Direct and Indirect Retainers

DEPARTMENTOF PROSTHODONTICS&IMPLANTOLOGY, SRMKDC&H

 Direct retainers 1. Intracoronal retainers 2. Extracoronal retainers

Structure of clasp assembly Requirements of clasp assembly Cast circumferential clasp Infrabulge clasp

Indirect retainers

Retainers: any type of device used for the stabilization or retention of a prosthesis. (GPT 8)

Direct retainer: that component of a partial removable dental prosthesis used to retain and prevent dislodgment, consisting of a clasp assembly or precision attachment.

Classification of direct retainers

Intracoronal Extracoronal Clasps According to construction
Cast Wrought wire Combination

According to design
Circumferential Bar type

Intracoronal direct retainers

Introduced by Herman E.S. Chayes in 1906 Consists of two components - Matrix (slot) - Patrix (flange)

Intracoronal direct retainers

Advantages Elimination of visible retention and support system Better vertical support Better stimulation of underlying soft tissues
Disadvantages Require prepared abutment and castings Complicated clinical and lab procedures Eventually wear Difficult to repair and replace Least effective on short tooth

Extracoronal direct retainers

Retentive clasp assemblies

Mechanics of retainer can be understood with two concepts path of insertion and removal, and height of contour

 Protheros cone theory Share common base referred to as greatest diameter of tooth Edward kennedy termed as height of contour

M.M. DeVan terms

Suprabulge direct retainers Infrabulge direct retainer

Structure of a clasp assembly

Requirements of a clasp assembly

Retention Support Stability Reciprocation Encirclement Passivity

Retention

Retention
The flexibility of the retentive clasp arm may be influenced by

Length cross-sectional form cross-sectional diameter longitudinal taper clasp curvature, and metallurgical characteristics of the alloy.

Retention
Clasp flexibility increases as clasp length increases The mathematical formula for deflection of a uniform cantilever beam. This formula may be expressed as: D= Ewt3 4PL3 where D deflection, P = applied force, L = length, E = modulus of elasticity, w =beam width, and t = beam thickness.

Retention
Cross-sectional diameter Longitudinal taper

Retention
Cross-sectional form

Retention
Metallurgical characteristics of the alloy

Retention
Location of each retentive clasp terminus relative to the height of contour may be described in two distinct dimensions: (1) a mediolateral or horizontal dimension and (2) an occlusal or vertical dimension.

Support
Support is the quality of a clasp assembly that resists displacement of a prosthesis in an apical direction. Other elements that contact the abutment occlusal to the height of contour (e.g., a reciprocal element or shoulder of retentive clasp) also may contribute to the support function.

Stability
Stability is the quality of a clasp assembly that resists displacement of prosthesis in a horizontal direction. All framework components that are rigid and contact vertically oriented hard and soft tissues may contribute to the stability of prosthesis.

Reciprocation
Reciprocation is the quality of a clasp assembly that counteracts lateral displacement of an abutment when the retentive clasp terminus passes over the height of contour.

Encirclement

Passivity

Location of retentive clasp terminus

Cast circumferential clasp Introduced by Nesbitt in 1916 Simple and easy to fabricate Tooth supported RPD Advantages Disadvantages

Design rules for cast circumferential clasp

A cast circumferential clasp should originate from a portion of the framework that lies above the height of contour. retentive terminus should be directed occlusally should terminate at the mesial line angle or distal line angle of the abutment The retentive arm should be positioned as far apically on the abutment as is practical.

Simple circlet clasp

Reverse circlet clasp

Multiple circlet clasp

Embrasure clasp

Ring clasp

C-clasp

Onlay clasp

Wrought-wire circumferential clasp

It used as early as 1847, the wrought wire circumferential clasp In 1965, Dr 0. C. Applegate introduced a modified wrought wire clasp assembly known as the combination clasp. consists of an occlusal rest a cast metal reciprocal arm, and a wrought wire retentive arm. The wrought wire component is circular in cross section. 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. Increased flexibility hence can be used in the greater undercut area. Minimal tooth surface contact

Infrabulge clasp
clasp approaches the undercut region of an abutment from an apical direction. Therefore an infrabulge clasp exhibits a push type of retention that is more effective than the pull retention associated with a suprabulge clasp. Flexibility of the infrabulge clasp is controlled by the taper and length of the approach arm. more esthetic than a suprabulge clasp

Design rules for infrabulge clasp

The approach arm of an infrabulge clasp 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 uniform tapering The clasp terminus should be more apically positioned on the abutment

Types of infrabulge calsp

These clasps are described by their geometric shapes. There are four main types of infrabulge clasp. T-clasp, the modified T-clasp, the Y- clasp, and the I-clasp or I-bar.

T-clasp design
Kennedy Class I or Class II partially edentulous and undercut is located adjacent to the edentulous area

Modified T clasp
The modified T-clasp is essentially a T-clasp that lacks the nonretentive, horizontal projection. improved esthetics in most applications used when canines or premolars will serve as abutments.

Y-clasp design
Practically Y clasp is equivalent to a Tclasp recontouring of the abutment surface

I bar design

Indirect Retainer
The effect achieved by one or more indirect retainers of a partial removable denture prosthesis that reduces the tendency for a denture base to move in an occlusal direction or rotate about the fulcrum line (GPT-8)

Principles of indirect retainer

Forms Of Indirect Retainers

Auxiliary Occlusal Rest Canine Rests Canine Extensions from Occlusal Rests Cingulum Bars (Continuous Bars) and Linguoplate

Reference
Phoenix, Cagna, DeFreest, Stewarts Clinical Removable Partial Prosthodontics, 3rd edition, 2003 Quintessence publications Co,Inc. pp 53-126 Carr A.B, Mc Givney G.P, brown D.T; Mc Crackens Removable Partial Prosthodontics; 11th edition 2005; Harcourt brace and company Asia Pte Ltd New Delhi Pp 271-299. Renner and Boucher; Removable Partial dentures; 1987, Quintessence Publication co., Inc Chicago; Pp 53-117. J. C. Davenport et al, Retention, British dental journal, 2000,volume 189, pages 646-657 J. C. Davenport et al, Indirect retention, British dental journal, 2001, volume 190, pages 128-132. Removable partial denture an overview pages 51-74

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