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Abstract
Attachment-retained Removable Partial Denture (RPD) is not an outdated treatment modality.
It is even more contemporary in today's appearance-oriented society than when it was first
introduced. There is significant number of patients who could benefit from this treatment
option, both short and long term. However, lack of proper knowledge, overwhelming number
of attachments available in the market, multiple adjustments and repairs are making dentist
reluctant to offer and provide attachment-retained RPD to their patients. The purpose of this
article is to provide an overview and a simplified approach to this treatment modality by a
clinical case report.
KEYWORDS: Attachment , Removable Partial Denture
Corresponding Author:
Dr. Sumit Makkar
Department of Prosthodontics
ITS-Centre for Dental
Research & studies,
Muradnagar Ghaziabad.
E- mail:
sumitmakkad@gmail.com
Contact no: 91-9268138938.
39
Introduction
Our ever-increasing knowledge of the oral environment, together with technological
improvements and good armamentarium, has taken us to give a restoration which is
esthetically pleasing and comfortable. This makes it all the more important to
reconcile what is actually feasible with the patient's own expectations.
Rehabilitation of partially edentulous situations can be challenging when it is distal
extension situations where a fixed prostheses cannot be fabricated. Implant retained
restoration are an option but this is sometimes not possible due to insufficient amount
of bone or economic reasons. In these cases acrylic or cast partial denture was largely
preferred, with barely satisfactory esthetical results.
Precision attachment has long been considered the highest form of partial denture
therapy. Attachment retained RPD is the treatment modality that can facilitate both
esthetic and a functional replacement of missing teeth and oral structures. The few
retrospective studies available show a survival rate of 83.3% for 5 years, of 67.3% up to
[1,2]
15 years and of 50% when extrapolated to 20 years.
This article outlines some of the essential considerations in planning of a precision
attachment retained partial denture with a clinical report.
An attachment is a connector consisting of two or more parts. One part is
connected to a root, tooth, or implant and the other part to prosthesis.
[3]
Precision attachments can be classified in to four main groups .
1. Intracoronal attachments: are mainly used in connecting units of fixed partial
prostheses, retaining restorations with distal extension or bounded removable
prostheses.
2. Extracoronal attachments. This type of attachment provides stability and
retention for removable distal extension prostheses.
3. Stud attachments. Usually in the form of ball & socket, this attachment serves
primarily for overdenture stabilization and retention of the prosthesis. Swiss
logic, ZAAG, Zest anchor is example of stud attachments. One of the
advantages
ofstud
is Journal
thatofthey
IJCDS MAY,
2011 2(2)
2011 Int.
Clinical promote
Dental Science better oral hygiene and crown root
ratio is improved with low profile stud attachments.
Table :1
:1 Classification
Classificationofofattachments
attachments
Class
Class
Class
Class
Class
Class
Class
1a
1b
2
3
4
5
6
IJCDS MAY, 2011 2(2) 2011 Int. Journal of Clinical Dental Science
40
[9]
Case report
A 55-year old female reported to private dental practice
with chief complain of missing teeth in lower posterior
region and inability to eat food. She was wearing a distal
extension removable partial denture and the presence of
mandibular extra coronal clasp retainers was negatively
affecting the aesthetics. On clinical examination
nd
st
mandibular 2 premolar, 1
& 2nd molar were absent
st
and mandibular canine & 1 premolar was of adequate
height with sound periodontal support.
In lieu of compromised aesthetics, impaired function with
existing partial denture it was planned to construct
mandibular removable partial denture with extracoronal
attachment. The patient rejected the options of implants
41
IJCDS MAY, 2011 2(2) 2011 Int. Journal of Clinical Dental Science
Discussion
[10]
References
1.
2.
3.
Preiskel
HW.
Precision
attachment
in
prosthdontics.1&2.
London:
Quintessence
Publishing Co Ltd,1995
IJCDS MAY, 2011 2(2) 2011 Int. Journal of Clinical Dental Science
42
4.
5.
6.
7.
8.
9.
43
10. Preiskel
HW.
Precision
Attachments
in
Prosthodontics: Overdentures and Telescopic
Prostheses. Volume 2. Chicago, II: Quintessence
Publishing Co,Ltd; 1985.
11. Preiskel H. Precision attachments for free-end
saddle prostheses. Br Dent J 1969;127:462-468.
12. Picton DC, Willis DJ. Viscoelastic properties of
the periodontal memebrane and mcous
membrane. J Prosthet Dent 1978;40:263-72.
13. Kapur KK, Deupree R, Dent RJ, Hasse AL. A
randomized clinical trail of two basic removable
partial denture designs. Part-I: Comparsion of
five year success rates and periodontal health. J
Prosthet Dent 1994;72(3):268-82.
14. Attachment
and
Prefabricated
Castables
Component. Accessed on 2011 april 11.
Available from: http://www.rhein83.com.
IJCDS MAY, 2011 2(2) 2011 Int. Journal of Clinical Dental Science