Removable Partial Denture

The main goal of RPD is to restore the patient's missing teeth without compromising the remaining natural dentition. RPDs restore a patient's ability to chew, speak, and appear natural while also preventing other teeth from shifting from their ideal position. RPDs are particularly beneficial as they can help maintain facial height and symmetry while also allowing for the chewing forces to be balanced side to side. Otherwise, the imbalance in forces can lead to TMJ disorders temporarily, or more tooth loss permanently.

RPDs would be appropriate for:

• Adults have lost multiple teeth but have retained some natural teeth that are periodontally stable.
• Patients who are not medically and/or financially eligible for fixed bridges or implants.
• Elderly patients who want to avoid surgical care for tooth replacement.
• Younger patients with periodontally progressive disease who would be better served with an RPD rather than a long-term fixed option.
• Patients needing a temporary prosthesis while waiting for a more permanent treatment option.

RPDs come in a variety of types each accommodating the specific clinical needs of individuals:

• Acrylic Partial Denture - made of acrylic resin, typically are used as interim or transitional prosthesis.
• Cast Metal Partial Denture -  Provides improved fit. strength and durability with a metal framework.
• Flexible Partial Denture - Made from flexible thermoplastics (Valplast, etc.) is comfortable, offers a better aesthetic.
• Combination Denture -  Combines metal frameworks with acrylic teeth; may include precision attachments.

Each type will vary in cost, durability, comfort, and aesthetics. It is essential to determine which is best for your oral condition and preferences.

• Initial Consultation and Oral Exam: Assessing your missing teeth, oral health and suitability for RPD.
• Taking Impressions and Registration of the Bite: Taking impressions of the upper and lower arches to make the best fit.
• Framework Try-In (if applicable): Trying on a metal framework before the addition of teeth.
• Trial Denture: The denture is mock-up in wax to assess aesthetics, fit, and bite.
• Final Denture Insertion: The manufacturing of the denture is complete and entirely satisfactory to the patient.
• Adjustments and Follow Up: Any required adjustments are arranged to enhance comfort and function. The full process may range from three to five appointments, depending on the complexity and denture type.

• The RPD restores the ability to chew food, and improves clarity in speech.
• The RPD improves facial aesthetics by supporting cheeks and/or lips that may have sunk due to missing teeth.
• The RPD may enhance a person's smile where natural appearance and function have been restored.
• The RPD prevents remaining adjacent teeth from shifting to preserve occlusion.
• The RPD is non-invasive and reversible and is best suited for patients preferring to avoid surgical invasive approaches.

• RPDs have the following benefits as compared to fixed prostheses:
• Lower costs, in comparison to dental implants or dental bridges.
• Shorter turnaround in fabrication and insertion, especially in situations with immediate needs.
• Ability to add additional teeth in the future without the requirement for a whole new denture.
• No need to grind natural teeth for some forms of bridgework.
• Can be a viable option for patients with residual bone loss and/or compromised ridges.

With proper care, a high-quality removable partial denture may last anywhere from 5 to 10 years. Factors influencing the lifespan includes:

• Quality of material (i.e.: metal, acrylic, flexible).
• Oral hygiene practices. Changes in the remaining teeth and oral tissues.
• Regularity of wear and care.
• The changes in mouth over time will lead to the need for relining and maintaining your denture periodically.

The total timeframe for treatment is anywhere between 2 to 6 weeks, depending on:

• Selected type of denture.
• Complexity of the case.
• Lab technician's turnaround times.
• Need for healing due to recent extractions.

A little adjustment time may be required to get used to the denture, and the new feel and function of the appliance.

What is the cost of RPDs?

The average cost of removable partial dentures varies greatly depending on:

• Materials being used (whether acrylic, cast metal or flexible).
• Type of denture and the number of teeth being replaced.
• City and clinic reputation.

Approximate cost range:

• Acrylic RPD: ₹3,000 – ₹7,000.
• Cast Metal RPD: ₹8,000 – ₹20,000.
• Flexible Denture: ₹10,000 – ₹25,000.

RPDs are usually safe but there are some possible complications or concerns, including:

• Gum irritation/soreness when first placed.
• Difficulty speaking or eating only during the adaptation stage.
• Property loss (like breakage or loosening) if treated improperly.
• Plaque accumulation if cleanings do not occur.
• Risk for allergic reaction in people with metal sensitivities.
• Regular visits to your dentist will help minimize problems and lengthen the life of your denture.

RPDs, like other dental prostheses, do have drawbacks or limitations:

• Less stable than fixed bridges or fixed dental implants.
• Mildly uncomfortable or feel foreign body sensation.
• Requires daily removal and cleaning.
• Regular adjustments to fit oral tissue or future tooth replacement needs.
• Acrylic and flexible dentures can break down over time from chewing pressure.

In spite of some limitations, affordability and relative convenience make RPDs a good treatment option for a lot of patients.

Some common alternatives include:

• Fixed Dental Bridges: Best option when there are adjacent teeth suitable for a prosthesis.
• Dental Implants: Best alternative because of permanence and stability, but cost and surgery needs to be considered.
• Complete Dentures: Can place when there are no remaining teeth in the arch.
• Resin-bonded bridges (Maryland bridges): Provides a way to replace teeth in younger patients.

The suitability of the alternatives would allow the patient to see pros/cons of each and compare the value to the condition of their oral health, their preferences, and their price point.

• You should remove your RPD, and rinse it off (with a soft denture brush and a non-abrasive cleaner) after every meal to keep the denture clean.
• Soak it overnight in a denture cleansing solution.
• Do not use hot water on your denture (that can warp it).
• Try to handle the denture nicely and do not ever plunge it or drop it accidentally.
• Maintain the hygiene of your remaining natural teeth.
• Be sure to go to your dentist every 6 months or more frequently for check-ups and adjustments.