Applying basic prosthodontic principles in the dentulous maxillectomy patient

The formulation of a design for a removable partial denture framework must be approached in a logical, organized fashion, whether the framework is conventional or designed to support an obturator. The number of abutment teeth, their relationship to one another and to the other teeth in each arch, the location of the fulcrum line if unilateral or bilateral extensions are to be used, the need for direct and indirect retention, and the quality and quantity of the support for the extension bases must all be considered. The occlusal scheme and esthetics should also be considered. Once the design is formulated, careful preparation of the mouth, good impressions, proper fitting of the framework, a good altered cast impression when necessary, careful adjustments at insertion, and patient instructions concerning care and maintenance of the prosthesis will increase the chances of success. All the basic principles must be considered and applied to the unique requirements of the maxillectomy patient.