Comparison of clasp retention on

enamel and composite resinrecontoured abutments following

repeated removal in vitro
Simindokht Zarrati, DDS, MSD,a Leyla Sadighpour, DDS, MSD,b
and Ghasem Jahanian, DDSc
Dental School, Tehran University of Medical Sciences, Tehran,
Iran; Dental School, Mashhad University of Medical Sciences,
Mashhad, Iran
Statement of problem. Loss of prosthetic retention over time is a concern with removable prostheses. Use of composite resin to modify an abutment contour receiving a removable partial denture clasp may offer a reasonable, less
invasive method of improving removable prosthesis retention.
Purpose. The purpose of this study was to evaluate the removal force of clasps over composite resin-recontoured
abutments during a simulated 4 years of service.
Material and methods. Twenty first mandibular premolars were selected to form 2 groups of specimens (n=5) resembling a tooth-supported edentulous space. A packable composite resin (Filtek P60) was used to create a 0.25-mm
undercut on the buccal abutment surfaces of the composite resin group. Teeth in the natural abutment group were
mounted in angulation to produce 0.25-mm undercuts on the buccal surfaces. The chrome-cobalt framework consisted of 2 individually fabricated T-clasps. Both groups were subjected to 4500 cycles of repeated removal using a
small shaker. Removal forces were recorded before the repeated removal test (T0), after 500 and 1000 cycles, and at
1000-cycle intervals thereafter. The mean values of forces between the 2 groups were compared at each stage using
the Mann-Whitney test (=.05).
Results. No debonding occurred during the test. At T0, the highest and lowest force values were observed in the composite resin group (3.75 N and 17.5 N, respectively). There was a significant difference between the removal forces
of the 2 groups after 500 cycles and at test completion (P=.008). Retention loss was 3 times greater in the composite
resin group than in the natural abutments group (53.65% vs. 15.80%).
Conclusions. Within the limitations of the study, removal forces of the composite resin-recontoured abutments were
threefold less than those of natural abutments after 4 years of simulated service. (J Prosthet Dent 2010;103:240-244)

Clinical Implications

Composite resin additions on removable partial denture

abutments may present a predictable and conservative
method for improving the retention of removable prostheses.
From a biomechanical perspective,
removable partial dentures (RPD) should
provide support, stability, and retention.1 Retention is typically provided by
clasps placed in definite undercuts on
the abutment teeth surfaces. How-

ever, there are situations in which

an adequate undercut does not exist
on natural abutments at an effective
path of insertion. In such circumstances, tooth contour modifications
can be used to develop the required

undercut.2 Although some conservative approaches, such as the addition of composite resin to the tooth
surface, have been suggested, other
approaches involve relatively invasive
procedures that are not suitable for

Supported by grant no. 6134-69004 from the Vice Chancellor for Research, Tehran University of Medical Sciences.
Assistant Professor, Prosthodontics Department, Dental School, Tehran University of Medical Sciences.
Assistant Professor, Prosthodontics Department, Dental School, Tehran University of Medical Sciences.
c
Prosthodontics Resident, Dental School, Mashhad University of Medical Sciences.
a

The Journal of Prosthetic Dentistry

Zarrati et al

241

April 2010
intact teeth, such as onlays and complete coverage crowns.3 The use of
implant-supported restorations with
highly predictable clinical outcomes
in partially edentulous patients,4 and
recent improvements in the material
science and technology of both composite resin and adhesive systems,
have allowed the development of
more conservative designs for RPDs.
Several authors have addressed how
composite resin use improves RPD design with respect to durability, wear resistance, and retention.5-10 Davenport
et al11 examined abrasion of composite resin and stainless steel wrought
wire clasps using a simplified abrasion
test on nonanatomical specimens. A
comparison of conventional posterior
composite resins, hybrid composite
resins, and a microfilled composite
resin revealed significant differences
in wear among the materials. In the
group with the greatest wear, a hybrid
composite resin (Valux; 3M ESPE, St.
Paul, Minn) group, 87% of the initial
undercut remained after a simulated
5-year period. Therefore, the authors
concluded that the creation of an undercut by the addition of composite
resin is likely to be clinically durable.
Hebel et al12 evaluated the wear of
RPD circumferential clasps against
a microfilled composite resin bonded to teeth, against demineralized
enamel, and against enamel over a
simulated 3-year service period. No
composite resin additions were lost;
however, significantly higher wear
was observed for the composite resincontoured group. Although retention
values were not measured, every manually examined specimen displayed
some degree of retention. Tietge et
al13 demonstrated that a hybrid composite resin was more wear resistant
than a small-particle composite resin.
In contrast, Hamirudin et al14 found
that after repeated movement of Ibar clasps over composite resin additions, the greatest abrasion occurred
for hybrid composite resins with larger filler sizes, and that the microfilled
composite resins showed the lowest
abrasion. Retention loss was not di-

Zarrati et al

rectly investigated in that study. Piirto

et al15 evaluated changes in the retention of an RPD over a bonded composite resin; however, the materials
tested in that study are no longer in
use clinically.
Wear resistance and abrasivity of
composite resin materials have been
attributed to filler volume, coupling
between the filler particles and the
resin matrix, and the filler geometry.13
Packable composite resins are heavily
filled composite resins with purportedly improved wear resistance over
conventional composite resins,16 although such improvements are controversial.17 Therefore, the purpose of
the present study was to evaluate the
clasp retention against a tooth surface modified by a heavily filled packable composite resin. The null hypothesis was that the retention values
of the composite resin and unaltered
enamel would not be different.

MATERIAL AND METHODS

Twenty recently extracted mandibular first premolars were included in
the study. Mandibular premolars were
selected because they are the teeth to
most frequently present with unfavorable contours for RPD retention.18
All teeth were stored in a 0.1% chloramine solution (Halamid; Axcentive
SARL, Bouc Bel Air, France). Teeth
with caries, cracks, cervical lesions, or
extensive wear were excluded from the
study. Crown heights and labioproximal surfaces were measured to the
nearest 0.01 mm using a digital caliper (Model 5805; Friedrich Richter
Measuring Tools GmbH & Co, Speichersdorf, Germany), and teeth of similar size were selected. Teeth were
numbered and randomly assigned to
2 experimental groups (n=5) based
on random number generation by a
computer program (Excel; Microsoft
Corp, Redmond, Wash). To fabricate
each specimen, 2 teeth were mounted
in an acrylic resin (Orthoresin; Dentsply Australia Pty Ltd, Mt Waverley,
Australia) block, 60 x 20 x 20 mm,
with a surveyor analyzer bar (Ney

Surveyor; Dentsply Ceramco, York,

Pa). In the control group, teeth were
mounted so that a 0.25-mm undercut was produced19 in 1 labioproximal surface of the tooth, between the
middle and gingival third of the tooth.
The undercut surfaces of each pair
were diagonally mounted. In the test
group, the teeth were mounted in an
angulated state so that no undercut
was present on the labial surface.
A technique by Alfonso et al8 was
followed to create a 0.25-mm undercut. The surface contours of the test
group teeth were waxed (White Utility
Wax; Coltne/Whaledent AG, Altsttten, Switzerland) to accommodate
a 0.25-mm undercut, and were verified with a surveyor (Ney Surveyor;
Dentsply Ceramco). Individual clear
matrices were fabricated using a clear
0.020-inch thermoplastic material
(Shenzhen Amei Brothers Plastic Co,
Ltd, Shenzhen, China) with an occlusal extension. After cleaning with slurry of pumice, a defined area on the
buccal surface of the teeth was etched
using 38% phosphoric acid gel (Total
Etch; Ivoclar Vivadent AG, Schaan,
Liechtenstein) for 15 seconds, rinsed
with water for 10 seconds, and then
air dried. An adhesive bonding agent
(Adper Single Bond; 3M ESPE) was
applied to the etched surfaces and exposed to light (Coltolux 50; Coltne/
Whaledent, Inc, Cuyahoga Falls,
Ohio) with an intensity of 500 mW/
cm2 for 10 seconds, at a distance of
1.0 mm or less.
Each matrix was carefully filled
with a packable composite resin material (Filtek P60; 3M ESPE) so as to
avoid trapping air, and was placed
over the corresponding tooth. The occlusal extension of the matrix worked
as an occlusal stop to ensure correct
positioning of the matrix.9 The composite resin was light polymerized
with the same unit for 20 seconds, at
a distance of 1.0 mm or less. The artificial undercuts were then resurveyed
to verify that the horizontal and vertical dimensions were equal. All specimens were then polished (Diagloss
Polishing Kit; Edenta AG, Au/St. Gal-

242

Volume 103 Issue 4

2 Fabricated framework in place.

1 Test machine and specimen secured with grip.

len, Switzerland), and the final sizes
of undercuts were reevaluated using
a surveyor (Ney Surveyor; Dentsply
Ceramco).
Custom trays were fabricated with
an autopolymerizing acrylic resin
(Major Tray; Major Dental, Moncalieri, Italy), and definitive impressions
were made using a silicone-based
impression material (Speedex Putty
and Wash; Coltne/Whaledent, Inc)
poured with a refractory investment
(Rema Exakt; Dentaurum, Ispringen,
Germany). Prefabricated patterns
(Dentaurum) were used to form 2
T-bar-type clasps engaging the 0.25mm undercut and connected to each
other with a 3.25-mm-thick wax sprue
(Modeling Wax; Dentaurum). Only a
single arm of the T-bar engaged the
undercut. The bar-type clasp was selected because of its superior fit to the
test apparatus. To secure the framework casting to the machine for repeated removal, a hexagonal washer
(Sama Pitch Car Mfg and Trading Co,
Tehran, Iran), 8 mm in diameter, was
inserted in the middle of the connecting sprue, which was cast with the
wax pattern. The wax patterns were
cast with a chrome-cobalt alloy (Remanium GM 380; Dentaurum) in a

centrifugal induction casting machine

(Fornax T; BEGO, Bremen, Germany).
After bench cooling, the castings were
divested and cleaned using airborneparticle abrasion with 50-m aluminum oxide particles for 15 seconds.
Cast specimens were inspected for
porosities and defects and examined
on the corresponding casts. Finishing
and polishing procedures were accomplished by a single technician using finishing stones (Occlupol; Edenta AG) and rubber wheels (Crysko
Enterprises Co Ltd, Shanghai, China)
(Fig. 1).
The baseline (T0) retention force
was recorded to the nearest 0.01 N
using a spring balance (Model 12;
Salter Brecknell, West Midlands, UK)
before removal was simulated using
a small shaker (Model 3560; Brel &
Kjaer Sound and Vibration A/S, Naerum, Denmark) (Fig. 2) and pulse analyzer software (PULSE; Bruel & Kjaer
Sound and Vibration A/S). Cyclic removal included 4500 removals at a
frequency of 3 Hz to simulate a 4-year
service period.14 The retention (removal) force was measured after the
first 500 and 1000 cycles, and then at
1000-cycle intervals. Retention loss
was measured using the following

The Journal of Prosthetic Dentistry

formula: Retention loss = (T4500 / T0)

100. The mean retention values of the
test and control groups were statistically analyzed at each interval using
the Mann-Whitney nonparametric
test (=.05), and P values were adjusted using the Bonferroni formula
with the aid of statistical software
(SPSS 11.0; SPSS, Inc, Chicago, Ill).

RESULTS
The removal forces for frameworks
in the test and control groups are
shown in Table I. At T0, the maximum
and minimum removal forces occurred in the composite resin group
(3.75 N and 1.75 N, respectively).
Removal forces declined over 4500
removal cycles in both the test and
control groups. The maximum reduction occurred during the first 500
cycles. The mean difference between
removal forces at T0 and T500 was not
significant, but became significant
thereafter (P =.008). Upon completion of 4500 cycles, retention loss
was 3 times greater in the composite
resin-recontoured abutments than in
natural teeth (53.65% and 15.80%)
relative to the initial values.

DISCUSSION

Zarrati et al

243

April 2010

Table I. Descriptive statistics of removal forces (N) (n=5)

Standard
Deviation

Number
of Cycles

Mean (N)

Maximum (N)

Minimum (N)

0.42

2.95

3.60

2.50

T0

0.37

2.79

3.34

2.38

T500

0.34

2.71

3.21

2.35

T1000

0.32

2.65

3.12

2.29

T15000

0.30

2.56

2.99

2.20

T2500

0.30

2.51

2.93

2.13

T3500

0.30

2.48

2.90

2.11

T4500

0.73

2.60

3.75

1.75

T0

0.68

1.99

3.00

1.25

T500

0.47

1.66

2.30

1.15

T1000

0.40

1.49

2.00

1.10

T15000

0.47

1.26

1.88

0.75

T2500

0.42

1.20

1.75

0.85

T3500

0.40

1.21

1.60

0.72

T4500

In the present study, the removal

forces of chrome-cobalt frameworks
over composite resin-recontoured
abutments and enamel were evaluated. Both groups showed some degree
of retention loss. However, significantly higher reductions in removal
forces were observed in the composite resin group. Therefore, the null hypothesis that there would be no difference in retention loss of composite
resin and enamel was rejected.
Retention loss may arise from the
mutual wear of composite resin additions and clasps over years of usage.
Composite resin wear may reduce
the initial undercut size, and clasp
wear may reduce the contact between
clasps and abutment surfaces. For
example, one study11 demonstrated
significant differences in abrasion
among various composite resin materials. However, the group with the
greatest reduction retained 86.8% of
the original undercut after 5 years of
clinical use.11 Although regarded as
not likely to significantly affect retention, the relationship between the
reduction in undercut size and reten-

Zarrati et al

tion was not addressed. The authors

also reported that the wear of stainless steel wrought wire clasps against
composite resin depends on the material tested. In 2 of the 9 groups, the
clasps suffered greater abrasions than
the composite resin itself. Using composite resins with wear ranging from
1 to 4 m, another study14 demonstrated that the abrasion of largerfilled composite resins was greater
than that of smaller-filled composite
resins. No significant weight loss was
found in the clasps.
In contrast with the previously
mentioned study, Tietge et al13 found
that the wear resistance of a microfilled composite resin was lower than
that of a hybrid composite resin with
a larger particle size. In the composite
resin with the smaller particles, 85%
of the retentive capability of the undercut created by the composite resin
was lost in fewer than 2 years. This
amount was 30% for a larger-filled
composite resin and 18% for natural
enamel. The authors concluded that
the volume and shape of the particle and the bonding between the
filler and the matrix each contribute

Group
Enamel

Composite

to the wear behavior of composite

resin materials. Hebel et al12 reported
an average of 20 m of wear over a
simulated 3-year period for enamel
against a chrome-cobalt I-bar, compared to 50 m of wear for composite
resin. Clasp wear was not measured
in that study, and the authors stated
that with a 0- to 50-m reduction of
a 250-m undercut over 3 years of
service, retention loss would likely not
be significant. Direct extrapolation of
evidence across the studies is not possible due to differences in tested materials, design of the RPDs, and the
test apparatus used. Therefore, the
true relationship between undercut
size and framework retention remains
unclear. Further research is needed to
measure undercut size and retention
forces simultaneously.
In the present study, simulation
of the components of a clasp assembly was attempted. After a simulated
4 years of service, more than half of
the retention in the composite resin
group was lost. However, it is not
possible to predict from the present results whether the remaining
retention would be adequate for clini-

244

Volume 103 Issue 4

cal service.
The wear of the composite resin addition was not measured in this study.
Instead, retention (removal force),
which simulates a clinical outcome,
was investigated. This is a limitation in
the present test design. Further study is
needed to investigate the relationship
between wear of the composite resin
addition and retention loss of RPDs.
The mean removal forces between
the composite resin and enamel groups
were not significantly different at baseline and after 500 cycles, indicating
similarity in the undercut sizes and configurations. Deformation of the clasps
over time is thought to affect the retention of RPDs.14 However, since this
deformation was expected to affect
both groups similarly, it is not considered to be a confounding factor in the
present study.
No debonding was observed in
the previously mentioned studies11-14
or in the present study. However,
clinical interpretation must be made
with caution, as there are many factors that can influence composite
resin performance in the oral environment. In none of the previously mentioned studies was thermal cycling included in the test design. It has been
suggested that thermal cycling would
adversely affect the bonding of composite resin to the tooth structure.13
For the sake of simplicity, micromotions and lateral movements were not
considered in the present study, adding another limitation to the study
design. Finally, no medium was used
during the testing procedure. It has
been suggested that saliva may influence certain properties of chromecobalt alloy.20 Lack of such a medium
is another limitation of the study. The
effects of different media on the wear
of composite resin materials against

clasps should be addressed in future

research.

CONCLUSIONS
Within the limitations of the present study, it was found that both the
natural and composite resin-recontoured abutments showed retention
loss during a simulated service period
of 4 years. Furthermore, the removal
forces of the modified abutment and
enamel were significantly different,
with the composite resin undercut
losing half of its retentive capability
by the end of the study.

REFERENCES
1. Carr AB, McGivney GP, Brown DT. McCrakens removable partial prosthodontics.
11th ed. St. Louis: Elsevier; 2004. p. 79.
2. Rudd RW, Bange AA, Rudd KD, Montalvo
R. Preparing teeth to receive a removable partial denture. J Prosthet Dent
1999;82:536-49.
3. Garcia LT, Bohnenkamp DM. The use
of composite resin in removable prosthodontics. Compend Contin Educ Dent
2003;24:688-94.
4. Naert I, Koutsikakis G, Duyck J, Quirynen
M, Jacobs R, van Steenberghe D. Biologic
outcome of implant-supported restorations
in the treatment of partial edentulism. Part
I: a longitudinal clinical evaluation. Clin
Oral Implants Res 2002;13:381-9.
5. Latta GH Jr. A technique for preparation of
lingual rest seats in light-cured composite. J
Prosthet Dent 1988;60:127.
6. Yard RA, Butler GV, Render PJ. Bonded
composite rests: a fabrication method. J
Prosthet Dent 1988;60:128-9.
7. Latta GH Jr. Composite resin contouring of abutment teeth for rotational path
removable partial dentures. J Prosthet Dent
1990:63;716-7.
8. Alfonso C, Toothaker RW, Wright RF,
White GS. A technique to create appropriate abutment tooth contours for
removable partial dentures. J Prosthodont
1999;8:273-5.
9. Pavarina AC, Machado AL, Vergani CE, Giampaolo ET. Preparation of composite retentive areas for removable partial denture
retainers. J Prosthet Dent 2002:88:218-20.

The Journal of Prosthetic Dentistry

10.Shimizu H, Takahashi Y. Highly filled

composite partial coverage restorations
with lingual rest seats and guide planes for
removable partial dentures. J Prosthet Dent
2008;99:73-4.
11.Davenport JC, Hawamdeh K, Harrington E,
Wilson HJ. Clasp retention and composites:
an abrasion study. J Dent 1990;18:198202.
12.Hebel KS, Graser GN, Featherstone JD.
Abrasion of enamel and composite resin by
removable partial denture clasps. J Prosthet
Dent 1984;52:389-97.
13.Tietge JD, Dixon DL, Breeding LC, Leary
JM, Aquilino SA. In vitro investigation of
the wear of resin composite materials and
cast direct retainers during removable
partial denture placement and removal. Int
J Prosthodont 1992;5:145-53.
14.Hamirudin MM, Barsby MJ. The abrasion
of dental composite by cobalt-chromium
clasps. Eur J Prosthodont Restor Dent
2007:15:13-8.
15.Piirto M, Eerikinen E, Siiril S. Enamel
bonding plastic materials in modifying the
form of abutment teeth for the better functioning of partial prostheses. J Oral Rehabil
1977;4:1-8.
16.Clelland NL, Villarroel SC, Knobloch LA,
Seghi RR. Simulated oral wear of packable
composites. Oper Dent 2003;28:830-7.
17.Wang L, Garcia FC, Amarante de Arajo
PA, Franco EB, Mondelli RF. Wear resistance of packable resin composites after
simulated toothbrushing test. J Esthet
Restor Dent 2004;16:303-14.
18.Toth RW, Fiebiger GE, Mackert JR Jr,
Goldman BM. Shear strength of lingual
rest seats prepared in bonded composite. J
Prosthet Dent 1986;56:99-104.
19.Bates JF. The mechanical properties of the
cobalt-chromium alloys and their relation to partial denture design. Br Dent J
1965;119:189-96.
20.Lassila LV, Vallittu PK. Effect of water and
artificial saliva on the low cycle fatigue
resistance of cobalt-chromium dental alloy.
J Prosthet Dent 1998;80:708-13.
Corresponding author:
Dr Leyla Sadighpour
Prosthodontics Department, Dental School
Tehran University of Medical Sciences
Ghods and Enghelab St
Tehran 14176-14411
IRAN
Fax: +98-21-66401132
E-mail: sedighle@tums.ac.ir and lsedigh@
yahoo.com
Copyright 2010 by the Editorial Council for
The Journal of Prosthetic Dentistry.

Zarrati et al