[Treatment of removable partial dentures. 2. Causes and consequences of a reduced occlusal system]

The occlusal system is part of the orofacial system and consists of the maxillary and mandibular alveolar ridge and teeth which are occluding or not or the removable denture teeth. The most prevalent causes of loss of teeth are insufficient oral self care or inadequate professional oral healthcare service. A reduced dentition can be described in terms of diastemas in the anterior region and number of occluding pairs of (pre)molars, differentiated as interrupted or shortened dental arches. Characteristic of a healthy functional occlusal system are the absence of pathology and the possibility to practice all oral functions without inconvenience. The consequences of a reduced occlusal system may be overload and/or migration of teeth, mandibular instability, and impaired esthetics and chewing function. Morphological and functional alterations can be considered to be adaptations to changed situations or to be pathological. The distinction between adaptation and pathology cannot be sharply defined. If prosthetic replacement of teeth is needed, the trend is to avoid removable partial dentures.