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REMOVABLE PARTIAL
DENTURE
PRESENTED BY
DR. SUKHJIT KAUR
Introduction
Choosing one of the possible procedures for restoring
partially edentulous arch involves border line
decisions.
If the relationship between the biologic behaviour of
the oral structures and the mechanical influence of the
denture is recognized we can provide a partial
denture.
The major connector may be compared with the frame
of an automobile or with the foundation of the
building.
Major connector must be rigid.
It is the dentists responsibility to ensure appropriate
design and fabrication.
CONNECTORS
The various components of
removable partial dentures are
connected together by connectors.
Connectors are described as being
either
A-Majorconnectors.
B. Minorconnectors
Functions of connectors:
Joining the component parts of the denture
together.
Contributetothesupport of the prosthesis, by
distribution of stresses applied to the prosthesis.
They may contribute to the functionsofbracing
and reciprocation
Contribute to retention of the prosthesis
Connectors resting on prepared dental or firm oral
tissues provide indirectretention (Connectors
that are relieved from the underlying tissues or lie
on inclined surfaces do not provide indirect
retention.)
Classification
a)According tothe materials:
Metallicornon metallic.
b) Accordingtothe rigidity: Rigid or nonrigid(stress breaking)
c) According tothedimensions: Bar(68mm), strap (8-12mm)or plate(>12mm).
If a plate covers whole of the palate, it is
termed complete palatal plate.
d)According tothe location:
Maxillaryormandibular.
MAJOR CONNECTOR
Definition
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.
single or combined
Indications
To replace one or two
teeth on each side of
arch and placed no
further anteriorly than
the second premolar
position. There must
be teeth capable of
bearing an additional
load both anteriorly
and posteriorly to the
edentulous space.
Contraindications
In distal extension
situation and when
anterior teeth are to
be replaced.
Advantages
It can be used in an
interim partial
denture until a
more definitive
treatment can be
considered.
Disadvantages
Most difficult for the
patient to adjust as to
maintain the degree of
rigidity, it has to be made
bulky.
Due its narrow anteriorposterior width, it derives
little vertical support from
the bony palate and must
be therefore supported
positively by rests on the
remaining natural teeth.
Palatal Strap
Palatal Strap
Advantages
Because the palatal strap is located in three
planes it offers great resistance to bending and
twisting forces. Thus greater rigidity with less
bulk of metal is produced.
It can be kept thin, thus increasing patient
comfort.
Little interference to tongue action and as a
result is accepted well.
It helps distribute stress over a broad area.
Retention is enhanced by the intimate contact
between the metal and soft tissue.
The strap also contributes some indirect
retention.
Disadvantages
The patient may complain of
excessive palatal coverage. This
complaint frequently can be traced to improper
positioning of the strap borders.
Indications
Used only when 1 or 2 teeth are
being replaced on either side.
Edentulous spaces are tooth bound
Need for palatal support is
minimal.
Structural Details
The palatal strap should be made wide and
thin, rather than narrow and thick, to achieve
the required rigidity and to be as innocuous as
possible to the tongue.
The anterior and posterior borders of the
strap should be lightly beaded to ensure
intimate contact with the mucosa, except
over hard structures such as a prominent
median raphe or a torus palatinus.
Waxing Specification
Anatomic replica pattern in 22- 24 gauge,
matte plastic pattern.
Parallelogram shaped
Relatively broad(8 to 10 mm) anterior and
posteriorpalatal straps.
Lateral palatal straps (7 to 9 mm) narrow and
parallel to curve ofarch;minimum of6 mm from
gingival crevicesof remainingteeth orshould extend
above the height of contourof the teeth
Anterior palatal strap
anterior border positioned as back as possible on the
rugae area,not placedfarther anteriorlythan anterior
rests and never closer than6 mm to lingual gingival
crevices; follows thevalleys of therugaeat right
angles tothe median palatal suture.
Posterior border if in rugae area, follows valleys of
rugae at right angles to the median palatal suture
Contraindications
When there is an inoperable maxillary torus
that extends posteriorly to the soft palate. In
this situation a broad U-shaped major
connector may be used.
Waxing specifications
Anatomic replica patternsor mattesurface
forms of22-gauge thickness
Posterior palatal componentA strap of22gauge thickness, 8to 10mm wide (a half-oval
form of approximately 6-gauge thickness and
width) may also be used
Indications
when support is not a major consideration
and when the anterior and posterior
abutments are widely separated.
for the maxillary arch which has a torus
palatinus that is either undercut,
lobulated, or too massive to be covered
with a full coverage connector or a strap.
The Patient's Mental Attitude: The A-P bar
may be used as a compromise for the
patient who strongly objects to the
greater bulk or area coverage of the full
palatal connector.
Contraindications
Periodontally weakened remaining teeth.
should not be considered as a first choice for
a maxillary major connector.
when a high narrow vault is present because the
anterior bar will interfere with phonetics.
When torus palatinus extends posteriorly to the
junction of hard and soft palate.
The main
advantage of the
antero-posterior
palatal bar is its
rigidity. In
comparison to the
amount of soft
tissue coverage, it
is by far the most
rigid maxillary
major connector.
Disadvantages
The antero-posterior
palatal bar is frequently
uncomfortable due to the
extra bulk of metal
needed for the narrow
bars. Also the many
borders of the bars are a
nuisance because the
tongue tends to want to
investigate them.
Less support from the
palate as tissue contact is
less.
May interfere with
speech- especially the
anterior bar.
Indications
Bilateral Distal Extension Bases:
Six Remaining Anterior Teeth:
It may be used as a plate of varying width that covers the
area between two or more edentulous areas
When the last remaining abutment tooth on either side of
a Class I arch is the canine or first premolar tooth,
complete palatal coverage is strongly advised, especially
in resorbed residual ridges
In individuals with well-developed muscles of mastication
and a full complement of mandibular teeth, heavy
occlusal forces can be anticipated
When flat or flabby ridges or a shallow vault is present
Occasionally, patients are treated with a transitional
partial denture in preparation for treatment with a
complete denture.
Cleft palate patients have a narrow, steep palatal vault.
To gain intimate tissue contact and to close any patent
air passages between the nasal and oral cavities, a cast
complete palate is most often the connector of choice.
Contraindication
Presence of tori which cannot be
surgically removed.
When patient can not tolerate full
palate coverage due to
exaggerated gag reflex or other
psychological reasons.
Combination,metal,andresin
plate:
Anterior metallicpart having
provisions for mechanical retention
to attach an acrylic posterior
portion.
Poor connector
Never use unless
absolutely
necessary
Requires bulk in the
rugae area (where
the tongue requires
freedom) for rigidity
Indications
Can be used in case of a large inoperable
tori
When several anterior teeth are to be
replaced.
In case of patients with exaggerated gag
reflex.
When periodontally weakened anterior teeth
need some stabilizing support.
Contraindications
Distal extension partial dentures.
RPDs in which cross arch stabilization is required.
Advantages
It is a reasonably strong connector that can derive some vertical
support and some indirect retention from the palate.
In patients with considerable vertical overlap of the anterior
teeth, the horseshoe is thin yet strong enough to support the
replacement teeth.
In the presence of a hard median suture line or an inoperable
torus, the anomaly can be avoided without sacrificing strength
or loss of vertical support.
Disadvantages
When vertical force is applied to either or both ends of the
horseshoe major connector, there is a tendency for the
connector to spread or straighten. Therefore it is a poor choice
for a distal extension partial denture.
This is not a good connector when cross-arch stabilization is
required. It has less resistance to flexing, and movement can
occur at the open end.
To avoid the tendency to flex, the metal crossing the rugae area
must be thicker than that used in most other major connectors.
Interferences with phonetics and patient comfort can result.
Disadvantages
They collect debris and become unclean.
They pinch the underlying soft tissues or
tongue as they open and close under
function.
They become fatigued by repeated
flexing and thus undergo permanent
distortion
Advantages of beading:
Prevents fooddebrisfrom
collectionunder theMajor
Connector.
Provide athinnest metal on the
polished surface while maintain
thenecessary strength. This is due
to the extrathickness of metal
provided by the beading.
REVIEW OF LITERATURE
Wagner G, Traweek FC (1982) compared
the major connectors for RPD. They compared
the subjective patient reactions to three
maxillary and two mandibular major connector
designs. In this study 20 dentists served as
subjects for the study.
Maxillary MC- Single palatal bar and A-P
palatal bars
Mandibular MC- Lingual bar and Lingual plate.
Most preferred major connector was the single
palatal bar and the mandibular lingual bar.
MANDIBULAR MAJOR
CONNECTORS
1. PLACEMENT OF BORDERS.
a. The superior borders are placed a t least 3 mm from the gingival margins
and parallel to the free gingival margin orfor the lingual plate it should be
extended to the cingulae of the anteriorteeth in which the gingival margin
should be relieved. Where a 3 mm distance from the gingival margins cannot
be obtained, the metal should extend on to the cingula of anterior teeth or
onto the lingual surfaces of the posterior teeth.
b. The inferior border
should be gently rounded above the moving tissues ofthe floor of the mouth
and should not interfere with the soft tissue movement of the floor of the
mouth.
2. Beading is never indicatedbecause of the need for relief under all
mandibularmajor connectors.
3. The metal should be highly polished on the tissue side to minimize
plaque accumulation.
4. RELIEF
Relief (0.5-1mm) must be provided between the mandibular majorconnectors
and the soft tissue to prevent the margins of the connectors from
inflammation or laceration of the friablelingual mucosaduring movement
Disadvantages:
It may be flexible if poorly constructed.
Rigidity is less compared to a well constructed
lingual plate.
Indications:
It should be used for mandibular removal
partial denture where sufficient space exists
between the slightly elevated alveolar lingual
sulcus and lingual gingival tissues.
Contraindications:
Inoperable lingual tori.
Highly attached lingual frenum.
Interferences to elevation of the floor of the
mouth during functional movements.
Waxing specifications
Six-gauge, half-pear
shaped wax form
reinforced by 22-24
gauge sheet wax adapted
to the design width.
Long bar require more
bulk than short bar.
Finishing lines
Butt joints with minor
connectors for retention
of denture bases.
Advantages:
The linguoplate is a rigid mandibular major connector and it
provides more support and stabilization when compared to
other connectors.
Can be used in stabilizing the periodontally-weakened teeth.
When it is supported at each end by a rest it contributes to
the action of indirect retention.
When properly contoured and fabricated, it will not cause
interference with tongue movements and will be more
comfortable to the patient.
Disadvantages:
It covers the tooth structure and the gingival tissue.
The metal coverage of the free gingival tissue prevents
physiological stimulation and self-cleansing of these areas
by saliva.
Indications:
It is indicated in cases where alveolar lingual sulcus so
closely approximates the lingual gingival crevices such as
high lingual frenum attachments.
If residual ridges in Class I arch have undergone severe
vertical resorption that they will offer only minimal
resistance to horizontal rotation.
It can be used to stabilize periodontally weakened teeth.
When future replacement of one or more incisor teeth
will be facilitated by the addition of retention loops to an
existing linguoplate.
Contraindications:
In lingually inclined mandibular anterior teeth.
Mandibular teeth with wide embrasures and diastema.
Waxing specifications:
Inferior border 6-gauge, half pear shaped wax
form reinforced with 24-gauge sheet wax.
Apron 24-gauge sheet wax.
Finishing lines:
Butt-type joints.
Indications:
The height of the floor of the mouth in relation
to the free gingival margin is less than 6mm.
If it is desired to keep the free gingival
margins of anterior teeth exposed and there is
inadequate depth of the floor of the mouth.
Contraindications:
Lingually tilted remaining natural teeth.
Inoperable lingual tori.
High attached lingual frenum.
Waxing specifications:
6-gauge, half-pear shaped wax form reinforced
by 22-24 gauge sheet wax.
Longer bar bulkier than shorter bar.
Finishing lines:
Butt-type joints.
from
the
final
data
that
the
Advantages:
The double lingual bar effectively extends indirect retention
in an anterior direction is supported by adequate rest.
It also contributes to horizontal stabilization.
It helps in minor amount of support to the prosthesis.
The gingival tissues and inter-proximal embrasures are not
covered by the connector, which helps in free flow of saliva.
Disadvantages:
Patient may feel discomfort because it alters the normal
position of the tongue.
If connector does not maintain intimate contact with tooth
surface there will be food entrapment.
Indications:
It is mainly used as a major
connector in periodontally
treated anterior teeth with wide
inter-proximal embrasures.
When linguoplate is
contraindicated due to poor
axial alignment of anterior teeth.
Contraindications:
In severely crowded anterior
teeth.
Waxing specifications:
Same as lingual bar.
Continuous bar pattern found by adapting two strips of 28-gauge
sheet wax over the cingula and into interproximal embrasures.
Finishing lines:
Butt joints.
Waxing specifications:
A cingulum bar pattern formed by adapting two
strips of 28-gauge, 3mm wide over the cingula and
into interproximal embrasures.
Finishing lines:
Butt-type joint.
Waxing specifications:
6-gauge half-pear shaped wax form
reinforced with 22-24 gauge
Long bar more bulkier than shorter bar.
Minor connector joined with occlusal or
other superior components by a labial
approach.
Finishing line:
Butt-type joints.
Indications:
Missing key abutments.
Unfavorable tooth contour.
Unfavorable soft tissue contours.
Teeth with questionable prognosis.
Contraindications:
Poor oral hygiene.
Shallow buccal labial vestibule.
High frenal attachment.
Conclusion
Major connectors by uniting the other components of a
removable partial dentures acts like a foundation bringing
about bilateral distribution of forces which depends on the
rigidity of the connector.
Utmost care should be taken to prevent a major connector
from interfering with normal functions or having any
damaging effects to the remaining oral structure.
Although there are many variations in major connector, a
thorough comprehension of all factors influencing their
design will lead to the best design for each patient.
Minor connectors
DefinitionComponents that serve as the
connecting link between major
connector or base of a removable partial
denture and other components of the
prosthesis such as the clasp assembly,
indirect retainers, occlusal rests or
cingulum rests.
Functions
Primary function-joining
other units of the prostheses
and denture bases to the
major connector.
Transfer functional stresses
to the abutment teeth.
Transfer the effect of
retainers, rests, stabilizing
components throughout the
prostheses.
Types
Join the clasp assembly to the major
connector.
Join direct retainers or auxilliary rests
to the major connector.
Join the denture base to the major
connector.
Serve as an approach arm for a
vertical projection or bar type.
on lingual
surface of incisors and canines, they connect
lingual rests to major connector.
Mesh construction
Thin sheet of metal with multiple
small holes that extends over crest
of residual ridge to the buccal,
lingual and posterior limits.
Used for replacement of multiple
teeth.
Major drawback difficult to pack
acrylic resin.
Does not provide a strong
attachment for denture base.
Tissue stops
Integral parts of minor connectors
retention of acrylic resin bases.
Provide stability for frame work during
the stages of transfer and processing.
Prevents distortion of framework during
acrylic resin processing
Fabrication
Disadvantages
Difficult to adjust metal base.
Cannot be adequately relined.
Weakest attachment of 3 types.
Finish lines
Finishing line junction with
major connector angle not
greater than 90 degree.
Finish line located too far
medially natural contour
of palate altered by
thickness of acrylic resin.
Thank you