Direct Retainers Part 1 Flashcards
RPD Retention
• Resist
dislodging forces
Primary Retention
– Mechanical from retaining elements on abutment
teeth
Secondary Retention
(2)
– Intimate contact of minor connector with guide planes
– Intimate contact of denture base & maxillary major
connector with underlying tissues
Direct Retainer
• RPD component used to retain and prevent
dislodgement
Types of Direct Retainers (2)
Intracoronal
Extracoronal
Intracoronal
(2)
– Internal precision attachment: key/keyway
– Most esthetic
Intracoronal
Disadvantages: (3)
require crown,
complex fabrication, & high maintenance
Extracoronal
(2)
– Clasp assembly
– More commonly used
Clasp Types (2)
Suprabulge
Infrabulge
Suprabulge
(2)
– Retentive arm approaches undercut from above the
survey line
– Circumferential, Akers, Circlet
• Synonyms
Infrabulge
(2)
– Retentive arm approaches undercut from below survey
line
– Bar clasps
A properly constructed suprabulge or infrabulge clasp assembly must incorporate the following
components:
(4)
a rest (A),
a retentive clasp (B),
a reciprocal element (C),
and one or more minor connectors (D).
skipped
Specific design features of the various components include (4)
vertical and horizontal approach arms, clasp
termini, clasp bodies, and clasp shoulders.
Rest: lies on (3)
– Prevent
occlusal, lingual, incisal surface
tissueward movement of clasp
Reciprocal components
(3)
– Rigid component
– Above height of contour
– Reciprocal clasp,
Lingual plate,
Proximal plate, Guide plate (minor
connectors)
Retentive clasp arm
(2)
• Proximal 2/3
• Rigid portion, above height of contour
Retentive terminal
(4)
• Distal 1/3
• Flexible
• Below height of contour
• Provides direct retention
Minor Connector
(2)
• Joins body of clasp to framework
• Rigid
Approach arm
(3)
• Component of bar clasp
• Connects clasp to framework
• Flexible minor connector (Exception to rule)
Requirements of Clasp Assembly
1. Support
– Resist vertical movement toward tissue
– Rests
Requirements of Clasp Assembly
2. Stability
(3)
– Resist horizontal displacement
– Areas above the survey line
– All rigid components of direct retainer
Requirements of Clasp Assembly
3. Encirclement of more than 180 degrees
(3)
– May be continuous or broken
– Minimum of 3 points used
– Prevents tooth from moving away from the
clasp
Requirements of Clasp Assembly
4. Reciprocation
(4)
– Reciprocal component contact tooth at same
time or sooner than retentive clasp
– Remain in contact while
retentive tip passes over
height of contour
– Resist retentive tip
lateral forces
– Requires parallel surface
to path of insertion
Requirements of Clasp Assembly
5. Passivity
(1)
– Components of direct retainer exert no force
when fully seated
Requirements of Clasp Assembly
6. Retention
(1)
– Resists displacement of RPD away from
supporting tissues
– Area below survey line: ideally in gingival 1/3
retention
• Clasp arm tip:
Terminal 1/3 below survey line
• Retention portion of tooth must be — in relation
to path of prosthesis insertion
undercut
Retention amount minimum necessary to
resist
reasonable dislodging forces
Retention Factors
(3)
• Angle of convergence of the undercut
• Depth of undercut
• Flexibility of the retentive clasp
• Depth of undercut
(3)
– 0.010”, 0.020”, 0.030”
Retentive clasps should become active ONLY
when
disclosing forces are applied to them.
Retentive Clasp
Their ability to provide retention is based on
the
resistance of the metal to deformation.
Retentive Clasp
Flexibility Factors
1. Length
(2)
– Flexibility = length^3
• Double length, 8x more flexible
– Increase length, curve clasp
Retentive Clasp
Flexibility Factors
Diameter
(1)
– Flexibility =1/diameter^3
• Double diameter,
8x less flexible
Retentive Clasp
Flexibility Factors
Taper (In 2 dimensions)
(2)
– Clasp terminal ½ as thick as origin
• 1mm to 0.5 mm
– Clasp terminal ½ as wide as origin
• ~2mm to 1mm
Retentive Clasp
Flexibility Factors
Cross-sectional form
– Round clasp more flexible than half-
round
• Round flexes in all spatial planes
• Half-round flexes in one plane
Cross-sectional Shapes
Half round: (2)
Almost always as in
circumferential clasps
‣Flexes in only one direction
Cross-sectional Shapes
Round: (3)
As in wrought wire clasps
‣Flexes omnidirectionally
‣Provides maximum flexibility
Retentive Clasp
Flexibility Factors
5. Material
(4)
– Cast chromium alloys less flexible than cast gold
alloys
– Wrought alloys more flexible than cast alloy
– Cast Chromium
Material
– With increasing clasp flexibility, must use deeper
undercut to obtain equal retention
• 0.010”:
• 0.015”:
• 0.020”:
Cast Chrome alloy
Cast Gold alloy
Wrought wire
Clasp Material
‣Alloy used in casting the
framework:
(2)
‣ Usually Ticonium (NiCr) or
Vitallium (CoCr)
‣ Easy to fabricate
Clasp Material‣ Wrought wire
(2)
‣ Produce by drawing metal through dies of smaller diameter
‣ Most flexible of all clasps
Clasp Material
‣ Other
(2)
‣ Stainless steel, type IV gold
The design of a retentive clasp arm should incorporate
maximum clasp length for optimal flexibility.
Circumferential clasp
(2)
– Approaches undercut from above the survey line
– “Pulls” toward occlusal
to resist displacement
Bar clasp
(3)
– Approaches undercut from below survey line
– “Pushes” toward occlusal to resist displacement
– Easier to seat, more difficult to remove than
circumferential clasp
Reciprocal Clasp
• Must be —
• Shaped different than —
• Taper..
rigid
flexible retentive clasp
Not tapered
Reciprocation is the means by which
one part of the
framework opposes the action of the retainer in
function.
skipped
Reciprocation may be achieved by:
(5)
• Rigid plating (LINGUAL PLATE)
• Minor connectors
• Guide planes extended around the vertical line of
abutments
• Reciprocal clasp arms
• Contact areas of proximal teeth
Most logical clasp for tooth-supported RPD
(Class III)
Circumferential Clasps
Circumferential Clasps
Advantages
– Excellent stabilization, support, bracing
– Easiest to design & construct
– Easier to repair
Circumferential Clasps
• Disadvantages
(3)
– Covers more tooth surface: more conducive to
caries by more plaque retention
– Increases tooth circumference
• May cause greater occlusal force exerted on tooth
– More difficult to adjust
skipped
Circumferential Clasp Configuration
• Clasp kept as low on crown as survey line permits
(4)
– Less torquing action on tooth
– Less interference with occlusion
– If survey line is too high, enamel surface must be
recontoured to lower the survey line
– Survey line too low, Surveyed crown required
Circumferential Clasp Configuration
• — clasp
Retentive
Circumferential Clasp Configuration
• Retentive clasp (4)
– Cast ½ Round
– Proximal 2/3
– Terminal retentive 1/3
– Tapers from origin (2.0mm)
to tip (1.0 mm)
Circumferential Clasp Configuration
– Proximal 2/3
(2)
• In middle 1/3 of tooth
• Above the survey line
Circumferential Clasp Configuration
– Terminal retentive 1/3
(3)
• In gingival 1/3
• Below survey line
• Tip curves to occlusal
Circumferential Clasp Configuration
• Reciprocal clasp
(4)
– Cast ½ round
– Entire clasp in middle 1/3
– Above the survey line
– No taper: Uniform width 1.5 –2.0 mm
Circumferential Clasp Configuration
– Above the survey line
(2)
• If survey line too high, must recontour
• Prepare surface parallel to path of insertion
skipped
Types of Circumferential Clasps
(7)
- Circlet
- Embrasure clasp
- Reverse Circlet (hairpin) clasp
- Ring clasp
- Reverse Circlet clasp
- Combination Clasp
- RPC clasp
Circumferential Clasps:
Circlet
(2)
• Circumferential clasp of choice Class III RPD
• Engage undercut remote from edentulous
area
Circumferential Clasps:
Embrasure Clasp
(3)
• 2 circlet clasps joined at body
• Used when retainer is necessary in a dentate area
• Requires heavy reduction of abutment teeth for
adequate clasp bulk
Circumferential Clasps:
Embrasure Clasp
• Used when retainer is necessary in a dentate area
(3)
– Class III with no modification space
– Class II with no modification space
– Class IV
Circumferential Clasps:
Embrasure Clasp
• Requires heavy reduction of abutment teeth for
adequate clasp bulk
– Inadequate preparation, clasp fracture common
Circumferential Clasps:
Reverse Circlet (Hairpin Clasp)
(5)
• Engage undercut adjacent to edentulous area Class
III RPD
• Covers extensive tooth surface, increased caries risk
• Difficult to fabricate
• Indication: Mesially-tipped mandibular molar with
mesiofacial undercut
• “Last choice” for mesially-tipped molars
Circumferential Clasps:
Reverse Circlet (Hairpin Clasp)
• Indication: Mesially-tipped mandibular molar with
mesiofacial undercut
– ½ T preferred for this situation, if no tissue undercut at
approach arm
Circumferential Clasps:
Ring Clasp
(6)
• Indication: Mesiolingually-tipped mandibular
molars Class III RPD
• Engage mesiolingual undercut
• Auxillary bracing arm for reciprocity
• Additional occlusal rest:
• Avoid if possible
• Incorrect Ring clasp: No reciprocation, No support
Circumferential Clasps:
Ring Clasp
• Additional occlusal rest:
– for
support, prevent further mesial movement
Circumferential Clasps:
Reverse Circlet Clasp
• Indication:
Retentive undercut adjacent to
edentulous space
Circumferential Clasps:
Reverse Circlet Clasp
• Indication: Retentive undercut adjacent to
edentulous space
(3)
– Class III RPD
– Tooth-tissue supported RPD (Class I or II distal
extension)
– ½ T bar clasp preferred, if no tissue undercut at
approach arm
Circumferential Clasps:
Reverse Circlet Clasp
• Difficult to
obtain adequate occlusal clearance
• Avoid, if possible
Circumferential Clasps:
Combination Clasp
(3)
• Wrought round wire retentive clasp
• Cast ½ round reciprocal clasp
Wrought wire soldered to framework
Circumferential Clasps:
Combination Clasp
• Indication:
Distal extension RPD (Class I & II)
Circumferential Clasps:
Combination Clasp
• Indication: Distal extension RPD (Class I & II)
(2)
– Mesial rest not possible, distal rest must be used
– Mesiofacial undercut
RPC Clasp (RPA)
• Rest (mesial), Proximal Plate, Circumferential
(Akers) clasp
RPC Clasp (RPA)
• Indication:
(2)
– Class I, II RPDs
– Mesiofacial retentive undercut
RPC Clasp (RPA)
Circumferential retentive clasp
(1)
– Cast ½ round (ALWAYS) except in periodontally
compromised teeth, cast round.
RPC Clasp (RPA)
• Reciprocation:
(2)
– Distal proximal plate
– ML minor connector