A novel Approach to Maxillary Long Kennedy Class II RPD Crossing Midline

Statement of problem: Unilateral distal-extension removable partial dentures (RPD) have always posed a challenging situation to the clinician particularly when it crossed the midline and having a linear alignment of the abutments. In such cases, providing adequate retention and stability is problematic thus, the good selection of the direct and indirect retainers would ensure the long-term success of the prosthesis and the remaining abutments. Purpose: The aim of this study was to apply the idea of unilateral obturator Aramany class IV principles to the patients suffering from linearly aligned abutments long Kennedy class II RPD crossing the midline through using buccal retention and lingual retention with guiding plane composite build-ups clasp designs. Treatment Plan: Three patients were treated in this study. All the patients are fully dentate or with restored mandibular jaw and partially edentulous maxillary jaw (Kennedy class II) crossing the midline with a maximum of six teeth present in a linear alignment. Each patient received RPD that was retained through engaging the buccal undercut on anterior distal abutment and lingual undercut with composite build-up guiding plane on posterior distal abutment. Conclusions: Our findings suggest that buccal retention on anterior abutments and lingual retention and guiding planes on posterior abutments for linear class II maxillary RPD provided better patient satisfaction and more retentive capability than RPD with regular buccal retention design.