Enzyme, Pharmaceutical Aids, Miscellaneous Last Part of Chapter no 5th.pdf
B- Retention of Removable Partial Dentures
1. B- Retention of Removable Partial
Dentures
By:
Prof. Amal Kaddah
2.
3. Dr. Amal Fathy Kaddah
Dr. Mohamed Farouk
Dr. Amro Abdullah
Faculty of Oral and Dental Medicine
Cairo University
RETENTION OF REMOVABLE
PARTIAL DENTURES
4.
5. Is the resistance of
the partial denture
to vertical
displacement away
from the tissues
7. • Frictional fit
Mechanical means of
Retention
Indirect R.
Direct
retainers
Parts of the denture
engaging tooth and
tissue undercuts.
• Clasps
• Attachments
12. 1-Aker’s clasp (Circlet clasp)
The most universally
employed of all clasps
designs
It is a double-arms clasp;
relatively rigid,
Engages an undercut of
0.01inch (1/4 mm) on the
buccal (or lingual) surface of
molars or premolars far from
the edentulous area
13. Indications
Unilateral and bilateral
tooth borne
Best suited for strong
abutments teeth
Advantages
Provides support, retention, and the best
bracing.
Does not distort easily.
Easily constructed.
Simple to repair.
14. Disadvantages
More tooth surface is covered.
Changes the morphology of the abutment
crown.
Due to its half round cross-section, the Aker
clasp can be adjusted to the tooth surface in
an inward or outward (Bucco-lingual) and not
upward or downward (occluso-gingival)
direction.
Cannot be used in free-end saddle cases due
to its rigidity, except with a stress equalizing
design or reversed.
15. 2-The Reversed Aker Clasp
Occlusal rest located away from the
edentulous area.
Retentive arm that engages an
undercut near the edentulous
area.
A rigid reciprocal arm.
Indication:
In distal extension cases when
the bar clasp is contraindicated
(when?).
16. 2-The Reversed Aker Clasp
Advantage:
clasp disengagement. Reduce
torque transmitted to the
abutment tooth.
Disadvantage:
May produce some wedging
force. This can usually be
countered by occlusal rests on
the approximating surfaces of
both teeth.
17. 3- DOUBLE AKER
(Embrasure, Butterfly, Compound clasp )
• Two Acker clasps arising
from a common body and
from the same minor
connector, Minor C. located
in the embrasure between
the two clasped teeth.
• Used on the dentulous side
of unilateral edentulous
(class II,III) cases having
no modifications, class IV.
19. 4- Circumferential `C` Clasp
Retentive arm turned back (curved ) to engage an undercut near
the edentulous area (below the point of origin (distobuccal un.)
Disadvantages:
Greater coverage of tooth surface, increase the functional load
on abut.
Food trapping at the loop of the arm, and
Inferior esthetics.
20. 5- Multiple Clasp
Consists of two opposing Aker’s clasps,
Two Lingual rigid reciprocal arms are
connected together at the terminal
ends to augment their rigidity.
Indications:
When Splinting of periodontally affected teeth is needed.
When RPD replaces an entire side of the dental arch.
Available retentive areas are only adjacent to each other.
Disadvantage
Utilizing two embrasures rather than a common one.
21. 6- Extended arm clasp
Indication:
Utilizing Adjacent tooth has a reasonable undercut
Advantages:
• The clasp has splinting action.
• Distributes the lateral load over
the two teeth.
Used when the undercut on the tooth
near the edentulous area is poor, while
that on the adjacent tooth is suitable.
22. 7- Half & Half clasp
It is used with isolated premolars and
molars for bounded .partial denture.
• Retentive arm arising from one
side of the tooth
• A reciprocal arm arising from the
other direction on the opposite
side of the tooth.
• Two minor connectors
• An auxiliary rest may sometimes
be used..
23. 8- R.P.A
A mesial occlusal rest .
A proximal plate
An Aker retentive arm
arising from the superior
portion of the proximal
plate.
Indication:
•In distal extension RPDs presented
with shallow vestibule or severe tissue
undercut
24. 1. Mesio-occlusal surface of
the tooth, permitting the
other components to release
from the tooth and drop into
undercuts when occlusal
loads are placed on the
denture base.
Advantages:
8- R.P.A
2. This in turn prevents tipping of the abutment.
3. Absence of a lingual rigid reciprocal arm minimizes
rotational forces falling on the abutment.
25. a- Properly designed RPA clasp showing movement from
occlusal forces. Proximal plate, drops gingivally and slightly
mesially as rotation occurs around mesial rest with approximate
center of rotation, B. Rigid portion of retentive arm contacts tooth
only along survey line, and moves gingivally and mesially.
Retentive end of clasp arm moves mesially and slightly gingivally.
b- Improperly designed RPA clasp located above survey line.
8- R.P.A
a- b-
26. 9- Ring Clasp
Provides unilateral bracing. Used for single tilted molars
More flexible than Aker because it is one arm clasp.
27. It is a single-arm
clasp, indicated on
tilted, isolated
molars.
Originates by a rest mesially located on the
marginal ridge. And the single arm encircles
nearly all the tooth surface resembling a
ring.
Exhibiting a mesiobuccal undercut in case of
upper molars and a mesiolingual undercut
on lingually tilted lower molars.
Engages a 0.02 or 0.03 of an inch undercut.
An auxiliary distal rest is preferably added to
prevent further mesial tilting of the tooth
A reinforcing supporting strut arm located on
the non-retentive side is usually considered
to limit the flexibility of the clasp.
9- Ring Clasp
28. Disadvantages of ring clasp:
1. Excessive tooth coverage that may
result in enamel decalcification and
caries.
2. Easily distorted because of length
and difficult to adjust.
3. Reinforcing arm may cause
marginal irritation and inflammation
and may act as a food trap.
9- Ring Clasp
29. 10- Back action clasp
Single arm clasp
Minor connector starts mesio-
lingually
It engages mesio-buccal
undercut.
O.R. is located distally.
Some times an additional rest
could be employed on the
mesial side to improve
support
Used in free end saddle.
30. Engage a mesiobuccal
undercut of 0.01 of an inch.
Disadvantages
• Excessive tooth coverage.
• Easily distorted
• Excessive display of metal,
• The occlusal rest is supported by the clasp arm and not by a rigid
minor connector, hence the rest cannot function adequately.
• Poor bracing and reciprocation.
• Food trap
32. 11- Reverse Back action clasp
Minor C.
originating
Mesio-
buccally
Retentive arm
engage
Mesio-lingual
undercut
• The minor connectors originates mesiobuccal line angle from the
saddle and ends to engage a mesiolingual undercut of 0.01 or 0.02
of an inch
• The clasp is Frequently used on lingually tipped bicuspids.
• It also provides single bracing only.
• It has an additional esthetic disadvantage.
37. • A retentive clasp arm
• A rigid reciprocal clasp
arm
• An occlusal rest and a
minor connector The tip
of the retentive arm may
be in the form I, T, U, C
or Y. One
1- The I-bar clasp (Roach clasp arm)
The I - bar clasp consists of
38. T clasp
Modified T clasp
Different forms of gingivally approaching clasps
I claspU clasp
39. 2- R.P.I
The base of the I bar
Should be 3mm away
From the gingival margin
Provides unilateral bracing.
Commonly used for tooth
mucosa borne partial
dentures.
A retentive
clasp arm
A mesial occlusal rest .
A proximal plate
I Bar retentive arm
40. P.P minor connector should contact
approximately 1 mm of the gingival portion of
the g. p. in distal extension cases
41. Contraindications for the use of
gingivally approaching clasps
• Shallow vestibule.
• High floor of the mouth
• Severe tissue or tooth undercut to avoid food or
tissue trap.
Contraindications
Indications:
• In distal extension cases, as it
provides a stress releasing
action.
• When tissue undercuts are
not severe
42. When tissue undercuts
begin 3 mm away from
the gingival margin, an
RPI clasp is used no
matter how deep the
facial surface tissue
under cut.
When tissue undercuts
begin less than 3mm from
the gingival margin and are
more than 1 mm in depth an
RPA may be used.
43. 3- RLS Clasp
Mesio-occlusal Rest,
A distolingual L-bar direct retainer
that is located on the abutment tooth
adjacent to the residual ridge and
Distobucca Stabilizer
Advantages:
• The mesial rest reduces the anterior component of movement
of the denture and reduces torque on the abutment tooth.
• A retentive clasp tip placed on the most distal part of the tooth
will undergo a downward vertical movement and disengage as
the distal extension base moves tissue-ward in function
It consists of
44. The design of clasp for a distal
extension RPD that helps
preserve both the abutment
teeth and the tissues of the
edentulous ridge is described.
The clasp assembly takes
advantage of surveyed lingual
undercuts to provide support,
retention, and stability.
Hiding Denture Clasp
3- RLS Clasp
45. 4- Devan clasp
be used if additional flexibility is required
• More esthetic due to interproximal position
• No distortion due to it`s proximity to denture border
• Food debris may be entrapped between the arm and
the denture base.
• Two occlusal rests on
abutment are used.
• The bar arm arises from the
border of the denture base.
Wrought wire clasp arm
could
47. • Buccal wrought wire retentive arm
soldered to the base
• Lingual casted bracing arm
Wrought wire retentive arm and casted bracing arm
5- Combination clasp
48.
49. Clasps with splinting action
Double Aker clasp
Extended arm clasp
Multiple Aker clasp
50. Clasps with stress breaking action
Gingivally approaching clasps except Devan
clasp
Occlusally approaching clasps
– Reverse Aker clasp
– Back action clasp
– Reverse back action clasp
– R.P.A.
– R L S
– Ring (bounded sad., isolated molar)
Combination clasps (wrought wire + casted)
53. B-DIAGONAL SURVEY LINE
Near occlusal
surface
In the near
zone
Near gingival
margin
In the far zone
Or Or Or
Back action &
Reverse back
C clasp
Ging.app. With T bar
Ging.app. With L bar
54. C-HIGH SURVEY LINE
Near to the occlusal surface
Wrought wire occlusally app.
Back action or reverse back action
commonly in inclined teeth
Bracing
Arm
55. D- LOW SURVEY LINE
Near the gingival margin
Extended arm clasp
• Devan clasp engaging
proximal undercut
• Crowning of the tooth
56. Tripping action is attributed to clasp arms that
engage the undercut directly from a gingival
direction.
Not all bar clasp arms have tripping action, since the
retentive terminal may actually engage the undercut
from an occlusal direction as is true with the "T" bar
or modified "T" bar.
57. Occlusally Gingivally
Retention due to tripping
action
Bracing 2 Arms above
survey line provide
bracing
Esthetics less visible due to
gingival position
Tolerance Gingivally app.clasp arm relieved from
gingiva creating space accumulating food
and causing discomfort
Caries More tooth coverage
increasing the risk
for caries
Gingival health Trauma may occur
due to distortion or
inadequate relief
59. MOVEMENT OF CLASP WITH DISTAL O.R.
Circlet clasp during function: Loading force
(F) causes clasp to rotate at (R). Where minor
connector breaks contact with tooth. Retentive
clasp arm tip moves occlusally during function
and directs a distal torquing force to the tooth.
60. In function, rotational forces take place
around distal occlusal rest. Cast
circumferential clasp places an extremely
destructive distal tipping or torquing force on
abutment tooth (arrows).
61. when force is directed against unsupported end
of beam cantilever can act as first class lever
Torque on the abutment tooth
F
62. A cantilever design allows
excessive vertical movement
toward the residual ridge also.
64. Properly designed RPA clasp showing movement from
occlusal forces. Proximal plate, C. drops gingivally and
slightly mesially as rotation occurs around mesial rest with
approximate center of rotation, B. Rigid portion of retentive
arm contacts tooth only along survey line, A. and moves
gingivally and mesially. Retentive end of clasp arm moves
mesially and slightly gingivally
65. a- Improperly designed RPA clasp located above
survey line. Under occlusal force A, rigid portion of
retentive arm cannot move gingivally. This moves
center of rotation distally. Mesial rest lifts out of its
rest seats. Retentive portion of clasp arm engages
mesial undercut, torquing tooth distally
a-
66. Laboratory blockout of refractory cast for RPA clasp.
Rigid portion of retentive clasp arm is waxed for
casting over blocked-out distofacial surface, E, only
anterior border will be in contact with tooth. Cast under
retentive end of clasp arm is not blocked out
67. Placement of the I bar at
the greatest prominence
(2) or to the mesial (3)
permits the I bar under
function to move freely
away from the tooth.
The I bar placed on the distal (1) cannot move
freely away from the tooth thereby producing
a torquing action
72. MOVEMENT OF CLASP WITH MESIAL O.R.
The cicumferential clasp arm and proximal
plate move in mesiogingival direction
disengaging from the tooth
73. WROUGHT WIRE CLASP DURING FUNCTION
Wrought wire (WW combination) clasp during function.
Loading force (F) causes clasp to rotate, where minor
connector breaks contact with tooth. WW clasp arm tip
moves occlusally and directs a distal torquing force to the
tooth. Flexibility of WW arm limits torquing.
74. Placing the occlusal rest away from the
distal extension base has the following
advantage
1- By changing the direction of torque on the abutment
from the distal to the mesial side of the tooth, the
resistance to torque action will be applied from the
neighboring teeth
76. Depression of the base does not exert a distal
stress (the pump handle effect) on the
abutment but rather a mesial one
3- Clasp disengagement from the tooth
2- Class II Lever
78. 4 - lever arm, represented by distance from
rest to denture base, is increased. This
increase in length makes rotational action
caused by up-and down movement of denture
base in function more vertical. A vertical
force in better tolerated by ridge than is a
horizontal oblique force
79. A vertical force in better tolerated by
ridge than is a horizontal oblique force
Click on the video
80. 5- As rest is moved anteriorly more
of residual ridge will resist rotation