DR VIKAS AGGARWAL

COMPONENTS OF REMOVABLE PARTIAL DENTURE

MAJOR CONNECTOR -the part of a partial

removable dental prosthesis that joins the components on one side of the arch to those on the opposite side (GPT 8TH )

 MINOR CONNECTOR the connecting link between

the major connector or base of a partial removable dental prosthesis and the other units of the prosthesis, such as the clasp assembly, indirect retainers, occlusal rests, or cingulum rests (GPT 8TH)

 DIRECT RETAINER- that component of a partial

removable dental prosthesis used to retain and prevent dislodgment, consisting of a clasp assembly or precision attachment (GPT 8TH)

 INDIRECT RETAINER- the component of a partial

removable dental prosthesis that assists the direct retainer(s) in preventing displacement of the distal extension denture base by functioning through lever action on the opposite side of the fulcrum line when the denture base moves away from the tissues in pure rotation around the fulcrum line (GPT 8TH)

 GUIDING PLANE- vertically parallel surfaces on abutment teeth or/and dental implant abutments oriented so as to contribute to the direction of the path of placement and removal of a removable dental prosthesis (GPT 8TH)

 6) REST- unit of a partial denture that is placed on an

abutment tooth , ideally in a prepared rest seat, so that it limits movement of denture in a gingival direction and transmits functional forces to the tooth. They are designated by the surface of the tooth prepared to receive them:
Occlusal rest- placed on the occlusal surface of a posterior tooth Lingual rest- placed on the lingual surface of an anterior tooth, Incisal rest- placed on the incisal edge of an anterior tooth.

 Denture base part of a denture (made of metal or resin)

that rests on a residual bone covered by soft tissue , to which teeth are attached and which effects the transfer of occlusal forces to supporting oral structures. Tooth replacements-refers to artificial teeth placed in denture. They can be acrylic, resin metal or porcelain

 Retention is that quality inherent in the removable partial denture that resists the vertical forces of dislodgement for e.g., the force of

gravity, the adhesiveness of foods or the forces associated with the opening of the jaws

A direct retainer is that component of a

removable partial denture used to retain and prevent dislodgement, consisting of a clasp assembly or precision attachment (GPT 8TH )

DIRECT RETAINER

EXTRACORONAL

INTRACORONAL

RETENTIVE CLASP ASSEMBLY

ATTACHMENTS

PRECISION ATTACHMENT

SEMIPRECISION ATTACHMENT

SUPRABULDGE

INFRABULDGE

EXTRACORONAL ATTACHMENTS
1900- introduced by Henry. R .Boos

1908- modified by F.Ewing.Roach

located outside the normal clinical

contours of abutment crowns derive their retention from closely fitting components termed matrices and patrices.

The male unit is soldered to the surface of the abutment crowns, forming a projection to which the female element, buried within the denture, can be joined. The male portion projects as an L shaped bar with a ball joint on the lower extremely The female section fits over the bar and engages the sides of the ball connection of the male. Advantages They provide excellent resistance to tooth distal and lateral displacing forces. Stress breaking effect. They require no buccal retainers or lingual bracing arms. esthetics They do not interfere with the contour of the abutment crown.

Dalbo attachment

Disadvantages Difficulty in maintaining plaque free environment

EXTRACORONAL DIRECT RETAINER/COMPONENTS Retentive clasp assembly

m/c method of extracoronal retention

first appeared in the dental literature with Dr W. G. A.

Bonwill's description in 1899 In 1916 Prothero advanced cone theory as the basis for clasp retention. He described the shape of crowns of premolar and molar teeth as that of two cones sharing a common base.

The line at which the two converging cones meet is called the height of contour, a term first used by Kennedy . De Van : SUPRABULGE and INFRABULGE Cummer called it GUIDELINE How clasp helps in retention?? If the clasp terminal is placed cervical to this line, it has to deform in order to escape from undercut area. In doing so, it generates resistance called retention.

Basic parts of a clasp assembly :

Rest : It is the part of the

clasp that lies on the occlusal, lingual or incisal surface of a tooth and resist tissue ward movement of the clasp.
Body of the clasp : It is

the part of the clasp that connects the rest and shoulder of the clasp to the minor connector.

Shoulder : It is the part of the clasp that connects the body to the clasp terminals. It must lie above the height of contour and provide some stabilization against horizontal displacement of the prosthesis. Reciprocal arm : A rigid clasp arm placed above the height of contour on the side of the tooth, opposing the retentive clasp arm.

Retentive arm : It is the part of the clasp comprising the shoulder which is not flexible and is located above the height of the contour. Retentive terminal : It is the terminal end of the retentive clasp arm. It is the only component of the removable partial denture that lies on the tooth surface cervical to the height of the contour. It possesses a certain degree of flexibility and offers the property of direct retention.

Extracoronal circumferential direct retainer

 Approach arm It is a component of the bar clasp. It is

a minor connector that projects from the framework, runs along the mucosa and turns to cross the gingival margin of the abutment tooth to approach the undercut from a gingival direction.

PRINCIPLES OF CLASP DESIGN

1) Encirclement basic principle ,more than 180 degree in the greatest

circumference of the tooth can be continuous contact, such as in a circumferential clasp, or discontinuous contact, such as in the use of a bar clasp. The clasp should make contact with three areas 1) occlusal rest and body area 2) the reciprocal terminal area 3) the retentive terminal area.

 2) The occlusal rest should be located in prepared recess on the occlusal surface so all forces are transmitted along the long axis of the abutment 3) Each retentive terminal should be opposed by a reciprocal component capable of resisting any pressure exerted by retentive arm during removal or insertion

4) Clasp retainers on abutment teeth adjacent to distal extension bases should be designed so that they will avoid direct transmission of tipping and rotational forces to the abutment

 5) Unless guiding planes will positively control the path of removal and stabilize

abutments against rotational movements, retentive clasps should be bilaterally opposed, i. e., buccal retention on one side of the arch should be opposed by buccal retention on the other, or lingual on one side opposed by lingual on the other

 6) To resist dislodgment path of escapement

for retentive clasp terminal must be other than parallel to the path of removal of prosthesis 7)The amount of retention should always be the minimum necessary to resist reasonable dislodging forces. 8) Reciprocal elements of the clasp assembly should be located at the junction of the gingival and middle thirds of the crowns of abutment teeth. The terminal end of the retentive arm is optimally placed in the gingival third of the crown. These locations permit better resistance to horizontal and torqueing forces.

All clasps must be designed so that they satisfy the following six basic requirements: 1.Retention 2.Support 3.Stability 4.Reciprocation 5.Encirclement 6.Passivity

1) RETENTION
Retention is provided mainly by the retentive arm but also by the effective

design and adequate construction of other parts The retention must be very definitely limited and minimal . The retention should be balanced the path of escapement of a retentive terminal must not be parallel to path of appliance removal

 Guiding planes control the path of

placement and removal; they can also provide additional retention for the partial denture by limiting the possibilities that exist for its dislodgment. The more vertical walls (guiding planes) that are prepared parallel, the fewer the possibilities that exist for dislodgment Therefore without guiding planes, clasp retention will either be detrimental or practically non-existent. If clasp retention is only frictional because of an active relationship of the clasp to the teeth, then orthodontic movement or damage to periodontal tissue, or both, will result. Instead a clasp should bear a passive relationship to the teeth except when a dislodging force is applied

Factors affecting retention

Size and the distance into the angle of cervical

convergence To be retentive a tooth must have an angle of convergence cervical to the height of contour. The location and depth of a tooth undercut available for retention are relative to the path of placement and removal of the partial denture. Greater the degree of gingival convergence, the greater will be the retention of the clasp, provided all other factors are equal

 When the angle of convergence

between two abutments differs uniformity of retention can be obtained by placing the clasp arms into the same degree of undercut (i.e. both .02"). A guiding principle of partial denture design is that retention should be uniform in magnitude and bilaterally opposed amongst abutments.
The tool used to identify the proper position for each clasp terminus is called an undercut gauge. Undercut gauges are available in 0.010-, 0.020-, and 0.030- inch configurations

Degree of undercut
When all other clasp factors remain constant, positioning the retentive clasp terminus at a greater horizontal undercut will result in increased retentive force. Therefore, a retentive clasp terminus positioned in a 0.020-inch horizontal undercut (B) will provide greater retentive force than will a clasp positioned in a 0.010-inch undercut (A).

FLEXIBILITY OF CLASP ARM

LENGHT OF CLASP ARM
Flexibility

LENGTH (POWER OF 3)

The retentive circumferential clasp arm

should be tapered uniformly from its point of origin through the full length of the clasp arm.
For the same length, the bar clasp arm is

less flexible than a circumferential clasp arm because of its half round cross section which lies in several planes and prevents total flexibility. In practice however, the gingivally approaching clasp is longer and more flexible, with less retentiveness than occlusally approaching clasp

DIAMETER OF CLASP ARM

FLEXIBILITY

1/(DIAMETER)3
The greater the average

diameter of a clasp arm the less flexible it will be. A clasp should be half as thick at the tip than at the origin.

CROSS-SECTIONAL FORM

Round form is used in distal extension cases where as half round is used in tooth supported partial dentures

 Material used for clasp arm : Two types of materials are

used : Type IV gold alloys and cobalt-chrome alloys which have different modulus of elasticity. The modulus of elasticity of cobalt-chrome alloys is greater than that of casting gold. Therefore a clasp of the same cross-section is stiffer in cobalt-chrome than in cast gold. This can be overcome by using longer clasps of thinner section. The retentive terminal has to be flexible and therefore have low modulus of elasticity. The reciprocal elements have to be stiff and unyielding and have high modulus of elasticity.

 Structure of the alloy: The alloy may be cast or wrought

in nature. Wrought wires have greater flexibility than a cast structure due to its grain structure being fibrous. The tensile strength of a wrought structure is at least 25% greater than that of the cast alloy from which it was made. Wrought forms can be used in smaller diameters to enhance the flexibility. They offer minimum friction and can have a stress breaking effect. Disadvantage of wrought alloy is recrystallization can lead to fracture

2.SUPPORT
Property that resist displacement of clasp in
gingival direction. Support in a clasp is generally provided by the rest. Thus while chewing food the rest prevents tissue ward movement of the clasp assembly, plus directs the force along the long axis of the tooth, thus reduces periodontal tissue damage. Secondary support is obtained by the rigid components i.e. body and shoulder of the clasp which are placed above the greatest diameter of the tooth.

3. STABILITY
Resistance to horizontal displacement of a prosthesis.
All clasp component except retentive terminal provide

stability Greatest contribution to the stability is offered by reciprocal element, shoulder and vertically oriented minor connector. The components of the cast circumferential clasp offer better stabilization than either the bar clasp or the wrought wire clasp, because of greater amount of rigidity of the clasp material.

4. RECIPROCATION
Reciprocation is the quality of clasp assembly

that counteracts lateral displacement of an abutment when the retentive clasp terminus passes over the height of contour. Ideally, reciprocal elements of the clasp assembly should be located at the junction of the gingival and middle thirds of the crowns of abutment teeth. The terminal end of the retentive arm is optimally placed in the gingival third of the crown. These locations will permit the abutment teeth to better resist horizontal and torqueing forces. Reciprocal arm is not tapered like retentive arm. It is tapered in one dimension(OG)

 During insertion of the prosthesis, the reciprocal element

should contact the abutment slightly before the retentive arm contacts the abutment. Contact of the reciprocal element should be maintained while the retentive terminus passes over the height of contour and into the prescribed undercut.

If the retentive terminus contacts the abutment before the reciprocal element contacts the abutment damaging non-axial forces may be applied to the abutment. For this reason, the abutment surface that will be contacted by the reciprocal element should be parallel to the removable partial denture's path of insertion and removal.

5.ENCIRCLEMENT
The clasp must be designed

to encircle more than 180 degrees. Encirclement may be: Continous contact (circumferential) Broken contact (bar) In bar, clasp contact at 3 diff. tooth areas: Occlusal rest, retentive terminal, reciprocal terminal

6. PASSIVITY
The retentive clasp arm should be passive (no active

force) until a dislodging force is applied. The retentive arm should be activated only when dislodging forces are applied to the removable partial denture

Classification of extra-coronal retainers:

1.Supra bulge clasps (occlusally approaching, circumferential or encircling clasps). The retentive arm approaches the undercut area from the suprabulge direction. 2.Infrabulge clasps (gingivally approaching, projection or bar clasps) The retentive arm approaches the undercut from the infrabulge direction ,e.g. Bar clasp arm (I-Bar etc.)

Circumferential Clasp
Introduced by Dr N. B. Nesbitt in 1916 Easiest to design and construct. Also it is easy to repair.

The most logical clasp to use with all tooth-supported partial

dentures because of its retentive and stabilizing ability

Design Rules for use Retentive clasp arm occlusal and Retentive terminal gingival to height of contour Terminal toward occlusal surface, never towards the gingiva. Retentive tip terminate at mesial and distal line angle and never in the centre of facial or lingual surface.

DISADVANTAGES: ADVANTAGES:
Good support ,bracing and retentive properties displays close adaptation to the
increased risk for

abutment and therefore

minimizes the entrapment of food and debris Easy to make and repair

decalcification covers large area width of occlusal table is increased More metal is visible

Types of circumferential clasps

Simple Circlet clasp. Reverse approach circlet. Multiple circlet Embrasure clasp

Ring clasp.
Back action clasp. Reverse action / hair pin clasp.

Half-and-half clasp.
Combination clasp. Onlay clasp. Extended clasp

Simple Circlet clasp

Most widely used least complex in design Clasp of choice for tooth supported RPD Approaches the undercut on abutment from the edentulous area. Engage the undercut remote from edentulous space

Advantages Easy to construct, repair. It provides better support, stability, reciprocity, encirclement, and passivity

Disadvantages Because of half round crosssection geometry adjustment of clasp arm is difficult. increase the occlusal table Increased calcification and compromised esthetics Cannot be used in distal extension cases

Reverse-action clasp
Features Retentive undercut adjacent to edentulous space. m/c DB under undercut Used when bar clasp cannot be used due to soft/hard tissue undercut

Advantages In distal extension partial dentures, as denture base is depressed under function, retentive clasp tip rotate gingivally to enter greater amount of undercut and reduce torsional stresses transmitted to abutment.

Disadvantages As the shoulder of the clasp extends over the abutments mesial marginal ridge, it may be difficult to provide adequate clearance without removing significant tooth structure The gingival mucosa may not be well protected because of the mesial occlusal rest resulting in food traps between proximal plate and surface of abutment. It may be esthetically compromised as it has a mesial approach.

Multiple circlet clasp.

Features The multiple clasp is simply two opposing circumferential clasps joined at the terminal end of the two reciprocal arms. Upon emerging through occlusal embrasure retentive arm engages opposite line angle . Indication: When additional retention is needed. Tooth borne partial denture Multiple clasping required, when the partial denture replaces an entire half of the dental arch. Used in the form of splinting tooth.

Disadvantage Two embrasure approaches are necessary rather than a single common embrasure for both clasps

Embrasure clasp/ modified crib clasps/ Bonwill clasp

Features Two simple circlet clasp joined at the body. Used on the side where no edentulous space Occlusal rest preparation on both teeth. Upon emerging through occlusal embrasure retentive arm engages opposite line angle Advantages The double occlusal rests prevent interproximal wedging by the prosthesis, which could cause separation of the abutment tooth and result in food impaction and clasp displacement. In addition to providing support, occlusal rests also serve to shunt food away from the contact area.

Disadvantages Sufficient space must be provided between the abutment teeth in their occlusal third to make room for the common body of the clasp. This involves more of tooth reduction, which increases caries susceptibility, and risk of encroachment of the pulp.

Ring clasp
Features It is that form of a circumferential clasp that encircles nearly the entire tooth from its point of origin. It is usually used when a proximal undercut cannot be approached by any other means Mandibular molars tend to drift mesiolingually and maxillary molars mesiobuccally Retentive undercut on mesiolingual line angle of mandibular molar and mesiobuccal line angle of maxillary molars The undercut is on the same side as the rest seat (i.e. adjacent to edentulous span) The lower bracing arm should be at least 1 mm from the free gingival margin and relieved to prevent impingement of the gingival tissues

Should always be used with a supporting strut on the nonretentive side with an auxiliary occlusal rest on the opposite side Omission of the supporting strut will allow the clasp arm to open and close with minimum or no reciprocation.

Advantages Provides adequate encirclement of more than 180 degrees. excellent retention with adequate flexibility due to increased length of clasp arm. restores the occlusal surface by its anatomy and thereby uprights the tooth decreasing unfavourable stress to the abutment. provides vertical support and prevents tissueward movement. The auxiliary distal rest prevent further mesial drift of the tooth.

Indication It is used mainly when the proximal undercut cannot be approached directly from the occlusal rest area, and / or tissue undercuts prevent a gingival approach of the clasp

Disadvantages: a. Covers a large area requiring meticulous hygiene b. Very difficult to adjust

Contra indication Limited vestibular depth contraindicated when the bracing arm must cross the soft tissue undercut.

Back action clasp

This clasp is a modification of the ring clasp with no apparent advantages. It lacks a guide plane and the occlusal rest does not have a rigid support. Here minor connector is connected to end of clasp arm and occlusal rest is left unsupported. Hence it is a biologically and mechanically unsound design.

FISH HOOK/HAIRPIN/ C CLASP

FEATURES Simple circlet clasp with retentive arm after crossing the facial surface, loops back in a hairpin to engage the undercut below its point of origin. Upper part is rigid considered as minor connector and lower part is flexible. Crown must have sufficient occlusogingival height. The bend that connects the upper and lower parts of the arm should be rounded to prevent strain accumulation and fracture of the arm at the bend

Indication:

Distal extension partial denture. Mesially inclined posterior teeth. If proximal undercut must be used on a posterior abutment and when the tissue undercut, tilted teeth or high tissue attachment prevent the use of bar clasp arm ( although ring clasp can be placed but lingual undercut may prevent the placement of supporting strut without tongue interference Indicated when reverse circlet clasp cannot used because of lack of occ. space

Contra Indication:

Tight occlusal contact, increase

posterior overbite and short crown. The clasp covers considerable tooth surface and may trap debris.. It has limited flexibility and is unesthetic for use on an anterior

abutment
Disadvantages Inadequate flexibility Difficult to fabricate Accumulation of food and debris Esthetically unacceptable

Half and half clasp

It consists of a circumferential retentive

arm arising from one direction and a reciprocal arm arising from another. The second arm must arise from a second minor connector, this arm is used with or without an auxiliary occlusal rest. Reciprocation is achieved with a short bar or with an auxiliary occlusal rest. The principle of half and-half clasp is used only for unilateral partial denture design.

ONLAY CLASP
Is extended occlusal rest with buccal

and lingual clasp arm. The clasp may originate from any point on the onlay that will not create occlusal interferences. Therefore, this type of clasp is used when the occlusal surface of the abutment tooth is below the occlusal plane. The onlay can be used to restore the lost vertical dimension. Indicated in caries resistant mouth

Extended clasp arm

Features similar to the circumferential arm but it covers two teeth. It remains above the survey line of the 1st tooth; crosses the undercut of the adjacent tooth..
Advantages: It has splinting and stabilization action. Distribution of lateral loads over two teeth. Disadvantages: More tooth structure covered, easily distorts and breakage of the arm.

Indications: Tooth supported RPD. tooth next to edentulous space that has no buccal and lingual undercut.

Contra Indication: Distal extension dentures because functional forces will cause rotation around the rest and upward movement of clasp tip.

COMBINATION CLASP
In 1965, Dr O. C. Applegate introduced a modified wrought-

wire clasp assembly known as the "combination clasp The combination clasp consists of a wrought-wire retentive clasp arm and a cast reciprocal clasp arm. . Indicated on abutment adj. to distal extension space, when the undercut is on mesiobuccal surface.

 The wrought-wire component is circular in cross section, thereby permitting flexure in all directions. This omnidirectional flexure allows the clasp to flex in all planes and can minimize the transfer of potentially harmful forces to the abutment

b) In addition to advantages of flexibility, adjustability, and appearance, wrought-wire retentive arm makes only line contact with abutment tooth, rather than broader contact of cast clasp

Uses Kennedy Class I or Class II posterior edentulous area when the usable undercut is located at the mesiofacial line angle of the most posterior abutment It is used on abutment tooth adjacent to a distal extension base where where a large tissue undercut contraindicates a bar type retainer.

ADVANTAGES
Not only the flexibility is maximal, but it is effective

in any direction.Greater flexibility of wrought wire act as stress equalizer, prevent undesirable forces. Can be placed in deeper undercut or in gingival third of clinical crown so more esthetic appearance. So often used on maxillary canines and premolars. Round wrought wire makes only a line contact, can be used in caries prone mouth. readily adjustable to more retentive position. better esthetics (due to its round form and smaller diameter - 18 gauge) can be placed in 0.02" undercut due to its flexibility (allows lower placement for better esthetics)

Disadvantages
More prone to breakage or damage. Need extra lab procedures

Easily distorted by careless handling by patient during

removal, who tend to remove it by lifting retentive portion of wrought wire clasp. Retentive arm not possess bracing or stabilizing quality due to its increased flexibility.

 There are four laboratory approaches to construct wrought wire clasp arm (JPD 1973) 1. Cast to. 2. Soldered to the minor connector. 3. Soldered to the base retentive mesh area. 4. Attached only in the resin of the denture base. This is most commonly used in the repair of broken clasp components. Wire components which have been incorporated into the casting are 42 per cent less flexible than wire components soldered to the base retentive mesh or unsoldered and buried in resin.

Clasp that allow functional movement

Clasp assemblies that accommodate functional prosthesis movement are designed to address the concern of a Class I lever. The concern is that the distal extension acts as a long "effort arm" across the distal rest "fulcrum" to cause the clasp tip "resistance arm" to engage the tooth undercut. This results in a harmful tipping or torquing of the tooth and is greater with stiff clasps and more denture base movement. Two strategies are adopted to either change the fulcrum location and subsequently the "resistance arm" engaging effect (mesial rest concept clasp assemblies), or to minimize the effect of the lever by use of a flexible arm (wrought-wire retentive arm)

Gingivally approaching clasps/infra bulge/push clasp/roach clasp

Clasp is termed by Dr. F. Ewing

Roach in 1930 Approaches the retentive undercut from a gingival direction. Push type of retention, which is better than pull type retention of roach clasp. The bar clasp is classified by shape of the retentive terminal T, modified T, I, Y forms, all of which originate from the denture base frame work and approaches the undercut from gingival direction It is easier to seat but difficut to remove

Advantages
Minimal tooth contact and minimal distortion of

normal tooth contours leading to improved tissue stimulation, oral hygiene, caries and periodontal problems. Improved esthetics if the approach portion of the arm is not visible as it crosses the gingiva. Increased retention because of tripping action. Decreased torqueing forces applied to terminal abutments in distal extension RPD. Large undercut can be engaged.

Disadvantages
Cannot be used in the presence of soft tissue

undercuts, shallow vestibule and high frenum attachments. Bracing action provided by bar clasp is considerable less than that provided by cast circumferential clasps. Food entrapment. Difficult to fabricate and adjust.

a) b) c)

horizontal projection portion of the approach arm (A), vertical projection aspect of the approach arm (B), location where the approach arm crosses perpendicular to the free gingival margin (C), point of first tooth contact at or occlusal to the height of abutment contour (D), terminus of the retentive clasp contacting the abutment apical to the height of contour(E), encirclement portion of the clasp contacting the abutment occlusal to the height of contour (F).

d)

e)

f)

Design rules
The approach arm must not impinge on the soft tissues adjacent to

the abutment The approach arm should cross perpendicular to the free gingival margin. The approach arm should never be designed to "bridge" an area of soft tissue undercut since this will produce an increased risk of food entrapment and may result in irritation of the soft tissue To optimize flexibility, the approach arm should be uniformly tapered from its origin to the clasp terminus. The clasp terminus should be positioned a far apically on the abutment as is practical. Proper placement of the clasp terminus yields a decrease in leverage-induced stresses resulting from movement of the prosthesis. The minor connector that attaches the occlusal rest to the framework should be rigid and should contribute to the overall bracing and stabilization characteristics of the prosthesis.

Approach arm must not bridge area of soft issue undercut can lead to food entrapment and soft tissue irritation

Upon loading of the extension base, the distal rest serves as a centre of rotation. The tip of the retentive clasp moves apically and mesially. This minimizes potentially harmful torqueing forces while transmitting a relatively small, mesially directed force to the abutment. The mesially directed force is well tolerated as a result of sound contact with the adjacent natural tooth.

Types of bar clasps

T- bar Modified T-bar Y- bar I- bar

T CLASP
Retentive terminal and its

opposing encircling finger project laterally from the approach to form T. Both projections should point toward the occlusal surface. The retentive terminal must cross under the height of contour to engage the retentive undercut. Used in distal extension base situations, on distobuccal undercut. Dont use it on mesiobuccal undercut.

 It shouldnot be used if approach arm bridge a soft

tissue undercut. If T clasp used on tooth where height of contour is close to occlusal surface then a large surface is covered b/w approach arm and tooth leads to food accumulation.

MODIFIED T CLASP
it is a T clasp with non

retentive finger of the crossbar of T terminal is omitted. It is used on canines and premolars for esthetic reasons. Potential danger the encirclement of 180 degrees is sacrificed for esthetics. .

Y CLASP
Basically it has T- bar

configuration , used when height of contour on the facial surface of the abutment tooth is high on the mesial and distal line angles but low at the center of the facial surface

I CLASP/ 1 BAR

Derives its name from its shape The clasp arm contacts the abutment surface over an area that extends from the measured undercut to the height of contour Typically, the contact area between the clasp and the abutment is 2.0 to 3.0 mm in height and 1.5 to 2.0 mm in width. The approach arm has a half round, cross-sectional geometry and is characterized by a gradual and uniform taper throughout its length.

 Often, the I-clasp design is used in conjunction with a

mesial rest preserving the abutment from torqueing forces This design is commonly used in the treatment of Kennedy Class I and Class II partially edentulous arches it may occasionally be used on the distobuccal surface of maxillary canines for esthetic reasons. Disadvantage: Encirclement horizontal stabilization may be compromised.

 I-clasp Is An Integral Retentive Component In Two

Distinct Design Philosophies: The Mesial Rest/I-bar Concept And The RPI Concept.

I BAR CONCEPT
It is modified type roach clasp designed by Kratochvil in 1963, which consisted of three separate units connected to each other only through the framework. They were the mesial occlusal rest, a distal guide plate and an I-bar retainer.

DESIGN
Mesial rest The mesioocclusal rest with the minor

connector is placed into the mesiolingual embrasure, but not contacting the adjacent tooth. Rest are extensively prepared as in premolars it involves marginal and triangular ridges where as in molar it extends into central fossa. Due to this occlusal forces are directed vertically thus eliminating harmful lateral stresses. It shifts the fulcrum line more anteriorly

 Proximal plates A distal guiding plane is prepared to receive a proximal plate. Usually guiding plane is 2-5 mm but in this case it is very long as it extends onto attached gingiva for 2 mm The buccolingual width of the guiding plane is determined by the proximal contour of the tooth. The proximal plate in conjunction with the mesial occlusal rest and minor connector provides the stabilizing and reciprocal aspects of the clasp assembly. This configuration permits improved stabilization of the prosthesis Long guide plane provides increased horizontal stability reduces food impaction between the tooth and the proximal plate Provides reciprocation during insertion and removal of the prosthesis Distributes occlusal forces throughout the arch

I bar retainer Arm of I bar is long tapering with half round cross section Retentive I bar is placed on buccal surface of abutment mesial to mesio distal height of contour The I bar should extend about 2 mm above tooth tissue junction Reciprocation here is mesiodistally

Advantages 1. Food accumulation is minimized because tooth contours are not significantly altered. 2. The clasp terminus disengages from the tooth when an occlusal load is applied to the adjacent distal extension base. 3. Because the approach arm does not contact the abutment, lateral forces are minimized. Disadvantages 1. Less horizontal stability than other types of clasp assemblies 2. Less retention

RPI CONCEPT
RPI concept was given by KROLL 1973

RPI means mesial rest, proximal plate and I bar.

The principle was stress control with minimal

tooth and gingival coverage. Normally retentive and reciprocal units act bucco-lingually but here they act in mesio-distal direction. He modified I bar clasp concept to meet minimal coverage criteria

 Mesial rest modification

Mesial rest extends only in triangular fossa even in molar preparation. It doesnt cover entire marginal ridge. Proximal plate modification The prepared guiding plane is 2 to 3 mm high

occlusogingivally, and the proximal plate contacts only the apical 1 mm of the guiding plane. Relief is provided at the tooth-tissue junction to allow the proximal plate to disengage when loaded. The stated purpose for reducing the proximal plate is to improve gingival health I bar modification Modifications in 1-bar configuration and placement are needed to compensate for reduced tooth contact by the proximal plate. The 1-bar terminus is pod shaped to allow additional tooth contact, and the vertical portion of the clasp arm assumes a more mesial position to achieve efficient reciprocation from the smaller proximal plate.

RPI CONCEPT

ADVANTAGES
More esthetic due to minimal tooth contact

Good for caries prone patients

Adequate encirclement by engaging more than

180 degree. Encirclement provided by mesial rest and proximal plate Under vertical masticatory forces, both the plate and I bar disengage the abutment.

Relative merits and demerits of occlusally and gingivally approaching clasps

Retention-The bar clasp is easier to seat on the tooth

and more difficult to remove than the circumferential clasp. If all factors i.e. length of clasp arm, depth of undercut, flexibility of the arm etc are equal, the bar clasp is more retentive than the circumferential clasp due to tripping action. In practice however, the gingivally approaching clasp is longer and more flexible, with less retentiveness than occlusally approaching clasp

 2) Bracing: The circumferential clasp is rigid in the

upper two-thirds of the retentive arm and offers some bracing or stabilization against lateral stresses. On the other hand, the bar clasp is flexible throughout its length and does not contribute to stability. 3) Stress breaking effect: The gingivally approaching clasp allows a certain degree of functional movement of the distal extension base which helps to dissipate the stresses and lessen the load on the abutment. Occlusally approaching clasps have the potential to torque abutment teeth in distal extension based partial denture situations.

 4) Tooth contact:

The gingivally approaching clasp contacts minimum tooth structure and

has a minimum interference with natural tooth contour permitting maximum natural cleansing action, whereas the occlusally approaching clasps covers more of tooth structure. This occlusal approach may increase the width of the occlusal table. 5) Oral health: The gingivally approaching clasp has a likely potential to create gingival pathology. The area of food stagnation is at the neck of the tooth and the cementum in this area is more likely to be affected by caries than enamel. Trauma to the gingiva can also occur with bar claps unless sufficiently relieved. Mishandling of the clasps by the patients during removal of the prosthesis can result in deformation of the clasp and damage to soft tissues. Decalcification of tooth is more in occlusally approaching clasp due to more tooth contact. 6) Esthetics: Gingivally approaching clasps are more esthetic than occlusally approaching clasps except in instances where large amounts of gingivae are visible on smiling.

RPA CLASP
The rest, proximal plate, Akers clasp was developed and described by Eliason in 1983. It consists of a mesial occlusal rest, proximal plate and a circumferential clasp arm, which arises from the superior portion of the proximal plate and extends around the tooth to engage the mesial undercut. It is indicated when bar-type clasp is contraindicated and desirable undercut is located in gingival third of tooth away from extension base area

RPL CLASP

Ben-Ur in 1988 described the rationale for using an L shaped bar clasp direct retainer for distal extension removable partial dentures. The L shaped bar crosses the gingival margin of the abutment tooth in the shortest possible line, ascends to the survey line, and engages the distobuccal undercut.

VRHR CLASP
developed by Grasso in 1980 A distal occlusal rest supported by a minor connector. A lingual vertical reciprocal component originating from the major connector. A horizontal retentive arm attached to either the major connector or the retention latticework for the denture base.
Advantages Minimum tooth contact No guide planes preparation required Used in high survey lines Esthetically acceptable

Cingulum clasp

Miller in 1972 designed a clasp to satisfy both the mechanical and esthetic requirements without the shortcomings of the internal attachment.

The cingulum clasp has 2 lingual clasp arms. The use of this clasp requires that the lingual surface of the abutment tooth be covered with a gold casting.

A guiding plane is incorporated into the distal surface of the crown and the clasp is designed as an integral part of the rigid metal framework.

Advantages Esthetic A tooth of short clinical crown can be used. The young pulp is not imperiled by close proximity to metal which shows thermal conduction. Less expensive.
Disadvantages The clasp arms are vulnerable to breakage.

Use The cingulum clasp can be used as a retainer on cuspid teeth when other extracoronal retainers are esthetically unacceptable

Choice of clasp
It depends upon 1. Position of tooth undercuts, restorations, occlusion, classification of edentulous arch, tooth type 2. Nature of the bony and soft tissue support. Is there an unfavourable: a) bony undercut b) frenal attachment c) vestibular depth 3. Esthetics

Kennedy I & II (Tooth & Tissue Borne)

Tooth supported partial

dentures Clasp of choice: cast circumferential if abutment is severely tilted use (depending on location of undercut): Cast circumferential clasp with lingual retention Ring clasp with support strut

For posterior abutments, or any tooth needing stress release:

Clasp of choice: RPI (mesial rest, distal proximal plate and I-bar) If cant use an I-bar in vestibule, because of frenum shallow vestibule deep soft tissue undercut then use an RPA retainer (mesial rest, distal proximal plate and wrought wire clasp) If cant use a mesial rest because of: rotation heavy centric contact on mesial large amalgam restoration on mesial then use Combination Clasp

INTRACORONAL RETAINERS AND ATTACHMENTS

The first intracoronal direct retainer was introduced by Herman E. S.

Chayes in 1906. As its name implies, an intracoronal direct retainer resides within the normal contours of an abutment and functions to retain and stabilize a removable partial denture The Glossary of Prosthodontic Terms defines a precision attachment as a retainer consisting of a metal receptacle (matrix) and a closely fitting part (patrix); the matrix is usually contained within the 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. The receptacle is also known as female/ keyway. The closely fitting part is also known as male/key.

 Intracoronal direct retainers may be subdivided into

two categories based on their method of fabrication and the tolerance of fit between components A) PRECISION ATTACHMENTS B SEMIPRECISION ATTACHMENTS Frequently used synonyms of precision attachments are internal attachment, frictional attachment, slotted attachment and parallel attachment

MECHANISM OF ACTION
When the removable partial denture is placed in the patient's mouth, the two

components interlock in a sliding joint configuration. This sliding joint resides within the normal clinical contours of an abutment and functions to retain, support, and stabilize the removable partial denture. Parallelism of multiple attachments must be carefully considered when designing a removable partial denture. The paths of engagement for the attachments ie, the long axes of the attachments must be parallel to each other and parallel to path of insertion. When parallelism is achieved, friction and binding between components occurs as forces act to dislodge the prosthesis.

ADVANTAGES
Elimination of a visible retentive component thereby contributing to

esthetics. Better vertical support through a rest seat located more favourably in relation to the horizontal axis of the abutment tooth. Compared to conventional occlusal rests, the apical extension of an intracoronal attachment reduces non-axial loading and diminishes rotational movement of the abutment It provides horizontal rest and prevents lateral stresses to the periodontium of the abutment teeth when inserting or removing the prosthesis. Cross arch stabilization is improved Broad stress distribution Applies broken stress philosophy thus reduces damaging forces applied to abutment

DISADVANTAGES
The teeth have to be extensively prepared to provide the required space

for the key resulting in encroachment and danger to the health of the pulp tissues and a need for prepared abutments and castings. Adequate crown length is required to generate the required frictional resistance. They require complicated clinical and laboratory procedures. They eventually wear with progressive loss of frictional resistance to denture removal. Difficulty in maintaining hygiene beneath the attachment. They are difficult to repair and replace. They are expensive. It requires the services of a skilled technician. This form of treatment is not justified in a poorly motivated and disinterested patient.

INDICATIONS

CONTRAINDICATIONS
Distal extension base partial

Tooth supported partial

denture when adequate abutments are available. In the anterior teeth where the display of a clasp arm would be esthetically objectionable. When splinting is required of the remaining abutment teeth

denture, because distal extension shows horizontal movement due to resilient supporting soft tissue. Since they dont provide horizontal movement, deleterious stresses are transferred to abutment. They can be used if stress breakers are used. Short clinical crowns minimum height of 4- 6mm is necessary

Preisikel 1979 has classified precision attachments into 1. Internal attachments ( Chayes attachment, McCollum attachment, Crismani 699) 2. External attachments ( Dalbo attachment) 3. Stud (Dalla Bona, Gerber )

Gerardo Becerra et al in 1987 classified precision attachments as :jpd 1987 58 322-327 1) Intra coronal attachments a. Frictional - tapered and parallel walled boxes and tubes - adjustable metal plates - springs - studs - locks b. Magnets

2)

Extra coronal attachments a. Cantilever attachments

- rigid attachments
- movable attachments b. Bar attachments

Tapered And Parallel Walled Boxes And Tubes

Designed to be used in FPD. Plastic pre fabricated patterns.

Provides vertical support and lateral stabilization.

Simple pin and tube or rectangular block and boxes.

E.g. : Mc Collum attachments.

McCOLLUM ATTACHMENTS

Adjustable Metal Plates

Similar to block and box variety . Provided with a narrow slit in the metal block or male

portion of the attachment to increase the friction. Provides a simple and effective form of direct retention. Atleast 2.5 mm of tooth height is required. E.g.: Crismani attachment. Mc Collum attachment. Stern attachment Chayes or Rley attachment.

 CHAYES ATTACHMENT

CRISMANI ATTACHMENT

Springs

Incorporated in the male part to control the friction. Approximately 4 5 mm of vertical height is required. E.g.: Schatzmann attachment.

SCHATZMANN ATTACHMENT

Studs

A metallic stud can be soldered to post and core and

cemented into an abutment.

Direct retention can be obtained by using a stud

which clips into an flexible ring.

Sufficient clearance is required to arrange the artificial teeth.

E.g.: Ceka attachment Rotherman attachment

Ceka attachment

Locks

These lock rigidly into the attachments . The vertical height required for this attachment is atleast 6 mm.

Retained with pins or incorporated in post and core .

E.g.: T - block attachment

Magnets
Small metal keeper is attached to the

tooth surface, usually into the root canal and magnet is incorporated into the resin.
Alloy in the magnet produces a

magnetic force that is strong .

Magnets are brittle and corrode unless

protected in a stainless steel shelf.

Cantilever attachments Rigid attachments

They are pin and tube joints that use a slit in the

pin or multiple pin tubes and slots to enhance

retentive friction between the parts with the natural teeth on the either side of the edentulous space. These attachments offer excellent stability and

retention in tooth supported partial dentures.

e.g.: Scott attachment Thompson dowel rest system.

 Movable attachments. These allow the prosthesis to rotate around a horizontal axis and transmit occlusal forces to the residual alveolar ridge . E.g.: Dolbo attachments

Bar attachments

These can be connected to the cast metal crowns or copings . Custom made bars can be cast with a flat upper surface to support the prosthesis and parallel sides that help to stabilize it. E.g.: Dolder bar.

Esthetic metal free clasps 1) Natural Flex clasps:

Based on acetyl resin technology
high elastic memory and remarkable dimensional stability biocompatible, non-allergenic and monomer-free 20 times harder than acrylic

Opti-flex clasps:
Is a acetyl resin homopolymer.

Properties:
20 times stronger than acrylic
High density, hardness,tensile strength compared to

other homopolymers Better wear strength Resistance to staining & water sorption.

Proflex clear wire clasp:

Valplast
Valplast is a flexible denture base resin that is ideal for

partial dentures and unilateral restorations. The resin is a biocompatible nylon thermoplastic .

Cu-Sil
Cu-Sil is a patented tissue-bearing appliance

featuring a soft elastomeric gasket which clasps the neck of each natural tooth, sealing out food and fluids, cushioning and splinting each natural tooth from the hard denture base.

Thank you