Gingival Stripping in RPD

Group E
Lecturer: Dr. Ho Ting Khee

What is gingival stripping?

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

Causes of gingival stripping in RPD

Lack of rest seat

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

Causes of gingival stripping in RPD

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

Less than 6mm from the gingival margin

Gingival stripping

Complication of gingival stripping

Effect on
a) gingival overlying edentulous ridge
b) abutment teeth
c) cost & time

Effects on edentulous ridge:

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

Effects on abutment teeth

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

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

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

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

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

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

References:
1) Vacaru R, Podariu AC, Jumanca D, Galuscan A, Muntean R.
Periodontal-restorative interrelationships. Oral Health Dent Med Bas Sci 2003; 3: 12-15.
2) Jin X, Sato M, Nishiyama A, Ohyama T.
Influence of loading positions of mandibular unilateral distal extension removable partial
denture on movement of
abutment tooth and denture base extension J Med Dent Sci 2004; 51: 155163.
3) Rania R., Osama Al-Jabrah, Mahasen A.
Adverse effects of removable partial denture on periodontal status and oral health in
partially edentulous patient.
4) british Dental Journal 189, 414 424 (2000)
5) Indian Journal of Dental Sciences (2010 -2011)
6) J. Royal Medical Services 2012; Vol 19, No 3