This document discusses the history and classification of precision dental attachments. It begins by outlining some of the early developments in attachment designs from the 19th century. It then classifies attachments based on their fabrication method, relationship to abutment teeth, stiffness, and geometric configuration. The advantages and disadvantages of attachments are provided. Key factors in selecting abutment teeth are identified. Requirements for ideal abutment teeth are outlined. Contraindications and the role of attachments in different types of prosthodontic treatments are summarized.
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Failures in Fixed Partial Denture
(Prosthodontics FPD- Dental science)
Various types of failures in the fabrication of fixed partial denture
Dr.Sachin Sunny Otta
St.Gregorios Dental College,Kothamangalam,Ernakulam
Non rigid connectors in fixed prosthesis / cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Precision attachments final / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Non rigid connectors in fixed prosthesis / cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Precision attachments final / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This seminar is of postgraduate level, which will be helpful for students. The presenter has added the information from various sources and the references are quoted in the last few slides of the seminar to gather more information about the seminar.
Direct retainer, designing consideration, requirements, indications
part 1 deals with designig principles and requirements of retainers.
part 2 deals with types of retainers and their specific condition
Precision attachments1 /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
A 46 years old Lebanese Patient presented to my university dental clinic before tow months of COVID-19 pandemic having missing teeth, fracture roots, failed PFM bridge, multiple failed RCT and caries...
Treatment plan and clinical steps are presented in the above presentation, clinical treatment is postponed due to the pandemic.
hope you like it...
stay safe
Neutral Zone
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature.of.the tongue are equal and balanced with the.forces exerted by the buccinators.muscle of the cheek.laterally and the orbicularis.oris muscle anteriorly
It is sometimes difficult in clinical and experimental situations to determine whether regeneration or new attachment has occurred and the extent to which it has occurred.
Although there are various evidences of reconstruction, the proof of principle for the type of healing is determined by histological studies.
A prosthetic technique for periodontal healthy teeth using feather edge preparation
in a flapless approach in both esthetic and posterior areas with ceramo-metal and zirconia restorations,
achieving high quality clinical and esthetic results in terms of soft tissue stability at the prosthetic/tissue interface, both in the short and in the long term.
Case presentation in Oral Diagnosis and PeriodontologyStephanie Chahrouk
Case 1: Gingival enlargement caused by Prednisone drug taken to treat Rheumatoid arthritis
Case 2: Generalized moderate chronic periodontitis
Case 3: Polyp on lateral surface of the tongue due to Irritable bowel syndrome
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Historical Background
Definition
Precision: Quality or state of being precise
Attachment: Mechanical device for the fixation, retention and stabilization of dental prosthesis.
INTRODUCTION
• The desire to balance between functional stability and cosmetic appeal in
partial dentures gave rise to the development of Precision Attachments
• Precision Attachments have always been surrounded by an aura of mystery.
• The use of Precision Attachments for partial denture retention is
• • A practice builder for the better class of dentistry
• • It helps to elevate the general standard of partial denture prosthetics.
• The precision attachment is sometimes said to be a connecting link between fixed and
removable partial denture as it incorporates features common to both types of
construction.
Winder
• “Winders design” Screw joint retention
Parr (1886)
• Extracoronal socket attachment
Stair
• Telescopic abutment restoration
Ash (1912)
• Split bar attachment system
3. PrecisionAttachment (GPT-8) :
• A retainer consisting of a metal receptacle (matrix) and a closely fitting part (patrix);
the matrix is usually contained within normal or expanded contours of the crown on the
abutment tooth and the patrix is attached to a pontic or the removable partial denture
framework.
• An interlocking device, one component of which is fixed to an abutment or abutments, and
the other is integrated into a removable prosthesis to stabilize and/or retain it.
Mechanical device – Direct retainer
• They are designed to replace occlusal rest, bracing arm, and retaining arm of the conventional
clasp retained partial denture.
• They function to retain, support and stabilize the removable partial denture.
4. CLASSIFICATION OFATTACHMENTS
1. Based on method of fabrication and the tolerance of fit
2. According to their relationship to the abutment teeth
a. Intr-acoronal (Internal attachment)
b. Extr-acoronal (External attachment)
Male attachments
• Patrix Flange insert key fitting part
Female attachments
• Matrix Slot crypt keyway Receptacle
Precision attachment (prefabricated
types)
-Semiprecision attachment (custom
made / laboratory made types) -
Prefabricated wax / plastic / nylon
patterns
5.
6. 3. Based on stiffness of the resulting joint
a. Rigid attachments
b. Resilient attachments (Non rigid)
4. Based on geometric configuration and design of the attachment.
a. Key and Keyway
b. Interlocks
c. Ball and socket
d. Bar and clip / sleeve
e. Hinge
f. Telescopic
g. Push button
h. Latch
i. Screw units
7. Classification used in literature:
M.C. Mensor (1973)
Classification according to shape, design and primary area of utilization of attachment.
Gerardo Beccera and others (1987)
Intra-dental attachments
- Frictional
- Magnetic
Extra-dental attachments
- Cantilever attachment
- Bar attachment
ADVANTAGES
Improved esthetics and elevated psychological acceptance
8. Mechanical advantage
Direct the forces along the long axis of the teeth / more apically
Force application closer to the fulcrum of the tooth
Reduces Non axial loading
Decreases Torquing forces
Rotational movement of the abutment
In Distal extension base cases – “Broken stress philosophy”
Reduced stress to the abutment
Stress free rotational/vertical movements
Cross arch load transfer and prosthesis stabilization
Compared to conventional clasp retained partial denture
Less liable to fracture than clasp
Less bulky and more esthetics
Better retention and stability
Less food stagnation
DISADVANTAGES
Complexity of design, procedures for fabrication & clinical treatment
Minimum occlusogingival abutment height (4-6mm)
To incorporate attachment without overcontouring
Enough length of parallel contact
Anatomy of the tooth – Limited faciolingual tooth width (incisor and canine areas)
Expensive
Complexity of laboratory and clinical procedure
Attachment maintenance (repair or periodic replacement)
Wearing of attachment components
Require high technical expertise – Dentist and laboratory technician
Requires aggressive tooth preparation
Cooperation and manual dexterity on the part of the patient
Difficult to insert and remove
Visually or manually challenged patient
Increase demandonoral hygiene performance
9. Removable Prosthodontics
As a retainer in a removable tooth supported partial denture
4 large well rounded abutments are available
For esthetic concern in the anterior part of the mouth
Stress Breakers
Free end saddles/Distal Extension Base cases (DEB)
When cantilevered pontic is to be used as abutment
For movable joints in sectional dentures
Periodontal involvement of the tooth
Contraindicates rigid FPDs
Most efficient bilateral bracing and support are essential
Divergent abutment teeth with high survey lines – parallel path of placement.
As a retainers in tooth supported over denture
FixedProsthodontics
As a connector in fixed partial denture construction (long span bridges)
To overcome alignment problems where abutments have differing path of withdrawal.
IMPLANTPROSTHODONTICS
Implant supported over denture
They are used for connection between the tooth and the implant
10. CONTRAINDICATIONS OF PRECISION ATTACHMENTS
Poor periodontal support.
Poor crown to root ratio
Poor oral hygiene habits
Abnormally high carious rate
Inadequate space / room to employ the attachment
Compromised endodontic and restorative conditions
SELECTION OF THE ABUTMENT TEETH
Factors :
Condition of abutment teeth
Number of the abutment teeth
Location of the abutment teeth
Periodontal condition
– Crown root ratio
– Periodontal support
Pulpal status
– Vitality of the pulp
– Size of the pulpchamber
REQUIREMENTS FOR THE ABUTMENT TEETH
Axial space requirement
Sufficient clinical crown length – for minimum of 4mm attachment
Maximum
attachment length
6-7 mm
Minimum
attachment length
4mm
Inadequate
attachment length
< 4mm
Buccolingual space
requirement
Adequate space
between the pulp
and the normal
contour of the tooth
11. Full crownretainers
Intracoronal attachments
Ideal Contours
More retentive /rigidIdeal contours
Cariesprotection
Partial coverage retainers
KennedysCl IIIpartial denture
Splintedabutmentteeth
Most vulnerable
Inadequate retention
Marginal leakage
Inlays/onlays/ pinledges
Notusedfor intracoronal attachments
Lack of retention
Marginal caries
Lesslife
Selection of the attachments
Intracoronal vs Extracoronal
Resilient vs Non resilient
EM attachment gauge (Matsuo (1970))
75 mm in length
Red 3-4 mm
Yellow 5-6 mm
Black 7-8 mm
13. Frictional :Preiskel groupI
Retention –Surface area contact
Functionof the length
– Controlledbyheightof clinical crown
– Intermaxillaryspace available
Functionof cross sectional dimensions
Mechanical : Preiskel groupII
Auxillarymechanical retentive features
Ex. Springloadedplunger/clips
Passive Attachment:
Matrix: Simple channels closes at one end to provide stop
Matrix: Solid slide
Channels of passive attachment may be round / elliptical slides
DEPENDINGON ARTICULARRETENTION
Passive attachment Active attachment LockedprecisionattachmentOmegaBeyeler
14. ACTIVE ATTACHMENT:
I. Active friction grip attachment
II. Active snap grip attachments
Lockedprecisionattachment
I. Attachments bolted by means of a sliding bolt or latch
II. Pinned or screwed together
Mc Collum attachment :
H shapedattachment
Single adjustmentslot
Retention expandingthe adjustmentslot
15. Sternattachment
Two adjustment slots
Stern Gold latch retained
Crismani attachment :
Available as Rigid/Resilient
Rigid crismani attachment
Frictional grip
Mechanical Springclip
16. Semiprecisionattachments
Semiprecision rest – intracoronal rest seat and resilient lingual arm.
“Laboratory fabricated rigid metalic extension (patrix) of a fixed or removable
dental prosthesis that fits into a slot type key way (matrix) in a cast restoration
allowing some movement between the component”.
Gillete (1923):
The firstsemiprecisionattachment
Rectangulardeeprestwithbuccal andlingual wroughtclaspsarms
Ira D Zinner (1979):
Lockingsemiprecisionattachment
Nonlockingsemiprecisionattachment
Louis blatter fein(1969) : Four aspects of rest seat preparation
Occlusal form / outline form – controls amount of rotation
Proximal form / side walls – lateral force control
The angle of the proximal wall with the gingival floor
Circular(Rigid – lockingtype) Dove tail (Rigid – lockingtype)
RectangularResilient Mortice Some resiliency(Non-lockingtype)
Parallel outline Taperingoutline
17. Gingival floor form: serves the function of reciprocation
Advantages:
Versatility for clinical situations – employing various rest seat outline forms.
Variation in tooth size and shapes are easily accommodated.
Better crown contour compared to prefabricated type
Disadvantages:
Long term wear is more – softness of alloy used.
No standardization of sizing : Lack of interchangeability of male and female
attachment.
Greater degree of laboratory skill and attention in detail.
Flat
Inclined
•Mortice occlusal
Channeled
•Rectangularocclusal form
18. EXTRA-CORONAL ATTACHMENTS
1. Introduced by Henry R. Boos (1900)
2. Modified by F Ewing Roach (1908)
Application: Kennedy‟s class I and class II
Boitel (1978)
Rigid attachments
Resilient attachments
Bar attachments
Advantages:
No alteration of contour of the abutment crown
Can be used in short abutment teeth
Greater freedom in the design
Ease of insertion and removal
Disadvantages (Wolf RE 1980):
Lack of occlusal stability
Bulky
Rebasing problems
Improper control of force distribution
Encroachment on the gingival papilla – use of mini attachment
EXTRACORONALATTACHMENT
Rigidattachments Hingedattachments(Stressbreaking
action)
ResilientattachmentsERA
O-ring
19. ROLEOF ATTACHMENTS AS STRESS BREAKER
Broken stress philosophy
Mensor stress can only be selected, altered or blocked
“Stress director”
Shohet (1969) Kratochvil (1981)
Low intensity forces on abutment teeth in contrast to rigid attachments.
Rationale of stress breaker movement should be strictly only to displaceable tissue
Disadvantages of stress director:
More complex, increased wear and breakage
Increased bone resorption and trauma
Occlusal contacts difficult to maintain
Spring like device tendency to fatigue
Rigid system
Non-rigid system
•Stress breaker Broken