Professional Documents
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DENTURES
CONTENTS
Introduction
Preparation
Requirements of retainer
Uses of retainer
Indication
Selection of retainer
Contraindication
Advantage
Classification of retainers
Disadvantage
Appearance-
Preparation
Classification of retainers
Extracoronal retainers
Full veneer crowns
Indication
Contraindication
Advantage
Disadvantage
Introduction
In fixed prosthodontics it is the retainer which provide retention and resistance
against horizontal oblique and vertical dislodging forces.
The selection of retainer plays on important role in success of fix partial
denture and so it becomes very important to select suitable retainer for the
existing situation by keeping physiologic, mechanical hygienic and esthetic
factors in mind.
According to Glossary of prosthodontics (1994) fixed partial denture
retainer is defined as the part of fixed partial denture that units the abutments to
the remainder of the restoration.
Requirements of retainer (Physiologic, mechanical hygienic and esthetics)
1. It should with stand the masticatory forces (Mechanical).
2. It should restore the anatomy of the tooth (Physiologic).
3. It should not be harmful to the pulp (Physiologic).
4. It should improve the aesthetics (aesthetics).
Uses of retainer
1. To improve the masticatory efficiency.
2. To establish the contact point to prevent food lodgement.
3. To be useful in correcting malalignment.
4. To close diastema in anterior teeth.
5. To prevent drifting of teeth.
Selection of retainer: It is dictated by following factors.
1. Age
2. D.M.F. Rate
3. Edentulous space
4. Periodontal support
5. Arch position of tooth
6. Skeletal relationship
7. Interocclusal conditions such as crown length
8. Oral hygiene status
9. Vitality of abutments
Classification of retainers
I)
C.
D.
Radicular retainers.
I)
Metals
e.g. Nickel chrome, Titanium, Cobalt chrome.
Porcelain
Acrylic resins
Composite resins
F.
I)
onlays.
Pinledge retainers.
I)
I)
C. Radicular retainers
Dowel crowns
Richmond crowns
MOD
b)
circumference of tooth.
It is generally indicated for maxillary molars and premolars that
degrees preserving the distal surface of the tooth while veneering the
remaining surface.
It is indicated for distally tilted molar abutment.
Indications:
2.
3.
4.
Short teeth
Teeth with short clinical crowns are not suitable for partial veneer crown.
The difficulty is in establishing adequate retention and resistance form.
5.
6.
Thin teeth
It is difficult to prepare groove of suitable length in teeth with insufficient
buccolingual width without undermining the facial enamel.
7.
Advantages:
Partial veneer crowns have several advantages over complete crowns.
1. Less tooth reduction conservation of tooth structure.
2. Having fever margins in the intra cervicular space increases
biocompatibility with supportive tissue less gingival involvement than
with complete cost crowns.
3. Easy margin accessibility for finishing and cleaning is improved.
4. Complete seating of casting is more easily verified with at least one
margin visible.
5. Complete seating of casting during cementation is enhanced by
diminished hydraulic pressure.
6. Electric pulp testing can be conveniently accomplished on the intact
enamel surface.
Disadvantages:
Partial veneer crowns have the following disadvantages.
1. It is less retentive than complete cast crown.
2. Limited adjustment of path of withdrawal / placement.
3. There is limited display of metal with partial veneer crowns.
4. The partial veneer crown preparation is limited to fairly intact teeth with
normally shaped average length clinical crown.
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Contraindications:
1. Large pulp chamber because of high risk of pulp exposure.
2. Intact facial wall
3. When more conservative retainer is technically feasible.
Advantages:
1. Superior esthetics as compared to complete cast crowns.
2. Strength imported to tooth is superior as compared to partial veneer.
Disadvantages:
1. Removal of substantial tooth structure.
2. Subject to fracture because porcelain is brittle.
3. Difficult to obtain accurate occlusion in glazed porcelain.
4. Inferior esthetics compared to porcelain jacket crown.
5. Expensive.
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Disadvantages:
1. Reduced strength compared to metal ceramic crown.
2. Proper preparation extremely critical to ensure mechanical success.
3. Least conservative.
4. Brittle nature of material.
5. Causes wear on the functional surfaces of natural teeth that oppose
porcelain restorations.
Intra coronal retainers
Intra coronal retainers obtain their retention and resistance to
displacement from their intimate fit to the restoration within the confines of the
coronal portion of the tooth.
Inlay (Class II) metal
Indications:
1. Small caries lesion in otherwise sound tooth.
2. Adequate dentinal support the abutment tooth should be bulky, well
supported periodontally.
3. Low caries index.
4. Tooth replacement should not exceed a single tooth, preferably a
maxillary second molar.
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Pin ledges
Indications:
1. Undamaged anterior teeth in caries free mouth.
2. A high esthetic requirement.
3. Where proximal grooves are impossible to prepare.
4. To alter lingual contour of maxillary anterior teeth or to alter occlusion.
5. Anterior splinting.
6. Anterior coronal form is present.
7. The crown of tooth is of average length or longer.
8. The tooth with average or greater labiolingual thickness in the incisal
one half of the crown.
Contraindications:
1. Large pulp
2. Thin teeth
3. Non vital teeth
4. High caries index
5. Problems with proposed path of placment / withdrawal of fixed partial
denture.
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Advantages:
1. Minimal tooth reduction
2. Minimal margin length
3. Minimal gingival involvement
4. Optimum access for margin finishing and hygiene
5. Adequate retention
6. Excellent esthetics
Disadvantages:
1. Less retentive than complete coverage crowns.
2. Alignments can prove difficult.
3. Not usable on non vital teeth.
4. Technically demanding.
Radicular retainer
While the root preparation retains the post the core establishes
retention and resistance for a complete veneer crown that restores the
pulpless tooth to normal form and function.
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The post or dowel and core may be custom cast, where the
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Advantages:
1. Esthetics.
2. Adequetely strong.
3. Permits alignment with other teeth.
4. Good tissue adaptability.
5. Easily removed for treatment of required.
Disadvantages:
1. Tooth must be non vital.
2. Weakening of root face and canal by enlarging.
Detached post crown with a cast base
When the coronal portion of the remaining tooth is missing to a
point below gingiva and it is impossible to adapt the crown and root face, a
cast metal base is interposed between the base of the crown and root face.
This cast base is rigidly attached to the dowel.
Indications:
Contraindications:
1. Poor oral hygiene.
2. Thin and narrow roots.
3. If possible to design other variety, such as core and jacket restoration.
Advantages:
1. Quite strong and lasting.
2. Strengthens remaining tooth structures.
3. Esthetics.
Disadvantages:
1. Tooth must be non vital.
2. Difficult to construct in comparison to the restoration without a cast
base.
Richmond crown: By Richmond (1835 1902)
A dowel retained crown made for an endodontically treated tooth using
porcelain facing.
Resin bonded retainers
Types : 1) Rochette.
2) Maryland
3) Sockwall
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Indications:
1. Retainer of fixed partial denture for abutments with sufficient enamel to
etch for retention.
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Disadvantages:
1. Longevity of prosthesis is questionable Debonding rate increases with
time.
2. Higher dislodgement rate with posterior resin retained fixed partial
dentures.
Indications for multiple retainers
1. Abutment teeth with short roots.
2. Lack of sufficient bone support.
3. Density of alveolar bone.
4. Excessive length span.
5. Excessive lever arm action because of shape of anterior arch.
6. Distal extension of pontic for increased function.
7. Replacement of a missing cuspid.
Summary and Conclusion
The objective in selection of retainer whether it involves a single tooth,
several teeth or complete restoration of masticatory mechanism, it should
restore and maintain function of dental arch. It should be therefore both
restorative and preventive.
To accomplish this objective preventive as well as theraputic measures
should be utilized. The efficiency in selecting the retainer depends on the
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