Partial Dentures
Partial Dentures
Partial Dentures
Major connectors
1. Unification
A major connector units all other components of a partial denture so
that the partial denture acts as one unit.
2. Stress Distribution
By unifying all elements of a partial denture the major connector can
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distribute functional loads to all abutment teeth, so that no one abutment
is subjected to extreme loading. Unification of the direct retainers with
the denture bases aids in distributing forces between both the teeth and
the mucosa. This is particularly important in Class I and II partial
dentures. In some maxillary cases a major connector with broad palatal
contact is selected, in these situations the broad base offers additional
support, distributing stress over a larger area.
3. Cross-Arch Stabilization (Counter leverage)
By uniting one side of the arch to the other bracing elements on one
side of the arch can aid in providing stability to the other. This can aid
in dissipating twisting and torquing forces.
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Characteristics (requirements) of major connector contributing to
health and well-being:
1- Made form an alloy compatible with oral tissue.
2- Is rigid and provides cross-arch stability through the principle of
broad distribution of stress.
3- Does not interfere with and is not irritating to the tongue.
4- Does not substantially alter the natural contour of the lingual
surface of the mandibular alveolar ridge or of the palatal vault.
5- Does not impinge on oral tissue when the restoration is
placed, removed, or rotated in function.
6- Covers no more tissue than is absolutely necessary.
7- Does not contribute to the retention or trapping of food particles.
8- Has support from other elements of the framework to minimize
rotation tendencies in function.
9- Contributes to the support of the prosthesis
10-Unobtrusive:The margins of the major connector should have a
smooth transition from connector to tissue so as to minimize the
obtrusiveness. All line angles and edges should be smooth and rounded.
Borders should not be placed in locations where they might interfere
with speech. Bulk should be reduced enough so as not to interfere with
speech or appearance, yet thick enough to ensure rigidity.
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1- SINGLE PALATAL STRAP:
Bilateral tooth-supported prosthesis, even those with short
edentulous spaces, are effectively connected with a single,
broad palatal strap connector, particularly when the
edentulous areas are located posteriorly. Its width should
confine within the boundaries of supported rests. Such a
connector can be made rigid without objectionable bulk
and interference with the tongue. It is less objectionable by
patients because it could be made wide and thin, and it helps
to distribute the force of stress over a wide area. Also its have
half oval shape with its thickest point at the center, such
thickness of major connector does not appreciably alter palatal
contours. The Strap should be 8 mm wide or approximately as
wide as the combined width of a maxillary premolar and first
molar.
Indications:
1- Class III or Class III, modification1
Partially edentulous arch (short edentulous span).
Contraindications:
1- Tooth-tissue supported partial
Dentures (Class I and Class II).
2- Present of palatal tori.
3- Extremely long tooth supported
edentulous space.
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Indications
1-When the remaining teeth are periodontally compromised,
complete palatal coverage permits distribution of the applied
force to the remaining teeth, as well as to the palatal tissue.
2- In Class II arch with large posterior modification space and
some missing anterior teeth.
3-When the last remaining abutment tooth on either side of a
Class I arch is the canine or first premolar tooth, especially
when the residual ridges have undergone excessive vertical
resorption.
4- In most situations in which only some or all anterior teeth
remain.
5-When relining is anticipated.
Contraindications
When less than complete palatal coverage is necessary and
there are sufficient remaining natural teeth to use a palatal
plate or strap major connector.
Advantages:
1-Provides the ultimate rigidity.
2- Provides maximum support, retention,
bracing, and direct-indirect retention
from the palate.
3-Fairly simple design.
4- Few metal teeth edges.
5- Easy to add new prosthetic teeth to
framework.
6-Can be easily converted to an interim complete denture.
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Mandibular major connectors
Six types of mandibular major connectors are:
1- Lingual bar.
2- Linguoplate (lingual plate).
3- Sublingual bar.
4- Lingual bar with cingulum bar (continuous bar).
5- Cingulum bar (continuous bar).
6- Labial bar and buccal bar
1- LINGUAL BAR:
Characteristic and location:
1- Half pear shaped in cross section with bulkiest portion
inferiorly located.
2- The major connector must be contoured so that it does not
present sharp margins to the tongue and cause irritation by an
angular form.
3- Superior border tapered to soft tissue (gingival tissue).
4- Superior border located at least 4 mm inferior to
gingival margins and more if possible.
5- Inferior border located at the ascertained height of the
alveolar lingual sulcus when the patient’s tongue is slightly
elevated.
6- The inferior border of the lingual bar should be slightly
round when the framework is polished. A round border will not
impinge on the lingual tissue when the denture bases rotate
inferiorly under occlusal loads.
Indications:
1- The lingual bar should be used for mandibular removable
partial dentures where sufficient space exists between the
slightly elevated alveolar lingual sulcus and the lingual gingival
tissue (at least 8 mm).
2- The lingual bar is the mandibular major connector of choice
if sufficient bracing and indirect retention can be provided by
clasp and indirect retainers, and if
future additions of prosthodontic
teeth to the framework to replace
extracted natural teeth are not
anticipated.
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3- Diastema or open cervical embrasures of anterior teeth.
4- Overlapped anterior teeth.
Contraindications:
1- Less than 8 mm between the marginal gingival and the
activated lingual frenum and floor of the mouth.
2- Lingually inclined teeth.
3- An undercut lingual alveolar ridge which would result in an
excessivespace between the bar and the mucosa.
4-When the future replacement of one or more incisor teeth.
3- SUBLINGUAL BAR:
A modification of the lingual bar that has been demonstrated
to be useful when the height of the floor of the mouth does
not allow placement of the superior border of the bar at least
4 mm below the free gingival margin. The shape of the
sublingual bar remains essentially the same as that of a lingual
bar, but placement is inferior and posterior to the usual
placement of a lingual bar, lying over and parallel to the
anterior floor of the mouth.
Indications
1- Where the height of the floor of the mouth in relation to the
free gingival margins will be less than 6 mm.
2-Bracing and indirect retention can be provided by clasps and
indirect retainers and future additions of prosthetic teeth to the
framework are not anticipated.
3- In the presence of an anterior lingual undercut that
would require considerable block out for a conventional
lingual bar.
4- Diastemas and open cervical embrasures of anterior teeth.
5- Overlapped anterior teeth.
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Contraindications
1-Where a lingual bar or lingual plate will suffice.
2- Where bracing and/or indirect retention must be provided by
contact of the major connector with the teeth.
3- Where future additions of prosthetic teeth to the framework
are anticipated.
4-Remaining natural anterior teeth
severely tilted toward the lingual.
5- Interference with lingual tori.
6- High attachment of a lingual
frenum.
7- Interference with elevation of
floor of mouth during functional
movements
Indications
1- When a lingual plate is indicated but the open cervical
embrasures of anterior teeth would objectionably display metal
in a frontal view.
Contraindications
1-Any contraindication for a lingual bar.
2-Any contraindication for a lingual plate except open cervical
embrasures.
3- Wide diastemas.
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Advantages:
1-More rigid than lingual bar.
2-Covers less tooth and tissue surface than lingual plate.
3- Because the gingival tissues and the interproximal
embrasures are not covered, a free flow of saliva is permitted
and the marginal gingiva receives natural stimulation.
Disadvantages:
1-Very complex design.
2- May be objectionable to patient
because there are four edges
exposed to the tip of the tongue.
3- Tendency to trap food debris.
5- CINGULUM BAR (CONTINUOUS BAR):
Indications:
1- When a lingual plate or sublingual bar is otherwise
indicated but the axial alignment of the anterior teeth is such
that the excessive block out of interproximal undercuts would
be required.
2- Height of activated lingual frenum and floor of the mouth
at the same level of marginal gingiva.
3- Inoperable tori or exostosis at the same level as the marginal
gingiva.
4- Severely undercut lingual alveolus.
5- Concern that a major connector traversing the gingival
sulcus will cause a periodontal problem.
6- Considerable gingival recession.
Contraindications:
1- Anterior teeth severely tilted to
the lingual.
2- When wide diastema exists
between the mandibular
anterior teeth and the cingulum
bar would objectionably display metal in a frontal view.
6- LABIAL BAR AND BUCCAL BAR:
These bars are situated in the labial or buccal sulcus.
Superior border located at least 4 mm inferior to labial and
buccal gingival margins and more if possible. Inferior border
located in the labial-buccal vestibule at the juncture of
attached (immobile) and unattached (mobile) mucosa. It is
always flatter and broader than the lingual bar and must be
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relieved in the canine eminence area. This type of mandibular
major connector used in few situations and it is the least one
used as mandibular major connector.
Indications:
1- When lingual inclinations of remaining mandibular
premolar and incisor teeth cannot be corrected, preventing
the placement of a conventional lingual bar connector.
2- When severe lingual tori cannot be removed and prevent the
use of a lingual bar or a lingual plate major connector.
3- When severe and abrupt lingual tissue undercuts make
it impractical to use a lingual bar or lingual plate major
connector.
Contraindications:
1- When a lingual major connector may be used.
2- The facial tori or exostosis.
3- The facial alveolar ridge is undercut,
4- High facial muscle attachment which would result in
less than 4 mm of space between the superior edge of the
labial bar and the marginal gingiva of the teeth.
Indications:
1- Missing key abutments (such as canine). By using all
the remaining teeth for retention and stability.
2- Unfavorable tooth contours. When existing tooth contours
(uncorrectable by recontouring with appropriate restorations)
or excessive labial inclinations of anterior teeth prevent
conventional clasp designs.
3- Unfavourable soft tissue contours. Extensive soft tissue
undercuts may prevent proper location of component parts of
a conventional removable partial denture.
4- Teeth with questionable prognosis (because all of the
remaining teeth function as abutments in the swing-lock
denture).
Contraindications:
1- Poor oral hygiene and lack of patient motivation.
2- Shallow buccal or labial vestibule.
3- High frenal attachment (labial or buccal frenum).
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