in order to take advantage on the cerebellar adaptation processes that are established after the insertion of the prosthesis itself. The supports were removed from the prosthetic design increasing the adhesion of the prosthetic base to the fibro-mucosa, and the metal clasps, optimizing patient’ aesthetics and comfort. RESULTS All the six patients, after a 24-months follow-up, reported comfort and satisfaction in the use of the prosthesis. Moreover, the adaptation period was short and no difficulties were observed, allowing an optimal rehabilitation. CONCLUSIONS Upper arch rehabilitation using RPDwFR was found to be safe and easy to perform. It is very important to optimize the extent of prosthetic support. The more edentulous sites are present, the more retentive units will be activated. In the lower arch (I-II Kennedy classes) it is necessary to adequately extend the vestibular shelf and it is important to perform a fractionated impression optimizing the ratio prosthetic skeleton-edentulous area. Based on the results obtained, the introduction of RPDwFR into clinical practice have the potential to significantly improve patient out­comes such as satisfaction with function and esthetics since the absence of clasps increase pa­tient’s compliance towards this model of RPD’s design. CLINICAL SIGNIFICANCE In daily dental practice RPDs represent a valid rehabilitation option widely used by dentists and still chosen by the patients themselves. There are numerous RPDs defined as “aesthetic” which however d