If you are missing only a few teeth scattered over either arch (upper or lower teeth), or even if you have a minimum of two teeth on both sides of the arch, then you can most inexpensively replace the missing teeth with are movable partial denture (RPD).  There are several types of RPD's.  All of them use standard plastic denture teeth as replacements for the missing natural teeth.  The differences between them are the materials that are used to support the denture teeth and retain the RPD in the mouth. 

The Treatment RPD (flippers)Affectionately known in dentistry as a "flipper", this is the least expensive of all the removable partial dentures.  The one pictured on the right replaces 4 missing teeth, leaving spaces for 7 natural teeth.  Two of the natural teeth are clasped with wrought wire clasps which are cured into the structure of the denture base.   

The pink plastic of the denture base is brittle acrylic, the same material used to make standard full dentures.  The largest single advantage to this type of RPD (aside from the cost) is that new teeth and new denture base can easily be added to an existing treatment RPD.  These are frequently fabricated even if the remaining teeth have existing decay or periodontal disease and their prognosis is doubtful.  If later in the course of treatment some of the existing natural teeth are extracted for any reason, new false teeth can be added quickly to the partial, maintaining the patient's appearance.  In spite of the fact that they are considered a temporary solution, many people keep this type of appliance for many, many years, because as long as they are properly maintained, they look outwardly as good as the more expensive permanent appliances described below.

One of the neatest tricks that a flipper can do is to act as an "immediate partial denture".  This means that the appliance can be made before the teeth are removed, and inserted immediately after the extraction of the offending teeth.  If the patient is presently wearing one of these inexpensive appliances, and needs to have an existing natural tooth extracted, an impression can be taken with the flipper in place.  The impression with the flipper embedded in it is sent to the lab and a new denture tooth put in place of the one to be extracted.  This can be done in the course of a single day, so a patient can come in with a bad tooth and walk out with a good false tooth in its position.  

 Flippers do have a number of disadvantages, however. The acrylic denture base is somewhat brittle, and due to their irregular shape, these partials tend to break frequently, especially those made for the lower arch.  (Full dentures are more regular in shape and tend to be fairly strong as a result.) 

In order to counteract their tendency to break, the acrylic is usually built fairly thick which can take some "getting used to".  

The denture base rests only on the gums, and even though they are much more stable than full dentures, they are much less stable than the more permanent RPD's which are "tooth born" 

As the gums resorb, the false teeth tend to sink below their original level making it necessary to reline them frequently, and sometimes even to reset the teeth which adds to their expense.

Flippers are most frequently retained with wire clasps (shown in image above).  These are frequently unsightly due to the limitations that pertain to their placement (they can't interfere with the way you bite).

Cast Metal RPD's

Removable Partial Dentures with cast metal frameworks are probably one of the oldest forms of dentistry.  Originally, the frameworks (an example seen on the right) were made out of wrought (hammered) silver.  One of the most famous American dentists was Paul Revere who was a silversmith when he wasn't fighting redcoats.

This type of partial denture offers numerous advantages over the treatment partial described above.  A close look at the pictures above will show you that these frameworks are cast to fit the teeth. Since they sit on the teeth, as well as being attached to them, they are extremely stable and retentive.  The teeth have been altered  slightly beforehand in order that the partial denture can rest upon them without interfering with the way the patient bites the teeth together.  

The metal framework does not contact the gums.  Thus, as the gums resorb, this type of partial does not sink with them and rarely requires relines.  Because the teeth are altered by the dentist beforehand, there are fewer limitations in the placement of clasps, and they are less likely to be seen than the wrought wire clasps of the treatment partial. Modern frameworks are cast from an extremely strong alloy called chrome cobalt which can be cast very thin and are much less likely to break than the all plastic variety.  They are also much less noticeable to the tongue.

The largest single advantage that cast metal framework partial dentures have over the newer flexible framework partials (covered below) is that sore spots are almost never an issue since neither the framework, nor the plastic extensions contact the soft oral tissues with any force!  Patients who exhibit the symptoms of TMJ or who are known bruxers are much better off with cast metal partials than with flexible framework partials.  

Making The Partial

Each partial is custom made to fit your mouth. Each of the following steps is needed to assure proper fit, function, and esthetics of your denture.

   Appointment 1- Full exam of mouth done including teeth, gums, jaws, soft tissues, bite, etc. Impressions are made of your teeth for study models. These are used to custom design your partial. If any teeth are found to have decay or periodontal needs these problems are addressed at this appointment as well. It is important to address the foundation teeth prior to making the denture, just as you would want a strong foundation for your

  Appointment 2- The teeth may be slightly altered in shape in order to ideally fit the design we have made for you. This reshaping involves very minor changes to the enamel which does not even need anesthesia it is so slight. An accurate impression is made of the teeth and supporting gum tissues.

  Appointment 3- Your partial is made of metal structure with acrylic teeth and gums to look natural. At this appointment we try in the metal portion and adjust as necessary. Bite records are taken. Sometimes we will have the teeth set in wax at this point to make sure the bite and esthetics are good.

  Appointment 4- Partial is tried in and adjusted to fit. Usually you will return in 24 - 48 hours to adjust any sore areas that develop. We may appoint more follow up appointments as needed until the partial is comfortable.

 The above appointments may be combined or extended, so each case may take less or more time depending upon the individual. In addition some patients opt for newer metal free partials, such as Valplast, which usually take fewer appointments. We want to be sure you will have a denture that looks good and fits well.

It will take you some time to get used to your new partial. Eating and speaking will seem awkward at first but with time you will learn how to use your partial. Each person is different in how fast they adapt, but eventually adaptation will occur.

Caring For Your Partial

You must take good care of your partial for it to last. You also must take care of the teeth remaining so the partial can maintain it's support. The following steps will help you keep your partial for a long time. 

   1.Take your partial out when you sleep and place it in water. This lets your gums and teeth rest from the pressure of the partial. Placing it in water keeps it from drying out and changing shape.

   2. Remove your partial to clean it using a denture brush and toothpaste. Also brush and floss your teeth with the partial out of your mouth.

   3. Occasionally soak your partial in a commercial brand soak designed specifically for partials to help disinfect them.

   4. Maintain your recall visits so we can check your partial and supporting teeth for any problems. Also call us for an appointment as soon as you develop any problem with your denture; soreness, looseness, etc.

Removable Partials