Group E -gingival Stripping In Rpd (1) 6y6u2n

Gingival Stripping in RPD Group E Lecturer: Dr. Ho Ting Khee

What is gingival stripping? • Gingiva is pulled off from the attachment to the tooth surface. • It is caused by physical trauma that strip off the gingiva, for example, the component of a partial denture that impinge on the gingival.

Causes of gingival stripping in RPD • • • •

Lack of rest seat Margin of maxillary major connector is less than 6mm Margin of mandibular major connector is less than 3mm Margin of acrylic baseplate is below the survey line of teeth

Causes of gingival stripping in RPD • Minor connector : too thin that cannot occlusal forces : no relief under minor connector when they cross gingival margin • Clasp too close to gingival margin • From plaque that accumulate around RPD • Inaccurate secondary impression ( causes the framework to be constructed in a way that it impinge on the soft tissue )

Less than 6mm from the gingival margin

Gingival stripping

Complication of gingival stripping Effect on • a) gingival overlying edentulous ridge • b) abutment teeth • c) cost & time

Effects on edentulous ridge: 1) Poorly design RPD => lack of => excessive force impinge on ridge => bone resorption 2) Bony resorption => loss of retention => loose denture

Effects on abutment teeth 1) Poorly design RPD without relief around gingival margin => impingement on gingival => trauma to PDL => recession => LOA => ↑ mobility => tooth loss 2) Loss of abutment => loss => ↓retention => loose denture

Management • Make a good denture design - rest is mandatory as it can act as and as vertical stop to prevent injury and over displacement of the soft tissue

Management - correct placement of retentive clasp : depends on survey line : 1/3 of the tip must be below the survey line, 2/3 above the survey line - tooth modification should be done when necessary ex: if the survey line is too low, add composite resin to prevent gingival stripping

Management • Free end saddle - use RPI or RPA system - I bar acts as retention - make sure the I bar is not too close to the gingiva

Management • Margin of major connector - maxillary : at least 6mm from gingiva margin - mandibular : at least 3mm from gingiva margin

Management • Gingival augmentation - periodontal surgery to cover gingival recession and stripping

References: 1) Vacaru R, Podariu AC, Jumanca D, Galuscan A, Muntean R. Periodontal-restorative interrelationships. Oral Health Dent Med Bas Sci 2003; 3: 12-15. 2) Jin X, Sato M, Nishiyama A, Ohyama T. Influence of loading positions of mandibular unilateral distal extension removable partial denture on movement of abutment tooth and denture base extension J Med Dent Sci 2004; 51: 155–163. 3) Rania R., Osama Al-Jabrah, Mahasen A. Adverse effects of removable partial denture on periodontal status and oral health in partially edentulous patient. 4) british Dental Journal 189, 414 – 424 (2000) 5) Indian Journal of Dental Sciences (2010 -2011) 6) J. Royal Medical Services 2012; Vol 19, No 3