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RPD REVIEW LECTURE

DR. WRSU ARE Z , M PH TO O TH FI X E R 2 4

REMOVABLE PARTIAL DENTURE

RE M O V AB LE PRO STH E SI S DE SI GNE D TO

RE PLACE

M I SSI NG TE E TH AND TO RE STO RE

CO NTO U R S I N A PARTI A LL Y E DE NTU LO U S ARCH E S

Goals of RPD service

Elimination of oral disease

Preservation of health and health of oral/ paraoral structures

Restoration of oral functions that are comfortable, esthetically pleasing and do not interfere with patients oral functions

Indications of RPD service

Long edentulous span

Need to contour tissue contours

Absence of adequate periodontal support

Anatomically compromised abutments

Need for cross arch stabilization

Distal extension

Anterior esthetics

Age

Ease of plaque removal

CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES

Class I

Bilateral edentulous areas located posterior to the remaining natural teeth

Class I  Bilateral edentulous areas located posterior to the remaining natural teeth

Class II

Unilateral edentulous area located posterior to the remaining natural teeth

Class II  Unilateral edentulous area located posterior to the remaining natural teeth

Class III

Unilateral edentulous area w/ natural teeth remaining both anterior & posterior to it

Class III  Unilateral edentulous area w/ natural teeth remaining both anterior & posterior to it

Class IV

A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth

IV  A single, but bilateral (crossing the midline), edentulous area located anterior to the remaining

Applegates rules for applying Kennedys clasification

Rule 1

Classification should follow rather than precede any extraction of teeth that might alter the original classification

Rule 2

If third molar is missing & not to be replaced, It is

not considered in the classification

Rule 2  If third molar is missing & not to be replaced, It is not

Rule 3

If the third molar is present & is to be used as an abutment, it is considered in the classification

Rule 3  If the third molar is present & is to be used as an

Rule 4

If second molar is missing and is not to be replaced, it is NOT considered in the classification (in cases of missing opposing 2 nd molar & is not to be replaced)

Rule 5

The most posterior edentulous area (or areas) always determines the classification

Rule 5  The most posterior edentulous area (or areas) always determines the classification

Rule 6

Edentulous areas other than those determining the classification are referred to as modifications and are designated by their number or count

classification are referred to as m o d i f i c a t i o

Rule 7

The extent of modification is not considered, only the number of additional areas

Rule 7  The extent of modification is not considered, only the number of additional areas

Rule 8

There can be no modification areas in class IV arches (other edentulous areas lying posterior to the single bilateral areas crossing the midline would instead determine the classification)

Surveying

19

in REMOVABLE PARTIAL PROSTHODONTICS

Surveying 19 in REMOVABLE PARTIAL PROSTHODONTICS Dr. Walter R. Suarez,MPH

Dr. Walter R. Suarez,MPH

Surveying 19 in REMOVABLE PARTIAL PROSTHODONTICS Dr. Walter R. Suarez,MPH
A dental cast s urveyor has been defined as an instrument used to determine the
A dental cast s urveyor has been defined as an instrument used to determine the

A dental cast surveyor has been defined as an instrument used to determine the relative parallelism of two or more surfaces of the teeth or other parts of the cast of a dental arch.

Aims & objectives of surveying?

1.

Locate proximal tooth surfaces that are or can be made parallel to act as guiding plane surfaces.

2.

Locate and measure undercuts for mechanical retention.

3.

Identify

areas

of

potential

hard

or

soft

tissue

interferences.

 

4.

Determine the most advantageous path of insertion/ dislodgement consistent with esthetic requirements.

Aims & objectives

6. Delineate the height of contour of the abutment

and identify the areas of undercut that must be avoided,

reduced, blocked out or preserved.

7. Help in planning restorative procedures . 8. Record the most ideal cast position for future reference. 9. Establish a formal plan for RPD design and the required mouth preparation.

teeth

n

e cu

:

An undercut is formed when the base of an object is smaller than its top

Undercut Area

Types of undercuts

Typ es of undercuts T ooth Undercuts (Proximal undercuts) Soft T issues or bon y Undercuts
Typ es of undercuts T ooth Undercuts (Proximal undercuts) Soft T issues or bon y Undercuts

Tooth Undercuts

(Proximal undercuts)

Soft Tissues or bony

Undercuts(on lingual side of ridge)

Types of undercuts

Typ es of undercuts

1-Desirable Und ercu ts :

those u sed

for

retention

2-Und esirable Und ercu ts:

A lmost all u nd ercu ts in or other way… shld be blocked

25

Prof. Dr.

S.Venugo

pal.

Path of Insertion(P.I) P.I Is The Direction in Which a Restoration/Prosthesis Moves From the Point of Initial Contact With the Supporting Teeth to the Terminal Resting Position Where the Occlusal Rests Are Seated and the Denture Base Is in Contact With the Tissue

Path of Removal(P.R): Reverse of the Path of Insertion

The Direction of Movement of the Restoration/Prosthesis From Its Resting Position to the Last Contact With the Supporting Teeth".

Post Is More Readil y Removed b y A pp lication of Force Near Its

Post Is More

Readily Removed by Application of Force Near Its Top Than by Applying Same Force Nearer Ground Level

27

Dental Surveyor

Dental Surveyor 28 P rof. Dr. S.Venugo pal. N ey Surveyor Jelenko Surveyor
Dental Surveyor 28 P rof. Dr. S.Venugo pal. N ey Surveyor Jelenko Surveyor
Dental Surveyor 28 P rof. Dr. S.Venugo pal. N ey Surveyor Jelenko Surveyor
Dental Surveyor 28 P rof. Dr. S.Venugo pal. N ey Surveyor Jelenko Surveyor

28

Prof. Dr.

S.Venugo

pal.

Ney Surveyor

Jelenko Surveyor

Surveying Tools

1- Analyzing Rods

2- Carbon Marker

3- Undercut Gauge 4- Wax Trimmer

29

Prof. Dr.

S.Venugo

pal.

Analyzing Rod

Anal yz ing Rod 3 0

30

Carbon Marker

31
31
Carbon Marker 31
Carbon Marker 31
Carbon Marker 31

Undercut Gauges

Undercut Gauges 3 2

32

Undercut Gauge

Undercut Gauge 33

33

Undercut Gauge

Prof. Dr. S.Venugo pal.
Prof. Dr.
S.Venugo
pal.

34

Wax Trimmer

W ax Trimmer 3 5
W ax Trimmer 3 5

Principles of Surveying

The Prosthesis Goes Smoothly Into Place Without Interference After Analyzing the Proximal Tooth Surfaces and Making the Necessary Alteration

Principles of Surveying

Principles of Surveying T he Location of the Undercut Area Can Be 3 7 Changed b
Principles of Surveying T he Location of the Undercut Area Can Be 3 7 Changed b

The Location of the Undercut Area Can Be

Principles of Surveying T he location of the undercut area can be changed b y
Principles of Surveying T he location of the undercut area can be changed b y

Principles of Surveying

Principles of Surveying T he location of the undercut area can be changed b y tilting
Principles of Surveying T he location of the undercut area can be changed b y tilting

The location of the undercut area can be changed by tilting the cast anteriorly or lateral

Prof. Dr.

S.Venug

opal.

Principles of Surveying

A Cast in a Tilted Relationship Represents a Path of Placement Toward the Side of the Cast That Is Tilted Upward

39

Selection of the Path of Insertion

Tilting the Cast to:

Create Suitable Undercuts

Insertion T ilting the Cast to : Create Suitable Undercuts Equali z e Undercuts on both

Equalize Undercuts on both Sides of the Arch Place the Clasp Tips in a Better Esthetic Position. Undercut Areas Should Be Present at Both Zero Tilt and the New Tilt Gross Inclination of the Cast to Create Apparent Undercuts Should Be Avoided

40

Considerations when surveying cast

Determine the RELATIVE PARALLELISM of tooth surface to act as GUIDING PLANES

Determine INTERFERENCES

Determine desirable / undesirable UNDERCUTS

Determine path of insertion which would permit placement of components with the best ESTHETIC advantage

Path of displacement

Direction along which the RPD dislodges

Always perpendicular to occlusal plane

Transferred to surveyor, it is neutral or zero degree tilt (Krol)

Desirable undercuts should be present when at zero degree tilt

Tripoding the Cast Scoring the Cast 43

Tripoding the Cast

Scoring the Cast

MAJOR CONNECTORS

Components of a typical RPD

1.

2.

Major connector

Minor connector

3. Rests

4.

5.

6.

2 . M ajor connector M inor connector 3. R ests 4. 5 . 6 .

Direct retainers

Indirect retainers (for distal extensions)

Denture base

MAJOR CONNECTORS

Unit of the partial denture that connects the parts of the prosthesis located on one side of the arch w/ those of the opposite side

Unit of partial denture to w/c all other parts are directly or indirectly attached

Chief functions includes (1)unification of prosthesis parts, (2)distribution of applied force throughout the arch to selected teeth and tissue & (3)minimize torque to teeth

Major connectors must be RIGID, to enable transfer of functional forces of occlusion from artificial teeth, to denture base, to supporting teeth and tissues within the arch for optimum stability (cross arch stabilization)

Flexible major connectors will jeopardize supporting oral structures, manifested by traumatic damage to periodontal support of abutment teeth, injury to residual ridges, impingement of underlying tissue

Location & design of major connectors

Should not impinge on movable tissues

Avoid impingement of gingival tissues

Bony & soft tissue prominences should be avoided during placement & removal

Relief provided beneath major connector to avoid

impingement of tissues (elevated median palatal suture, inoperable tori)

Relieved & Located to prevent impingement of tissues as distal extension denture rotates in function

Margins of major connector adjacent to gingival tissues should be located far enough to avoid impingement

In mandible, atleast 4mm below gingival margins

 In mandible, atleast 4mm below gingival margins  In maxilla, atleast 6 mm away from
 In mandible, atleast 4mm below gingival margins  In maxilla, atleast 6 mm away from

In maxilla, atleast 6mm away from gingival margins and parallel to the mean curve of free gingival margins

Intimate contact bet w een connector an d su pp orting tissues a dd s ntimate contact between connector and supporting tissues adds to the support, stability & retention of denture

Avoi d rugae crest if p ossible void rugae crest if possible

Posterior limitation of maxillary major connector s h oul d be just anterior to t osterior limitation of maxillary major connector should be just anterior to the vibrating line

RULE:

Try to avoid adding any part of denture framework to an already convex surface. Rather try to use existing contours & embrasures. All components should be tapered where they join convex surface

Mandibular major connectors

LINGUAL BAR

Preferred mandibular major connector design except in cases where (1)floor of mouth is high, (2)extreme lingual tilt of anterior teeth, (3)inoperable tori

extreme lingual tilt of anterior teeth, (3) inoperable tori  Indicated if there is sufficient space

Indicated if there is sufficient space between the elevated lingual sulcus & lingual gingival tissue

Lingual Bar

Half pear shape with greatest bulk at inferior border while superior border is tapered toward gingival tissue

p erior bor d er is ta p ere d to w ar d gingival tissue
p erior bor d er is ta p ere d to w ar d gingival tissue

Located above moving tissue but as far below the gingival tissue as possible (min 4mm)

Made of reinforced 6-gauge

LINGUOPLATE

INDICATIONS:

When the space available for lingual bar is limited (high lingual frenum)

In class I cases w/ excessive resorption of residual ridge

For stabilizing periodontally weakened teeth

Future replacement of one or more incisor

Rule

R ule N o com p onent s h oul d be a dd e d

No component should be added arbitrarily or conventionally. Each component should be added for a good reason & to serve a definite purpose

Reason for adding component

1.

Support

2.

Stabilization against horizontal rotation

3.

Retention

4.

Preservation of health of tissues

5.

Esthetics

6.

Patients comfort

the dentist alone is responsible for the choice of design & must have good reasons

Upper border follow the natural curvature of

supracingular surfaces of teeth and not be located above the middle third of lingual surface, except to cover the interproximal spaces to contact points

d above t h e mi dd le t h ir d of lingual surface, exce
d above t h e mi dd le t h ir d of lingual surface, exce
d above t h e mi dd le t h ir d of lingual surface, exce

Linguoplate

Half pear shape forms the inferior border and provides rigidity

Ideally should have a terminal rest at each end

All gingival crevices and deep embrasures must be blocked out parallel to path of placement to avoid gingival irritation and wedging effect on teeth

SUBLI NG U A L B AR  Indicated if height of floor of the

SUBLINGUAL BAR

Indicated if height of floor of the mouth is less than 6mm & does not allow placement of bar 4mm below gingival margins

Can be used if lingual frenum does not interfere

CONTRAINDICATIONS: (1)lingual tori, (2)high frenum attachment, (3)high elevation of floor of the mouth during functional movements, (4)severe lingual tilt of anterior teeth

CINGULUM (continuous) BAR RETAINER

INDICATION:

CI NG ULU M (continuous) B AR RE T A I NER INDICATION: Wh en linguo

When linguoplate is indicated but the axial alignment of anterior teeth would require excessive blockout of interproximal undercuts

d icate d but t h e axial alignment of anterior teet h w oul d
d icate d but t h e axial alignment of anterior teet h w oul d

CONTRAINDICATIONS:

Severe lingual teeth of lower anteriors

Wide diastema between lower anteriors CHARACTERISTICS & LOCATION

Thin, narrow(3mm) metal strap on cingula of anteriors,

Scalloped to follow interproximal embrassures;

Superior border tapered to tooth surface

Should have rests on terminal end

L A BI A L B AR I N DIC A TI ON S :

LABIAL BAR

INDICATIONS:

When lingual inclinations of remaining premolar & incisors cannot be corrected, preventing the placement of lingual bar

Severe lingual tori cannot be removed

Severe or abrupt lingual tissue undercut

MAXILLARY MAJOR CONNECTORS

SINGLE PALATAL STRAP

INDICATIONS:

Short span, bilateral edentulous spaces on posterior area in tooth supported cases

T A L ST RA P I N DIC A TI ON S :  Short
T A L ST RA P I N DIC A TI ON S :  Short

Can be rigid w/out objectionable bulk and

interference with tongue

DO NOT connect anterior replacement to distal extension with single palatal strap for reason of

torque and leverage (needs bulk to resist torque and provide adequate vertical support and horizontal stabilization)

of torque and leverage (needs bulk to resist torque and provide adequate vertical support and horizontal
of torque and leverage (needs bulk to resist torque and provide adequate vertical support and horizontal

CHARACTERISTICS & LOCATION

Anatomic replica form

Anterior border follows the valleys between rugae as nearly as possible at right angles to median suture line Posterior border at right angle w/ median suture line

Strap should be atleast 8mm wide

Confined w/in an area bounded by 4 principal rest

FINISHING LINES:

No farther than 2mm medial from imaginary line contacting lingual surfaces of principal abutment and teeth to be replaced

Follow curvature of arch

imaginary line contacting lingual surfaces of principal abutment and teeth to be replaced  Follow curvature
imaginary line contacting lingual surfaces of principal abutment and teeth to be replaced  Follow curvature

ANTERIOR-POSTERIOR STRAP MAJOR CONNECTOR

INDICATIONS

Class I & II arches w/ adequate abutment & ridge support

Long edentulous span in class II mod 1

Class IV arches

Presence of inoperable tori that do not extend posteriorly to hard-soft tissue junction

CHARACTERISTIC & LOCATION

Parallelogram shaped & open in center

8-10mm anterior & posterior straps

Lateral palatal straps (7-9mm) broad & parallel to curve of arch minimum of 6mm from gingival crevice of remaining teeth

palatal straps ( 7 - 9mm) broad & parallel to curve of arch minimum of 6
palatal straps ( 7 - 9mm) broad & parallel to curve of arch minimum of 6

Anterior strap: anterior border NOT placed farther

anteriorly than anterior rests & never closer than 6mm from lingual gingival crevice; follows the valleys of rugae at right angle to median palatal suture

closer than 6 mm from lingual gingival crevice; follows the valleys of rugae at right angle
closer than 6 mm from lingual gingival crevice; follows the valleys of rugae at right angle

Anterior connector maybe extended anteriorly to support anterior tooth replacement

Posterior strap placed as far posteriorly as possible (to avoid interference to tongue) but anterior to the line of flexure formed by junction of hard and soft palate

Anatomic replica or matte surface

but anterior to the line of flexure formed by junction of hard and soft palate 
but anterior to the line of flexure formed by junction of hard and soft palate 

PALATAL PLATE TYPE

Are t h in, broa d , contoure d p alatal coverage covering ½ or re thin, broad, contoured palatal coverage covering ½ or more of hard palate

Use anatomic re p lica for uniform t h ickness & strengt h se anatomic replica for uniform thickness & strength

alatal coverage covering ½ or more of h ar d p alate U se anatomic re
alatal coverage covering ½ or more of h ar d p alate U se anatomic re
alatal coverage covering ½ or more of h ar d p alate U se anatomic re

Indications of single broad palatal major connector

Class 1 arches w/ little vertical ridge resorption

V or U shaped arches

Strong abutments

More teeth in arch than 6 anterior teeth

Direct retention not a problem

No interfering tori

CHARACTERISTIC & LOCATION

Anatomic replica form

Anterior border follow valleys of rugae at right angle to median suture line as possible & not extending anterior to occlusal rest or indirect retainers Posterior border located at junction of hard & soft palate, not extending onto soft palate, at right angle to median suture line; extended to pterygomaxillary notches

palate, not extending onto soft palate, at right angle to median suture line; extended to pterygomaxillary
palate, not extending onto soft palate, at right angle to median suture line; extended to pterygomaxillary

INDICATIONS OF COMPLETE PALATAL COVERAGE

In most instances wh ere only some or all anterior teet h remain n most instances where only some or all anterior teeth remain

Class 2 w / large p osterior mo d ification & some anterior missing lass 2 w/ large posterior modification & some anterior missing

Class 1 w / 1 - 4 p remolars & some anterior remaining w / lass 1 w/ 1-4 premolars & some anterior remaining w/ poor abutment support, excessive vertical resorption of residual ridge, direct retention difficult to obtain

No torus o torus

SINGLE PALATAL BAR

Most widely used yet the least logical

NOT RIGID ENOUGH

To have rigidity for cross arch stabilization, it must have bulk

Choice would depend on the size of denture bearing areas that are connected

arch stabilization, it must have bulk  Choice would depend on the size of denture bearing

U-SHAPED PALATAL CONNECTOR

Least d esirable from p atients & mec h anical stan dp oint ( lacks east desirable from patients & mechanical standpoint (lacks rigidity)

Shoul d never be use d arbitrarily ould never be used arbitrarily

Use d only in situation wh ere anterior teeth are to be replaced & inoperable sed only in situation where anterior teeth are to be replaced & inoperable tori extend to the posterior limit of the hard palate

Any p ortion of connector exten d ing anteriorly from p rinci p al occlusal ny portion of connector extending anteriorly from principal occlusal rest must be supported by indirect retainer

Anterior border must be kept atleast 6mm from adjacent teeth If in any case, it contact teeth, it must be supported by rest in a properly prepared rest seat

from adjacent teeth  If in any case, it contact teeth, it must be supported by
from adjacent teeth  If in any case, it contact teeth, it must be supported by
from adjacent teeth  If in any case, it contact teeth, it must be supported by

PRINCIPAL OBJECTIONS TO USE OF U-SHAPE It lacks rigidity; may induce torque to abutment

Designs will not provide good support & may permit impingement of underlying tissue when subjected to loading

Bulk to enhance rigidity results in increase thickness in areas most frequented by tongue

Antero-posterior palatal bar

Not rigid enough

Should be bulky to be rigid and provide support and stability but will interfere with tongue function

ot rigid enough  Should be bulky to be rigid and provide support and stability but
ot rigid enough  Should be bulky to be rigid and provide support and stability but

Beading of maxillary cast

Term used to denote the scribing of a shallow groove on cast outlining the palatal major connector

Accomplished using a cleoid carver

Groove not exceed 0.5mm width/depth

Slightly rounded preferred than v-shaped

Purpose of beading

To transfer the major connector design to investment/ duplicate cast

To provide a visible finish line for the casting

Ensure intimate contact of major connector w/ selected palatal tissues

MINOR CONNECTORS

Minor connectors

Unites major connectors with other parts of the denture

Arises from the major connector

May be continuous with some parts of the denture

t h e d enture  A rises from t h e major connector  M

Functions

1.

To transfer functional stress to abutment (prosthesis to abutment)

2.

To transfer the effects of retainers, rests & stabilizing components to the rest of the denture (abutment to prosthesis)

Form & location

Must have sufficient bulk to be rigid & effective

Located in embrasures, not on convex surface

Pass vertically from major connector

Thickest toward lingual surface tapering toward contact area

 P ass vertically from major connector  Th ickest to w ar d lingual surface
 P ass vertically from major connector  Th ickest to w ar d lingual surface

Minor connector should form a right angle w/ major connector

1.

Gingival crossing be abrupt

2.

Cover as little gingival tissue as possible

angle w / major connector 1 . Gingival crossing be abru p t 2 . C
angle w / major connector 1 . Gingival crossing be abru p t 2 . C

Sharp angles should be avoided

Spaces should not exist (avoid food entrapment)

 Sh ar p angles s h oul d be avoi d e d  Sp
 Sh ar p angles s h oul d be avoi d e d  Sp

Minor connector that contacts guiding plane of abutment: PROXIMAL PLATE)

at contacts gui d ing p lane of abutment : PROXIMAL PLATE)  M ust be

Must be wide enough to use guiding plane to the fullest (2/3 of distance between cusp tips of abutment

2/3 of length of enamel crown

Minor connector:

Portion of framework where acrylic denture base will be attached

Designed to be completely imbedded into the denture base

acrylic d enture base w ill be attac h e d  D esigne d to

Finishing lines

Junction of minor connector (denture base attachment) with the major connector should be a butt type joint but w/out appreciable bulk

Angles formed should not be greater than 90degrees to ensure the strongest mechanical connection (undercut)

forme d s h oul d not be greater t h an 90d egrees to ensure
forme d s h oul d not be greater t h an 90d egrees to ensure

Mandibular minor connector for distal extension base should extend posteriorly about 2/3 of the length of edentulous ridge & have elements both on buccal & lingual

p osteriorly about 2 /3 of t h e lengt h of e d entulous ri
p osteriorly about 2 /3 of t h e lengt h of e d entulous ri
p osteriorly about 2 /3 of t h e lengt h of e d entulous ri

Tissue stops

Integral part of minor connector designed for retention of acrylic denture base

Provide stability to framework during transfer and processing

Prevent distortion of denture during acrylic processing

Should engage buccal & lingual slopes of residual ridge for stability

FINISHING LINES

Junction of major and minor connector

Not greater than 90 degrees

For the thickness of denture base resin

Finishing lines

Located 2mm medial from an imaginary line that would contact the lingual surface of missing posterior teeth

ocate d 2 mm me d ial from an imaginary line t h at w oul
ocate d 2 mm me d ial from an imaginary line t h at w oul
 D irect retainer arm ta p ers from ti p to finis h ing

Direct retainer arm tapers from tip to finishing line

Finish line at junction of I bar direct retainer arm & minor connector for denture base attachment (if w/out finish lines flexing of clasp arm could create cracks in denture base)

for d enture base attac h ment ( if w/out finish lines flexing of clasp arm

Finishing lines location

1. Minimizes bulk of resin

2. Restores palatal contours

3. Enhance speech

4. contribute to natural feeling for patient

bulk of resin 2 . R estores p alatal contours 3 . E n h ance
bulk of resin 2 . R estores p alatal contours 3 . E n h ance

RESTS & REST SEATS

PROSTHODON TICS 2

REST

Any unit of partial denture that rest on a tooth surface that serves to provide vertical support

Rests should always be located on tooth surfaces (abutments) that are properly prepared (rest seat)

Designated by the tooth surface prepared to receive them

Rest should restore the surface of the tooth before rest seat preparation

Always remember that the most effective resistance can be provided if the tooth is stressed along its long axis. Therefore, prosthesis framework should engage the tooth in a manner that encourages axial loading”

Functions of rests

PRIMARY PURPOSE: Provide vertical support for RPD

Maintain components in their planned position

Maintains established occlusal relationships by preventing settling of denture

Prevents impingement of soft tissues

Directs & distributes occlusal load to abutment teeth

Functions of rests

Assist in distributing load over several teeth

Prevent extrusion of unopposed abutment

Direct food away from tooth contacts & embrasure

Provide lingual bracing on anterior teeth

Requirements/ design consideration

Sufficient thickness of metal to prevent fracture especially at the junction of rest and minor connector (1.5mm for chrome cobalt, 2mm for gold)

Placed on surfaces which would direct forces along the long axis of teeth (should not be placed on inclined planes)

Should be extended to as close to the center as feasible to promote axial direction of forces

Placed in rest seats with smooth and rounded line angles

Rest seats should be on enamel or on restoration which will resist fracture and distortion when subjected to occlusal forces

Form of occlusal rest & rest seat

Outline form should be rounded triangular in shape w/ the apex toward the center of occlusal surface

rest seat  O utline form should be rounded triangular in shape w/ the apex toward
rest seat  O utline form should be rounded triangular in shape w/ the apex toward
rest seat  O utline form should be rounded triangular in shape w/ the apex toward

Form of occlusal rest

Should be as long as it is wide. Base of triangular shape at marginal ridge should be atleast 2.5mm for both molars & premolars

Form of occlusal rest

Marginal ridge of abutment must be lowered to permit sufficient bulk of metal for strength & rigidity. Reduction of about 1.5mm is usually necessary

lowered to permit sufficient bulk of metal for strength & rigidity. R eduction of about 1.5mm

Form of occlusal rest

Floor of occlusal rest should be apical to the marginal ridge & should be concave or spoon shaped. Caution not to create sharp edges or line angles

Form of occlusal rest

Angle formed by occlusal rest & vertical minor connector where it originates should be less than 90degrees to direct forces along long axis

rest & vertical minor connector where it originates should be less than 9 0 degrees to
rest & vertical minor connector where it originates should be less than 9 0 degrees to
rest & vertical minor connector where it originates should be less than 9 0 degrees to

Floor of rest more than 90degrees

F loor of rest more t h an 90d egrees
F loor of rest more t h an 90d egrees

Extended occlusal rest

In mesially tipped abutment to:

(1) minimize further tipping (2) ensure that forces are directed along the long axis of tooth

to : ( 1 ) minimize furt h er ti pp ing (2) ensure t h
to : ( 1 ) minimize furt h er ti pp ing (2) ensure t h

Rest should extend more than half of the mesiodistal width of tooth, 1/3 buccolingual width, and minimum 1mm thickness of metal, rounded with no undercuts or sharp angles

buccolingual w i d t h , an d minimum 1 mm t h ickness of
buccolingual w i d t h , an d minimum 1 mm t h ickness of

Interproximal/ embrassure occlusal rest

Rest seat are prepared as individual rest seats but preparation are extended farther lingually

occlusal rest  R est seat are prepared as individual rest seats but preparation are extended
occlusal rest  R est seat are prepared as individual rest seats but preparation are extended

Reason???

(1 ) avoi d inter p roximal w e d ging by frame w ork 1)avoid interproximal wedging by framework

(2) s h unt foo d a w ay from contact area shunt food away from contact area

R eason??? ( 1 ) avoi d inter p roximal w e d ging by frame
R eason??? ( 1 ) avoi d inter p roximal w e d ging by frame

Lingual rests on canines & incisors

Sufficient space must be present or created to avoid interference

Root form, root length, crown inclination, crown root ratio must be considered

Lingual rest more preferred than incisal rest for it is nearer the horizontal axis of rotation—less tendency to tip tooth– more esthetically acceptable

Lingual rest are usually indicted for maxillary canines (sometimes mx central) for they have a gradual lingual incline & prominent cingulum

Lingual rest seat in enamel of mandibular anteriors are unsatisfactory for they lack enamel thickness

Lingual rest seat prepared on enamel

Slightly rounded v shaped on junction of middle & gingival 3 rd

Apex of V directed incisally

on enamel  Slightly rounded v shaped on junction of middle & gingival 3 r d
on enamel  Slightly rounded v shaped on junction of middle & gingival 3 r d

Lingual rest seat

Prepared using inverted cone then progressing to round end

Eliminate all line angles

Rest seat should be prepared only on enamel & highly polished Always consider the predetermined path of insertion

Floor of rest should be toward the cervical not on axial

Care not to produce undercuts

Lingual rest seat on cast restoration

The most satisfactory from standpoint of support

Done by preparing in wax pattern before casting

restoration  The most satisfactory from standpoint of support  Done by preparing in wax pattern
restoration  The most satisfactory from standpoint of support  Done by preparing in wax pattern

Incisal rests & rest seats

Placed at incisal angles of anterior tooth & on prepared rest seat

Least desirable

Predominantly used as auxiliary rest or as indirect retainers

More applicable for mandibular canines

May produce some orthodontic movement due to leverage

Incisal rests & rest seats

Rounded notch in incisal angle or on incisal edge w/ deepest portion apical to incisal edge

Notch should be beveled both labially & lingually Approximately 2.5mm wide & 1.5mm deep

edge N otch should be beveled both labially & lingually  A pproximately 2 . 5
edge N otch should be beveled both labially & lingually  A pproximately 2 . 5

Full incisal rest

Used when other suitable placements of incisal rests and rests seat are not available

F ull incisal rest  U se d wh en ot h er suitable p lacements
F ull incisal rest  U se d wh en ot h er suitable p lacements

Patient should be well aware of location, form & esthetic impact

“topography of any rest should be such that it restores the topography of the tooth existing before rest seat is prepared”

Rest seat preparation always must follow proximal preparation…. Never precede it

DIRECT RETAINERS

PROSTHODON TICS 2

Forces acting to displace prosthesis from tissue

Force of gravity acting on maxillary prosthesis Action of adherent foods when mouth opens during chewing

Functional forces acting acting across the fulcrum line

Retention of denture bases

ADHESION: attraction of saliva to denture & tissues

COHESION: attraction of molecules of saliva for each other

ATMOSPHERIC PRESSURE: dependent on border seal & result in partial vacuum beneath denture base

Physiologic molding of tissues around the polished surface of denture

Effect of gravity on mandibular denture

Direct retainer

Any unit of removable partial denture that engages an abutment in such a manner as to resist displacement of prosthesis away from basal seat tissues

Can be accomplished by (1)frictional means (2)by engaging a tooth in undercut lying cervically to its height of contour

Removable partial denture retention

PRIMARY RETENTION: accomplished mechanically by placing retaining elements on abutment teeth

SECONDARY RETENTION: provided by intimate relationship of denture base & major connector (maxillary) w/ underlying tissues

Engagement of an attachment mechanism on dental implant

Basic principles of clasp design

ENCIRCLEMENT

Basic principles of clasp design  EN CI R CL EMEN T  M ore than1

More than180 degrees in the greatest circumference of tooth should be engaged

Basic principles of clasp design

Occlusal rest designed to prevent cervical movement of clasps

Retentive arm should be opposed by

reciprocal/stabilizing arm (Stabilizing and reciprocating components must be rigidly connected bilaterally for reciprocation of retentive elements)

(Stabilizing and reciprocating components must be rigidly connected bilaterally for reciprocation of retentive elements)
(Stabilizing and reciprocating components must be rigidly connected bilaterally for reciprocation of retentive elements)

Basic principles of clasp design

Amount of retention should be the minimum necessary to resist reasonable dislodging force

Clasp on abutments adjacent to distal extension must be designed so as to avoid direct transmission of tipping & rotational forces to abutment (act like stressbreakers)

Proper location of retentive end in relation to rest Use of more flexible clasp arm

Basic principles of clasp design

Unless guiding plane will positively control the path of removal, retentive clasps should be bilaterally opposed

of removal, retentive clasps should be bilaterally opposed  The path of escapement for each retentive

The path of escapement for each retentive arm must be other than parallel to the path of removal

Basic principles of clasp design

Reciprocal elements of clasp should be located at the junction of gingival and middle 3 rd of crown (the terminal end of retentive arm placed at gingival 3 rd )

the junction of gingival and middle 3 r d of crown (the terminal end of retentive
the junction of gingival and middle 3 r d of crown (the terminal end of retentive

Functions of reciprocal arm

Provide stabilization & reciprocation against action of retentive arm

& reciprocation against action of retentive arm  Located so that denture is stabilized against

Located so that denture is stabilized against

horizontal movement (only if rigid reciprocal arm, rigid minor connector, rigid major connector)

May act as an indirect retainer (if it rests in suprabulge

of abutment anterior to fulcrum line

Extracoronal direct retainers

Uses mechanical resistance to displacement by components placed on external surfaces of abutments

Clasp type retainer

Uses mechanical resistance to displacement by components placed on external surfaces of abutments Clasp type retainer
Uses mechanical resistance to displacement by components placed on external surfaces of abutments Clasp type retainer
Uses mechanical resistance to displacement by components placed on external surfaces of abutments Clasp type retainer

Extracoronal direct retainers

Function & position of clasp assembly parts

Component

Function

Location

part

Rest

Vertical support

Occlusal, lingual, incisal

Minor

Stabilization

Proximal surface from marginal ridge to junction of middle & gingival 3rd

connector

Clasp

Stabilization

Occlusal 1/3 of crown Gingival 1/3 of crown in

arms

Retention

   

measured undercut

Basic categories of clasp design

Circumferential clasp arm: approaches retentive undercut from occlusal surface

Bar clasp arm: approaches retentive undercut from cervical

Clasp designed to accommodate functional movement

RPI

RPA

Bar Clasp

Designed to address concern of lever in distal extension cases

Class I RPD

A distal extension acts as a long effort arm across the distal rest (fulcrum) to cause the clasp tip to (resistance arm) to engage tooth undercut::::

RESULTING TO TIPPING AND TORQUING OF ABUTMENTS which is greater with stiff clasp and increased denture base movement

STRATEGIES to minimize effect on abutments:

Mesial rest concept: change fulcrum & resistance arm location

Use flexible arm: minimize effect of lever

Bar clasp (roach clasp)

Arise from denture base or metal framework & approaches the retentive undercut from gingival direction

Classified base on shape of retentive terminal (I, A, T, modified T, or Y ) Form has little significance as long as it is:

(1)mechanically & functionally effective, (2)covers as little surface as possible, (3)displays as little metal as possible

RPI (rest, proximal plate, i-bar)

Mesiocclusal rest w/ minor connector placed on mesiolingual embrassure but not contacting adjacent tooth

i - bar)  Mesiocclusal rest w/ minor connector placed on mesiolingual embrassure but not contacting
i - bar)  Mesiocclusal rest w/ minor connector placed on mesiolingual embrassure but not contacting

RPI

Proximal plate: a distal guiding plane is prepared extending from marginal ridge to junction of middle & gingival 3 rd to receive proximal plate

plane is prepared extending from marginal ridge to junction of middle & gingival 3 r d
plane is prepared extending from marginal ridge to junction of middle & gingival 3 r d

RPI

Proximal plate: buccolingual width of guiding plane is determined by proximal contour of tooth

of guiding plane is determined by proximal contour of tooth  P roximal plate plus the
of guiding plane is determined by proximal contour of tooth  P roximal plate plus the

Proximal plate plus the minor connector supporting the mesial rest will provide reciprocation

RPI

I-bar: located on gingival 3 rd of facial surface in 0.01inch undercut

Tapered to its terminus, w/ no more than 2mm of tip contacting abutment Approach arm located atleast 4mm from gingival margin

w/ no more than 2 mm of tip contacting abutment  A pproach arm located atleast
w/ no more than 2 mm of tip contacting abutment  A pproach arm located atleast

RPA

Modification of RPI when abutment demonstrate contraindication to RPI (severe lingual/ buccal tilt, severe tissue undercut, shallow vestibule) & desirable undercut is located in gingival 3 rd of tooth away from extension base area

Indications of bar clasp

Small degree of cervical undercut (0.01in) which can be approached in from gingival

Abutment for tooth supported partial denture or tooth supported modification areas 7-17

Distal extensions

In cases where esthetics must be considered

contraindications

Deep cervical undercut or severe tooth &/or tissue undercut

Shallow vestibule

Excessive buccal or lingual tilt of abutment

or severe tooth &/or tissue undercut  Shallow vestibule  E xcessive buccal or lingual tilt

Combination clasp

Can be used to reduce the effect of Class I lever in distal extension through the use of flexible component resistance arm

Consist of wrought wire retentive clasp arm & cast reciprocal cast arm

Advantages

Flexibility Adjustability

Esthetic retentive arm than c-clasp

Minimum tooth surface covered

Less service fatigue failure than casted

Can be used on weak abutments adjacent to distal extension

Uses of combination clasp:

Abutment tooth adjacent to distal extension base with only mesiogingival undercut Large tissue undercut

Weak abutments

Parts of a CIRCUMFERENTIAL clasp assembly

Minor connector

Principal rest

Retentive arm

Reciprocal arm

CI R CU M F EREN TI A L clasp assembly  M inor connector 
CI R CU M F EREN TI A L clasp assembly  M inor connector 
CI R CU M F EREN TI A L clasp assembly  M inor connector 

Circumferential clasp

Most logical to use on tooth supported cases except in cases when undercut can be approached better w/ bar clasp or esthetics

to use on tooth supported cases except in cases when undercut can be approached better w/
to use on tooth supported cases except in cases when undercut can be approached better w/

Disadvantages of c-clasps

More tooth surface covered than with bar clasp

Occlusal approach may increase the width of occlusal surface

More metal display than bar clasp especially in mandibular arch

Half round form prevent edgewise adjustment to increase or decrease retention

Disadvantages can be minimized by proper mouth preparation

Basic form of c-clasp

Consist of buccal and lingual arm originating from a common body

of buccal and lingual arm originating from a common body  C ORRE CT F ORM:
of buccal and lingual arm originating from a common body  C ORRE CT F ORM:
of buccal and lingual arm originating from a common body  C ORRE CT F ORM:

CORRECT FORM: one retentive arm opposed by a non-retentive reciprocal arm

Ring clasp

Modification of circumferential wherein it encircle nearly all tooth from its point of origin

Used only when proximal undercut cannot be approached by other means (ex.distobuccal or

distolingual undercut cannot be approached directly from the occlusal rest area or with tissue undercut preventing the use of bar clasp)

NEVER be used as an unsupported ring (always have supporting strut on nonretentive side)

Ring clasp

R ing clasp
R ing clasp

Back action clasp

Modification of ring clasp w/ same disadvantages and no advantages

Difficult to justify its use

action clasp  M odification of ring clasp w/ same disadvantages and no advantages  Difficult

Embrassure clasp

In class II or class III partial denture w/ no edentulous spaces on opposite side

Sufficient space must be provided in occlusal 3 rd to make room for a common body, yet contact area is not eliminated

Historically has high degree of fracture if abutment not properly prepared

Usually need to protect abutment (crown)

Embrasure clasp

E mbrasure clasp
E mbrasure clasp
E mbrasure clasp

Should always be used w/ double occlusal rest to avoid interproximal wedging (can cause separation of

teeth resulting to food impaction and casp displacement)

Should have 2 retentive & 2 reciprocal arms either bilaterally or diagonally opposed

and casp displacement)  Should have 2 retentive & 2 reciprocal arms either bilaterally or diagonally
and casp displacement)  Should have 2 retentive & 2 reciprocal arms either bilaterally or diagonally

Multiple clasp

2 opposing circumferential clasp joined at the terminal end of 2 reciprocal arms

Used when additional retention is needed usually in tooth supported

Maybe used for multiple clasping when entire half of arch are to be replaced

Used when retentive areas are adjacent to each other

Disadvantage: 2 embrassure approach

Angle of cervical convergence

A triangle of light visible between tooth & surveyor

blade

triangle of light visible between tooth & surveyor blade  Height of contour : a line

Height of contour: a line encircling the tooth at its greatest diameter in respect to path of placement

Undercut: portion of tooth that lies between ht of contour & gingiva

Factors that determine the amount of retention of clasp

Tooth factors

Size of angle of cervical convergence (depth of undercut)

How far into the angle of cervical convergence the clasp is placed

Prosthesis factors

Flexibility of clasp arm

Clasp length

Clasp relative diameter

Clasp cross-sectional form or shape

Material used

Retentive clasp arm must be located so that they lie in the same approximate degree of undercut on each abutment tooth

R etentive clasp arm must be located so that they lie in the same approximate degree
R etentive clasp arm must be located so that they lie in the same approximate degree

INDIRECT RETAINERS

Tooth supported partial denture (Class III)

Movement of partial denture toward ridge prevented primarily by rests placed on abutments at each end of space

Movement of base away from tissues is prevented by activation of passive direct retainers (clasp)

Horizontal & longitudinal rotational prevented by stabilizing component on primary abutment