Direct Retainers Part 2 Flashcards

1
Q
  • Suprabulge
    (2)
A

– Retentive arm approaches undercut from above the survey line
– Circumferential, Akers, Circlet
* Synonyms

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2
Q
  • Infrabulge
    (2)
A

– Retentive arm approaches undercut from below survey line
– Bar clasps

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3
Q

Bar Clasps
* Indicated:
(2)

A

– Distal extension RPD
– Tooth-supported RPD, esthetics factor

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4
Q

Bar Clasps
* Most common
(2)

A

– I-bar clasp
– ½ (modified) T-bar clasp

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5
Q

Bar Clasps
* Advantages
(4)

A

– More esthetic
– More flexible
– Less conducive to caries (less tooth coverage)
– Wider range of undercut adaptability
* MF, Mid-F (I-bar)
* DF ( ½ T-bar)

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6
Q

Bar Clasps
* Disadvantages
(4)

A

– Less bracing
– Possible tissue impingement
– Food impaction
– More difficult to repair or replace

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7
Q

Bar Clasps Rules
* Approach arm
(5)

A

– Must not impinge on soft tissue
– Tapered
* (Flexible minor connector: exception to rule)
– Cross gingival margin at 90 degrees
– Extend onto abutment tooth to the height of
contour
– Not positioned over soft tissue undercut: food
trap, tissue irritation

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8
Q

Selection of RPD Clasps
* Tooth-supported RPDs :
* Tooth-tissue supported RPDs :

A

– Class III RPD, short-span Class IV

– Class I & II RPD, long-span Class IV

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9
Q

Tooth-supported RPD Clasps
* Circumferential (Circlet)
(3)

A

– Most common
– Retentive undercut remote from edentulous
area
– Reciprocal clasp

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10
Q

Tooth-supported RPD Clasps
* I-bar
(3)

A

– Mesiofacial, Midfacial undercut
– Reciprocal clasp
– Tissue undercut prevents use

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11
Q

Tooth-supported RPD Clasps
* ½ T-bar
(4)

A

–Retentive undercut adjacent
to edentulous area
–Distal facial undercut
–Reciprocal clasp
–Tissue undercut prevents use

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12
Q

Tooth-supported RPD Clasps
* Reverse Circlet (Hairpin)
(3)

A

–Retentive undercut adjacent
to edentulous area
–Used when tissue undercut present
* ½ T or I-bar cannot be used
–Excess tooth coverage, disadvantage

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13
Q

Tooth-supported RPD Clasps
* Embrasure clasp
(4)

A

– Used when retainer is
necessary in a dentate area
–Used in Class IV & Class III arch with no
modification space
–Also used in Class II tooth-tissue
supported RPD, when no modification
space exists

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14
Q

Fulcrum Line
Glossary of Prosthodontic Terms

A
  • an imaginary line, connecting occlusal rests,
    around which a partial removable dental
    prosthesis tends to rotate under masticatory
    forces. The determinants for the fulcrum line
    are usually the cross arch occlusal rests
    located adjacent to the tissue borne
    components
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15
Q

Tooth-tissue supported RPD Clasp Selection
* Rotation of the RPD toward the residual
ridge around the horizontal fulcrum line
(3)

A

– Factor in Class I & II extension RPDs
– RPD potentially functions as a lever
– Can result in detrimental clasp
forces on the abutment teeth

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16
Q

Tooth-tissue supported RPD Clasp Selection
* Why rotation of the RPD toward the
residual ridge around the horizontal
fulcrum line?
(3)

A

– Difference in potential movement of abutment
& mucoperiosteum over residual ridge
– 0.25mm periodontal ligament, 2mm
mucoperiosteum
– 0.25mm = 0.01” (related to retentive clasp)

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17
Q

Distal Extension RPD Clasp Selection
* Distal abutment retentive clasp should
NOT be anterior to terminal rest fulcrum
line
(2)

A

– Distal rest/Distal guide plane
- Mesial rest/Distal guide plane

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18
Q

– Distal rest/Distal guide plane
(2)

A
  • Class I lever
  • Torquing force on abutment
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19
Q

– Mesial rest/Distal guide plane
(3)

A
  • Class II lever
  • Retentive tip disengages abutment
  • Stress-release clasp design
20
Q

Anterior placement of the rest helps
direct the forces more — onto
the tissues of the residual ridge

A

vertically

21
Q

Tooth-tissue supported
(Distal Extension)RPD Clasp Selection
* Stress-release clasps used on Class I & II
RPDs distal abutments
(5)

A

– RPI clasp assembly
– RPC (A) clasp assembly
– Combination clasp
– ½ T clasp
– Reverse circumferential clasp

22
Q

RPI Clasp assembly
(3)

A
  • Rest (mesial), Proximal Plate, I-bar
  • Mesiofacial or Mid-facial retentive undercut
  • Reciprocation
    – ML Minor connector
    – Distal proximal plate
23
Q

RPI Clasp assembly
* Prepared Guiding Planes:
– Distal Guiding plane: Occlusal 1/3-1/2
(3)

A
  • 2-3 mm
  • Guide plate contacts ~1-1.5mm of plane
  • Undercut is necessary below the guide plane
24
Q

RPI Clasp assembly
* Prepared Guiding Planes:
– ML Minor Connector GP: Occlusal 1/3
(1)

A
  • 1-2 mm
25
Q

RPI Clasp assembly
* Structural Details:
(4)

A

– I-bar 2mm contact at retentive undercut
– Approach arm
– Distal proximal plate width
– Major connector

26
Q

RPI clasp assembly
– Approach arm
(2)

A
  • ~3mm from gingival margin
  • Crosses gingival margin 90°
27
Q

RPI Clasp assembly
– Distal proximal plate width

A

– Line angle to line angle

28
Q

RPI Clasp assembly
– Major connector
* — from gingival margin: mandible
* —- from gingival margin: maxilla

A

3mm
6mm

29
Q

RPI Clasp assembly
* Stress release:
(3)

A

– Rotation around mesial rest/fulcrum
– Distal guide plate & I-bar move mesiogingivally
* I-bar disengages from tooth (Stress release)
– ML minor connector rotates
mesio-occlusally

30
Q

RPI Clasp assembly
* Stress release design criteria:
(2)

A

– Relief below distal plate, Undercut below guide
plane
* Allow proximal plate movement
– ML minor connector not contact adjacent
tooth to allow rotation

31
Q

RPI Clasp assembly
* Design criteria
* Consideration:

A

need 5mm separation between
vertical minor connector
* If not 5mm, then should use lingual plate

32
Q

RPI Clasp RPI Clasp assembly
* Contraindications
(3)

A

– Excess tissue undercut
– Shallow vestibule
* Tissue impingement
– Abutment excess facial inclination
* High survey line
* Retentive undercut too high
– Not in gingival 1/3

33
Q

RPC Clasp assembly (RPA)
(4)

A
  • Rest (mesial), Proximal Plate,
    Circumferential (Akers) clasp
  • Mesiofacial retentive undercut
  • Circumferential retentive clasp
    – Cast round for Kennedy I w/o modification and
    periodontally compromised teeth
34
Q

RPC Clasp assembly (RPA)
* Reciprocation:
(2)

A

– ML minor connector
– Distal proximal plate
* Wrap to lingual

35
Q

RPC Clasp assembly (RPA)* Structural Details:
(3)

A

– Hybrid clasp: RPI and circumferential concepts
– Similar criteria to Circumferential
Retentive Clasp
* Proximal 2/3
– Middle 1/3 of tooth
– On the survey line
* Terminal retentive 1/3
– Gingival 1/3, Below survey line
– Guide planes same as RPI
* Same criteria

36
Q

RPC Clasp assembly (RPA)
* Stress release:
(2)

A

– Rotation around mesial rest/fulcrum
– Circumferential clasp & distal guide plate move
mesiogingivally
* Clasp disengages from tooth
* ML minor connector rotates
mesio-occlusally

37
Q

RPC Clasp assembly (RPA)
* Stress release design criteria
(3)

A

– Relief below distal guide plate, undercut below plane
– Proximal 2/3 of retentive
clasp exactly on survey line
* Relief is provided below proximal 2/3
* Allow clasp to disengage during rotation
– Failure to follow criteria
* Fulcrum moves to proximal
area of clasp
* Class I lever with detrimental force

38
Q

Combination Clasp
(2)

A
  • Distal rest, Wrought wire
    retentive clasp, Cast reciprocal clasp
  • Mesiofacial undercut
39
Q

Combination Clasp
* Indications
(2)

A

– Mesial-inclination of abutment distal surface
* No undercut below guide plane
* RPC, RPI no stress release
– Mesial rest cannot be used
* RPC, RPI no stress release

40
Q

Combination Clasp
* Stress release:
(2)

A

– Rotation occurs at distal rest minor connector
– Clasp moves occlusally
* Class I lever occurs
* Distal torquing force occurs
* Flexibility of wrought wire limits
torque

41
Q

Modified (1/2) T Clasp

A
  • Mesial rest, Distal Proximal plate, ½ T-bar
    clasp
42
Q

Modified (1/2) T Clasp
Indication:
* Reciprocation:

A

– Distofacial retentive undercut

ML minor connector,
Distal plate

43
Q

Modified (1/2) T Clasp
* Contraindications
(3)

A

– Tissue undercut
– Shallow vestibule
– Abutment excess facial inclination
* High survey line
* Retentive undercut too high
– Not in gingival 1/3

44
Q

Reverse Circumferential Clasp

A
  • Mesial rest, Distal guide plate, Reverse cast
    circumferential retentive clasp
45
Q

Reverse Circumferential Clasp
* Indications:
(2)
* Reciprocation:
(1)

A

– Distofacial retentive undercut
– ½ T clasp contraindicated

– ML minor connector, Distal plate

46
Q

Clasp Selection:
Abutment Anterior to Horizontal Fulcrum
* Class I lever occurs in Class II RPD with
posterior modification
Limit torquing forces by:
(4)

A
  1. No clasp
  2. Clasp in less undercut
    (i.e. MB tooth #6)
  3. Non-retentive clasp (tip not
    in undercut)
  4. Wrought wire clasp