I.

INTRODUCTION
Partial Denture Rest - A rigid extension of a fixed or 'removable partial
denture that prevents movement towards the mucosa and transmits
functional forces to the teeth.
According to glossary of Prosthodontic terms -
1.Rest - is a projection or attachment, usuall on the side of an object.
2 .Rest seat - is the prepared recess in a tooth or restoration created to
receive the occlusal, incisal, cingulum or lingual rest.
According to Earnest L. Miller -
I .Rest - is a projection of the clasp which lies in a prepared recess of the
abutment tooth and acts to support and stabili!e the removable partial
denture
2. Rest seat - "he prepared recess in a tooth created to receive the occlusal,
incisal or lingual rest.
According to Mccrackens -
1 .Rest - An unit of a partial denture that rests on a tooth surface to
provide vertical support.
2 .Rest seat - "he prepared surface of an abutment to receive the rest.
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II. HISTORICAL RIVIEW
#$ %t was in #&'' that (onwill recommended the use of rests on
removable partial denture which have been universall
considered inviolate.
)$ *enderson D, +teffel , -iller and -c.rac/en stated that the
principle function of the rest is to transfer vertical occlusal
stresses to the abutment teeth and to prevent movement of the
removable partial denture in a cervical direction.
0$ -ac 1regor and +tewart stated that rests maintain clasps in
their correct position prevent food impaction and prevent the
denture from sin/ing into or causing over displacement of the
soft tissues.
2$ "haer and 3rate+chvil stated that when all forces are borne b
the removing bone bone and soft tissues more rapid bone
resorption will occur. And rest reduces the bone resorption.
III. ENGINEERING THE REST PREPARATION
%n order for tooth support to be optimall effective, it must be
provided b sturd rests, placed in properl engineered recesses, in the
surfaces of the teeth. "he planning and preparation of the recess should.
be carried out in consonance with well established bioengineering
principles. A fundamental fact is that periodontal ligament is not designed
)
b nature to provide a cushioning effect for the tooth but on the contrar, is
a suspensor ligament b means of which the tooth is suspended in its
alveolus.
"hus it ma be seen that a hori!ontal stress applied against the tooth
will be resisted b fewer than half of the periodontal membrane fibres,
whereas a vertical stress will be resisted b all of the fibres with the
exception of those at the apex.
"he forces which act on the tooth in a direction along its long axis-
are transferred b the periodontal ligament to the bone as tension, which is
tolerated 4uite well. %n contrast to this, the transverse or torsional stresses
that are transmitted to the tooth are transferred to the periodontal ligament
and to the bone as pressure, which will not be well tolerated. Depending
on the magnitude and the duration of the stress, the result ma be crushing
of the periodontal ligament or even necrosis and bone resorption. "hus
appling this principle to the foundation for the rests, it becomes apparent
that the recess should be prepared within the confines of the greatest tooth
mass, so that force directed against the tooth will be resisted b the greatest
number of periodontal fibres. Another important point to be noted is that
the floor of the recess should be perpendicular to the long axis of the tooth,
so that stress will be directed axiall and so that torsional stresses are
reduced to a minimum.
0
IV. FUNCTIONS 07 THE RESTS
#$ "he primar purpose of the rest is to provide vertical support for the
partial denture and thus resist the movement in a cervical direction. '
)$ %n doing so it also maintains components in their planned positions
maintains established occlusal relationships b preventing
setting of the denture
0$ Prevents impingement of soft tissues
2$ Directs and distributes occlusal loads to the abutment teeth
%t transmits vertical load as well as the lateral load to the tooth.
I. TRANSMISSION OF VERTICAL LOAD
5hen vertical load is applied to a bounded saddle which is
supported at both ends b occlusal rests, pressure is exerted against the
rested teeth. "his results in a stretching of the periodontal fibres and an
eventual stressing of the bone that surrounds the teeth.
"he proportion of the magnitude of load that will be transmitted to
the teeth on which the rests are placed can be varied -which was discussed
b chic/.
6or e.g. rests placed at e4ual distances from the middle of the
saddle'-will, assuming the load to be applied to the middle of the saddle,
transmit an e4ual load to the teeth on which the are placed. According to
2
this, the load on the premolar can be reduced and that on the molar
increased b moving the rest to the mesial aspect of the premolar and this
ma be desirable as molar teeth can accept greater loads than premolars.
"hus, it ma be stated as a general principle that if it is necessar to
decrease the magnitude of the load on a tooth, then the rest should be
moved awa from the saddle concurrentl this will increase the load on the
other tooth b an e4ual amount.
"hus transmission of the vertical load to the tooth with the help of
rests, preserves bone o7 the edentulous ridge and also helps to prevent -
#$ (rea/down of the periodontal membrane
)$ 8oss of correct occlusal relationships
0$ 8oss of correct position of clasp arms
II. TRANSMISSION OF LATERAL LOAD
5hen a saddle carries occlusal rests at each end the ma aid in the
distribution of lateral load to the abutment teeth. %f the occlusal surface of
the abutment is flat, then no lateral stress is communicated to it, whereas if
the rest fits accuratel into a box shaped preparation the lateral load is
transmitted entirel to the tooth. 5hen the occlual rest is placed in
contact with the sloping walls of the cusps of the tooth, an intermediate
9
condition exists and some of the lateral force is conveed as lateral stress
to the teeth.
%t is more usual to provide saucer shaped rest seat
preparations which allow a ver slight lateral movement of the rests over
the. teeth. "his allows the flanges of the saddles to compress the mucosal
tissues and transfer a proportion of stress to the underling bone, thus
sharing the load between the ridge and the abutment teeth.
III. PREVENTS IMPINGEMENT OF SOFT TISSUE
%f rests are not placed - there ma be bone resorption and as the
saddle sin/s, damage to the related gingival margin and periodontal
membrane ensues. "he pressure of the saddle on the gingival margin has
two effects.
#$ 1ingivitis is initiated which is liable to develop into a
periodontal involvement of the abutment tooth and hasten its loss
)$ As the saddle sin/s it effects a mechanical stripping of the gingiva
and periodontal membrane from its tooth attachment and later tooth
loss. (ecause of these two processes a partial denture which has
ho occlusal rests in its design has become /nown as :1um stripper:.
"hus a rest is a controlling factor in the triad of prosthesis -
tooth - periodontium.
;
IV. It maitai t!e components especiall clasps in their position on
the tooth so as to maintain a desired tooth clasp and tooth base relationship.
%t provides reciprocation and bracing. (racing is the provision of resistance
to lateral displacement of the denture and is a function performed jointl b
the rest and b the clasp arms in a clasp unit. Reciprocation in anterior
tooth b a rest. "his is seen most commonl where a cingulum rest on a
canine acts as reciprocation for a gingival l approaching retentive clasp
arm placed on the labial surface of the tooth.
%t prevents a spreading of the clasp arms, with subse4uent
displacement of the clasp and the prosthesis.
V. De"#e$ti% %" t!e "%%&
"he occlusal rest covers a space which might otherwise exist
between the saddle and abutment.
A free end lower saddle lightl clasped to its abutment tends, in
function, to be displaced bac/wards, opening up the potential apace
between saddle and tooth, into which food is liable to be pac/ed. "his ma
because of caries on the proximal surface of the tooth or more often
result in a traumatic gingivitis. 5hen an occlusal rest covers-this space,
entrance of food is prevented since it is deflected buccall or linguall.
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VI. Im'(%)es t!e %$$#*si%
An occlusal rest can be shaped to improve the existing occlusion. A
common example of this is when a rest placed on a tilted tooth is built up
to give larger contact with opposing teeth.
VII. A rest ma serve to prevent s*'(a e(*'ti% of the tooth on which it is
placed where no opposing tooth is present to perform this function.
VIII. A rest ma act as an I&i(e$t (etaie(
All tpes of rests, =occlusal, cingulum, incisal$ ma function as
indirect retainers when placed on the opposite side of the fulcrum axis to
that on which the displacing saddle is situated A.A.1rant>?ohnson.
An example of this application is seen in the design of partial
denture for /enned class iv upper dentition.
During the mastication of stic/ foods, there will be tendenc for
the saddle to move awa from the underling tissues, the denture rotating
about an axis joining the rests placed for saddle support. "his tendenc
for rotation can be resisted b placing occlusal rests bilaterall on the
posterior aspects of the last standing teeth. "he posterior rests are joined to
the saddle b means of anteroposteriorl directed bars ling on the palate.
&
AU+ILLAR, REST
"he most fre4uentl used indirect retainer is an auxiliar rest
located on an occlusal surface as far awa from the distal extension base as
possible. %n case of 3enned class % arch, the are placed on mesial
marginal ridge of first premolar though the longest perpendicular to the
fulcrum line would be in the vicinit of central incisors which are too
wea/. (ilateral rests on first premolars' are 4uite effective, even though
located closer to the axis of rotation.
%n class %% partial dentures the are placed on the opposite first
premolar tooth of the distal extension base.
AMINE e-tesi%s "(%m %$$#*sa# (ests
+uch an extension is used to effect indirect retention b
increasing the distance of resisting element from the fulcrum line.
Caie (ests
5hen mesial marginal ridge of the first premolar is too close to the
fulcrum line then a rest on adjacent canine tooth ma be used.
Rests can be discussed under two headings - Ate(i%( a&
P%ste(i%( rests.
"he anterior rest design has the basic support area as close to the
centre of the tooth as possible.
'
#. "he ideal anterior rest fulfils the following re4uirements@
#$ "he centre is deeper than the surrounding rest surface
)$ %t is rounded in all aspects =no sharp line angles$
0$ "here is eas access for impression ma/ing and cleaning
2$ "here are no undercuts
9$ %t is placed as close to the gingiva and bone as' possible to reduce
leverage
;$ "here is no interference with planned occlusion
<$ %t is contoured so that when increased force is applied to the
prosthesis the rest will engage more securel to prevent separation.
&$ %t is positioned in line with the residual ridge
). "he ideal posterior rest fulfils the following re4uirements
#$ %t provides rigid support
)$ %t extends to the centre of the tooth-in tooth supported situations
0$ All aspects are rounded, with no sharp angles =for ease of cleaning
and ma/ing impressions and to prevent tooth fracture$
2$ "he end of the rest is slightl deeper and rounded.
9$ "here are no undercuts in path of insertion
;$ %t restores the occlusal plane
#A
<$ %t provides reciprocation
OCCLUSA#. REST
%s a rigid extension of a removable partial denture that contacts the
occlusal surface of a tooth or restoration, the occlusal surface of which
ma have been prepared to receive it.
FORM OF OCCLUSAL REST AND REST SEAT
1eneral configuration.
#$ "he outline form of an occlusal rest seat should be a
:rounded: triangular shape with the apex towards the centre of the
occlusal surface
)$ %t should be as long as it is wide and the ideal width for the occlusal
recess is approximatel one-half the measurement between buccal
and lingual cusp tips of the bicuspids and slightl less for molars
0$ 5hen the tooth is in normal alignment, the recess should be
centered over the rest of the residual ridge although it is not possible
when the teeth are mar/edl rotated or tipped.
2$ %t is important that the proximo occlusal line angle of the
preparation not be sharp but have a smoothl flowing contour of a
waterfall.
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The reasons for this:
a$ %f the angle is left sharp, the rest ma be too thin at this
point, hence vulnerable to fracture.
b$ "he resulting short, unprotected enamel rods are
susceptible to brea/age.
c$ (ecause the distal extension base will inevitabl move to
some extent in function, the entire bearing area of the recess
should be formed +o as to allow the clasp a slight degree of
movement without transmitting a torsional stress to the tooth.
"hus there is no place in a properl prepared, recess for sharp
angles.
9$ Depth of the recess
#$ "he base o7 the triangular shape should be at least ).9 mm for both
molars and premolars. Rest seats of smaller dimensions do not
provide for an ade4uate' bul/ of metal for rests, especiall if the rest
is contoured to restore the occlusal morpholog of the abutment
tooth.
)$ "he marginal ridge of the abutment tooth at the site of the rest seat
must be lowered to permit a sufficient bul/ of metal for - strength
and rigidit of the rest and minor connector.
#)
"his then means that a reduction of the marginal ridge of
approximatel #.9 mm is usuall necessar.
0$ "he floor of the occlusal rest seat should be apical to the
marginal ridge and occluaal surface and should be concave or spoon
shaped.
2$ "he angle formed b the occlusal rest and the vertical minor
connector from which it originates should be less than 'AB onl in
this wa can the occlusal forces be directed along the long axis of
the abutment tooth. An angle greater than 'AA fails to transmit
occlusal forces along the supporting axis of the abutment tooth.
%t also permits slippage of the prosthesis awa from the abutment
and causes orthodontic forces applied to an inclined plane.
9$ %f the recess is being prepared in an uncovered tooth surface, it
should not be so deep as to penetrate the enamel. %f clearing the
opposing occlusion re4uire a depth of the recess that ris/s
penetration of the enamel into the underling dentin a gold
restoration should be placed in the tooth. %f the tooth cannot be
restored in gold then the height of the opposing cusp in order to gain
inter occlusal clearance.
;$ Rest seats are preferabl not prepared opposite supporting cusps,
as the opposing teeth will change position and the space provided b
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rest seats will be obliterated b the time denture is fitted. %f it is
necessar then .place them a little to one side, or flatten the tip of a
supporting cusp to provide enough room for occlusal rest but et
allow the sides of the cusp to contact the- opposing tooth at the
edges of the rest seat.
<$ %f the penetration of the enamel does occur during the
preparation of the recess despite due precautions, a small cavit is
made and filled with amalgam or gold foil.
&$ 6issures and grooves which lie adjacent to the boundaries of the
recess should blend smoothl with the margins of the
preparation especiall in premolars when rest seats prepared cross
the central fissure of the tooth and ma produce a food trap
between the apex of the occlusal rest and the fissure.
Rounding the end of the rest in a conventional manner leaves a
pramidal hollow between it and the fissure where as a slight pointed
extension towards the fissure reduces this hollow and ma decrease the ris/
of caries.
CHOICE OF THE FOUNDATION SURFACE
"ooth surfaces, upon which the recess for an occlusal rest must be
prepared, differ in both contour and thic/ness of enamel from tooth to
tooth and from mouth to mouth. "he nearest thing to an ideal surface upon
#2
which to place an occlusal rest is gold allo. Catural tooth is next- in order
followed b fused porcelain and last the silver amalgam.
"he rest should never be placed on a silicate cement nor on one of
acclic resin, because the cannot sustain the vigorous stresses to which it
will be exposed under the partial denture clasp unit.
T!e R%tate& t%%t!
5hen it is necessar to clasp a tooth which has rotated out of its
normal position, the preferred treatment is to cover the crown with a
restoration which realigns the surface of the tooth. "he other alternative
if possible alter its axial surfaces sufficientl to render it more suitable
for clasping and to place the occlusal rest in the mesial or distal
fossae, eventhough the be situated buccal or lingual to alveolar ridge. %f it
is not practical to place in either fossae, it should be remembered that the
occlusal rest ma be placed an where on the surface of the tooth where a
properl designed recess can be prepared to support it -
MANDI.ULAR .ICUSPID WITH RUDIMENTAR, CUSP
%t is difficult to prepare occlusal rest in such a situation the solution
is to cover such a crown with gold restoration, building a 4uasi-cingulum
rest into the wax pattern similar to the tpe emploed for the mandibular
cuspids.
#9
THE INDIRECT RETENTION REST
"he rest which is used for this purpose should be located as far
anterior to the fulcrum line as mouth condition permits. Dcclusal rest are
pef erred to anterior rest. "he mesial fossa of the bicuspid is prepared in
conventional saucer shape. "he rest for indirect retainer is then designed to
get into the prepared recess on the bicuspid and tDi extend over onto the
lingual surface of the cuspid. "he lingual surface of the cuspid re4uires
no preparation. +uch a design exploits the excellent indirect retention
which the cuspid is capable of suppling and combines it with the e4uall
excellent vertical support offered b the bicuspid.
THE REST RECESS IN TH. A.RADED TOOTH
"he preparation: of the rest seat in enamel which has alread been
worn is 4uestionable and covering the tooth with a cast crown is the
preferred treatment.
THE MESIALL, INCLINED MOLARS
5hen the molar abutment teeth are severel tilted, it is usuall
supposed that the occlusal rest should be placed on the part of the tooth
furthest from the deepest undercut in the belief that this will prevent further
tilting of the tooth. Euite fre4uentl occlusal rest placed in this position
re4uires 4uite a deep rest seat to accommodate it, since it lies on the part of
the occlusal surface that is in contact with the opposing teeth, whereas
#;
there ia space on the side of the tooth to which it is tilted. "he rest ma be
prepared on the side to which the tooth is tilted provided the seat of the rest
is at right angles to the long axis of the tooth and provided that the saddle
abuts on the tooth in such a wa that it cannot tilt forward while the saddle
i.e. in place. "he favourable form of the rest is a tooth of rounded contour
where the connector for the rest lies against a sloping mesial surface
preventing mesial rotation of the tooth.
THE EM.RASURE REST /Ite( '(%-i#tia# %$$#*sa# (est seats0
#$ "he design of direct retainer assembl ma re4uire that
interproximal occlulaal rests be used. "he rest seats are prepared as
adjoining occlusal rest seats with the exception that the preparations
must be extended farther linguall than conventional preparation.
Adjacent rests rather than a single rest are used to avoid inter
proximal wedging -b the framewor/ and also the shunt the food awa
from contact points.
%n preparing such rest seats, care must be exercised to avoid
eliminating contact -point of abutment teeth. Fet +ufficient tooth structure
must be removed to allow for ade4uate bul/ of the component to be so
shaped that occlusion will not be altered. "he lingual interproximal area
re4uires onl a modicum of preparation and creation of vertical groove
must be avoided to prevent tor4uing effect on the abutments b the minor
#<
connector. Analsis of the diagnostic casts is mandator to assess inter
occlusal contact areas where rests are to be placed.
THE ONLA, REST
Dn the abutment tooth which has an occlusal surface below the
plane of occlusion an onla rest is preferred. "his should be done onl in
caries resistant mouth as there is danger -of enamel de calcification.
(etter tooth be covered with gold crown. Patients hgiene maintained and
prosthesis worn onl & hrs a da fissures be widened and shallowed for self
cleansing purpose.
INTERNAL OCCLUSAL RESTS
A partial denture that is totall tooth supported b means of cast
retainers on all abutment teeth ma use internal occlusal rests for tooth
occlusal support and hori!ontal stabili!ation.
An internal occlusal rest is not an internal attachment occlusal
support is derived from the floor of the rest' seat and from an additional
occlusal bevel if such is provided.
*ori!ontal stabili!ation is derived from the rest should be parallel to
the path of placement slightl tapered occlusall and slightl dovetailed to
prevent dislodgement proximall.
#&
"he advantage of this rest is it facilitates the elimination of visible
clasp arm buccall and permits the location of the rest seat in a more
favourable position in relation to the :tipping: axis of the abutment.
Retention provided b lingual clasp arm ling in a natural or prepared
infrabulge area on the abutment tooth.
RING RESTS
Dcclusal rests on isolated posterior teeth present a particular
problem. -an of these teeth are in firm occlusion with their opponents
and an modification of their occlusal surfaces allows them to change
position either b tilting or b errupting further. Ring rests are usuall best
for isolated teeth provided there is sufficient area of tooth above the surve
line to accommodate them. An additional advantage of ring rests is that
the provide a better distribution of load to the abutment 1eddes #'9&
made a variet of cobalt chromium castings with different tpe of
occlusal rests, he found that the biting load on tooth borne saddles was
closel related to the /ind of occlusal rest used
#$ "he average maximum load on the natural premolar tooth #; /g
and molar )# /g. +o theoriticall the combined load 0< /g the
patient is able to bite but where short occlusal rests were used onl
)< /g exerted.
)$ 8ong oeclusal rests - 0) /gs
#'
0$ 5here ring rests surrounding the tooth above the surve line were
used, load exceeded b % /g =0& /gs. $
THE EFFECT OF OCCLUSAL REST ON A TOOTH
6or purpose of discussion - a tooth ma be considered to be a
section of cone with a curved surface. and two parallel flat circular
surfaces. '' "he circular surface of greater si!e ma be ta/en as occlusal
surface and that the smaller area the apical area of the tooth. =Gxceptions
are upper #st and )nd molars the have divergent roots$.
#$ %f vertical pressure is applied over the whole of the occlusal surface
an uncomplicated downward movement of the tooth ta/es place into
its soc/et.
)$ %f, however, a vertical pressure is applied at the peripher of 'the
occlusal surface the downward movement is complicated b a
tor4ue being placed on the tooth and a rotator effect is introduced.
+uch a rotator effect should be minimised and three methods
available for this purpose are@
a$ A large mesio distal coverage of the tooth ma be used,
the tip of the rest preferabl extending to the centre of
the mesiodistal. fissure.
)A
b$ A second is b. reciprocation, ) shorter rests placed
diametricall opposite one on the mesial part of the' occlusal
surface and one on distal.
c$ "he third to place the rest on the surface of tooth further
removed from the saddle so that contiguous standing teeth
help to resist the rotator, movement.
%n majorit of the cases this tor4ue can be resisted b the bon
support of the natural tooth, if the tooth is verticall placed in the same axis
as the force under consideration. *owever, if the tooth is tilted and its long
axis lies at an angle to vertical force complication ma arise. 6ran/-?.
3ratochvil, .ommander - demonstrated the influence of occlusal rest
position on movement .of abutment teeth.
A training aid was used to demonstrate the effect of the rest
placement. "his aid had a changeable rotation pin, and the movement of a
partial denture base can be shown.
"he direction of movement of denture base with a distal rest is
shown.
"he gingival part of the denture base adjacent to the posterior
abutment moves in an arc almost parallel to the mucosa. "his results in
little or no support from the mucosa near the tooth. Also, the soft tissue
adjacent to the tooth ma be pinched, with resultant tissue strangulation.
)#
As the denture is followed posteriorl, the arc of the movement becomes
nearl perpendicular to the surface of the mucosa.
( the movement of the rotation point =occlusal rest$ to the mesial
surface of the most posterior tooth. "he arc of movement of the denture
base is changed. "he direction of movement and force applicatin is more
nearl perpendicular to the surface of the mueosa in each region under the
base.
"he mesial fulcrum will increase the support provided b the soft
tissues. Also the direction of movement at the gingival region adjacent to
the tooth is less li/el to cause punching or strangulation of the gingival
tissues.
"he placement of an occlusal rest distall to the central axis of the
posterior abutment tooth will tend to tip the teeth posteriorl. %f the rest
is placed on the mesio-occlusal surface, it will tend to tip the tooth
mesiall so it will receive support and bracing assistance from the teeth
anterior to it.
5hen movement of the edentulous base occurs the force exerted on
the tooth can be compared to that of a precision-constructed and fitted
'wrench'. which tends to tip or pull the tooth bac/ward. "his can result
in tooth mobilit, bone loss, and tooth and denture movement bodil,
with resulting occlusal disharmon.
))
As a result of transfering the rest to the mesial surface, the denture
movement will force the tooth anteriorl and reverse the wrench effect.
All remaining teeth will continue to help withstand this forward force.
REST SEAT PREPARATION
I. S%*& Eame#
%n most instances, preparation of proximal tooth surfaces is
necessar to provide proximalguiding planes and to eliminate undesirable
undercuts that rigid parts of the frame wor/ must pass during its placement
and removal.
"he preparation of occlusal rest seats alwas must follow proximal
preparation, never precede it. Dnl after the alteration is completed the
location of the occlusal rest seat in relation to the marginal ridge be
determined. 5hen proximal preparation follows occlusal rest seat
preparation the inevitable conse4uence is that the marginal ridge is too low
arid two sharp with the centre of the floor of the rest seat too close to the
marginal ridge. +o it is impossible to correct the rest preparation
without ma/ing it too deep and then irreparable damage has been done.
Dcclusal rest seats in sound .enamel ma be prepared with diamond
points of approximatel the si!e of no.; and & round burs or with carbide
burs. "he larger of the two diamonds is used first to lower the marginal
ridge and to establish the outline form of the rest seat. "he resulting
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occlusal rest seat is then complete except that the floor is not sufficientl
concave.
"he smaller diamond point is then used to deepen the floor of the
occlusal rest seat, at the same time forming th desired spoon shape inside
the lowered marginal ridge.
+moothing the enamel rods b the planing action of a round bar of
suitable si!e revolving at moderate speed, followed b use of an abrasive
rubber point, is usuall the onl polishing needed.
5hen a small enamel defect is encountered in the preparation of an
occlusal rest seat, ignore it at-a point until the rest preparation is
completed and then with small burs preparing the remaining defect to
receive a small gold foil restoration. A fluoride gel should be applied to
abutment teeth following enamel recontouring. Application should be done
after impression are made for the cast on which frame wor/ is fabricated as
fluoride gel and irreversible hdrocolloids are incompatible.
II. OCCLUSAL REST SEAT PREPARATIOIM IN E+ISTING
RESTORATION
%t is same as in enamel. Proximal preparation first and then rest
seat should be placed.
"here is alwas' a possibilit that an existing restoration ma be
perforated in the process of ma/ing an ideal occlusal rest seat. "hough
)2
some compromise is permissible the basic principles of rest seat
preparation should not be violated when perforation occurs it ma be filled
with gold foil.
III. OCCLUSAL REST SEATS IN NEW RESTORATION
"he should be placed in the wax pattern. "he location of the
occlusal rest should be shown when the tooth is prepared for a crown or an
inla so that sufficient clearance ma be provided in the preparation for the
rest.
IV. OCCLUSAL REST SEATS IN CROWN AND INLA,S
"hese are generall made larger and deeper than the enamel. "hose
made in abutment crowns supporting tooth borne dentures ma be slightl
deeper than those in abutments supporting a distal extension base
Ite(a# (ests - are also created first in wax, either with suitable burs
in a handpiece holder or b waxing around a lubricated mandrel held in
the surveor.
ANTERIOR RESTS
#$ .ingulum rest
)$ %ncisal rest
Ci1*#*m (est@ %s a portion of partial denture that contacts the prepared or
natural cingulum of the tooth.
)9
I$isa# (est 2 A rigid extension of a removable partial denture that contacts
the tooth at the incisal edge.
Li1*a# (est@ A metallic extension of a removable partial denture frame
wor/ that fits into a prepared depression within an abutment tooth's
lingual surface.
Anterior tooth do not naturall bend themselves to either clasping or
to accommodation of rest due to their morpholog.
Root form, root length, inclination of the tooth and ratio of length
of clinical crown to the alveolar support must be considered in
determining the site and form of rests placed in anterior teeth.
5here morpholog of the tooth is such that the hori!ontal surface is
present at the superior aspect of cingulum rest ma be placed directl
without an preparation.
-an problems are encountered where direct placement is used
without preparation of the tooth.
Fi(st#3
#$ "he rest presents a positive built-up on the tooth surface in an area
of high tongue activit and so ma give rise to tongue irritation.
)$ Hnless the surface on which the rest is placed is at right
angles to the long axis of the tooth =which is a rare finding$ a
);
hori!ontal- force component will arise b inclined plane action
when the rest applies load to the tooth. "his ma cause
hori!ontal tooth movement, which is undesirable.
0$ %nade4uate apace ma be present for a rest where the anterior tooth
relationship is close.
Ci1*#*m Rest@ "he cingulum rest on an anterior tooth has an important
advantage over incisal rest, in that it is closer to the centre of rotation of
the tooth and hence will exert less leverage.
It has two additional advantages:
#$ %t is discretel hidden from view
)$ %t tends to be less bothersome to a curious tongue
%f the maxillar cuspid and incisor that ma be considered for this
rest.
%n incisors the' enamel is thin and so the should be first covered
with metal before rest.
THE PREPARATION OF THE ANTERIOR TOOTH TO RECEIVE
THE REST
#$ A slightl rounded 'v' ia prepared on the lingual surface at the
junction of the gingival and middle third of the tooth. "he apex of
the 'v' is directed incisall. "he preparation is started b using an
)<
inverted cone shaped diamond stone and progressing to smaller,
tapered stones with round ends to complete the preparation. All
line angles must be eliminated and enamel seat must be polished.
"he floor of the rest seat should be toward the cingulum rather than
the axial wall. .are should be ta/en not to create an enamel
undercut, which would interfere with placement of the denture.
)$ A rest ma also be placed on the lingual surface of a cast veneer
crown, three 4uarter crown or of inla.
10 RESTS IN INLA,S AND ONLA,S
A basic inla with parallel pins can provide a positive rest when the
remainder of the tooth does not re4uire restoring.
"he advent of acid etching and bounding has introduced a
completel new, time saving an non-invasive procedure that shows great
promise. "he rests can be fabricated of metal and bounded to the enamel
with minimum preparation of the tooth surface.
20 COMPOSITE LIGHT CURES
%n some instances, it is possible to build up the lingual cervical
portion of the tooth with light cured plastic to provide an ade4uate rest if
the support part of the rest is contoured in enamel and if the plastic onl
reinforces the lateral side of the rest form. "his can be done onl in tooth
supported cases.
)&
INCISAL RESTS
"he ideal incisal rest fulfils the following re4uirements
#$ %t provides a positive seat b extending over the incisal edge onto
the labial surface of the tooth.
)$ %t restores anterior anatom as re4uired
0$ %t stabili!es mobile teeth
Indications for use of the incisal 'rest are:
#$ "he need to provide a positive rest
)$ "he need to provide stabili!ation.
0$ "he need to restore anterior guidance
2$ 1eriatric considerations
%ncisal rests can be placed on an anterior tooth. "he ma ta/e various
forms
Form 1: An extension of metal wor/ on the lingual or palatal surface of an
anterior tooth to provide a thin cover over the whole incisal surface of the
tooth. "his provides a ver positive resting action, but presents an
unesthetic show of metal -
Form 2: %ncisal rest at incisal angles on prepared rest seats. "hese are
used as auxiliar rests or an indirect retainers. "he incisal rest seat is
)'
prepared in the form of a rounded notch at an incisal angle or on an incisal
edge, with the deepest portion of the preparation apical to incisal edge.
"he notch should be beveled both linguall and labiall. A incisal rest seat
should be approximatel ).9 mm wide and #.9mm deep so that the rest will
be strong without leaving to exceed the natural contours of the incisal edge.
Form 3: 6ull incisal rests. % use of such placement depends on following
factors@
#. "he ma ta/e the advantage of natural incisal facetating.
). "ooth morpholog ma not permit other designs.
0. +uch rests can restore defective or abraded tooth anatom.
2. %ncisal rests provide stabili!ation
9. 6ull incisal rests ma restore or provide guidance.
DISCUSSION
10 WIDENING THE SUPPORT .ASE
As large =wider$ as possible can be easil achieved in class %%%
without modification.
.lass %, adjacent to edentulous area and bilaterall as distal as possible.
.lass %% adjacent to the edentulous area as well as adjacent to modification
areas or embrassure clasps ma/ing it triangular.
0A
.lass % - adjacent to the edentulous area moving mesiall and additional
rests anteriorl to minimi!e vertical load or soft tissue.
%n class %%%, %, - the support area is usuall 4uadrangular
%n class %% - triangular
%n class % I linear or narrow !one
Prior abutments - mesial or distal
%n case of anterior modifications cingulum or cingulum rests.
II. CARE DURING THE PREPARATION
.are should be ta/en while preparing the rest seat namel
#$ "he speed and coolant for the preservation of the vitalit of the pulp
)$ "he preparation should extend onl in enamel in a natural tooth
0$ "here should not be an sharp angles
2$ "he seat should be prepared in a manner that the forces are
directed along the long axis of the tooth
9$ Accurac of the fit of the rest in their rest seats
Albert +eiden - #'9& gave reasons for ill fiting rests
a$ Poor impression and duplicating techni4ue
IV. THE EFFECT OF REST DESIGN ON TRANSMISSION OF
LOAD TO A.UTMENT TOOTH
0#
-esial rest and distal rest or combination.
A laborator stud b (ert ". .ecooni, determined the effects of several
tpes of partial denture rests on abutment tooth movement. %t was
found that, as related to the transmission of abutment teeth, the 'depth of
the 'rest =in a gingival direction$ is more significant factor than the tpe of
rest and thus the decrease abutment tooth movement, it was also
stated that bilateral loading of a removable partial, denture causes less
abutment tooth movement than does unilateral loading.
V. SO CALLED INDIRECT RETENTION RESTS
3ened class %,.
"he example given b A. A. 1rant>?ohnson said the posteriorl
placed occlusal rest as indirect retainer.
(ut according to definition of indirect detention - %t is onl in cases
of distal extension cases.
"hese posteriorl placed occlusal rests onl prevent the tissue ward
movement of the the denture base and the retentive portion of the clasp arm
helps preventing movement awa from the tissue.
0)
VI. INCISAL RESTS
"he incisal rest seat preparation at the incisal angles is far awa
from the axis of rotation as alread mentioned. +o if the incisal rest. seat
preparation ma be done on the marginal ridge close to the cervical
portion it ma serve two purposes.
#$ %t is close to the axis of rotation so ma be less chances of tilting
movement of the abutment tooth
)$ -ore esthetic.
00
SUMMAR,
Rests and rest seats deserve special consideration in removable
partial denture construction. Proper understanding of the functions, design
and placement of the rests is necessar in partial denture treatment and also
in providing foundation to maintain health of remaining structures
supporting partial denture prosthesis.
02
REFERENCES
#. 6RAC3 ?.3RA"D.*,%8,.D-ACDGR =D.$ H+C@ %nfluence of
occlusal rest position and clasp design on movement of abutment
teeth. ?.P.D. #';#.
). (ron P. +ansom, Robert ?. 6linton, ,incent ?. Pai/s@ Rest designs
for inclined posterior abutments. A photoelastic comparison. ?.P.D.
?ul, #'&<.
0. -itchell A +tem, ?ames +. (ruidvi/ and Richard P. 6ran/@ .linical
evaluation of removable partial denture rest seat adaptation. ?.P.D.
#'&9.
2. (ert " .ecooni @ Gffect of rest design on transmission of forces to
abutment teeth. ?.P.D. #'<2.
9. Douglas A. -einig @ Removable partial denture without rests.
?.P.D. #''2.
;. Albert +eiden @ Dcclusal rests and rest seats. ?.P.D. #'9&.
<. (radle, Angleo, .aputo@ Photoelastic analsis of stress in resin
bonded cigulum rest seats. ?.P.D. #'&;.
&. -e .rac/en's @ Removable partial denture prosthodontics. &th
edition.
09
'. Grenst 8. -iller, ?oseph G. 1rasso @ Removable partial
prosthodontic )
nd
edition.
#A. ?ohn Dsborne, 1eorge Alexander 8ammie @ Partial dentures, 2th
edition.
##. A.A. 1rant > 5. ?ohnson @ Removable denture prosthodontics. )nd
edition.
#). 3ratochvil @ Partial removable prosthodontics.
#0. David -. 5att, A Ro -ac 1regor @ Designing partial dentures.
#2. D.?. Ceill, ?.D. 5alter @ Partial dentures. )
nd
edition.
#9. ?ohn 6. (ates @ Removable partial denture construction. )
nd
edition.
#;. Russell ?. +tratton J 6ran/ ?. 5iebelt @ An atlas of removable
partial dentures design.
0;
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