Metal removable partial dentures (RPDs) remain a reliable and cost-effective solution for partially edentulous patients.
Their clinical and laboratory fabrication requires precision, proper case selection, and strong communication between the dentist and dental technician.
Below is an evidence-based, step-by-step guide outlining the key phases in the fabrication process.
1. Comprehensive Clinical Evaluation and Diagnosis
A full clinical and radiographic examination must be conducted to assess the condition of the remaining teeth, supporting tissues, and overall oral health.
✔ Goal: Evaluate occlusion, abutment integrity, periodontal status, and hygiene before prosthetic planning.
✔ Reference: Carr, A. B., & Brown, D. T. (2020). McCracken's Removable Partial Prosthodontics (13th ed.).
2. Preliminary Design and Diagnostic Cast Analysis
Diagnostic casts are mounted in a semi-adjustable articulator. The initial design includes selection of:
✔ Major connector, direct retainers, guiding planes, occlusal rests, and indirect retainers.
✔ Reference: Phoenix, R. D., Cagna, D. R., & DeFreest, C. F. (2013). Stewart’s Clinical Removable Partial Prosthodontics.
3. Pre-Prosthetic Mouth Preparation
All required intraoral adjustments are made before impressions:
✔ Guide plane preparation, crown placement or modification, extractions, and periodontal therapy.
✔ Reference: Krol, A. J., Jacobson, T. E., & Finzen, F. C. (2003). Removable Partial Denture Design: A Revisit.
4. Final Impression with High-Precision Material
A custom tray and elastomeric impression material (e.g., polyether or addition silicone) are used.
✔ Accurate capture of both hard and soft tissues is crucial.
✔ Reference: Kumar, M., & Hedge, C. (2020). Clinical accuracy of elastomeric impression materials. Journal of Prosthodontics.
5. Master Cast and Refractory Model Duplication
A master cast is created from the impression, and a refractory duplicate is prepared for framework fabrication.
✔ Final design details are transferred to the laboratory via design sketches and written instructions.
✔ Reference: Bezzon, O. L., & Pedrazzi, V. (2014). Fundamentals of Removable Partial Prosthodontics.
► Read also: Understanding Applegate's Eight Rules: A Guide to Kennedy's Classification of Partial Edentulism
6. Metal Framework Casting
The dental technician waxes the framework, invests it, and casts it using a cobalt-chromium alloy.
✔ A passive fit of the framework is then verified intraorally.
✔ Reference: Zarb, G. A., Bolender, C. L., & Eckert, S. E. (2012). Prosthodontic Treatment for Edentulous Patients.
7. Maxillomandibular Relationship Records
If necessary, jaw relation records are obtained for mounting the cast in the articulator.
✔ Reference: Petropoulos, V. C., & Rashedi, B. (2001). Evaluation of the accuracy of articulator mounting. The Journal of Prosthetic Dentistry.
8. Tooth Setup and Esthetic Try-In
Artificial teeth (usually acrylic) are selected and set in wax for esthetic, phonetic, and occlusal evaluation.
9. Final Processing and Polishing
The denture is processed with heat-polymerized acrylic resin and polished for delivery.
✔ Final prosthetic adjustments are performed before delivery.
✔ Reference: Anusavice, K. J., Shen, C., & Rawls, H. R. (2012). Phillips’ Science of Dental Materials.
10. Delivery, Patient Instructions, and Follow-Up
✔ The denture is delivered and adjusted. The patient is instructed on hygiene, use, and maintenance.
✔ Follow-up is scheduled at 24–48 hours, one month, and semiannually.
Conclusion
The success of a metal RPD depends on careful planning, clinical expertise, and effective collaboration with the dental laboratory. An evidence-based workflow ensures predictable, long-lasting results and improved patient satisfaction.
