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GOOD MORNING
CLASSIFICATION OF
PARTIALLY
EDENTULOUS ARCHES
DR. EAKETHA LOKESH
PG 2nd YEAR
DEPT: OF PROSTHODONTICS
CONTENTS
• Introduction
• Need for classification
• Requirements of classification
• Different systems of classification
• Conclusion
• References
3Dr. Eaketha Lokesh
Partial edentulism - The absence of
some, but not all the natural teeth in a
dental arch.
McGarry TJ, Nimmo A, Skiba JF, et al: Classification system for partial
edentulism. J Prosthodont 2002;11:181-193
4Dr. Eaketha Lokesh
• Various types of edentulous situation or partial
edentulism is seen.
• Edentulism means state of being without teeth or
lacking teeth.
• There may be loss of one or more teeth but not all the
teeth in partially edentulous or semi edentulous
situation.
INTRODUCTION
5Dr. Eaketha Lokesh
• Unless and until actual case or a cast is seen, one will
not know exactly how many teeth and also which teeth
are missing.
• These various partially edentulous situations are
difficult for remembering and memorization.
• Therefore a system of classification is required which
will help to group or specify the situation and design
them in such a way, so as to give the exact idea of the
missing tooth.
6Dr. Eaketha Lokesh
• The primary purpose of creating a classification system
for partially edentulous arches is to enable the dentist
to clearly communicate to a listener or reader , the
condition of oral cavity in which missing teeth are to be
replaced with a prosthesis.
7Dr. Eaketha Lokesh
• Several classifications have been proposed and in use
but a method which best classifies all possible
configuration is still not achieved.
8Dr. Eaketha Lokesh
Need For Classification
1. To formulate a good treatment plan.
2. To anticipate the difficulties commonly to occur for
particular design.
3. To communicate with professionals.
4. To design the denture according to occlusal load
usually expected for a particular group.
9Dr. Eaketha Lokesh
REQUIREMENTS OF CLASSIFICATION
Allow visualization of the type of partially
edentulous arch being considered.
Permit differentiation between tooth supported
and tooth- tissue supported partial dentures.
Serve as a guide to the type of design to be used.
Be universally accepted.
10Dr. Eaketha Lokesh
EVOLUTION OF DIFFERENT
SYSTEMS OF CLASSIFICATION
1. Cummer (1920)
2. Kennedy (1923)
3. Bailyn (1928)
4. Mauk (1942)
5. Neurohr (1939)
6. Wild (1949)
7. Godfrey (1951)
8. Beckett (1953)
9. Friedmann (1953)
10. Craddock (1954)
11. Austin & Lidge (1957)
12. Skinner (1957)
13. Watt (1958)
14. Applegate – Kennedy (1960)
15. Avant (1960)
16. Costa (1974)
17. Fiset (1973)
18.Fábián & Fejérdy (1979)
19. Osborne Lammine ( 1979)
20. Misch & Judy
21. ACP-PDI (2002)
22.Naeem & Basheer (2004)
23. Arbabi et al (2007)
24. ICK- Al Johany (2008)
11Dr. Eaketha Lokesh
• One simple system classifies the prosthesis according
to the type of support they receive from dental arch.
Soft tissue supported
Tooth supported
Tooth-stissue supported
12Dr. Eaketha Lokesh
• DEMERITS
There are many possible variations of tooth tissue
supported partial denture that is simplified
This does not adequately describe the design that
must be considered.
Therefore this system is not suited for general use in
discussing ,identifying or planning the prosthesis.
13Dr. Eaketha Lokesh
CUMMERS CLASSIFICATION
SYSTEM (1920)
• First recognized classification by the professional
• Based on the relationship of the edentulous spaces to the
abutment teeth
• Based on the number and position of the DIRECT
RETAINER
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 14Dr. Eaketha Lokesh
• His mathematical computations indicated that there
are some 65,534 possible combinations of teeth
present and missing in the dental arch.
• Cummer believed that “the possible combinations and
their classifications had a particular relevance to
partial denture design and that a good classification
system would immensely simplify the development of
sound and universally applicable design principles”.
15
Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent 1970;
24(1):25-40Dr. Eaketha Lokesh
• Class I – A partially dentulous arch in which two diagonally
opposite teeth are chosen as an abutment for the attachment of
direct retainers with an indirect retainer.
• Class II – A partially dentulous arch in which two diametrically
opposite teeth are chosen as abutment for the attachment of the
direct retainers with an indirect retainer. 16Dr. Eaketha Lokesh
• Class III – A partially dentulous arch in which one or more
teeth on the same side are chosen as abutment for the
attachment of the direct retainers with or without an indirect
retainer.
• Class IV – A partially dentulous arch in which three or more
teeth are chosen as abutment for the attachment of the direct
retainers (Triangular or Quadrilateral)
17Dr. Eaketha Lokesh
MERITS
• Helps in design
• Allows analysis of
support available
DEMERITS
• Edentulous area has
no representation
• No. or class of teeth
not elaborated
18Dr. Eaketha Lokesh
KENNEDY'S SYSTEM
In 1923, Dr. Kennedy's system based on the relationships
of the edentulous spaces to abutment teeth.
19Dr. Eaketha Lokesh
• Class I – Bilateral edentulous regions located posterior to the
remaining teeth.
• Class II – Unilateral edentulous region posterior to the
remaining teeth.
20Dr. Eaketha Lokesh
• Class III – Unilateral edentulous region bounded anteriorly and
posteriorly by natural teeth.
Class IV – Single bilateral edentulous region anterior to the
remaining teeth, crossing the midline
21Dr. Eaketha Lokesh
Advantages of Kennedy’s
System
Permits immediate visualization of the partially
edentulous arch
Permits a logical approach to the problems of design
It makes possible the application of sound principles
of partial denture design
Differentiates between bounded & free end saddles
22Dr. Eaketha Lokesh
DEMERITS
1. Edentulous areas have no individual
representation
2. No. of teeth missing in modification spaces &
condition of abutment teeth not elaborated
upon
23Dr. Eaketha Lokesh
• Class I arches being the most common and
class IV being the least common
• Class I partial denture is designed as tooth-
tissue supported prosthesis.
• Class III as wholly tooth supported partial
denture.
• Class II as combination of I and III partly tooth
tissue supported and partly tooth supported.
24Dr. Eaketha Lokesh
Dr. O.C. Applegate (1960) attempted
to expand the Kennedy classification
by adding classes V and VI
25Dr. Eaketha Lokesh
APPLEGATE- KENNEDY CLASSIFICATION
(1960)
• Class V – An edentulous area bounded anteriorly and
posteriorly by natural teeth ,but in which the anterior
abutment is not suitable for support.
26Dr. Eaketha Lokesh
APPLEGATE- KENNEDY CLASSIFICATION
• Class VI – An edentulous situation in which the teeth
adjacent to the space are capable of total support of the
required prosthesis.
27Dr. Eaketha Lokesh
APPLEGATE RULES
• Classified partially edentulous arches based on
Kennedy's classification.
• Any teeth require extraction it should be done prior to
classification.
• Applegate has given 8 rules as follows
28Dr. Eaketha Lokesh
Rule 1- Classification should follow rather than precede
extractions that might alter the original classification
Rule 2- If 3rd molar is missing and not to be replaced ,it is
not considered in the classification.
Rule 3- If 3rd molar is present and is to be used as
abutment it is considered in the classification.
Rule 4- If 2nd molar is missing and not to be replaced it is
not considered in the classification.
29Dr. Eaketha Lokesh
Rule 5-The most posterior edentulous area or areas determine
the classification
Rule 6 –Edentulous areas other than those determining the
classification are referred to as modification spaces and are
designated by there number.
Rule 7 – The extent of modification is not considered, only the
number of additional edentulous areas.
Rule 8- There can be no modification areas in class 4 arches .
Any edentulous area lying posterior to single bilateral area
determine the classification 30Dr. Eaketha Lokesh
BAILYN CLASSIFICATION
(1928)
• Dr. Charles M Bailyn
• Based on whether the prosthesis is tooth borne ,tissue
borne and combination of the two that is based on
support.
• Bailyn divided all removable partial dentures into
anterior restoration and posterior restoration using
the letters a and p.
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-5731Dr. Eaketha Lokesh
• A - Anterior restorations where there are saddle areas
(denture bases) anterior to the first bicuspid
(premolar).
• P -Posterior restoration saddle areas (denture bases)
posterior to canine.
32Dr. Eaketha Lokesh
• Further they are subdivided into :-
 Class I - BOUNDED SADDLE (Abutment teeth present at each
extremity of a saddle area representing a span of not
more than three teeth.
33Dr. Eaketha Lokesh
Class II - FREE END SADDLE (there is no distal abutment).
Class III – BOUNDED SADDLE (more than 3 teeth missing).
34
Class II
Class III
Dr. Eaketha Lokesh
35
Class P.I
Class P.II
Class P.III
Posterior edentulous region between
two available abutments, not more than
three teeth distant from each other
Edentulous
(bilateral) regions
posterior to the
cuspids with one
available abutment
for each denture-
base area
An edentulous
region, with at least
three teeth posterior
to the cuspid with a
distal abutment
Dr. Eaketha Lokesh
• Class A.III. – an edentulous space anterior to the first
bicuspid with b/w two teeth, which might be available
as abutments, more than three teeth distant from each
other.
36
Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent
1970; 24(1):25-40 Dr. Eaketha Lokesh
• Class A.I.P. II – One of the two edentulous areas is
anterior to the first bicuspid and between two
available abutments <3 teeth distant from each other,
the other edentulous space being posterior to the
cuspid with only one tooth available as abutment.
37Dr. Eaketha Lokesh
• Class P.I.P. II – Both edentulous spaces are posterior to
the cuspids; one with only one tooth available for
anchorage, the other with two available teeth
separated by a distance of <3 teeth.
38Dr. Eaketha Lokesh
• Class A.I.P. III – It has three edentulous
spaces.
i. anterior to the first bicuspid with two
available anchor teeth separated by a
distance of <3 teeth
ii. another posterior to the cuspid with
only one tooth available for anchorage
iii. third one posterior to the cuspid with
two teeth available for abutments
separated by <3 teeth
39Dr. Eaketha Lokesh
MERITS
• First to emphasize the
importance of support
to partial denture by the
remaining tissue
DEMERITS
• Does not give immediate
visualization of partially
edentulous arch
• No representation of
individual teeth involved
40
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57
Dr. Eaketha Lokesh
Neurohr's classification (1939)
Class I – Tooth bearing.
Class II – Tooth and tissue bearing
Class II Div. II
41
Dr. Ferdinand Neurohr
* not commonly used due to its complexity.
Dr. Eaketha Lokesh
Class I – Tooth bearing.
 A partial denture situation falls under this classification when there are teeth
posterior to all spans, and when there are no more than four teeth missing in
any space.
A. Class I-A - when there are teeth posterior to all spans, and when there are
no more than four teeth missing in any space.
B. Class I-B- Posterior teeth are missing, and anterior teeth are in place.
C. Class I-C- Posterior teeth are missing, and some anterior teeth are missing.
D. Class I-D- Anterior teeth are missing, and posterior teeth are in place.
42Dr. Eaketha Lokesh
43Dr. Eaketha Lokesh
• Class II – Tooth and tissue bearing.
A partial denture situation falls under this classification when
there are no teeth missing posterior to one or more spans, or
when there are more than four teeth in one or more spans.
Class II-A - Posterior teeth are missing, and anterior teeth are
in place.
Class II-B - Posterior teeth are missing, and some anterior
teeth are missing.
Class II-C - Anterior teeth are missing, and some posterior
teeth are missing.
44Dr. Eaketha Lokesh
45Dr. Eaketha Lokesh
• Class II Div. II
Teeth posterior to all spans, but there are more than
four teeth (including a cuspid) in one or more spans.
(A) Posterior teeth and some anterior teeth are missing.
(B) Anterior teeth are missing, but the posterior teeth
are in place.
(C) Anterior and posterior teeth are missing.
46Dr. Eaketha Lokesh
47Dr. Eaketha Lokesh
MERITS DEMERITS
• Complexity
• Does not provide the
location of edentulous
span- side, quadrant, etc.
• No representation of
individual teeth
48
• Classifies on the basis of
length of span, hence
provides an idea about
support required.
• Defines the dominant
edentulous area of
concern
Dr. Eaketha Lokesh
Mauk's classification (1941)
Number, length, and position of the
spaces
Number and position of the remaining
teeth.
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57
49
 Dr. Edwin. H. Mauk
 Based on studies conducted on over 100
Dr. Eaketha Lokesh
• Class I – Bilateral posterior spaces and teeth remaining
in a segment in the anterior region.
• Class II – Bilateral posterior spaces and one or more
teeth at the posterior end of one space.
Class I
Class II
50Dr. Eaketha Lokesh
• Class III – Bilateral posterior spaces and one or more teeth at the
posterior end of both spaces.
• Class IV – Unilateral posterior space with or without teeth at the
posterior end of the space.
The arch is unbroken on the opposite side.
51
Class III Class IV
Dr. Eaketha Lokesh
• Class V – Anterior space only.
The posterior part of the arch is unbroken on either side.
• Class VI – Irregular spaces around the arch.
The remaining teeth are single or in small groups
52
Class V
Class VI
Dr. Eaketha Lokesh
MERITS DEMERITS
No clear representation
with respect to multiple
edentulous spans(CLASS-
VI??)
No. of teeth missing per
span not described
No representation of
individual teeth involved
53
Differentiates between
unilateral v/s bilateral,
tooth supported v/s
tooth-tissue supported
edentulous spans.
Dr. Eaketha Lokesh
Wild's classification (1949)
 Proposed a simple, yet self- explanatory
classification
54
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57Dr. Eaketha Lokesh
55
Class I – Interruption of the
dental arch (bounded)
Class II –
Shortening of the
dental arch
Class III – Combination of 1 and 2
Dr. Eaketha Lokesh
Godfrey's classification (1951)
• Proposed in 1951 by Dr.R.J. Godfrey as was being
implemented by him at the time at the University of
Toronto
• Based on the location and extent of the edentulous
spaces.
• i.e; tooth- borne, mucosa-borne, anterior or posterior
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57
56Dr. Eaketha Lokesh
No modifications
or subdivisions to
main classes
57Dr. Eaketha Lokesh
• Class A – tooth-borne denture bases in the anterior part of the
mouth.
It may be an unbroken five-tooth space
broken five-tooth space
unbroken four-tooth space.
58Dr. Eaketha Lokesh
• Class B – Mucosa-borne denture bases in the anterior
of the arch.
It may be an unbroken six-tooth space
unbroken five-tooth space
broken five tooth space.
59Dr. Eaketha Lokesh
• Class C – Tooth-borne denture bases in the posterior
part of the arch.
It may be an unbroken three-tooth space
broken three-tooth space
unbroken two-tooth space
broken two-tooth space.
60Dr. Eaketha Lokesh
• Class D – Mucosa-borne denture bases in the posterior
part of the mouth.
It may be an unbroken four-tooth space or a three-tooth,
two-tooth, or single-tooth space
61Dr. Eaketha Lokesh
MERITS DEMERITS
• No description provided with
regard to unilateral /bilateral
edentulous situation
• Quadrant wise location not
provided
• No representation of no. or
type of teeth missing in the
edentulous span
62
 Differentiates between
anterior and supported
edentulous spans
Dr. Eaketha Lokesh
Beckett's classification (1953)
• Dr.Leonard S.Beckett
• Based on the load distribution of the individual
component saddles of the partial denture.
• Inspired by Bailyn’s classification,i.e, kind of support
available for the saddle.
63Dr. Eaketha Lokesh
• Class I – saddles (denture bases) which are
tooth-borne.
64Dr. Eaketha Lokesh
• Class II – saddles (denture bases) which are mucosa-
borne.
• Two types: all free end saddle, bounded saddle where
the length of the saddle or condition of the abutment
teeth contraindicates a tooth-borne saddle.
65Dr. Eaketha Lokesh
• Class III – inadequate abutments to support the saddle
(denture base) and probably inadequate mucosa
support.
66Dr. Eaketha Lokesh
• Dr. Beckett states, “. . . these three basic classes of saddles
frequently appear in combination.
• Thus, there are dentures which would contain both Class
1 and Class 2 denture bases - designated Class 1.2
dentures.
67Dr. Eaketha Lokesh
• In a similar way, there are Class 1.3 dentures, Class 2.3
dentures, and Class 1.2.3 dentures.
• Therefore, partial dentures can be classified into seven
groups from a functional point of view.”
68Dr. Eaketha Lokesh
MERITS DEMERITS
 Anteroposterior location of
saddle not specified. specified.
 Quadrant wise location not
provided.
 No representation of exact no.
or type of teeth missing in the
teeth missing in the
edentulous spans
69
 Kind of support, quality
of support specified for
every individual
edentulous span.
Dr. Eaketha Lokesh
Friedman's classification (1953)
• Dr.Joel Freidman
• Based on three essential segment types occurring
either as discrete or continuous segments.
70Dr. Eaketha Lokesh
A – An anterior space (i.e., one or more of the six
anterior teeth).
B – a bounded posterior space.
C – Refers to a cantilever situation or a posterior free
end space.
D - C-A-B spaces
71Dr. Eaketha Lokesh
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially
edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 72Dr. Eaketha Lokesh
MERITS DEMERITS
• Location of saddle not
specified from
quadrant/unilateral-bilateral
quadrant/unilateral-bilateral
point of view. view.
• No representation of exact no.
or type of teeth missing in the
of teeth missing in the
edentulous spans
73
 Simplicity
Dr. Eaketha Lokesh
Craddock's classification
(1954)
• Dr. William H Craddock
• Based on the support.
• Class I, II, III
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces:
A literature review. Indian J Multidiscip Dent 2019;9:49-57 74Dr. Eaketha Lokesh
75
Class I – saddle
supported at
both ends by
substantial
abutment teeth
Class II – vertical
biting forces
applied to
denture insisted
entirely by soft
tissue
Class III – tooth
supported at only
one end of the
saddle
Dr. Eaketha Lokesh
MERITS DEMERITS
• No light is shed upon the
anteroposterior location,
quadrant or jaw
76
 Classifies the kind of
support available on
either side of a saddle
Dr. Eaketha Lokesh
Austin And Lidge Classification
• Dr.Karl P. Austin Dr. Eduard F. Lidge
• Based on the position of edentulous space.
• Pointed out 65,000 possible combinations
 “A” designates anterior spaces
“P” designates posterior spaces
“Bi” designates bilateral
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A
literature review. Indian J Multidiscip Dent 2019;9:49-57 77Dr. Eaketha Lokesh
• Class A – Missing anteriors
• A1: Missing anteriors on one side only
• A2: Missing anteriors on both right and left sides.
78Dr. Eaketha Lokesh
• Class P – Missing posteriors
• P1: Missing posteriors on one side. Unilateral
construction.
• P2: Posterior teeth are missing on both right and left
sides.
79Dr. Eaketha Lokesh
• P1Bi: Missing posterior on one side, with bilateral
construction.
80Dr. Eaketha Lokesh
• Class AP – Missing anterior and posteriors.
• A1P1: Anterior and posterior teeth are missing on one
side only
81Dr. Eaketha Lokesh
• Austin & Lidge suggest that, if desired, an X might be
used to designate a free-end denture base.
• Thus, a partial denture situation wherein a lower
lateral incisor and all posterior teeth missing on both
sides (posterior to the second bicuspids) could be
designated as A1 P2 X2.
82Dr. Eaketha Lokesh
MERITS DEMERITS
• Quadrant not defined
• No representation of exact no.
or type of teeth missing in the
teeth missing in the
edentulous spans
83
 First to classify in a
unilateral v/s bilateral
perspective with respect
to antero-posterior
edentulous spans.
 Provision for
visualization of the
general edentulous span
location. Dr. Eaketha Lokesh
Watt's classification (1958)
Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A
literature review. Indian J Multidiscip Dent 2019;9:49-57 84
Entirely tooth-borne
Entirely tissue borne
partially tooth and tissue -borne
By Watt et al
Dr. Eaketha Lokesh
Skinner's classification (1957)
• Dr. C.N. Skinner
• Based on the relationship of the abutment to the residual
alveolar ridge.
• He stated that “ the value of RPD – directly related to the
quality & degree of support which it receives from the
abutment teeth & the residual ridge”
85
Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent
1970; 24(1):25-40 Dr. Eaketha Lokesh
• Class I – abutment teeth located both anterior and posterior
to the denture base, and the spaces may be unilateral or
bilateral.
Ahila S C, Suganya S, Muthukumar B.
Critical analysis of classification system of
partially edentulous spaces: A literature
review. Indian J Multidiscip Dent
2019;9:49-57 86Dr. Eaketha Lokesh
• Class II – All teeth are posterior to the denture base which
functions as a partial denture unit (may be unilateral or
bilateral)
• Class III – All abutment teeth are anterior to the denture base
which functions as a partial denture base and may occur
unilaterally or bilaterally. 87Dr. Eaketha Lokesh
• Class IV – Denture bases are located both anterior and
posterior to the remaining teeth, and these may be unilateral
or bilateral.
• Class V – Abutment teeth are unilateral in relation to the
denture base
88Dr. Eaketha Lokesh
MERITS DEMERITS
• Quadrant not defined
• No representation of exact no.
or type of teeth missing in the
teeth missing in the
edentulous spans
89
 Defines the relation of
the abutment teeth to
the edentulous space in
an anteroposterior and
saggital plane, providing
an idea about the
support available.
Dr. Eaketha Lokesh
Swenson's classification
• Dr. Swenson et al (1963)
• Described in the textbook authored by Terkla and
Laney in 1955
• Based on logical reasoning.
90Dr. Eaketha Lokesh
• The 4 primary classes represent only slight
modifications of the Kennedy system,
• whereas the modification of these 4 primary classes
are changed more dramatically.
91Dr. Eaketha Lokesh
• Class I – An arch with one free-end denture base.
• Class II – An arch with two free-end denture bases.
92Dr. Eaketha Lokesh
• Class III – An arch with an edentulous space posteriorly on one or
both sides of the mouth but with teeth presents anteriorly and
posteriorly to each space.
• Class IV – An arch with an anterior edentulous space and with five
or more anterior teeth missing. 93Dr. Eaketha Lokesh
• Class I A – An arch with one free end base and one or more
missing anterior teeth.
• Class II A – Basic Class II with an anterior space.
• Class IV P– Basic Class IV with a posterior space
94Dr. Eaketha Lokesh
MERITS DEMERITS
• Criteria for dominant and
subdivided edentulous space
not edentulous space not
described
• No representation of exact no.
or type of teeth missing in the
of teeth missing in the
edentulous spans.
95
 Classifies on the basis of
support available and
allows for
anteroposterior design
to be visualised
Dr. Eaketha Lokesh
Avant's classification (1960)
• Based on the position of the
edentulous space on the anterior
and posterior segments of the arch.
• Class I – replaces one or more
posterior teeth on one side of the
arch mesial to the most distal
abutment.
Avant WE. A universal classification for removable partial denture situations. J Prosthet Dent 1966;16:533-9.
96
• Dr. W.E.Avant
Dr. Eaketha Lokesh
Class I F – Replaces one or more posterior teeth on
both sides of the arch terminating a free end.
“a”-anterior
segment
“p”–posterior
segment
“ap”-both
segments.
97Dr. Eaketha Lokesh
• Class II – Replaces one or more posterior teeth on both sides
of the arch mesial to the most distal abutment tooth on both
sides.
• Class II F – Replaces one or more posterior teeth on both
sides of the arch terminating in free ends on both sides.
98Dr. Eaketha Lokesh
• Class III – Replaces one or more anterior teeth.
• Class I-F-a - Class I-F situation with anterior teeth
being replaced also
99Dr. Eaketha Lokesh
MERITS DEMERITS
• Memory
dependant;complexity.
• No representation of exact no.
or type of teeth missing in the
of teeth missing in the
edentulous spans
100
 Provides a significant
idea of the primary
edentulous area of
concern.
 Combines the abutment
location aspect with
support available..
Dr. Eaketha Lokesh
Costa's classification
• Dr. Charles. E. Costa in 1974 described the existing
edentulous condition as anterior, lateral and terminal.
Anterior – Edentulous space located in the ant: part
Lateral - Edentulous space bounded mesially and distally by
remaining teeth.
Terminal - Edentulous space with no remaining teeth distal
to it.
101Dr. Eaketha Lokesh
Fiset's classification
• In 1973, Dr.Jacques Fiset used Applegate–Kennedy system.
• Added 4 additional classes &made AKS to 10 classes.
• Class VII – An edentulous situation in which all the
remaining teeth are located on one side of the arch.
• The fulcrum line is rather compatible with the action of
physiologic forces.
102Dr. Eaketha Lokesh
• Class VIII – An edentulous situation in which only one or
two remaining teeth are located at either anterior corner
of the arch.
• The fulcrum line is rather incompatible with the action of
physiologic forces.
103Dr. Eaketha Lokesh
• Class IX – An edentulous situation in which functional
and cosmetic requirements and the magnitude of inter-
occlusal distance require the use of a telescoped
prosthesis.
• Remaining teeth are capable of total or partial support.
104Dr. Eaketha Lokesh
• Class X – An edentulous situation in which the
remaining teeth are incapable of any support.
• If the teeth are kept to maintain alveolus integrity, the
arch must be restored with an OVERDENTURE which is
a complete denture supported primarily by the denture
foundation area.
105Dr. Eaketha Lokesh
MERITS DEMERITS
• Edentulous areas have no
individual representation.
representation.
• Concept of modification
spaces not involved.
• Individualised representation
of teeth missing/present not
available.
106
 Adds to Kennedy’s &
Applegate’s system with
regard to large partially
edentulous situations
such as those resulting
from maxillofacial
trauma, congenital
defects, generalised
periodontal compromise
etc. Dr. Eaketha Lokesh
Osborne's classification (1979)
• Osborne Lamminein 1979 classification includes
i. Class I – Mucosa borne
ii. Class II – Tooth borne
iii. Class III – combination of mucosa and tooth-borne.
107Dr. Eaketha Lokesh
Fábián & Fejérdy Classification
(1979)
Based on:
1. Position of remaining teeth in the arch
2. No. of occlusal contacts
3. Torquing* movement on constructed denture
-Enhances treatment planning and denture design procedures
(Torque-/tɔːk/-rotatory force resulting from the vertical component
of the occlusal load acting on a prosthesis; GPT-9)
108Dr. Eaketha Lokesh
CLASS I
Completely tooth supported edentulous spans
Torquing movement on occlusal/incisal surface of denture teeth
CLASS 1A
One or more fulcrum lines based on the no. of tooth bound edentulous
spaces
No additional secondary abutments needed
CLASS 1B
Moderate torquing effects require utilisation of secondary abutments
Fulcrum line created outside of pontic space due to arch configuration/span
109Dr. Eaketha Lokesh
CLASS II A CLASS II B
• Tooth & tissue
supported longer spans
• Longer bounded saddles
or short free end saddles
• Structural modifications
to prevent fulcral
rotation indespensable
• Primarily tissue and
secondarily tooth
supported edentulous
spans
110Dr. Eaketha Lokesh
Class III
Denture exhibits movement in more than one directions
about more than one axis
Large amount of tissue support derived
Extended edentulous areas with lesser teeth remaining than
missing and located diagonally
Mostly telescopic in design
Indirect retention impossible plan hence complete coverage
desired 111Dr. Eaketha Lokesh
MERITS DEMERITS
• Edentulous areas have no individual
representation wrt location/tooth
representation wrt location/tooth
type/no. of teeth/etc.
112
 First and only classification to
categorize based on the kind
of forces acting on the
denture as a consequence of
the no. and location of
missing teeth.
 Contributes functionally to
treatment planning and
denture design procedures
Dr. Eaketha Lokesh
Arbabi, Ahmadian and Sharifi
Classification
• Rasoul Arbabi, Leila Ahmadian & Esmaeel Sharifi
(2007)
• They attempted to provide a simpler classification of
partially edentulous arches while considering most of
Kennedy’s and all of Applegate’s rules in this system.
113
Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS
2007;7(2) : 85-87 Dr. Eaketha Lokesh
• Based on NUMERICAL CODES
• Enable quick visualization of the partial
edentulous arch.
114
Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS
2007;7(2) : 85-87 Dr. Eaketha Lokesh
6 Rules of this Numerical system
1) An edentulous area is coded from the right to the left
2) The code “0” shows the midline
3) A distal extended area is denoted by the code “1”
4) A tooth-supported edentulism is illustrated by the code “3”
5) The code “4” indicated a tooth supported edentulism that
crossing the midline
6) The code “5” is used to illustrate distal extended
edentulism that crosses the midline. 115Dr. Eaketha Lokesh
The code “2” is not used in this system,
therefore, any possibility of confusion
between this numeral code and
Kennedy’s class II has been eliminated.
116
Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS
2007;7(2) : 85-87 Dr. Eaketha Lokesh
117
Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS
2007;7(2) : 85-87
Kennedy’s Class II – Unilateral distal extension – left side
code “01”
Dr. Eaketha Lokesh
118
Code: 101
Code: 05Code: 103
Code: 4
Dr. Eaketha Lokesh
Potential benefits of the system
1. Determination of the position of the edentulous area
in the arch with respect to the midline
2. Simplified imagination of the partial edentulous arch
3. Improved professional communication
4. Facilitated data transformation from the edentulous
arch to the computer
119
Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS
2007;7(2) : 85-87 Dr. Eaketha Lokesh
ACP CLASSIFICATION SYSTEM
(2002)
• American College of Prosthodontist (ACP) developed a
classification systemin 1999 & published in 2002 for
partially edentulous patients
• based on clinical criteria
120
Loto Adolphus Odogun., et al. “A Newly Proposed Quantitative Codification of the
Principles of Classification Partial Edentulism”. EC Dental Science 18.6 (2019): 1091-
1103.
Dr. Eaketha Lokesh
Number (extent) of missing teeth
Location of missing teeth
Relationship of abutment teeth to the edentulous space/s
and to each other in the same dental arch
The periodontal conditions of the abutment teeth
Occlusal balance (conditions and relationship of the
remaining teeth in both jaws)
Pattern and degree of resorption of alveolar ridge of the
edentulous space.
121
6
1
2
3
4
5
Dr. Eaketha Lokesh
122Dr. Eaketha Lokesh
Additional guidelines to assist the consistent
application of the classification
1. Consideration of future treatment procedures must not
influence the decision as to which diagnostic level to place
the patient in.
2. Initial pre-prosthetic treatment and/or adjunctive therapy
can change the initial classification level.
The classification may need to be re-assessed after the
removal of existing prostheses.
123Dr. Eaketha Lokesh
3. Esthetic concerns or challenges raise the classification in complexity
by one level in Class I and II patients.
4. In the presence of TMD symptoms, the classification is increased in
complexity by one or more levels in Class I and II patients
5. Periodontal health is intimately related to the diagnosis and
prognosis for partially edentulous patients.
For the purpose of this system, it is assumed that patients will
receive periodontal therapy to achieve and maintain periodontal health
so that prosthodontic care can be accomplished.
124Dr. Eaketha Lokesh
6. In the situation where the patient presents with an edentulous
maxilla opposing a partially edentulous mandible, each arch is
diagnosed with the appropriate classification system.
• In this situation, the maxilla would be classified according to the
complete edentulism classification system and the mandible
according to the partial edentulism classification system.
• A single exception to this rule is when the patient presents with an
edentulous mandible opposed by a partially edentulous or dentate
maxilla.
• This clinical situation presents significant complexity and long-
term morbidity and as such, should be diagnosed as a Class IV in
either system.
125Dr. Eaketha Lokesh
MERITS DEMERITS
• Edentulous areas have no individual
representation wrt location/tooth
126
 Provides a clear clinical
description of the quality of
support(tooth/tissue),
condition of the edentulous
foundation, state of occlusion,
etc.
 Demarcates between shorter
and longer edentulous spans
hence classifying the kind of
support required.
Dr. Eaketha Lokesh
Misch and Judy Classification
• Recently, Misch and Judy described a classification
system depending on the Applegate–Kennedy system,
with emphasis on the available bone in the edentulous
area for implant placement.
• Their classification involves four divisions:
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.127Dr. Eaketha Lokesh
• Divisions A and B when bone is available for implant
placement,
• Division C when bone is not available for implant
placement,
• Division D, restricted to cases with severe atrophy of
the edentulous area involving basal bone.
128Dr. Eaketha Lokesh
Implant-corrected Kennedy (ICK)
classification
• Implants with or without attachments can be used to improve
the support, stability, and retention of an RPD.
• The esthetic result of the RPD can be greatly improved by the
use of implant attachments, thus eliminating unesthetic clasps.
• With the use of implants, the options for RPD use have
increased, and the high demands of many patients for esthetic
prostheses have been satisfied
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.129Dr. Eaketha Lokesh
Implant-corrected Kennedy
classification
• In 2008, Al-Johany and Andresdescribed the situations
without implants, and then the implant-corrected
classification can be used to describe the situation with
implants.
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.130Dr. Eaketha Lokesh
Guidelines for the New Classification System
1. No edentulous space will be included in the
classification if it will be restored with an implant-
supported fixed prosthesis.
2. To avoid confusion, the maxillary arch is drawn as half
circle facing up and the mandibular arch as half circle
facing down.
The drawing will appear as if looking directly at the
patient; the right and left quadrants are reversed.
131Dr. Eaketha Lokesh
3. The classification begins with the phrase “Implant-
corrected Kennedy (Class)” followed by the description of
the classification
• It can be abbreviated as follows:
(i) ICK I, for Kennedy class I situations,
(ii) ICK II, for Kennedy class II situations,
(iii) ICK III, for Kennedy class III situations, and
(iv) ICK IV, for Kennedy class IV situations.
132Dr. Eaketha Lokesh
4. The abbreviation “max” for maxillary and “man” for mandibular
can precede the classification. The word modification can be
abbreviated as “mod.”
5. Roman numerals will be used for the classification, and Arabic
numerals will be used for the number of modification spaces and
implants.
6. The tooth number using the American Dental Association (ADA)
system is used to give the number and exact position of the implant
in the arch. (Note: other tooth numbering systems such as
F´ed´eration Dentaire Internationale [FDI] can be used, as can the
tooth name. The ADA system was used by the authors because of
familiarity).
133Dr. Eaketha Lokesh
7. The classification of any situation will be according to the following order:
main classification first, then the number of modification spaces, followed by
the number of implants in parentheses according to their position in the
arch preceded by the number sign (#).
8. The classification can be used either after implant placement to describe
any situation of RPD with implants, or before implant placement to indicate
the number and position of future implants with an RPD.
9. A different name, ICK Classification System, is given to this classification
system to be differentiated from other partially edentulous arch
classification systems.
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.134Dr. Eaketha Lokesh
Eg; for Kennedy’s Class I (ICK-I)
ICK I (#2, 15) ICK I (#2)
ICK I (#18,22,31)
135Dr. Eaketha Lokesh
ICK -I with
Modifications
136Dr. Eaketha Lokesh
ICK II (#2)
Eg; for Kennedy’s Class II (ICK-II) &
MODIFICATIONS
ICK II (#2,7)
ICK II Mod 2 (#24,29)
ICK II Mod 1 (#21,26,30)
137Dr. Eaketha Lokesh
Eg; ICK -III with Modifications
ICK III (#6)
ICK III Mod 1 (#6,11)
ICK III mod 3 (#23,26)
138Dr. Eaketha Lokesh
Eg; ICK -IV
ICK IV (#6,11)
ICK IV (#19,22)
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.139Dr. Eaketha Lokesh
The proposed
classification can
be used before or
after implant
placement.
The original Kennedy
classification can be used
to describe the situation
without implants, and
then the implant-
corrected classification
can be used to describe the
situation with implants
140Dr. Eaketha Lokesh
Classification can be used either
retrospectively to describe an existing
situation, or prospectively for future
planning.
Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.141Dr. Eaketha Lokesh
ADVANTAGES OF ICK CLASSIFICATION
1. The presented classification is simple and easy to
visualize , but needs practice for familiarization.
2. A software program (Dental Flash, Attachments
International, San Mateo, CA) can be used to assist in
drawing and designing any classification, and printing
the design cleanly.
142Dr. Eaketha Lokesh
DRAWBACKS OF ICK CLASSIFICATION
1. The classification will be difficult for
individuals who are unfamiliar with the
Kennedy classification.
2. Information is provided about the location
and the number of the implants, but not the
quality of the bone.
143Dr. Eaketha Lokesh
Naeem & Basheer Classification
(2014)
• Proposed in 2014 by Naeem A & Basheer T
• Based on location of missing teeth
• Notations used– Maxillary(Mx), Mandibular(Md), Left(L),
Right(R), Numbering 1,2,3… – for Incisors, canine etc.
• Class denoted by roman numerals, type by arabic.
• Tooth missing other than the classification denoted
thereafter.
144Dr. Eaketha Lokesh
CLASS I
• Type 1-Both 2nd molar’s missing
(M2)
• Type 2-All molar’s missing (M2, M1)
• Type 3-All molar’s, 2nd pre-molar
missing (M2, M1, PM2)
• Type 4-All posterior teeth missing
(M2, M1, PM2, PM1)
• Type 5-All posterior teeth + any
anterior tooth missing (M2, M1, PM2,
PM1, Ant.) 145Dr. Eaketha Lokesh
CLASS II
• Type 1-Unilateral 2nd molar missing (M2)
• Type 2-Unilateral both molar’s missing
(M2, M1)
• Type 3-Unilateral both molar’s, 2nd pre-
molar missing (M2, M1, PM2)
• Type 4-Unilateral all posterior teeth
missing (M2, M1, PM2, PM1)
• Type 5-Unilateral all posterior teeth
missing +any anterior tooth (M2, M1,
PM2, PM1, Ant.) 146Dr. Eaketha Lokesh
CLASS III
• Type 1-Unilateral 2nd molar missing (M2)
• Type 2-Unilateral 2nd molar, 1st molar
missing (M2,M1)
• Type 3-Unilateral 2nd molar, 1st molar, 2nd
premolar missing (M2, M1, PM2)
• Type 4-Unilateral 2nd molar, 1st molar,
both premolars missing (M2, M1, PM2,
PM1)
• Type 5- Unilateral 2nd molar, 1st molar,
both premolars missing + any anterior
tooth (M2, M1, PM2, PM1, Ant.)
147Dr. Eaketha Lokesh
CLASS IV
• Type 1-Bilateral central incisor missing
(CI)
• Type 2-Bilateral incisor missing (I)
• Type 3-Bilateral anterior missing (I,C)
• Type 4-Bilateral anterior, 1st premolar
missing (I, C,P)
• Type 5-Bilateral anterior, both
premolars missing(I, C, P)
• Type 6-Bilateral anterior, both
premolar, 1st molar missing (I, C, P, M1)
148Dr. Eaketha Lokesh
149
Mx, Class-I,Type-1,L5 Mx, Class-II,Type-1R,L5
Mx, Class-III,Type-2R,L5 Mx, Class-I,,L1,1
Dr. Eaketha Lokesh
MERITS DEMERITS
• Complexity requires
memory based analysis.
• No information retrieved
regarding periodontal
status of periodontal
status of
abutments/general soft
tissue structure
150
 Only classification to
specify the tooth type,
quadrant, no. of teeth
involved in the partially
edentulous state.
 Gives invidualised
reference to every
variety of support vs
space situation
Dr. Eaketha Lokesh
151Dr. Eaketha Lokesh
152Dr. Eaketha Lokesh
153Dr. Eaketha Lokesh
154
Loto Adolphus Odogun., et al. “A Newly Proposed Quantitative Codification of the Principles of
Classification Partial Edentulism”. EC Dental Science 18.6 (2019): 1091-1103.Dr. Eaketha Lokesh
155Dr. Eaketha Lokesh
156Dr. Eaketha Lokesh
CONCLUSION
• The originators of systems tried to solve huge number
of possible combinations into classes and subclasses,
but so far none of the classifications proposed by
researchers fulfill all the requirements of classification.
• If anyone of the classification systems was to be
accepted, it would be in favor of either Kennedy or
American College of Prosthodontics.
157Dr. Eaketha Lokesh
JOURNAL REFERENCES
1. Ahila S C, Suganya S, Muthukumar B. Critical analysis of
classification system of partially edentulous spaces: A literature
review. Indian J Multidiscip Dent 2019;9:49-57
2. Avant WE. A universal classification for removable partial denture
situations. J Prosthet Dent 1966;16:533-9.
3. Al-Johany and Andres. Classification system for RPD’s with
Implants. J Prosthodont 2008; 17: 502-507.
158Dr. Eaketha Lokesh
4. Miller E.L. System for classifying partially edentulous
arches. J Prosthet Dent 1970; 24(1):25-40
5. Arbabi et al. A simplified classification system for partial
edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87
6. Loto Adolphus Odogun., et al. “A Newly Proposed
Quantitative Codification of the Principles of Classification
Partial Edentulism”. EC Dental Science 18.6 (2019): 1091-
1103.
159Dr. Eaketha Lokesh
TEXTBOOK REFERENCES
1. Rodney D Phoenix, David R Cagna, Charles F DeFreest. Stewarts
clinical removable partial prosthodontics, 3rd Edition,
Quintessence books.
2. Alan B Carr, David T Brown. Mc Crackens removable partial
prosthodontics, 12th Edition, 2012, Elsevier Mosby.
3. Alan B Carr, David T Brown. Mc Crackens removable partial
prosthodontics, 1st South Asia Edition, 2012, Elsevier Mosby.
160Dr. Eaketha Lokesh
161Dr. Eaketha Lokesh

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Classification systems for partially edentulous arches

  • 2. CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES DR. EAKETHA LOKESH PG 2nd YEAR DEPT: OF PROSTHODONTICS
  • 3. CONTENTS • Introduction • Need for classification • Requirements of classification • Different systems of classification • Conclusion • References 3Dr. Eaketha Lokesh
  • 4. Partial edentulism - The absence of some, but not all the natural teeth in a dental arch. McGarry TJ, Nimmo A, Skiba JF, et al: Classification system for partial edentulism. J Prosthodont 2002;11:181-193 4Dr. Eaketha Lokesh
  • 5. • Various types of edentulous situation or partial edentulism is seen. • Edentulism means state of being without teeth or lacking teeth. • There may be loss of one or more teeth but not all the teeth in partially edentulous or semi edentulous situation. INTRODUCTION 5Dr. Eaketha Lokesh
  • 6. • Unless and until actual case or a cast is seen, one will not know exactly how many teeth and also which teeth are missing. • These various partially edentulous situations are difficult for remembering and memorization. • Therefore a system of classification is required which will help to group or specify the situation and design them in such a way, so as to give the exact idea of the missing tooth. 6Dr. Eaketha Lokesh
  • 7. • The primary purpose of creating a classification system for partially edentulous arches is to enable the dentist to clearly communicate to a listener or reader , the condition of oral cavity in which missing teeth are to be replaced with a prosthesis. 7Dr. Eaketha Lokesh
  • 8. • Several classifications have been proposed and in use but a method which best classifies all possible configuration is still not achieved. 8Dr. Eaketha Lokesh
  • 9. Need For Classification 1. To formulate a good treatment plan. 2. To anticipate the difficulties commonly to occur for particular design. 3. To communicate with professionals. 4. To design the denture according to occlusal load usually expected for a particular group. 9Dr. Eaketha Lokesh
  • 10. REQUIREMENTS OF CLASSIFICATION Allow visualization of the type of partially edentulous arch being considered. Permit differentiation between tooth supported and tooth- tissue supported partial dentures. Serve as a guide to the type of design to be used. Be universally accepted. 10Dr. Eaketha Lokesh
  • 11. EVOLUTION OF DIFFERENT SYSTEMS OF CLASSIFICATION 1. Cummer (1920) 2. Kennedy (1923) 3. Bailyn (1928) 4. Mauk (1942) 5. Neurohr (1939) 6. Wild (1949) 7. Godfrey (1951) 8. Beckett (1953) 9. Friedmann (1953) 10. Craddock (1954) 11. Austin & Lidge (1957) 12. Skinner (1957) 13. Watt (1958) 14. Applegate – Kennedy (1960) 15. Avant (1960) 16. Costa (1974) 17. Fiset (1973) 18.Fábián & Fejérdy (1979) 19. Osborne Lammine ( 1979) 20. Misch & Judy 21. ACP-PDI (2002) 22.Naeem & Basheer (2004) 23. Arbabi et al (2007) 24. ICK- Al Johany (2008) 11Dr. Eaketha Lokesh
  • 12. • One simple system classifies the prosthesis according to the type of support they receive from dental arch. Soft tissue supported Tooth supported Tooth-stissue supported 12Dr. Eaketha Lokesh
  • 13. • DEMERITS There are many possible variations of tooth tissue supported partial denture that is simplified This does not adequately describe the design that must be considered. Therefore this system is not suited for general use in discussing ,identifying or planning the prosthesis. 13Dr. Eaketha Lokesh
  • 14. CUMMERS CLASSIFICATION SYSTEM (1920) • First recognized classification by the professional • Based on the relationship of the edentulous spaces to the abutment teeth • Based on the number and position of the DIRECT RETAINER Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 14Dr. Eaketha Lokesh
  • 15. • His mathematical computations indicated that there are some 65,534 possible combinations of teeth present and missing in the dental arch. • Cummer believed that “the possible combinations and their classifications had a particular relevance to partial denture design and that a good classification system would immensely simplify the development of sound and universally applicable design principles”. 15 Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent 1970; 24(1):25-40Dr. Eaketha Lokesh
  • 16. • Class I – A partially dentulous arch in which two diagonally opposite teeth are chosen as an abutment for the attachment of direct retainers with an indirect retainer. • Class II – A partially dentulous arch in which two diametrically opposite teeth are chosen as abutment for the attachment of the direct retainers with an indirect retainer. 16Dr. Eaketha Lokesh
  • 17. • Class III – A partially dentulous arch in which one or more teeth on the same side are chosen as abutment for the attachment of the direct retainers with or without an indirect retainer. • Class IV – A partially dentulous arch in which three or more teeth are chosen as abutment for the attachment of the direct retainers (Triangular or Quadrilateral) 17Dr. Eaketha Lokesh
  • 18. MERITS • Helps in design • Allows analysis of support available DEMERITS • Edentulous area has no representation • No. or class of teeth not elaborated 18Dr. Eaketha Lokesh
  • 19. KENNEDY'S SYSTEM In 1923, Dr. Kennedy's system based on the relationships of the edentulous spaces to abutment teeth. 19Dr. Eaketha Lokesh
  • 20. • Class I – Bilateral edentulous regions located posterior to the remaining teeth. • Class II – Unilateral edentulous region posterior to the remaining teeth. 20Dr. Eaketha Lokesh
  • 21. • Class III – Unilateral edentulous region bounded anteriorly and posteriorly by natural teeth. Class IV – Single bilateral edentulous region anterior to the remaining teeth, crossing the midline 21Dr. Eaketha Lokesh
  • 22. Advantages of Kennedy’s System Permits immediate visualization of the partially edentulous arch Permits a logical approach to the problems of design It makes possible the application of sound principles of partial denture design Differentiates between bounded & free end saddles 22Dr. Eaketha Lokesh
  • 23. DEMERITS 1. Edentulous areas have no individual representation 2. No. of teeth missing in modification spaces & condition of abutment teeth not elaborated upon 23Dr. Eaketha Lokesh
  • 24. • Class I arches being the most common and class IV being the least common • Class I partial denture is designed as tooth- tissue supported prosthesis. • Class III as wholly tooth supported partial denture. • Class II as combination of I and III partly tooth tissue supported and partly tooth supported. 24Dr. Eaketha Lokesh
  • 25. Dr. O.C. Applegate (1960) attempted to expand the Kennedy classification by adding classes V and VI 25Dr. Eaketha Lokesh
  • 26. APPLEGATE- KENNEDY CLASSIFICATION (1960) • Class V – An edentulous area bounded anteriorly and posteriorly by natural teeth ,but in which the anterior abutment is not suitable for support. 26Dr. Eaketha Lokesh
  • 27. APPLEGATE- KENNEDY CLASSIFICATION • Class VI – An edentulous situation in which the teeth adjacent to the space are capable of total support of the required prosthesis. 27Dr. Eaketha Lokesh
  • 28. APPLEGATE RULES • Classified partially edentulous arches based on Kennedy's classification. • Any teeth require extraction it should be done prior to classification. • Applegate has given 8 rules as follows 28Dr. Eaketha Lokesh
  • 29. Rule 1- Classification should follow rather than precede extractions that might alter the original classification Rule 2- If 3rd molar is missing and not to be replaced ,it is not considered in the classification. Rule 3- If 3rd molar is present and is to be used as abutment it is considered in the classification. Rule 4- If 2nd molar is missing and not to be replaced it is not considered in the classification. 29Dr. Eaketha Lokesh
  • 30. Rule 5-The most posterior edentulous area or areas determine the classification Rule 6 –Edentulous areas other than those determining the classification are referred to as modification spaces and are designated by there number. Rule 7 – The extent of modification is not considered, only the number of additional edentulous areas. Rule 8- There can be no modification areas in class 4 arches . Any edentulous area lying posterior to single bilateral area determine the classification 30Dr. Eaketha Lokesh
  • 31. BAILYN CLASSIFICATION (1928) • Dr. Charles M Bailyn • Based on whether the prosthesis is tooth borne ,tissue borne and combination of the two that is based on support. • Bailyn divided all removable partial dentures into anterior restoration and posterior restoration using the letters a and p. Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-5731Dr. Eaketha Lokesh
  • 32. • A - Anterior restorations where there are saddle areas (denture bases) anterior to the first bicuspid (premolar). • P -Posterior restoration saddle areas (denture bases) posterior to canine. 32Dr. Eaketha Lokesh
  • 33. • Further they are subdivided into :-  Class I - BOUNDED SADDLE (Abutment teeth present at each extremity of a saddle area representing a span of not more than three teeth. 33Dr. Eaketha Lokesh
  • 34. Class II - FREE END SADDLE (there is no distal abutment). Class III – BOUNDED SADDLE (more than 3 teeth missing). 34 Class II Class III Dr. Eaketha Lokesh
  • 35. 35 Class P.I Class P.II Class P.III Posterior edentulous region between two available abutments, not more than three teeth distant from each other Edentulous (bilateral) regions posterior to the cuspids with one available abutment for each denture- base area An edentulous region, with at least three teeth posterior to the cuspid with a distal abutment Dr. Eaketha Lokesh
  • 36. • Class A.III. – an edentulous space anterior to the first bicuspid with b/w two teeth, which might be available as abutments, more than three teeth distant from each other. 36 Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent 1970; 24(1):25-40 Dr. Eaketha Lokesh
  • 37. • Class A.I.P. II – One of the two edentulous areas is anterior to the first bicuspid and between two available abutments <3 teeth distant from each other, the other edentulous space being posterior to the cuspid with only one tooth available as abutment. 37Dr. Eaketha Lokesh
  • 38. • Class P.I.P. II – Both edentulous spaces are posterior to the cuspids; one with only one tooth available for anchorage, the other with two available teeth separated by a distance of <3 teeth. 38Dr. Eaketha Lokesh
  • 39. • Class A.I.P. III – It has three edentulous spaces. i. anterior to the first bicuspid with two available anchor teeth separated by a distance of <3 teeth ii. another posterior to the cuspid with only one tooth available for anchorage iii. third one posterior to the cuspid with two teeth available for abutments separated by <3 teeth 39Dr. Eaketha Lokesh
  • 40. MERITS • First to emphasize the importance of support to partial denture by the remaining tissue DEMERITS • Does not give immediate visualization of partially edentulous arch • No representation of individual teeth involved 40 Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 Dr. Eaketha Lokesh
  • 41. Neurohr's classification (1939) Class I – Tooth bearing. Class II – Tooth and tissue bearing Class II Div. II 41 Dr. Ferdinand Neurohr * not commonly used due to its complexity. Dr. Eaketha Lokesh
  • 42. Class I – Tooth bearing.  A partial denture situation falls under this classification when there are teeth posterior to all spans, and when there are no more than four teeth missing in any space. A. Class I-A - when there are teeth posterior to all spans, and when there are no more than four teeth missing in any space. B. Class I-B- Posterior teeth are missing, and anterior teeth are in place. C. Class I-C- Posterior teeth are missing, and some anterior teeth are missing. D. Class I-D- Anterior teeth are missing, and posterior teeth are in place. 42Dr. Eaketha Lokesh
  • 44. • Class II – Tooth and tissue bearing. A partial denture situation falls under this classification when there are no teeth missing posterior to one or more spans, or when there are more than four teeth in one or more spans. Class II-A - Posterior teeth are missing, and anterior teeth are in place. Class II-B - Posterior teeth are missing, and some anterior teeth are missing. Class II-C - Anterior teeth are missing, and some posterior teeth are missing. 44Dr. Eaketha Lokesh
  • 46. • Class II Div. II Teeth posterior to all spans, but there are more than four teeth (including a cuspid) in one or more spans. (A) Posterior teeth and some anterior teeth are missing. (B) Anterior teeth are missing, but the posterior teeth are in place. (C) Anterior and posterior teeth are missing. 46Dr. Eaketha Lokesh
  • 48. MERITS DEMERITS • Complexity • Does not provide the location of edentulous span- side, quadrant, etc. • No representation of individual teeth 48 • Classifies on the basis of length of span, hence provides an idea about support required. • Defines the dominant edentulous area of concern Dr. Eaketha Lokesh
  • 49. Mauk's classification (1941) Number, length, and position of the spaces Number and position of the remaining teeth. Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 49  Dr. Edwin. H. Mauk  Based on studies conducted on over 100 Dr. Eaketha Lokesh
  • 50. • Class I – Bilateral posterior spaces and teeth remaining in a segment in the anterior region. • Class II – Bilateral posterior spaces and one or more teeth at the posterior end of one space. Class I Class II 50Dr. Eaketha Lokesh
  • 51. • Class III – Bilateral posterior spaces and one or more teeth at the posterior end of both spaces. • Class IV – Unilateral posterior space with or without teeth at the posterior end of the space. The arch is unbroken on the opposite side. 51 Class III Class IV Dr. Eaketha Lokesh
  • 52. • Class V – Anterior space only. The posterior part of the arch is unbroken on either side. • Class VI – Irregular spaces around the arch. The remaining teeth are single or in small groups 52 Class V Class VI Dr. Eaketha Lokesh
  • 53. MERITS DEMERITS No clear representation with respect to multiple edentulous spans(CLASS- VI??) No. of teeth missing per span not described No representation of individual teeth involved 53 Differentiates between unilateral v/s bilateral, tooth supported v/s tooth-tissue supported edentulous spans. Dr. Eaketha Lokesh
  • 54. Wild's classification (1949)  Proposed a simple, yet self- explanatory classification 54 Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57Dr. Eaketha Lokesh
  • 55. 55 Class I – Interruption of the dental arch (bounded) Class II – Shortening of the dental arch Class III – Combination of 1 and 2 Dr. Eaketha Lokesh
  • 56. Godfrey's classification (1951) • Proposed in 1951 by Dr.R.J. Godfrey as was being implemented by him at the time at the University of Toronto • Based on the location and extent of the edentulous spaces. • i.e; tooth- borne, mucosa-borne, anterior or posterior Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 56Dr. Eaketha Lokesh
  • 57. No modifications or subdivisions to main classes 57Dr. Eaketha Lokesh
  • 58. • Class A – tooth-borne denture bases in the anterior part of the mouth. It may be an unbroken five-tooth space broken five-tooth space unbroken four-tooth space. 58Dr. Eaketha Lokesh
  • 59. • Class B – Mucosa-borne denture bases in the anterior of the arch. It may be an unbroken six-tooth space unbroken five-tooth space broken five tooth space. 59Dr. Eaketha Lokesh
  • 60. • Class C – Tooth-borne denture bases in the posterior part of the arch. It may be an unbroken three-tooth space broken three-tooth space unbroken two-tooth space broken two-tooth space. 60Dr. Eaketha Lokesh
  • 61. • Class D – Mucosa-borne denture bases in the posterior part of the mouth. It may be an unbroken four-tooth space or a three-tooth, two-tooth, or single-tooth space 61Dr. Eaketha Lokesh
  • 62. MERITS DEMERITS • No description provided with regard to unilateral /bilateral edentulous situation • Quadrant wise location not provided • No representation of no. or type of teeth missing in the edentulous span 62  Differentiates between anterior and supported edentulous spans Dr. Eaketha Lokesh
  • 63. Beckett's classification (1953) • Dr.Leonard S.Beckett • Based on the load distribution of the individual component saddles of the partial denture. • Inspired by Bailyn’s classification,i.e, kind of support available for the saddle. 63Dr. Eaketha Lokesh
  • 64. • Class I – saddles (denture bases) which are tooth-borne. 64Dr. Eaketha Lokesh
  • 65. • Class II – saddles (denture bases) which are mucosa- borne. • Two types: all free end saddle, bounded saddle where the length of the saddle or condition of the abutment teeth contraindicates a tooth-borne saddle. 65Dr. Eaketha Lokesh
  • 66. • Class III – inadequate abutments to support the saddle (denture base) and probably inadequate mucosa support. 66Dr. Eaketha Lokesh
  • 67. • Dr. Beckett states, “. . . these three basic classes of saddles frequently appear in combination. • Thus, there are dentures which would contain both Class 1 and Class 2 denture bases - designated Class 1.2 dentures. 67Dr. Eaketha Lokesh
  • 68. • In a similar way, there are Class 1.3 dentures, Class 2.3 dentures, and Class 1.2.3 dentures. • Therefore, partial dentures can be classified into seven groups from a functional point of view.” 68Dr. Eaketha Lokesh
  • 69. MERITS DEMERITS  Anteroposterior location of saddle not specified. specified.  Quadrant wise location not provided.  No representation of exact no. or type of teeth missing in the teeth missing in the edentulous spans 69  Kind of support, quality of support specified for every individual edentulous span. Dr. Eaketha Lokesh
  • 70. Friedman's classification (1953) • Dr.Joel Freidman • Based on three essential segment types occurring either as discrete or continuous segments. 70Dr. Eaketha Lokesh
  • 71. A – An anterior space (i.e., one or more of the six anterior teeth). B – a bounded posterior space. C – Refers to a cantilever situation or a posterior free end space. D - C-A-B spaces 71Dr. Eaketha Lokesh
  • 72. Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 72Dr. Eaketha Lokesh
  • 73. MERITS DEMERITS • Location of saddle not specified from quadrant/unilateral-bilateral quadrant/unilateral-bilateral point of view. view. • No representation of exact no. or type of teeth missing in the of teeth missing in the edentulous spans 73  Simplicity Dr. Eaketha Lokesh
  • 74. Craddock's classification (1954) • Dr. William H Craddock • Based on the support. • Class I, II, III Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 74Dr. Eaketha Lokesh
  • 75. 75 Class I – saddle supported at both ends by substantial abutment teeth Class II – vertical biting forces applied to denture insisted entirely by soft tissue Class III – tooth supported at only one end of the saddle Dr. Eaketha Lokesh
  • 76. MERITS DEMERITS • No light is shed upon the anteroposterior location, quadrant or jaw 76  Classifies the kind of support available on either side of a saddle Dr. Eaketha Lokesh
  • 77. Austin And Lidge Classification • Dr.Karl P. Austin Dr. Eduard F. Lidge • Based on the position of edentulous space. • Pointed out 65,000 possible combinations  “A” designates anterior spaces “P” designates posterior spaces “Bi” designates bilateral Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 77Dr. Eaketha Lokesh
  • 78. • Class A – Missing anteriors • A1: Missing anteriors on one side only • A2: Missing anteriors on both right and left sides. 78Dr. Eaketha Lokesh
  • 79. • Class P – Missing posteriors • P1: Missing posteriors on one side. Unilateral construction. • P2: Posterior teeth are missing on both right and left sides. 79Dr. Eaketha Lokesh
  • 80. • P1Bi: Missing posterior on one side, with bilateral construction. 80Dr. Eaketha Lokesh
  • 81. • Class AP – Missing anterior and posteriors. • A1P1: Anterior and posterior teeth are missing on one side only 81Dr. Eaketha Lokesh
  • 82. • Austin & Lidge suggest that, if desired, an X might be used to designate a free-end denture base. • Thus, a partial denture situation wherein a lower lateral incisor and all posterior teeth missing on both sides (posterior to the second bicuspids) could be designated as A1 P2 X2. 82Dr. Eaketha Lokesh
  • 83. MERITS DEMERITS • Quadrant not defined • No representation of exact no. or type of teeth missing in the teeth missing in the edentulous spans 83  First to classify in a unilateral v/s bilateral perspective with respect to antero-posterior edentulous spans.  Provision for visualization of the general edentulous span location. Dr. Eaketha Lokesh
  • 84. Watt's classification (1958) Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 84 Entirely tooth-borne Entirely tissue borne partially tooth and tissue -borne By Watt et al Dr. Eaketha Lokesh
  • 85. Skinner's classification (1957) • Dr. C.N. Skinner • Based on the relationship of the abutment to the residual alveolar ridge. • He stated that “ the value of RPD – directly related to the quality & degree of support which it receives from the abutment teeth & the residual ridge” 85 Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent 1970; 24(1):25-40 Dr. Eaketha Lokesh
  • 86. • Class I – abutment teeth located both anterior and posterior to the denture base, and the spaces may be unilateral or bilateral. Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 86Dr. Eaketha Lokesh
  • 87. • Class II – All teeth are posterior to the denture base which functions as a partial denture unit (may be unilateral or bilateral) • Class III – All abutment teeth are anterior to the denture base which functions as a partial denture base and may occur unilaterally or bilaterally. 87Dr. Eaketha Lokesh
  • 88. • Class IV – Denture bases are located both anterior and posterior to the remaining teeth, and these may be unilateral or bilateral. • Class V – Abutment teeth are unilateral in relation to the denture base 88Dr. Eaketha Lokesh
  • 89. MERITS DEMERITS • Quadrant not defined • No representation of exact no. or type of teeth missing in the teeth missing in the edentulous spans 89  Defines the relation of the abutment teeth to the edentulous space in an anteroposterior and saggital plane, providing an idea about the support available. Dr. Eaketha Lokesh
  • 90. Swenson's classification • Dr. Swenson et al (1963) • Described in the textbook authored by Terkla and Laney in 1955 • Based on logical reasoning. 90Dr. Eaketha Lokesh
  • 91. • The 4 primary classes represent only slight modifications of the Kennedy system, • whereas the modification of these 4 primary classes are changed more dramatically. 91Dr. Eaketha Lokesh
  • 92. • Class I – An arch with one free-end denture base. • Class II – An arch with two free-end denture bases. 92Dr. Eaketha Lokesh
  • 93. • Class III – An arch with an edentulous space posteriorly on one or both sides of the mouth but with teeth presents anteriorly and posteriorly to each space. • Class IV – An arch with an anterior edentulous space and with five or more anterior teeth missing. 93Dr. Eaketha Lokesh
  • 94. • Class I A – An arch with one free end base and one or more missing anterior teeth. • Class II A – Basic Class II with an anterior space. • Class IV P– Basic Class IV with a posterior space 94Dr. Eaketha Lokesh
  • 95. MERITS DEMERITS • Criteria for dominant and subdivided edentulous space not edentulous space not described • No representation of exact no. or type of teeth missing in the of teeth missing in the edentulous spans. 95  Classifies on the basis of support available and allows for anteroposterior design to be visualised Dr. Eaketha Lokesh
  • 96. Avant's classification (1960) • Based on the position of the edentulous space on the anterior and posterior segments of the arch. • Class I – replaces one or more posterior teeth on one side of the arch mesial to the most distal abutment. Avant WE. A universal classification for removable partial denture situations. J Prosthet Dent 1966;16:533-9. 96 • Dr. W.E.Avant Dr. Eaketha Lokesh
  • 97. Class I F – Replaces one or more posterior teeth on both sides of the arch terminating a free end. “a”-anterior segment “p”–posterior segment “ap”-both segments. 97Dr. Eaketha Lokesh
  • 98. • Class II – Replaces one or more posterior teeth on both sides of the arch mesial to the most distal abutment tooth on both sides. • Class II F – Replaces one or more posterior teeth on both sides of the arch terminating in free ends on both sides. 98Dr. Eaketha Lokesh
  • 99. • Class III – Replaces one or more anterior teeth. • Class I-F-a - Class I-F situation with anterior teeth being replaced also 99Dr. Eaketha Lokesh
  • 100. MERITS DEMERITS • Memory dependant;complexity. • No representation of exact no. or type of teeth missing in the of teeth missing in the edentulous spans 100  Provides a significant idea of the primary edentulous area of concern.  Combines the abutment location aspect with support available.. Dr. Eaketha Lokesh
  • 101. Costa's classification • Dr. Charles. E. Costa in 1974 described the existing edentulous condition as anterior, lateral and terminal. Anterior – Edentulous space located in the ant: part Lateral - Edentulous space bounded mesially and distally by remaining teeth. Terminal - Edentulous space with no remaining teeth distal to it. 101Dr. Eaketha Lokesh
  • 102. Fiset's classification • In 1973, Dr.Jacques Fiset used Applegate–Kennedy system. • Added 4 additional classes &made AKS to 10 classes. • Class VII – An edentulous situation in which all the remaining teeth are located on one side of the arch. • The fulcrum line is rather compatible with the action of physiologic forces. 102Dr. Eaketha Lokesh
  • 103. • Class VIII – An edentulous situation in which only one or two remaining teeth are located at either anterior corner of the arch. • The fulcrum line is rather incompatible with the action of physiologic forces. 103Dr. Eaketha Lokesh
  • 104. • Class IX – An edentulous situation in which functional and cosmetic requirements and the magnitude of inter- occlusal distance require the use of a telescoped prosthesis. • Remaining teeth are capable of total or partial support. 104Dr. Eaketha Lokesh
  • 105. • Class X – An edentulous situation in which the remaining teeth are incapable of any support. • If the teeth are kept to maintain alveolus integrity, the arch must be restored with an OVERDENTURE which is a complete denture supported primarily by the denture foundation area. 105Dr. Eaketha Lokesh
  • 106. MERITS DEMERITS • Edentulous areas have no individual representation. representation. • Concept of modification spaces not involved. • Individualised representation of teeth missing/present not available. 106  Adds to Kennedy’s & Applegate’s system with regard to large partially edentulous situations such as those resulting from maxillofacial trauma, congenital defects, generalised periodontal compromise etc. Dr. Eaketha Lokesh
  • 107. Osborne's classification (1979) • Osborne Lamminein 1979 classification includes i. Class I – Mucosa borne ii. Class II – Tooth borne iii. Class III – combination of mucosa and tooth-borne. 107Dr. Eaketha Lokesh
  • 108. Fábián & Fejérdy Classification (1979) Based on: 1. Position of remaining teeth in the arch 2. No. of occlusal contacts 3. Torquing* movement on constructed denture -Enhances treatment planning and denture design procedures (Torque-/tɔːk/-rotatory force resulting from the vertical component of the occlusal load acting on a prosthesis; GPT-9) 108Dr. Eaketha Lokesh
  • 109. CLASS I Completely tooth supported edentulous spans Torquing movement on occlusal/incisal surface of denture teeth CLASS 1A One or more fulcrum lines based on the no. of tooth bound edentulous spaces No additional secondary abutments needed CLASS 1B Moderate torquing effects require utilisation of secondary abutments Fulcrum line created outside of pontic space due to arch configuration/span 109Dr. Eaketha Lokesh
  • 110. CLASS II A CLASS II B • Tooth & tissue supported longer spans • Longer bounded saddles or short free end saddles • Structural modifications to prevent fulcral rotation indespensable • Primarily tissue and secondarily tooth supported edentulous spans 110Dr. Eaketha Lokesh
  • 111. Class III Denture exhibits movement in more than one directions about more than one axis Large amount of tissue support derived Extended edentulous areas with lesser teeth remaining than missing and located diagonally Mostly telescopic in design Indirect retention impossible plan hence complete coverage desired 111Dr. Eaketha Lokesh
  • 112. MERITS DEMERITS • Edentulous areas have no individual representation wrt location/tooth representation wrt location/tooth type/no. of teeth/etc. 112  First and only classification to categorize based on the kind of forces acting on the denture as a consequence of the no. and location of missing teeth.  Contributes functionally to treatment planning and denture design procedures Dr. Eaketha Lokesh
  • 113. Arbabi, Ahmadian and Sharifi Classification • Rasoul Arbabi, Leila Ahmadian & Esmaeel Sharifi (2007) • They attempted to provide a simpler classification of partially edentulous arches while considering most of Kennedy’s and all of Applegate’s rules in this system. 113 Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 Dr. Eaketha Lokesh
  • 114. • Based on NUMERICAL CODES • Enable quick visualization of the partial edentulous arch. 114 Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 Dr. Eaketha Lokesh
  • 115. 6 Rules of this Numerical system 1) An edentulous area is coded from the right to the left 2) The code “0” shows the midline 3) A distal extended area is denoted by the code “1” 4) A tooth-supported edentulism is illustrated by the code “3” 5) The code “4” indicated a tooth supported edentulism that crossing the midline 6) The code “5” is used to illustrate distal extended edentulism that crosses the midline. 115Dr. Eaketha Lokesh
  • 116. The code “2” is not used in this system, therefore, any possibility of confusion between this numeral code and Kennedy’s class II has been eliminated. 116 Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 Dr. Eaketha Lokesh
  • 117. 117 Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 Kennedy’s Class II – Unilateral distal extension – left side code “01” Dr. Eaketha Lokesh
  • 118. 118 Code: 101 Code: 05Code: 103 Code: 4 Dr. Eaketha Lokesh
  • 119. Potential benefits of the system 1. Determination of the position of the edentulous area in the arch with respect to the midline 2. Simplified imagination of the partial edentulous arch 3. Improved professional communication 4. Facilitated data transformation from the edentulous arch to the computer 119 Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 Dr. Eaketha Lokesh
  • 120. ACP CLASSIFICATION SYSTEM (2002) • American College of Prosthodontist (ACP) developed a classification systemin 1999 & published in 2002 for partially edentulous patients • based on clinical criteria 120 Loto Adolphus Odogun., et al. “A Newly Proposed Quantitative Codification of the Principles of Classification Partial Edentulism”. EC Dental Science 18.6 (2019): 1091- 1103. Dr. Eaketha Lokesh
  • 121. Number (extent) of missing teeth Location of missing teeth Relationship of abutment teeth to the edentulous space/s and to each other in the same dental arch The periodontal conditions of the abutment teeth Occlusal balance (conditions and relationship of the remaining teeth in both jaws) Pattern and degree of resorption of alveolar ridge of the edentulous space. 121 6 1 2 3 4 5 Dr. Eaketha Lokesh
  • 123. Additional guidelines to assist the consistent application of the classification 1. Consideration of future treatment procedures must not influence the decision as to which diagnostic level to place the patient in. 2. Initial pre-prosthetic treatment and/or adjunctive therapy can change the initial classification level. The classification may need to be re-assessed after the removal of existing prostheses. 123Dr. Eaketha Lokesh
  • 124. 3. Esthetic concerns or challenges raise the classification in complexity by one level in Class I and II patients. 4. In the presence of TMD symptoms, the classification is increased in complexity by one or more levels in Class I and II patients 5. Periodontal health is intimately related to the diagnosis and prognosis for partially edentulous patients. For the purpose of this system, it is assumed that patients will receive periodontal therapy to achieve and maintain periodontal health so that prosthodontic care can be accomplished. 124Dr. Eaketha Lokesh
  • 125. 6. In the situation where the patient presents with an edentulous maxilla opposing a partially edentulous mandible, each arch is diagnosed with the appropriate classification system. • In this situation, the maxilla would be classified according to the complete edentulism classification system and the mandible according to the partial edentulism classification system. • A single exception to this rule is when the patient presents with an edentulous mandible opposed by a partially edentulous or dentate maxilla. • This clinical situation presents significant complexity and long- term morbidity and as such, should be diagnosed as a Class IV in either system. 125Dr. Eaketha Lokesh
  • 126. MERITS DEMERITS • Edentulous areas have no individual representation wrt location/tooth 126  Provides a clear clinical description of the quality of support(tooth/tissue), condition of the edentulous foundation, state of occlusion, etc.  Demarcates between shorter and longer edentulous spans hence classifying the kind of support required. Dr. Eaketha Lokesh
  • 127. Misch and Judy Classification • Recently, Misch and Judy described a classification system depending on the Applegate–Kennedy system, with emphasis on the available bone in the edentulous area for implant placement. • Their classification involves four divisions: Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.127Dr. Eaketha Lokesh
  • 128. • Divisions A and B when bone is available for implant placement, • Division C when bone is not available for implant placement, • Division D, restricted to cases with severe atrophy of the edentulous area involving basal bone. 128Dr. Eaketha Lokesh
  • 129. Implant-corrected Kennedy (ICK) classification • Implants with or without attachments can be used to improve the support, stability, and retention of an RPD. • The esthetic result of the RPD can be greatly improved by the use of implant attachments, thus eliminating unesthetic clasps. • With the use of implants, the options for RPD use have increased, and the high demands of many patients for esthetic prostheses have been satisfied Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.129Dr. Eaketha Lokesh
  • 130. Implant-corrected Kennedy classification • In 2008, Al-Johany and Andresdescribed the situations without implants, and then the implant-corrected classification can be used to describe the situation with implants. Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.130Dr. Eaketha Lokesh
  • 131. Guidelines for the New Classification System 1. No edentulous space will be included in the classification if it will be restored with an implant- supported fixed prosthesis. 2. To avoid confusion, the maxillary arch is drawn as half circle facing up and the mandibular arch as half circle facing down. The drawing will appear as if looking directly at the patient; the right and left quadrants are reversed. 131Dr. Eaketha Lokesh
  • 132. 3. The classification begins with the phrase “Implant- corrected Kennedy (Class)” followed by the description of the classification • It can be abbreviated as follows: (i) ICK I, for Kennedy class I situations, (ii) ICK II, for Kennedy class II situations, (iii) ICK III, for Kennedy class III situations, and (iv) ICK IV, for Kennedy class IV situations. 132Dr. Eaketha Lokesh
  • 133. 4. The abbreviation “max” for maxillary and “man” for mandibular can precede the classification. The word modification can be abbreviated as “mod.” 5. Roman numerals will be used for the classification, and Arabic numerals will be used for the number of modification spaces and implants. 6. The tooth number using the American Dental Association (ADA) system is used to give the number and exact position of the implant in the arch. (Note: other tooth numbering systems such as F´ed´eration Dentaire Internationale [FDI] can be used, as can the tooth name. The ADA system was used by the authors because of familiarity). 133Dr. Eaketha Lokesh
  • 134. 7. The classification of any situation will be according to the following order: main classification first, then the number of modification spaces, followed by the number of implants in parentheses according to their position in the arch preceded by the number sign (#). 8. The classification can be used either after implant placement to describe any situation of RPD with implants, or before implant placement to indicate the number and position of future implants with an RPD. 9. A different name, ICK Classification System, is given to this classification system to be differentiated from other partially edentulous arch classification systems. Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.134Dr. Eaketha Lokesh
  • 135. Eg; for Kennedy’s Class I (ICK-I) ICK I (#2, 15) ICK I (#2) ICK I (#18,22,31) 135Dr. Eaketha Lokesh
  • 137. ICK II (#2) Eg; for Kennedy’s Class II (ICK-II) & MODIFICATIONS ICK II (#2,7) ICK II Mod 2 (#24,29) ICK II Mod 1 (#21,26,30) 137Dr. Eaketha Lokesh
  • 138. Eg; ICK -III with Modifications ICK III (#6) ICK III Mod 1 (#6,11) ICK III mod 3 (#23,26) 138Dr. Eaketha Lokesh
  • 139. Eg; ICK -IV ICK IV (#6,11) ICK IV (#19,22) Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.139Dr. Eaketha Lokesh
  • 140. The proposed classification can be used before or after implant placement. The original Kennedy classification can be used to describe the situation without implants, and then the implant- corrected classification can be used to describe the situation with implants 140Dr. Eaketha Lokesh
  • 141. Classification can be used either retrospectively to describe an existing situation, or prospectively for future planning. Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507.141Dr. Eaketha Lokesh
  • 142. ADVANTAGES OF ICK CLASSIFICATION 1. The presented classification is simple and easy to visualize , but needs practice for familiarization. 2. A software program (Dental Flash, Attachments International, San Mateo, CA) can be used to assist in drawing and designing any classification, and printing the design cleanly. 142Dr. Eaketha Lokesh
  • 143. DRAWBACKS OF ICK CLASSIFICATION 1. The classification will be difficult for individuals who are unfamiliar with the Kennedy classification. 2. Information is provided about the location and the number of the implants, but not the quality of the bone. 143Dr. Eaketha Lokesh
  • 144. Naeem & Basheer Classification (2014) • Proposed in 2014 by Naeem A & Basheer T • Based on location of missing teeth • Notations used– Maxillary(Mx), Mandibular(Md), Left(L), Right(R), Numbering 1,2,3… – for Incisors, canine etc. • Class denoted by roman numerals, type by arabic. • Tooth missing other than the classification denoted thereafter. 144Dr. Eaketha Lokesh
  • 145. CLASS I • Type 1-Both 2nd molar’s missing (M2) • Type 2-All molar’s missing (M2, M1) • Type 3-All molar’s, 2nd pre-molar missing (M2, M1, PM2) • Type 4-All posterior teeth missing (M2, M1, PM2, PM1) • Type 5-All posterior teeth + any anterior tooth missing (M2, M1, PM2, PM1, Ant.) 145Dr. Eaketha Lokesh
  • 146. CLASS II • Type 1-Unilateral 2nd molar missing (M2) • Type 2-Unilateral both molar’s missing (M2, M1) • Type 3-Unilateral both molar’s, 2nd pre- molar missing (M2, M1, PM2) • Type 4-Unilateral all posterior teeth missing (M2, M1, PM2, PM1) • Type 5-Unilateral all posterior teeth missing +any anterior tooth (M2, M1, PM2, PM1, Ant.) 146Dr. Eaketha Lokesh
  • 147. CLASS III • Type 1-Unilateral 2nd molar missing (M2) • Type 2-Unilateral 2nd molar, 1st molar missing (M2,M1) • Type 3-Unilateral 2nd molar, 1st molar, 2nd premolar missing (M2, M1, PM2) • Type 4-Unilateral 2nd molar, 1st molar, both premolars missing (M2, M1, PM2, PM1) • Type 5- Unilateral 2nd molar, 1st molar, both premolars missing + any anterior tooth (M2, M1, PM2, PM1, Ant.) 147Dr. Eaketha Lokesh
  • 148. CLASS IV • Type 1-Bilateral central incisor missing (CI) • Type 2-Bilateral incisor missing (I) • Type 3-Bilateral anterior missing (I,C) • Type 4-Bilateral anterior, 1st premolar missing (I, C,P) • Type 5-Bilateral anterior, both premolars missing(I, C, P) • Type 6-Bilateral anterior, both premolar, 1st molar missing (I, C, P, M1) 148Dr. Eaketha Lokesh
  • 149. 149 Mx, Class-I,Type-1,L5 Mx, Class-II,Type-1R,L5 Mx, Class-III,Type-2R,L5 Mx, Class-I,,L1,1 Dr. Eaketha Lokesh
  • 150. MERITS DEMERITS • Complexity requires memory based analysis. • No information retrieved regarding periodontal status of periodontal status of abutments/general soft tissue structure 150  Only classification to specify the tooth type, quadrant, no. of teeth involved in the partially edentulous state.  Gives invidualised reference to every variety of support vs space situation Dr. Eaketha Lokesh
  • 154. 154 Loto Adolphus Odogun., et al. “A Newly Proposed Quantitative Codification of the Principles of Classification Partial Edentulism”. EC Dental Science 18.6 (2019): 1091-1103.Dr. Eaketha Lokesh
  • 157. CONCLUSION • The originators of systems tried to solve huge number of possible combinations into classes and subclasses, but so far none of the classifications proposed by researchers fulfill all the requirements of classification. • If anyone of the classification systems was to be accepted, it would be in favor of either Kennedy or American College of Prosthodontics. 157Dr. Eaketha Lokesh
  • 158. JOURNAL REFERENCES 1. Ahila S C, Suganya S, Muthukumar B. Critical analysis of classification system of partially edentulous spaces: A literature review. Indian J Multidiscip Dent 2019;9:49-57 2. Avant WE. A universal classification for removable partial denture situations. J Prosthet Dent 1966;16:533-9. 3. Al-Johany and Andres. Classification system for RPD’s with Implants. J Prosthodont 2008; 17: 502-507. 158Dr. Eaketha Lokesh
  • 159. 4. Miller E.L. System for classifying partially edentulous arches. J Prosthet Dent 1970; 24(1):25-40 5. Arbabi et al. A simplified classification system for partial edentulism: A theoretical explanation JIPS 2007;7(2) : 85-87 6. Loto Adolphus Odogun., et al. “A Newly Proposed Quantitative Codification of the Principles of Classification Partial Edentulism”. EC Dental Science 18.6 (2019): 1091- 1103. 159Dr. Eaketha Lokesh
  • 160. TEXTBOOK REFERENCES 1. Rodney D Phoenix, David R Cagna, Charles F DeFreest. Stewarts clinical removable partial prosthodontics, 3rd Edition, Quintessence books. 2. Alan B Carr, David T Brown. Mc Crackens removable partial prosthodontics, 12th Edition, 2012, Elsevier Mosby. 3. Alan B Carr, David T Brown. Mc Crackens removable partial prosthodontics, 1st South Asia Edition, 2012, Elsevier Mosby. 160Dr. Eaketha Lokesh

Hinweis der Redaktion

  1. Classification should satisfy these norms for acceptance : – 1. Allow visualization of the type of partially edentulous arch being considered. 2. Permit differentiation between tooth supported and tooth tissue supported partial dentures. 3. Serve as a guide to the type of design to be used. 4. Be universally accepted.
  2. A number of classifications have put forward some have been over simplified and others are immensely complex.
  3. 1928  Bailyn system introduced a classification based on whether the prosthesis is tooth borne ,tissueborne and combination of the two that is based on support.  Bailyn divided all removable partial dentures into anterior restoration and posterior restoration using the letters A and P.
  4. Class I – Abutment teeth present at each extremity of a saddle area representing a span of not more than three teeth. Class II – Tooth support at one extremity only of the saddle area. Class III – Tooth support at both extremities of the saddle area representing a span of more than three teeth.
  5. Neurohr,4 in his textbook, devoted an entire chapter to the subject of classification of partially dentulous jaws (Figs. 5, 6, and 7). He described the difficulties in communication which he frequently experienced as lecturer and clinician when a specific partial denture situation was discussed. Although Neurohr sought to simplify the classification process, the system which he proposed is, by any standard, one of the most complex of all those reviewed. The literature contains little reference to it, and from all available evidence, it is little used at present.
  6. Mauk's classification
  7. Class 1 -
  8. In this system, all of Applegate’s classifi cation rules have been considered. There was no conflict between Kennedy’s classifi cation and our system.
  9. The current practices require that a good classification system should give the practitioner the therapeutic solution [5]. Consequently, the desire to ensure that a classification system contains as many pieces of information as possible led the American College of Prosthodontist (ACP) to develop a classification system based on clinical criteria for partially edentulous patients in 2002 [5]. Six main criteria were identified after a thorough review of all selected scientific papers on the common classification systems. These criteria include: 1. Number (extent) of missing teeth; 2. Location of missing teeth; 3. Relationship of abutment teeth to the edentulous space/s and to each other in the same dental arch; 4. The periodontal conditions of the abutment teeth; 5. Occlusal balance (conditions and relationship of the remaining teeth in both jaws); and 6. Pattern and degree of resorption of alveolar ridge of the edentulous space.
  10. The most high-graded criteria establishes the class of the case  Extra aesthetic requirements increase the complexity of the class (for class 1 & 2 for every criteria)  If temporo-mandibular disorder is present this also increases the complexity of the class (for class 1 & 2 for every criteria).  If the maxillary arch is completely edentulous and the mandibular one partially edentulous than each one is considered in its own classification system.