__________ CHART #: ___________________ GROUP PRACTICE: _____________ STUDENT: _____________________________________________ STUDENT #: _________________ DATE: _________________ TYPE OF PROSTHESIS / ADA CODE: □ Maxillary Co-Cr alloy RPD / 05213 □ Mandibular Co-Cr alloy RPD /05214 ( Note: Use only one form for each RPD ) RESTS Tooth Numbers Rests Mesial Rest Distal Rest Cingulum Rest CLASPS Tooth Numbers Clasp Type CCC RPI Infra bulge Ring Clasp Embrasure GUIDE PLANES Tooth Numbers Gui.

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How to fill out the NYU Preliminary RPD Design Form online

The NYU Preliminary RPD Design Form is essential for documenting the design of removable partial dentures at New York University College of Dentistry. This guide will walk you through the process of filling out the form accurately and efficiently online.

Follow the steps to successfully complete the form.

  1. Press the ‘Get Form’ button to acquire the document and access it in the online editor.
  2. Begin by entering patient information in the designated fields, including patient name, chart number, group practice, and student details. Ensure all required fields are filled in correctly.
  3. Specify the type of prosthesis by checking the appropriate box for either maxillary or mandibular Co-Cr alloy RPD, making sure only one form is used for each RPD type.
  4. Complete the rest section by indicating the specific tooth numbers for mesial, distal, and cingulum rests, as required.
  5. In the clasps section, list the tooth numbers and select the appropriate clasp type, including options like CCC, RPI, infra bulge, ring clasp, or embrasure.
  6. Detail the guide planes by entering the tooth numbers and specifying whether the planes are mesial or distal.
  7. For the major connectors, select the type for either maxillary or mandibular major connectors by checking the corresponding box, such as palatal strap, U shaped, or full palatal.
  8. Indicate the location of any undercut on the tooth using arrows on the provided dentogram area.
  9. Finally, fill in the names and signatures for reviewing faculty and GPD, including their respective identification numbers.
  10. Review the completed form for accuracy before saving your changes, downloading, printing, or sharing the document as necessary.

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