Direct Retainers
Direct Retainers
GUIDED BY PRESENTED BY
DR.C.RADHA B.PAVANI 1
CONTENTS
• INTRODUCTION
• CLASSIFICATION
• DEFINITIONS
• INTRACORONAL RETAINERS
• EXTRACOONAL RETAINERS
• BASIC PRINCIPLES OF ASSEMBLY
• COMPONENTS OF CLASP ASSEMBLY
• BASIC PRINCIPLES OF CLASP DESIGN
• CRITERIA FOR CLASP SELECTION
• TYPES OF CLASP ASSEMBLY
• OTHER TYPES OF CLASP ASSEMBLY
• OCCLUSALLY AND GINGIVALLY APPROACHING CLASPS: RELATIVE MERITS AND
DEMERITS
• REFERENCES
2
INTRA ORAL FORCES DIRECTING
ON PROSTHESIS
Direction of forces
Towards the tissue Across the tissue Away from the tissue
3
Towards the tissue Resulted from forces of occlusion of
Masticatory forces
Across the tissue
6
Primary retention of the denture Resistance to dislodging forces
7
CLASSIFICATION
DIRECT RETAINERS
EXTRACORONAL
INTRACORONAL
ATTACHMENTS
PRECISION SEMI PRECISION RETENTIVE
ATTACHMENT ATTACHMENT CLASP
ASSEMBLIES
SUPRABULGE INFRABULGE
8
INTRA-CORONAL RETAINERS
These provide retention through components placed inside the
(within ) normal contour of the abutment tooth
9
IINTRACORONAL DIRECT RETAINER COMPONENTS
MATRIX PATRIX
10
PRECISION ATTACHMENT SEMI PRECISION ATTACHMENT
The attachment that is Attachment that is fabricated by
fabricated from milled alloys direct casting of plastic, wax,
or refractory patterns
11
IINTRACORONAL DIRECT RETAINER COMPONENTS
MATRIX PATRIX
12
SEMI PRECISION ATTACHMENT
13
INDICATIONS LIMITATIONS
•To provide movable joint in 1. Large pulp size which is
Removable Bridgework, fixed usually related to the age of
removable bridges. patient.
• To stabilize unilateral saddles. 2. Length of the clinical
• Pier abutments. crown, not used in short or
•Titled molars. F.P.D's in abraded teeth.(6mm crown)
severely misaligned abutments. 3. Expensive
•Use in Over dentures (different 4. Distal extension denture
forms of retainer are bar, bases
telescopic, use of auxillary
attachments).
• Fixed removable implant
restorations. 14
ADVANTAGES
1. Esthetically acceptable.
2. It is preferred in many of the situation because of its vertical
3. intermittent vertical massage.
4. It permits proper tooth form.
5. It provides for excellent retention
15
CLASSIFICATION
Classification by Good Kind and Baker in 1976 :
1)Intra coronal
a. resilient
b. non resilient
2)Intracoronal retainers
Frictional resistance.
Tapered and parallel-walled boxed and tubes.
Adjustable metal plates.
Springs.
Studs.
Locks.
Magnetic resistance.
16
MATERIAL OF CHOICE
•Pt, Iridoplatinum, Gold and Pt, Gold and Pd.
•Type III and IV type of gold is to be used for crown castings.
• Base metal alloys are also used now a days as low cost
17
PRECISION ATTACHMENT SELECTION
18
Int J Prosthodont. 1990 Mar-Apr;3(2):169-74
•Another philosophy, known as the stable base precision attachment
RPD concept or floating denture base concept recommends
incorporation of rigid internal attachments and a cast metal base
made from mucostatic impression of the residual ridge.
•The male portion of the attachment is connected to the denture base
, allowing the complete seating within the abutment.
19
2. Kennedy’s class III partially 3. Kennedy’s class IV partially
edentulous arch edentulous arch
20
ADVANTAGES
DISADVANTAGES
22
EXTRA-CORONAL DIRECT RETAINERS
23
EXTRA CORONAL ATTACHMENTS
24
BASIC PRINCIPLES OF CLASP ASSEMBLY
25
PRINCIPLE OF ENCIRCLEMENT
26
All the clasp designs should engage the abutment tooth for more than 180 degrees
along the long axis of the tooth
27
OTHER BASIC PRINCIPLES
Rest
28
29
The clasp retainers on the abutment teeth that are adjacent to the distal extension bases
should be designed so that they do not transmit the direction of tipping or rotational
forces on the abutment teeth
Clasp assembly on
The last abutment
(a)bilaterally buccal or
(b) bilaterally lingual.
32
The amount of retentive force applied by clasp should be necessary enough
to resist dislodging forces
Retentive forces
• HEIGHT OF CONTOUR???
34
PROTHEROS CONE THEORY
35
Devan [1955] referred to the surface
occlusal to the height of contour as
suprabulge,
& the surface inclining cervically as
infrabulge.
36
M.M DEVAN introduced the terms Suprabulge and Infrabulge. These terms
explain the coronal form, clasp form and clasp placement. According to him :
37
As an extension of DeVan’s concepts, professionals have defined two basic
categories of retentive clasp assemblies:
38
39
40
41
COMPONENTS OF CLASP ASSEMBLY
RETENTIVE ARM
RECIPROCAL ARM
REST
42
REST
43
SHOULDER
44
RECIPROCAL ARM RETENTIVE ARM
45
RETENTIVE
RETENTIVEARM
ARM
A RETENTIVE ARM IS THE ONLY PORTION OF A REMOVABLE PARTIAL DENTURE
THAT CONTACTS THE SURFACE OF AN ABUTMENT APICAL TO THE HEIGHT OF
CONTOUR AND PROVIDES RETENTION
46
Basic Principles of clasp design
47
Retention
“Retention is the inherent quality of the clasp assembly that resists forces
acting to dislodge components away from the tooth structure.”
The amount of retention designed into a removable partial denture
should always be the minimum necessary to resist reasonable
dislodging forces
48
AMOUNT OF RETENTION
Tooth factors
Size of angle of convergence
How far clasp is placed in angle of convergence
Prosthetic factors
Clasp length
Clasp diameter
Clasp cross sectional form
Material used for making clasp
49
ANGLE OF CO
NVERGENCE
50
PROSTHESIS FACTORS:-
51
DIAMETER OF THE CLASP:
The greater the diameter of a clasp arm the less flexible it will be.(only in
uniform taper)
If its taper is absolutely uniform ,the avg diameter will be at a point midway
between its origin & its terminal end.
But if taper is not uniform a point of flexure –therefore a point of weakness
will exist.
52
Cross-sectional form:
The only universally flexible form is the round form.
Clasp arm should only flex away from tooth so half round is used.
Round shaped clasp arm used only in distal extension denture bases
so that it can flex in all directions during functional movement and
minimize stresses.
53
Material used for construction:
Chrome alloys have a higher modulus of elasticity & therefore less flexibility.
So in less undercut areas CoCr alloy can be used but in cases of deep
undercut wrought metal can be used.
54
RELATIVE UNIFORMITY OF RETENTION:
1.Retention on all principal abutments should be as
equal as possible.
2. Retentive clasp arms should be located so that
they lie in the same approx.. Degree of undercut
on each abutment tooth.
3. Retentive clasp positioning should also be same
on the contralateral side of arch.(atleast for one
teeth)
55
Support
“Support is the quality of a clasp assembly that resists displacement of a
prosthesis in an apical direction.”
57
Reciprocation
58
Points to be remembered while providing reciprocation
59
Encirclement.
60
Passivity.
61
CRITERIA FOR CLASP SELECTION
Survey line
Requirements of retention and stability depending on the number,
configuration of edentulous areas.
Nature of support
Root size and form
Esthetics
Presence of excessive tissue undercut
Oral hygiene and patient awareness
63
CLASP DESIGNED TO ACCOMMODATE
FUNTIONAL MOVEMENT
RPI,RPA,BAR CLASP
64
65
THREE DIFFERENT APPROACHES TO RPI CLASP
These approaches are based on the location of proximal plate ,location of
the I bar
66
67
This design had certain basic disadvantages:
Physiologic relief was required to prevent impingement of gingival tissues
during function.
Since the proximal plate covers a greater surface area of the tooth, the
functional forces are directed in the horizontal direction, thus the tooth is
located more than the edentulous ridge.
68
Krol in 1973 made certain modifications in the design under the “MINIMAL
COVERAGE CRITERIA”
Rest preparations are less extensive in the RPI system.
Rests extend only into the triangular fossa, even in molar preparations, and
canine rest
2-3mm guide plane in which only 1mm contact was seen from the guide plate.
71
Design rules…
1. The approach arm of an infrabulge clasp must not impinge on the soft
tissues adjacent to the abutment.
2. The approach arm should cross perpendicular to the free gingival margin. It
shouldn’t impinge the underlying gingiva.
3. Shouldn’t be used in area of tissue undercut.
4. Uniform length and adequate taper should be given for sufficient flexibility.
5. The clasp terminus tip should be placed as apical as possible on the
abutment teeth.
72
T clasp
73
Design rules…
1. The approach arm of an infrabulge clasp must not impinge on the soft
tissues adjacent to the abutment.
2. The approach arm should cross perpendicular to the free gingival margin. It
shouldn’t impinge the underlying gingiva.
3. Shouldn’t be used in area of tissue undercut.
4. Uniform length and adequate taper should be given for sufficient flexibility.
5. The clasp terminus tip should be placed as apical as possible on the
abutment teeth.
74
In modified t clasp the non retentive arm is absent.
Y clasp is similar to t clasp with the approach arm ending cervical to the
retentive arm.
I clasp lack the horizontal retentive arms but only a horizontal retentive tip.
Only the retentive tip contacts the abutment surface only at the undercut
region.
The amount of contact is about 2 to 3mm in height and 1.5 mm in width.
75
77
78
COMBINATION CLASP
Consist of wrought –wire retentive clasp arm and a cast reciprocal clasp arm
79
INDICATIONS :-
•When maximum flexibility is desirable, such as on abutment tooth
adjacent to a distal extension base or on a weak abutment
• Adjustability when precise retentive requirements are unpredictable
and later adjustment to increase or decrease retention may be
necessary
•Esthetic advantage over cast clasps
80
ADVANTAGES DISADVANTAGES
•Flexibility •Extra steps in fabrication,
•Adjustability particularly when high-fusing
•Esthetics chromium alloys are used
•Minimum of tooth surface covered • Distorted by careless handling on
because of its line contact with the the part of the patient
tooth • Less accurately adapted to the
•Less likely occurrence of fatigue tooth and therefore provide less
failures in service with the tapered stabilization in the suprabulge
wrought-wire retentive arm versus the portion
cast, half- round retentive arm • It may distort with function and not
engage the tooth
81
EXTRA CORONAL RETAINERS ASSEMBLIES THAT MAY BE USED ON
ABUTMENT ADJACENT TO DISTAL EXTENSION BASE
Arrows indicate the general direction of movement of retentive tips of retainer arms
when the denture base rotates toward and away from the edentulous ridge.
A, Distobuccal undercut engaged by one-half T-type bar clasp. The portion of the clasp
arm on and above the height of contour might afford
some stabilization against horizontal rotation of the denture base.
B, I-bar placed in undercut at the middle (anteroposteriorly) of the buccal surface. This
retainer contacts the tooth only at its tip.
82
• . C, interproximal ring clasp engaging the distobuccal undercut. Bar-type retainer
cannot be used Because of tissue undercuts inferior to the buccal surface of the
Abutment.
• D, round, uniformly tapered 18-gauge wrought-wire Circumferential retainer arm
engaging the mesiobuccal undercut.
83
E, A hairpin clasp may be Used when the undercut lies cervical to the origin of the retainer
Arm. Both hairpin and interproximal ring clasps may be used to Engage the distobuccal
undercut on the terminal abutment of the Distal extension denture. Hairpin and interproxima
ring clasps are The least desirable of the clasping situations illustrated here.
F, lingual view shows the use of double occlusal rests, connected To the lingual bar by the
minor connector in illustrated designs. This design eliminates the need for a lingual clasp arm
places. For support, and provides stabilization against horizontal rotation of the denture base
84
RPA clasps
The rest-proximal plate-Aker’s 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.
85
CLASP DESIGNED TO ACCOMMODATE FUNTIONAL
MOVEMENT
CIRCUMFERENTIAL,RING,EMBRASURE,OTHERS.,
86
CAST CIRCUMFERENTIAL Design rules..
CLASP 1. The clasp should arise from the main body of
First proposed by Dr N B
the clasp assembly above the height of
contour. The retentive arm should extend
Nebbit.
cervically and circumferentially in a gently
Later modified by Dr Polk E
arcing manner.
Aker.
2. All the components of the C clasp should be
• Simple and easy to
present above the height of contour except the
construct .
retentive tip.
3. The retentive terminus should always be
directed towards the occlusal surface never
towards the gingiva.
4. It should always terminate at the mesial or
distal line angle never at midfacial or
midlingual surface. 87
Design rules..
1. The clasp should arise from the main body of the clasp assembly above
the height of contour. The retentive arm should extend cervically and
circumferentially in a gently arcing manner.
2. All the components of the C clasp should be present above the height
of contour except the retentive tip.
3. The retentive terminus should always be directed towards the occlusal
surface never towards the gingiva.
4. It should always terminate at the mesial or distal line angle never at
midfacial or midlingual surface.
88
5. The retentive arm should be Some improper applications of
positioned as far apically on the circumferential clasp design and their
recommended corrections
abutment as is practical.(not impinging
the gingiva)
6. Special considerations in case of distal
extension case:-
91
Reverse circlet clasp
Used when undercut is located at the facial distoangle
adjacent to an edentulous space.
DESIGN
It consists of a mesial occlusal rest, a horizontal
reciprocal arm, and a retentive arm engaging the
distobuccal undercut adjacent to the edentulous area.
DISADVANTAGES:-
Week clasp if sufficient preparation is not done.
Poor aesthetics' if used in premolars and cuspids. 92
Multiple circlet clasp: Embrasure clasp
A multiple circlet clasp design involves two
simple circlet clasps Also known as the Bonwill clasp.
Used in periodontally weekend teeth to
fabrication of unmodified Class
splint them
II or Class III partial denture
Disadvantages are same as circlet clasp.
situation;
when there are no edentulous
spaces available on the opposite
side of the arch to aid in clasping
93
Reverse circlet clasp
Used when undercut is located at the facial distoangle
adjacent to an edentulous space.
DESIGN
It consists of a mesial occlusal rest, a horizontal
reciprocal arm, and a retentive arm engaging the
distobuccal undercut adjacent to the edentulous area.
DISADVANTAGES:-
Week clasp if sufficient preparation is not done.
Poor aesthetics' if used in premolars and cuspids. 94
Embrasure clasp
95
Ring clasp
ADVANTAGES:-
Circumferential clasp encircles nearly all Provides adequate encirclement.
of the tooth from its point of origin. excellent retention with adequate
•It is usually used when a proximal flexibility due to increased length of
undercut cannot be approached by any clasp arm
other means.
•In case of tilted molars DISADVANTAGES:-
•A support strut is provided on the non Decalcification of teeth
retentive arm Increased occlusal table.
Poor structure of clasp
96
ADVANTAGES:-
Provides adequate encirclement.
excellent retention with adequate
flexibility due to increased length of clasp
arm
DISADVANTAGES:-
Decalcification of teeth
Increased occlusal table.
Poor structure of clasp
97
Hairpin clasp or reverse action or fish
hook clasp
•A simple circlet clasp in which the retentive
arm loops back to engage an undercut apical to
the point of origin.
• Used when a distofacial undercut is present
adjacent to the edentulous space.
99
Onlay clasp:-
•Indicated when the occlusal surface of
the abutment lies noticeably apical to
the occlusal plane.
•occlusal surfaces of the abutments are
covered with crowns
100
101
OTHER TYPES OF CLASP PHILOSOPHIES.
DeVan’s Clasp
VRHR clasp or Grasso clasp
Euipose clasp
others
102
VRHR Clasp
104
105
Metal free-
1. Natural-flex
2. Optiflex
3. Proflex clear wire
4. Valplast
5. Cu-sil
106
107
108
109
OCCLUSALLY AND GINGIVALLY APPROACHING
CLASPS: RELATIVE MERITS AND DEMERITS
110
RETENTION
111
STRESS-BREAKING EFFECT
112
CONTACT WITH TOOTH STRUCTURE
BRACING
113
DAMAGE TO ORAL TISSUES MINIMUM
114
Esthetics
115
CONCLUSION
Direct retainers should be chosen based on their ability to distribute
forces evenly, minimize stress on the abutment teeth and
surrounding tissues, and provide sufficient retention to prevent
dislodgement of the prosthesis during function. By adhering to these
principles and customizing the design to suit the individual needs of
the patient, clinicians can ensure the long-term success and patient
satisfaction with removable partial dentures.
116
REFERENCES
117
118
•Davenport J.C., Baskar R.M., Heath J.R., Ralph J.P. “A color atlas of
RPD”, Wolfe Medical Publications Ltd., 1988.
•Krol A.J. “Clasp design for extension base RPD”. J. Prosthet. Dent.,
1973; 29 : 408-415.