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At the beginning of the lecture the doctor answered the exam's questions

What's the difference between these two partial dentures? The one on the right side if sticky food tries to get out of the patient's mouth there isn't anything to keep the posterior part from going out and if the he bits down the denture will go down and it will compress on the gingiva. The one on the left side if the denture tries to come out there will be a clasp on the other side that will keep the denture in its place. The rest won't keep the denture in it's place it's just give support not retention , it will prevent the denture from completely coming out but it will not prevent it from rotation, it will act as a point of rotation so to prevent this the denture will be extended to the front (indirect retention) I can't put a direct clasp in the back on the maxillary tuberosity (direct retention) so what I do is I put a rest in front so when the denture starts to come up rest comes up clasp engages it will start to rotate the rest that I put in then front will prevent it from rotation "it reduces the amount of rotation.

Indirect retention is not as effective as direct retention it is just prevent rotation of the distal extension or the mesial in class 4 from coming away from the tissue or rotating away from the tissue.

*Remember: it's all about rotation

The Point of rotation is the clasp tip

For support the axis of rotation is different in the posterior part of the denture if the patient bits down the denture will encounter the mucosa and because it's compressible the denture will compress on it but because there's a rest which is the first point of support it will give support and prevent the denture from going down but unfortunately I can't provide indirect retention so I have nothing to prevent this rotation so prevent this ,there is something in design that I do which is called "altered cast technique" in which I pre-compress the tissue. So when I put the rest in fort I change my prostheses from class 1 lever class 2 lever.

*where should the indirect retention be?

The indirect retention should be a positive rest seat you don't want it just to be on incline because the incline provides weak indirect retention, usually I want to be far away because the longer the extension will be more effective in term of physics. *for indirect retention I have to keep two things in mind : 1- the length from the axis of rotation ( the distance from the axis of rotation. 2- What the tooth I am supporting on if I am supporting on lower central incisor the tooth is not very strong even if the distance is too long. *so I have to choose the tooth correctly and the distance correctly*

Usually what we do is we look at the primary abutment " primary axis of rotation" for example the primary axis of rotation in Kennedy class 1 is usually the most posterior abutments, so we look at the clasp tip in these abutment and we draw a line like in the picture below we draw a perpendicular line to the axis of rotation the longest perpendicular point from the center of the axis of rotation will provide us with the best indirect retention (provided the tooth is strong enough).

For example the picture below when we draw a perpendicular line it will be on the central incisors but we can't put a cingulum rest on the incisors because we will have esthetic problems so we put it on canines but the problem is if we put it in one canine the perpendicular line will be too short so we divide the line into two on both canines. So instead of having one extension we will have two to give more support.

Note: If we have a modification space we also look for the most posterior
clasp assembly. * In Kennedy class 4 it's the opposite we are looking for the most anterior clasp assembly.

The picture below shows Kennedy class 4 the stars mean that the denture is going away from the tissue. The axis of rotation is from the clasp tip of the first molar to the clasp tip of the other first molar which is located on the mesial side of the first molar. If the denture keep coming out the rest will not keep in it's place the first thing that is going to engage is the clasp tip that is on the first molar so the axis of rotation is from this clasp tip the indirect retention should be on the other side so the indirect retention on the picture below is on the second molars although the first molar is more effective than the second but the farther away the better it will be.

There is a difference between support and retention, Kennedy classification doesn't make a differentiation it just tells you which teeth are missing. When we say Kennedy class 2 modification 1 doesn't mean that we have a clasp on every tooth or when we say Kennedy class 3 modification 1 doesn't mean that we have rest and clasp assembly on every tooth, so when we look at the design we should know where the clasps are and where the retention is.

In Applegate modification if the 2nd molar or the 3rd molar aren't included in the design I don't include it in my classification, but what Applegate doesn't talk about is Retention he tried to help in support but he didn't really help in retention. For example if I have no rests in the front what this will be tooth-tissue borne or tooth borne? It will be tooth-tissue Applegate doesn't even talk about this modification.

In this picture below it's Kennedy class 3 modification 1" tooth borne prostheses" , let's assume that these four corners of the prostheses have support but no retention and if we don't have direct retention we need indirect retention if we have an axis of rotation with the portion behind that axis. If sticky food comes and we look at the canine and we find no clasp on for esthetic reasons or mobility reasons so in this canine we have support but we don't have direct retention so the extension will be a free end extension when it wants to come out there is nothing to prevent it and since it comes out we will have an axis of rotation so we start looking for the most posterior axis of rotation in relation to the edentulous area and on this picture it's on the 2nd molar and the 1st premolar and what is going to prevent this rotation is the rest on the 2nd molar on the left side as shown in the picture below.

If the edentulous space in the front keep going back until you find retentive clasps, the most anterior retentive clasps will give you the axis
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of rotation if edentulous area was posterior keep going forward until you encounter 2 clasps that will be your axis of rotation. *in 95 % of the cases this will solve your problem.

Let's go back to the example above (Kennedy class3 mod 1) if we look at the picture we can notice a star o the 1st premolar this tell us that in this side of the prostheses will come out and because we don't have a clasp on the canine we will need an indirect retention on the other side, let's assume that the star was on the 2nd premolar on the other side "the left side" because we have a clasp on the canine it will prevent it from going out so we will not need an indirect retention. So Indirect retention is a secondary measure to solve something that we don't have