Partial Dentures

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Lec 4

Dr.Israa Mohammed\Assist prof.

5th week\ 3rd class


Component parts of Chrome Cobalt
Removable Partial Denture
1. Major connectors
2. Minor connectors
3. Rests
4. Direct retainers
5. Indirect retainers
6. Denture base
7. Artificial teeth

Major connectors

A major connector is the component of the partial denture that


connects the parts of the prosthesis located on one side of the
arch with those on the opposite side. It is that unit of the partial
denture to which all other parts are directly or indirectly
attached. This component also provides the cross-arch stability to
help resist displacement by functional stresses.
The prosthesis must extend to both sides of the arch. This enables
transfer of functional forces of occlusion from the denture base
to all supporting teeth and tissues within an arch for optimum
stability.
A properly designed rigid major connector effectively distributes
forces throughout the arch and acts to reduce the load to any
one area while effectively controlling prosthesis movement.

THE CHIEF FUNCTIONS OF A MAJOR CONNECTOR INCLUDE

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.

following guidelines in mind:


1- Major connectors should be free of movable tissue.

2- Impingement of gingival tissue should be avoided.

3- Bony and soft tissue prominences should be avoided during


placement and removal.

4- Relief should be provided beneath a major connector to prevent its


settling into areas of possible interference, such as inoperable tori
or elevated median palatal sutures.

5- Major connectors should be located and/or relieved to prevent


impingement of tissue because the distal extension denture rotates in
function.

6- Relief from gingival margin should be provided. For maxillary major


connector (6-8 mm) and for mandibular major connector (3-4 mm).

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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.

Maxillary major connectors:


Six basic types of maxillary major connectors are considered:

1- Single palatal strap.

2- Combination anterior and posterior palatal strap-type connector.

3- Palatal plate-type connector.

4- U-shaped palatal connector.

5- Single palatal bar

6- Anterior-posterior palatal bars.

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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.

2- COMBINATION ANTERIOR AND POSTERIOR PALATAL STRAP-TYPE


CONNECTOR:
This is a rigid palatal major connector. The anterior and
posterior palatal strap combination may be used in almost
any maxillary partial denture design. A posterior palatal
strap should be flat and a minimum of 8 mm wide. Posterior
palatal connectors should be located as far posteriorly as
possible to avoid interferences with the tongue but anterior
to the line formed by the junction of ten hard and soft palates.
The anterior connector may be extended anteriorly to support
anterior tooth replacement if there is anterior missing area.
The strength of this major connector design lies in the
fact that the anterior and posterior components are joined
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together by longitudinal connectors on either side, forming a
square or rectangular frame. Each component braces the
others against possible torque and flexure; therefore, it is the
least flexible type of these types of major connectors.
Indications:
1- Class III or Class III, modification 1 particularly edentulous
arch with long span edentulous space or spaces.
2- Class I and II arches in which excellent abutment and
residual ridge support exists, and direct retention can be
made adequate without the need for indirect retention.
3- Class IV arches in which anterior teeth must be replaced
with a removable partial denture.
4- Inoperable palatal tori that do not
extend posteriorly to the junction of the
hard and soft palates.
Contraindications:
1- When there is an inoperable maxillary
torus that extends posteriorly to the
junction of the hard and soft palate.

3- PALATAL PLATE-TYPE CONNECTOR(COMPLETE PALATE):


The words palatal plate are used to designate any thin, broad,
contoured palatal coverage used as a maxillary major
connector and covering one half or more of the hard palate.
Characteristics and location:
1-A uniformly thin plate that reproduces the anatomic
contours of the palate (anatomic replica form) for full palatal
metal casting supported anteriorly by positive rest seats and
designed for the attachment of acrylic resin extension
posteriorly.
2-The anterior border must be kept 6 mm from the marginal
gingivae, or it must cover the cingula of the anterior teeth.
3-Posterior border must be terminated at the junction of the
hard and soft palates; extended to hamular notch area(s) on
distal extension side(s); at a right angle to median suture line.
4-more acceptable to tongue and underling tissue due to its
uniform thinners and the thermal conductivity

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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.

4- U-SHAPED PALATAL CONNECTOR (HORSE SHOE PALATAL


CONNECTOR):
U-shaped palatal connector is the least desirable of maxillary
major connectors.
Indications:
1- When a large inoperable palatal torus exists.
2- Occasionally when several anterior teeth are to be replaced.
Disadvantages:
1- Its lack of rigidity (compared with other designs) can allow
lateral flexure under occlusal forces, which may induce torque
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or direct lateral force to abutment teeth.
2- The design fails to provide good support characteristics
and may permit impingement of underlying tissue when
subjected to occlusal loading.
3- Bulk to enhance rigidity results in increased thickness in
areas that are a hindrance to the tongue.
Many maxillary partial dentures have failed for no other
reason than the flexibility of a U-shaped major connector. To
be rigid, the U-shaped palatal connector must have bulk where
the tongue needs the most freedom, which is the rugae area.
Without sufficient bulk, the U-shaped design leads to increased
flexibility and movement at the open ends. In distal extension
partial dentures, when tooth support posterior to the
edentulous area is non-existent,
movement is particularly
noticeable and is traumatic to
the residual ridge.

5- SINGLE PALATAL BAR:


-To differentiate between a palatal bar and a palatal
strap, a palatal connector
Component of less than 8 mm in width is referred to as a bar.
- It's run across the palate, having
narrow half oval shape in its cross
section with its most thickness in
the center.
-Have poor support from the hard
palate due to narrow anterio-
posterior width
-Not used anterior to the premolar region due to interference
to the tongue.
-Used only when 1 to 2 teeth are loss on each side because has
poor vertical support, and in Kennedys CL III cases, because
present the teeth anteriorly and posteriorl to the edentulous
space.
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6- COMBINATION ANTERIOR AND POSTERIOR PALATAL BAR-TYPE
CONNECTOR (RING DESIGN ):
this combination of major connectors exhibits many of the
same disadvantages as the single palatal bar. To be
sufficiently rigid and to provide the needed support and
stability, these connectors could be too bulky and could
interfere with tongue function and speech. The anterior
bar is a flat bar located as far posteriorly as possible to
avoid rugae area coverage and tongue interferences. It
should be 6 mm away from the
gingival margin. The posterior
bar is half oval in section located
as far posteriorly as possible but
still entirely placed on the hard
palate. The two parts are joined by
flat longitudinal elements on each
side of palate .
Indication:
It may be used in any partial denture design. It should be made
bulky thus it will be objectionable by patient.

Beading of the maxillary cast

It is the scribing of a shallow groove (not in excess of 0.5 mm


in width or depth) on the maxillary master cast outlining the
palatal major connector exclusive of rugae areas.
The purposes of beading are as follows:
1-To transfer the major connector design to the investment
cast.
2- To provide a visible finishing line for the casting.
3- To ensure intimate tissue contact of the major connector
with selected palatal tissue.

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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.

2- LINGUOPLATE (LINGUAL PLATE):


The linguoplate is a lingual bar with superior border extending
upwards to contact cingula of anterior teeth and lingual
surface of involved posterior teeth on their high of contour.
Upper border should follow the natural curvature of the
supracingular surfaces of the teeth and should not be located
above the middle third of the lingual surface except to cover
interproximal spaces to the contact points. The half-pear
shape of a lingual bar should still form the anterior
border providing the greatest bulk and rigidity. All gingival
cervices and deep embrasures must be blocked out parallel
to the path of placement to avoid gingival irritation and
any wedging effect between the teeth. The linguoplate does
not in itself serve as indirect retainer. When indirect retention
is required, definite rests must be provided for this purpose.
Both the linuoplate and the cingulum bar should ideally have a
terminal rest at each end regardless of the need for indirect
retention.
Indications
1- When a clinical measurement from the free gingival margins
to the slightly elevated floor of the mouth is less than 8 mm
2- When the residual ridges in Class I arch have undergone such
vertical resorption that they will offer only minimal resistance
to horizontal rotations of the denture through its bases. When
a removable partial denture will replace all mandibular
posterior teeth, a lingual plate should be used
3- When the remaining teeth are periodontally weakened; the
lingual plate may be used to splint these weak teeth, and to
distribute applied forces over the remaining teeth in group
function to provide support to the prosthesis.
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4- When the future replacement of one or more incisor teeth
will be facilitated by the addition of retention loops to an
existing linguoplate.
Contraindications:
1- Overlapped anterior teeth, that leads to small gaps between
the superior1. edge of the plate and the teeth.
2-Lingually inclined teeth.
3- Open cervical embrasures where the plate would be visible,
so a lingual bar with continuous bar or labial bar should be
considered.
4- Diastemas, unless the lingual plate can have slots in it (step
backs design) to avoid display of metal.

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

4- LINGUAL BAR WITH CINGULUM BAR (CONTINUOUS BAR):


This type of mandibular major connector consists of lingual bar
with another bar crossing the lingual surface of lower anterior
teeth located on or slightly above the cingula of anterior teeth .
Characteristics and location:
1-The lower bar should be shaped and located same as lingual
bar major connector component when possible.
2-The upper bar should be half oval in cross section, thin (1
mm), narrow (3 mm) metal strap located on cingula of anterior
teeth, scalloped to follow interproximal embrasures with
inferior and superior borders tapered to tooth surfaces.
3-The two bars should be joined by rigid minor connectors at
each end.
4-Terminal rests should be placed at each end of the upper bar.

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.

Hinged continuous labial bar:

A modification to the linguoplate is the hinged continuous


labial bar. This concept is incorporated in the swing-lock
design, which consists of a labial or buccal bar that is
connected to the major connector by a hinge on one end and a
latch on the other end. Support is provided by multiple rests on
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the remaining natural teeth. Stabilization and reciprocation are
provided by a linguoplate contacting the remaining teeth and
are supplemented by the labial bar with its retentive struts.
Retention is provided by a bar type of retentive clasp arms
projecting from the labial or buccal bar and contacting the
infrabulge areas on the labial surfaces 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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