Mechanical and biological criteria have to be met in retaining the metal frame of a removable partial denture. Additionally, a removable partial denture is part of the occlusal interface by the clasps and the denture teeth. With respect to mechanical aspects, all rigid parts of the removable partial denture are of importance. However, as clasp arms tend to loose retention during long-term function, it is primarily the minor connectors and rigid clasp arms that provide stability and retention by friction with the guiding planes of the abutment teeth. With respect to biological aspects, comfort and cleansing ability are most important. Their functioning is enhanced by a low number of components crossing the marginal gingiva, such as minor connectors and infrabulge clasps. In the occlusal interface, occlusal interferences both in occlusion and during articular excursions should not be introduced by retainers or denture teeth.

The most frequently reported disadvantages of removable partial dentures are the more demanding daily oral hygiene self-care, especially for people who already experience difficulties in self-care, and the possible harmful influence on the remaining dentition. These disadvantages can be expressed in an extreme form in (frail) elderly people. The elderly show relatively large amounts of oral plaque, (root) caries, and periodontal disease. Considerations which may or may not indicate a partial denture for a (frail) elderly person are: the expressed problem and demand for treatment, the general health condition of the patient, oral mucosal health, the condition of the opposing jaw, the possible contribution to function and/or aesthetics, the possibilities of oral self-care and/or volunteer aid, the patient’s personal adaptability, and possible hazards. Extreme care in subsequent, decisions should be the rule. Key concepts are: explicit demand for treatment, appropriateness, safety, and oral self-care/volunteer aid.

In maxillo-facial prosthodontics, removable partial dentures are still widely used for tooth replacement, but also for the replacement of bone and soft tissue or for soft tissue support. The original indication range has partially been taken over by implant-supported prostheses, especially in cases involving congenital defects. Despite this trend, removable partial dentures are still the treatment of choice in head and neck oncology rehabilitation and in cleft and trauma patients.

In order to assess the enhanced value of removable partial dentures on the quality of life, patients at 2 university clinics were screened for the presence of complete or shortened dental arches. Those selected were assigned to 1 of 5 subgroups: 1) a shortened dental arch with all frontal teeth, 2) a shortened dental arch with one or more frontal diastemas, 3) a shortened dental arch with all frontal teeth, restored by a removable partial denture, 4) a shortened dental arch and several diastemas, restored by a removable partial denture, 5) a complete dental arch. The participants completed the Oral Health Impact Profile (OHIP-49) and the Short Form Health Survey (SF-36). Clinical data recorded were: whether any teeth were missing and if so which, whether or not these had been replaced by a removable partial denture, and the number of occluding pairs of (pre)molars. The results revealed that a shortenend dental arch has a certain impact on the quality of life. However, the participants only experienced benefit from a removable partial denture if the denture also replaced frontal teeth.