Kennedy’s Classification in Cast Partial Denture

Classification of partially edentulous arches

1. KENNEDY’S CLASSIFICATION AND APPLEGATE’S RULES DR. AAMIR GODIL DEPARTMENT OF PROSTHODONTICS M.A.R.D.C.

2. UNDERSTANDING PARTIAL EDENTULISM Partial edentulism: One or more, but not all teeth missing Completely edentulous mandibular arch Partially edentulous maxillary arch

3. CAST PARTIAL DENTURES Cast partial denture framework Cast partial denture

4. NEED FOR CLASSIFICATION To formulate a good treatment plan. To anticipate the difficulties commonly to occur for that particular design. To communicate with a professional about a case. To design the denture according to the occlusal load usually expected for a particular group.

5. CLASSIFICATION SYSTEMS

6. KENNEDY’S CLASSIFICATION

7. Kennedy’s Classification Dr Edward Kennedy of New York proposed this classification in 1925. This is the most popular classification. Kennedy divided all partially edentulous arches into four basic classes. Edentulous areas other than those that determine the basic classes were designated as modification spaces Kennedy’s classification is positional or anatomical and conveys a picture of certain teeth and their relationships, but gives little information about the teeth present and their positional relationships.

8. KENNEDY’S CLASS I Bilateral edentulous areas located posterior to the natural teeth The planned denture will take support from teeth as well as tissues Distal extension denture base

9. KENNEDY’S CLASS II A unilateral edentulous area located posterior to the remaining natural teeth The planned denture will take support from teeth as well as tissues Distal extension denture base

10. KENNEDY’S CLASS III A unilateral edentulous area with natural teeth remaining both anterior and posterior to it The planned denture will take support only from teeth

11. KENNEDY’S CLASS IV A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth If the edentulous space does not cross the midline, it is classified as Kennedy’s Class III

12. KENNEDY’S APPLEGATE’S CLASS V Edentulous area bounded anteriorly and posteriorly by natural teeth but in which the anterior abutment (e.g. lateral incisor) is not suitable for support. It is basically a class III situation where the anterior abutment cannot be used for any support. Hence, it cannot be treated like a conventional class III edentulous space

13. KENNEDY APPLEGATE’S CLASS VI Edentulous area in which the teeth adjacent to the space are capable of total support of the required prosthesis. This denture hardly requires any tissue support. Most of the removable partial dentures are tooth tissue supported. Hence, this condition is classified as a separate group

14. APPLEGATE’S RULES

15. Applegate’s Rules for Kennedy’s Classification In 1954, Dr O. C. Applegate provided the following rules to govern application of the Kennedy system

16. Rule 1: Applegate’s Rules Classification should follow rather than precede extractions that might alter the original classification In this instance, the indicated extractions yield a Kennedy Class II, Modification 1 arch.

17. Rule 2: Applegate’s Rules If the third molar is missing and not to be replaced, it is not considered in the classification. For purposes of this discussion, each tooth that is missing and to be replaced is shaded. Each tooth that is missing and not to be replaced is identified with an X . Hence, the illustration represents a Kennedy Class III arch.

18. Rule 3: Applegate’s Rules If a third molar is present and is to be used as an abutment, it is considered in the classification. Consequently, this illustration represents a Kennedy Class III arch.

19. Rule 4: Applegate’s Rules If a second molar is missing and is not to be replaced (that is, the opposing second molar is also missing and is not to be replaced), it is not considered in the classification. This illustration represents a Kennedy Class III arch.

20. Rule 5: Applegate’s Rules The most posterior edentulous area(s) always determines the classification. As a result, this pattern of edentulism represents a Kennedy Class II, Modification 1 arch.

21. Rule 6: Applegate’s Rules Edentulous areas other than those determining the classification are referred to as modification spaces and are designated by their number. This illustration represents a Kennedy Class II, Modification 2 arch.

22. Rule 7: Applegate’s Rules The extent of the modification is not considered, only the number of additional edentulous areas. Consequently, both illustrations represent Kennedy Class II, Modification 1 arches.

23. Rule 8: Applegate’s Rules There can be no modification areas in Class IV arches. Any edentulous area lying posterior to the single bilateral area determines the classification. This illustration depicts a Kennedy Class III, Modification 1 arch.

24. CLINICAL SCENARIOS

25. QUICK GUIDELINES After you identify the partially edentulous arch/ cast (Maxilla/ Mandible), 1. Consider extractions if any 2. Determine the most posterior edentulous space 3. Determine the replacement of third molars and second molars 4. Determine the primary classification 5. Count the number of edentulous spaces other than the primary classification 6. Denote them as modification spaces. Number of modification spaces is added to the primary classification 7. Join all the information and provide the final classification

26. EXAMPLE Maxillary partially edentulous cast No extractions indicated Posterior most region: Unilateral area (26, 27) → Kennedy’s Class II 4. Number of edentulous spaces: 4 → Modification 4 Final classification: Maxillary Kennedy’s Class II Modification 4 Arch

27. 1 Maxillary Kennedy’s Class I Modification 1 Arch

28. 2 Mandibular Kennedy’s Class II Modification 1 Arch

29. 3 Maxillary Kennedy’s Class III Modification 1 Arch

30. 4 Mandibular Kennedy’s Class I Modification 1 Arch

31. 5 Maxillary Kennedy’s Class IV Arch

32. 6 To be restored with a metal crown Mandibular Kennedy’s Class II Modification 2 Arch

33. 7 Mandibular Kennedy’s Class III Arch

34. 8 Root pieces to be extracted Maxillary Kennedy’s Class II Modification 2 Arch

35. 9 Mandibular Kennedy’s Class II Modification 2 Arch

36. 10 Maxillary Kennedy’s Class III Modification 1 Arch

37. References

38. THANK YOU