Examples of Kennedy’s Classification

Kennedy’s class lV

* A single bilateral edentulous area crossing the midline.

Kennedy’s class l – mod 2

* Class I :Bilateral edentulous area most posteriorly . Mod 2 : two extra edentulous areas

Kennedy’s Class III- mod I

* Class III- Edentulous area present between anterior and posterior natural teeth posteriorly. Mod I : one extra edentulous space

Kennedy’s Class II

* Unilateral Edentulous area

Kennedy’s class I

* Bilateral Edentulous area

Kennedy’s Class III

* Edentulous area between anterior and posterior natural teeth

Kennedy’s Class II- mod 2

* Class II : unilateral edentulous area present from most posteriorly. Mod 2: Extra 2 edentulous space

Kennedy’s Class III- Mod 1

* Class III- Edentulous area present between anterior and posterior natural teeth. Mod 1 – one extra edentulous space present.

Reference : Google pictures

Mouth preparation for complete dentures (part 1)

Mouth rehabilitation is defined as restoration of form and function of the masticatory apparatus to as nearly normal as possible.

# Adjunctive care :Lesions like ulcer, abscess should be cure and be given time for healing. During their healing period adjunctive therapies like tissue massage, use of mouth washes etc. are used. For normal patients, 48 hour rest with tissue massage is sufficient.

#Removal of retained dentition : An OPG gives a clear idea whether to remove the retained dentition or not.

Removal of unerupted teeth::

The unerupted teeth lying close to ridge should be removed but the one which deeply submerged and non symptomatic can be left untouched.

Removal of retained roots::

All the retained roots should be removed but if it’s removal can cause large bony defect and is asymptomatic , then it can be left untouched.

# Correction of Hypermobile Ridge tissue :

Hypermobile or flabby ridge

Hypermobile tissues are caused by excessive residual ridge resorption. Small Hypermobile tissues which do not affect functioning of denture can be left untouched but the large pendulous Hypermobile tissues should be removed.

#Removal of soft tissue interfaces : Firm soft tissue interference, which do not affect the stability of the denture,can be left intact. In case of maxillary tuberosity with excessive fibrous tissue, there is need for surgical removal.

#Removal of Hypertrophic maxillary labial frenum:

High frenum attachment

In case of high frenum attachment ,where the frenum is not so close to crest of the ridge , surgery is not mandatory, only labial notch in the denture is sufficient. But when this notch breaks the peripheral seal , in that case surgical procedure is done.

( ref : Textbook of prosthodontics: Deepak nallaswamy , images : Google images)

Mouth preparation for complete dentures (part 2)

#Removal of a Hypertrophic Lingual frenum:

Hypertrophic Lingual frenum

Frenectomy is indicated in this case. Tongue tie test is performed.Patient is asked to touch his upper lip with tongue, if the denture is displaced by doing so then frenectomy is to be done.

#Correction of prominent buccal frenum: Removal is generally not necessary as they are not present as so large. Buccal frenum is soft and it can be easily displaced by denture without any injury.

#Removal of Papillary hyperplasia:

Papillary hyperplasia

These hyperplastic lesions occur due to irritation. It can be large or small . Small lesions are treated by curettage and large by split thickness supraperiosteal excision.

#Treatment of Epulis fissuratum:

Epulis fissuratum

It is an soft tissue reaction in sulcular regions due to overextension of denture flanges. No specific treatment except shortening and smoothening of denture borders.Give it time to heal.

# Removal of ridge undercuts: Small and moderate unilateral undercuts can be left untouched , while severe undercuts or bilateral moderate requires surgical correction ( alveoloplasty).

( ref: textbook of prosthodontics , Deepak nallaswamy , images: Google images.)

Mouth preparation for complete dentures ( part 3)

#Management of prominent Mylohyoid and internal oblique ridges: They are seen in lingual surfaces of mandible. Sometimes they become prominent due to ridge resorption. If there is repeated ulceration, loss of peripheral seal , they should be surgically reduced.

#Reduction of Maxillary tuberosity: Reduction of wide tuberosity is easier compared to vertically large tuberosity. Before it’s reduction, radiological evaluation is mandatory,as maxillary sinus tends to expand in tuberosity.

#Treatment of sharp spiny ridges: These type of ridges usually occur in lower anterior region due to resorption of labial and lingual cortical plates. For this ,ridge augmentation can be done. 

Meyer’s classification for knife edge ridges:

⛔Saw-tooth

⛔Razor-like

⛔Ridge with discrete spiny projections

#Excision of Tori :

Excision of torus mandibularis

Tori are small bony projections of unknown etiology. Indications for maxillary Tori removal:

Interference of speech

Loss of posterior palatal seal

Poor denture stability

All the mandibular Tori should be excised .

#Vestibuloplasty:

Vestibuloplasty

It is the surgical procedure to increase the vestibular depth. Techniques for vestibuloplasty are::

Mucosal Advancement

Secondary Epithelialisation

Epithelial Graft Vestibuloplasty

( ref : textbook of prosthodontics,Deepak nallaswamy, image: Google images)