MINISTRY OF HEALTH OF UKRAINE

National Pirogov Memorial Medical University, Vinnytsya

"APPROVED"
at the methodical meeting of the department
orthopedic dentistry

Head of Department Assoc. Belyaev EV

"27" August 2022

GUIDELINES
FOR INDEPENDENT WORK OF STUDENTS

Academic Discipline Orthopaedic stomatology

Class Topic 21 Finishing of ARD (grinding and polishing). The methods of ARD
finishing. The necessary materials used for ARD finishing.
Course 3
Faculty Stomatological

Vinnytsya – 2022
1 . Actuality of theme:
Various orthopedic devices, including the metal frame of the clasp prosthesis , require
careful treatment to give them a smooth, polished, mirror surface. In addition to convenience and
aesthetics, it increases the hygienic quality system, facilitate remove food and plaque that causes
varying degrees of change expressed tion in paradont. In addition, the amount of plaque is
directly dependent on the roughness of the denture.
Properly polished surface contributes to the corrosion resistance of metals (alloys) and
increase the physical and mechanical properties.
Clasp dentures are the most common orthopedic design for the treatment of dentition
defects. Their prevalence is due to the following factors:
- rationality of masticatory pressure transfer;
- no need for tooth preparation;
- the ability to maintain good oral hygiene;
- relative ease of manufacture;
- possibility of repair and change of a design.
Restoration of function (chewing and aesthetics) depends on the competent design of the
dentition in the manufacture of clasp dentures.

2. Specific objectives:
 Know the stages of the city ehanichn first processing and frame byuhelnoho prosthesis .
 Know method of claim iskostrumenn first processing and frame byuhelnoho prosthesis.
 Know the method of electrolytic polishing.
 Know the method of spraying spouts .
 Be able to fit the frame to the working model .
 Master T ehnolohi pit machining and.
 Know of aterialy that are used for mechanical processing frame byuhelnoho prosthesis .
 Be able to determine the indications and contraindications to the manufacture of clasp
prostheses.
 Be able to correctly choose the design of the clasp prosthesis taking into account
the clinical condition of the oral cavity.
 Learn the features of artificial teeth in clasp dentures.
 Learn the features of artificial teeth on the inflow in the frontal area in the manufacture of
clasp dentures.

3. Basic level of training:

Name of the previous Acquired skills
discipline
Normal anatomy Know the structure of the teeth of the tissues that are part of the
dental system
Physics Analysis of mechanical properties of materials such as strength,
elasticity, resilience, hardness .
Propaedeutics of orthopedic Analyze the data of the section " Clinical Materials Science " .
dentistry
Orthopedic dentistry Know the basic technological processes used in orthopedic
dentistry.

4 . Topic content:
Mechanical treatment of the frame of the clasp prosthesis.
 Sandblasting.
Oxides and packing mass on the surface of the frame can be removed manually or by
automatic sandblasting. For this purpose, alumina with a grain size of 250 cm is used, with
a working pressure of 4-6 bar for manual and 5 - 6 bar for automatic processing. For
cleaning critical areas, such as the inner surfaces of the shoulders, a grain size of 110 cm is
recommended. Increased wear of the material occurs especially with automatic sandblasting
with 250 cm under high pressure. If there are less than three objects for automatic
processing, it is recommended to put old foundry cones in addition to them. This will help
avoid inaccuracies in the fit due to roughness and wear of the material. It should be borne in
mind that the new nozzles have a large capacity. Solid metal nozzles made of
tetraborcarbonate extend their service life. Worn nozzles must be replaced in a timely
manner. The smaller the distance to the object, the greater the force of impact on the object
and the wear of the material. Areas covered by gutter channels are processed
purposefully. The gutter channels are cut only after sandblasting. The metal frame is
carefully monitored for oxide residues. Tyazhkodostupni place, such as an occlusal
overlays, require special attention.
Requirements for the cast object:
• Slight oxide formation, no reaction with the packing mass.
• Fully cast frame - without defects and shrinkage shells.
• Homogeneous, without pores and shrinkage shells.
• Without tension and distortions.
• Smooth surface, no roughness.
Pruning of foundries.
For circumcision gate channels and final treatment uses the benefits of
fast grinding al these tools. High power and speed of rotation, and also the tools built in
a stationary shaft allow to work rationally and quickly. In this dental technician can send an
object with little pressure with both hands. Protective glass protects against injuries. Most
of these devices have an integrated , powerful hood or the ability to connect to a
central hood. For circumcision gate channels using separating disks with a diameter of
25 mm and a thickness of 0.5 mm.
Large or mesh discs will not be used for reasons of security , the
holder drive at warp object can be bent , which increases the risk of getting injured. The
connection points of the gutter channels are cleaned with a perforated disk (25 mm x 3
mm). Further processing and polishing with a rubber polisher can be carried
out completely on the machine.
Electrolytic polishing.
Polishing the frame of the clasp prosthesis can be done electrolytically. For this porcelain
tableware about ' in volume of approximately 120 ml, height 150 mm placed cathode (stainless
steel plate measuring 76 * 38 * 0.8 mm); the anode is the frame of the prosthesis. The vessel is
filled with electrolyte (1-1.5 l ), which includes ethyl alcohol ( 120 g ), distilled water ( 120 g ),
orthophosphoric acid ( 120 g ), ethylene glycol ( 540 g ), concentrated sulfuric acid ( 120 g). ). In
the manufacture of the solution, sulfuric acid is poured into ethylene glycol.
The current source is a power rectifier BC-24, which supplies current up to 6A, voltage up
to 24V. After grinding, the frame of the clasp prosthesis is fixed in a vessel at a distance of 40
mm from the cathode and in the process of polishing it is gradually moved so as to make open all
hard-to-reach areas. Electropolishing is carried out in the following mode: current - 2A, time - 10
- 15 min, followed by rinsing under running water. The finished frame is transferred to the clinic
for examination in the patient's mouth.
Fitting the frame to the working model.
After finishing the frame, it is checked on a plaster model. The frame should be
superimposed on the plaster model without significant force in compliance with the previously
chosen route of insertion of the prosthesis. With significant shrinkage or deformation during
processing, the frame may not overlap with the plaster model. One of the signs of violation of its
accuracy may be damage to gypsum teeth or their breakage. Having imposed a skeleton on
model, it is necessary to be convinced of accuracy of manufacturing of its separate details. First
of all check the position of the support and retaining clasps. Their shoulders should fit snugly to
the surface of the tooth and repeat its shape. The tip of them should go into the interdental space
and cover as much as possible the abutment tooth. Shortening of the shoulder during modeling or
processing of the finished frame leads to the loss of its spring properties and, as a consequence,
to the violation of the fixation of the clasp prosthesis.
The position of the occlusal pad should also match the pattern indicated on the model. Its
displacement to the side or changes in size can cause an increase in the distance between the
alveolar distances and the violation of occlusal relations with various movements of the
mandible.
Then you need to check the location of the arc of the frame. It should not touch the surface
of the model, the clearance between it and the model should indicate the accuracy of the casting
of the frame. Thus, too close location of the arc to the surface of the model in the future may
cause injury to the adjacent mucosa after prosthesis. This is especially dangerous with loose,
easily pliable mucous membrane, which tends to significant atrophy, as is the case with
generalized inflammatory or dystrophic periodontal disease. The uneven gap between the arch
and the prosthetic bed may be the result of significant shrinkage of the frame after casting. Too
long a gap makes it difficult to get used to the clasp prosthesis, causes inconvenience when
using, contributes to a significant accumulation of food, poor hygiene and speech.
The arc must be clearly located within the defined boundaries. Its displacement on the lower
jaw down is unacceptable, as it can lead to injury of the bridle of the tongue, and its high
location, on the contrary, can dramatically disrupt the relief of the lingual slope of the alveolar
process and teeth, which significantly affects the habituation to the prosthesis.
The arch on the upper jaw may also be positioned incorrectly. Its excessive forward
movement will lead to a violation of speech, its too posterior position makes it difficult to
swallow. If the arch lags far behind the mucous membrane, the addiction to the prosthesis is also
broken.
Estimation of accuracy of manufacturing of a framework can be carried out only on
condition of its correct imposing. For this purpose it is necessary to keep insulating linings on
plaster model. The tight fit of the frame to them will indicate the accuracy of casting.
Particular attention when checking the frame on the gypsum model should be paid to
assess the accuracy of the placement of the bodies of the staples in the area of the
undergrowth. The destruction of gypsum in these places will indicate inaccurate insulation
before preparing the model for duplication. In this case, when applying the frame, the body of
the clasp falls into the zone of penetration below the boundary line only after the destruction of
the plaster above the boundary line. To correct this shortcoming, the excess metal should be
carefully removed in the appropriate place of the clip, thus ensuring the unobstructed overlap of
the frame in the oral cavity.
After making sure of the accuracy of the manufacture of the entire frame, you must once
again pay attention to the quality of its processing. At the same time it is necessary to check up
once again smoothness of transition of separate details of a skeleton in each other. The sharp
angle formed between the parts is highly undesirable, as these areas, firstly, are difficult to
process, polish and poorly cleaned of food residues, and secondly, such a frame structure violates
the nature of elastic stress distribution, causing disturbances in the biomechanics of the
prosthesis as a whole.
Machining technologies.

Correction and treatment with rubber polishers

With the exception of the arch of the upper jaw and the inner sides of the clamp, the frame is
 completely polished with rubber polishers. Only in this way can a smooth, even surface be
achieved. A small separation disk and a sintered diamond first slightly separate the areas
between the individual elements of the clip. The limiting edge for plastic on the underside of
the frame gets a clear outline. Klammery, and zokruhlenyy lining the inside of the
small ' Connector carefully zahladzhuyutsya rubber polishers. At the same time the tips of a
paper clip are carefully blunted. The edges of the arch of the upper jaw and the arch of the
lower jaw are treated with a small rubber polishing disc. Separated or hard-to-reach areas for
rubber polishing discs are treated with polishing lenses. The lower side of the arch of the
upper jaw is treated with rubber polishers only in areas not adjacent to the mucous
membrane. The edges of the prosthesis, especially where the arch may settle or have direct
contact with the tongue, are more rounded and carefully smoothed.

Polishing and final control of the clasp prosthesis before fitting

Rigid polishing brushes made of natural bristles are used to polish the clasp
prosthesis. Wax-based polishing pastes specially designed for cobalt-chromium alloys must be
used for polishing. Polish at a speed of approximately 2800 rpm
For a mirror shine take the same polishing paste and a medium-sized round brush with a
wooden core. When used correctly, you get a pronounced mirror shine. Small scratches
disappear after polishing with a small amount of paste. Careful final polishing that reaches all
niches and corners prevents the formation of plaque on the metal frame. Hard-to-reach places are
polished on a micromotor with a small brush. Polishing the frame on a plaster base, which can be
made individually without much time, especially protects the clasp prostheses of the upper jaw
from deformation. To do this, gypsum is densely mixed with warm water.

Materials used for processing.

A well-thought-out choice of tool is the key to rational processing. Cutters, depending
on the diameter and volume, can only operate at a certain speed. It is not recommended to
work on the grinder with mills having diameter of a shaft in 2,35. The thickness of the
shank of 3 mm has increased fracture toughness, higher stability and less
vibration. According to the technology of clasp prosthetics, abrasive tools mounted on a
ceramic bond can be used. Clogged or unevenly ground abrasive tools are corrected on the
cutting stone. Sintered diamond tools are especially good for processing. They are used
with low pressure and at a speed of 15000 -18000 rpm. For rough machining, you can use
carbide cutters with a cross-shaped notch. Finishing begins with the arc of the frame -
rounding the edges. To do this, the clasp prosthesis is clamped, for example, in a metalwork
vise. Then processed with paper clips, pads and a small connector. It is necessary to aspire
to graceful registration of a skeleton, rounding off transitions as far as it allows to keep
stability. Massive or overly enlarged areas are treated with purposeful movements. Small
bubbles on the underside of the arc are removed by a spherical boron of hard alloy. The
embossed side of the arc is processed only after electrolytic polishing. Pay attention to the
thickness and stability of the small connector and the shoulders of the clip. You can prevent
food particles from sticking by slightly rounding the underside of the small connectors to
improve self-cleaning. Between the retention and the arch, the dental technician draws up
an acute-angled limiter for plastic. Clear boundaries for plastic are also important on small
connectors and clamp arms. Flat areas, such as the edges of the frame, can be smoothed at
low speed with emery cloth (grain size 120).

Tools for surface treatment of clasp prosthesis:

• Partition discs (25.0 mm x 0.5 mm) for cutting gutters.

• Perforated discs (22.0 mm x 3.0 mm) for cleaning gutters.
• Mounted abrasive tools (white) for roughing 10,000 - 20,000 rpm.
• Carbide cutters with a cross-shaped notch.
• Grinding stones of different sizes, for rough and fine processing 20,000 - 30,000 rpm
• Rubber polishing discs, tips and lenses; green = soft, black = hard (18,000-20,000 rpm)
• Superflex rubber polishing discs for separation.
• Holders for polishers and discs (ideal diameter 3 mm).
• Sandpaper (grain size 120) for smoothing after processing.
• Sintered diamond tools (15,000 -18,000 rpm) to change shape and smooth.
• Carbide spherical boron (0.10 mm) for processing the embossed side.
• Stupid carbide tool for processing the inside of the paper clip.

The doctor indicates to the dental technician the color of the teeth, their style, which
depends on the shape of the patient's face, the size and shape of the alveolar process and
adjacent teeth. The size of the teeth is chosen by the dental technician on the
adjacent remaining teeth, the size and shape of the alveolar process, the type of bite. In
the absence of all anterior teeth of the upper jaw, they are selected according to the
guidelines
made by the doctor in determining the central occlusion: the distance between the lines of the
canines select the width of the teeth, and the distance between the smile line and the
lower edge of the occlusal roller - length (height) of teeth.

Installation of artificial teeth

in partial removable plate prostheses
Artificial teeth on the basis of the prosthesis can be placed in two ways - on the inflow
(when artificial teeth are ground directly to the edentulous alveolar process)
- artificial gums (when artificial teeth are installed on the basis of the prosthesis). For
example, at well or moderately expressed toothless alveolar process of an upper jaw in front
department and the shortened upper lip it is expedient to put artificial teeth on sharpening. At
moderately expressed alveolar process or its sharp atrophy in combination with a long upper lip
it is necessary to give preference to statement of teeth on artificial gums. Careful assessment
of intra- and extraoral features (degree of atrophy of alveolar sprouts, length of lips, degree of
exposure of alveolar sprout and teeth with a smile ) allow to choose the right method of
artificial teeth and to individualize it as much as possible, departing from generally
accepted standards. more natural. The longitudinal and transverse dimensions of artificial
teeth, their style are determined primarily by the shape of the patient's face face to face and in
profile, the length of the defect of the dentition and the interalveolar space. At well expressed
alveolar sprout it is necessary to apply artificial teeth with small curvature of a neck and, on the
contrary, at considerable atrophy of an alveolar part - with more expressed curvature.
At statement of artificial teeth in front department first of all pay attention to degree of an
atrophy of an alveolar sprout. With a small and fairly evenly atrophied alveolar part, artificial
teeth should be expanded in the cervical region.
Lateral artificial teeth are selected according to the length of the defect and the value
of the interalveolar distance.

Technique of artificial teeth

Before installing artificial teeth, you should choose the necessary set according to the
style, color and size of the teeth. Today, manufacturers of artificial teeth in addition to the
above parameters allow you to select teeth according to age. From the picked up set
the oriented statement becomes . To do this, the teeth are placed in the area of the defect of
the dentition and determine the exact location for their installation and the amount of
grinding. Picking up artificial teeth, prepare a plaster model for their installation. To do this,
make a wax base, the boundaries of which are slightly wider than the boundaries of the
prosthesis marked on the model, so you can glue the wax base to the model
without breaking the prosthetic bed.
Start with the front teeth. The inner surface of the artificial tooth facing the alveolar process is
subject to grinding. In this case, 2/3 of the thickness of the anterior tooth should be placed in
front of the alveolar ridge. Artificial teeth should restore the shape of the dental arch, maintain a
certain level of the upper lip, preventing depression. When grinding teeth to the alveolar part
(processes) it is necessary to monitor the preservation of their anatomical shape, compliance with
its shape and position of natural teeth and the occlusal relationship with the tooth antagonists.
The gingival part of the lower anterior artificial teeth is placed strictly in the middle
of the crest of the alveolar process with a slight slope of the cutting edges, outward or inward,
depending on the type of bite or the relationship with the teeth - antagonists. This helps to
transfer the pressure arising from the bite of food to the middle of the alveolar part of the
jaw, better fixation of the prosthesis and prevent overload of the tissues of the prosthetic bed.
With severe atrophy of the alveolar part (process, artificial teeth in the anterior part are
placed on artificial gums, ie plastic base. The rules of artificial teeth in this case differ only in
that it does not require precise grinding of the gingival part to the slope of the alveolar process,
because it sinks into wax base. Thus, within the thickness of the wax base may vary and form
pryyasnevoyi of artificial teeth. in addition, when determining the size of the artificial teeth
should be considered marking the labial surface of the occlusion roller - sector bounded by lines
"smile" and canines and split the middle line between Between the midline and the canine line ,
2.5 teeth should be placed on each side.The "smile" line is a guide when determining the height
of artificial teeth.
Artificial teeth in the lateral parts of the upper and lower jaws are often placed
on artificial gums in the middle of the alveolar part (process). As noted by VS Pogodin and VA
Ponomareva (1983), the interalveolar lines connecting the middle of the ridges of the edentulous
alveolar processes of the upper and lower jaws should pass through the middle of the
masticatory surfaces of artificial teeth. This creates conditions for optimal distribution of
masticatory pressure on the underlying tissues of the prosthetic bed, contributes to better
stability of the prosthesis during function. When placing artificial teeth in the lateral parts of the
jaws, it is also necessary to pay attention to the restoration of the shape of dental arches,
which has a beneficial effect on the appearance of the patient and the quality of speech
restoration. Artificial narrowing of the dental arch causes a feeling of compression of the tongue,
and areas with slightly beveled surfaces on the inside. If the alveolar part (process) in the
anterior part is well preserved, but narrow, then preference should be given to artificial teeth,
narrowed in the iliac part and significantly beveled on the inside.
When placing artificial teeth in the anterior part, the greatest difficulties arise when there is
a lack of space for placing teeth, pronounced indentations in the teeth, limiting the defect, pear-
shaped vestibular slope of the alveolar part of the jaw and the selection of the appropriate
color.
The lack of space for artificial teeth can be associated primarily with the deformation of
the dentition, when the teeth that limit the defect are shifted towards the extracted teeth. The
same situation occurs when removing teeth on the background of anomalies, such as clustered
position of the front teeth of the upper or lower jaw. If orthodontic correction of displaced
teeth is not possible, the best way to overcome this problem is, firstly, a reasonable grinding of
the contact surfaces of the teeth, which interfere with the placement of teeth of normal size, and,
secondly, carefully thought out placement of artificial teeth in the so-called overlap. that
mimics the crowded position of the teeth. Thus for achievement of good aesthetic effect it is
necessary to use for statement artificial teeth of the same size, as natural. In addition,
the method of pre-treatment of teeth that limit the defect of the dentition can be combined with
the clustered placement of artificial teeth .
Sharply pronounced undercuts on the teeth, limiting the visible defect of the dentition,
look especially ugly when placing artificial teeth on artificial gums. Aesthetics can
be improved in this situation by placing artificial teeth on the sharpener, by reducing the undercut
when grinding the most protruding surface of the tooth or using the so-called inclined or
rotating, ways to insert the prosthesis, when the undercut is filled with base material. In this case,
it is also useful to use the enlarged and thinned edges of the artificial gums, which closes the
undercut or defect of the edentulous alveolar part.
With a pear-shaped toothless alveolar part, the usual route of administration is impossible
without prior grinding of the plastic that fills the undercut. Changing the way the denture is
inserted can create additional indentations in the area of the lateral teeth, which will also require
the removal of excess plastic. However, this in turn can lead to poor fixation of the
prosthesis. The solution may be to shorten the base on the labial side or the placement of
artificial teeth on the grind.
A special problem in the installation of artificial teeth is the reproduction of the beauty,
depth and color variability of natural teeth. The best conditions for color selection is considered
to be bright daylight. To do this, the patient should be brought to the window and turn off
artificial lighting. In doubtful cases, you should choose slightly darker teeth that will look
lighter after sanding. This is due to the fact that the main color-forming zone in acrylic
teeth is located on the side of grinding. The inflow tooth loses most of the staining plastic
and looks lighter. If it is excessively ground , the metal frame can shine through, which
should be pre-masked with an opaque.
It can also be the cause of prolonged speech disorders or deterioration of the patient's
appearance after prosthetics.
With advanced atrophy of the alveolar parts (processes) of the upper and lower jaws
often there is a significant discrepancy between their ridges in the transverse plane, and
the interalveolar lines have a large slope. At such clinical picture it is necessary to change
places the top and bottom teeth, the right and left (cross statement), creating sometimes
back overlapping when buccal tubercles of the lower molars overlap buccal tubercles of the top.
Particular attention should be paid to artificial teeth adjacent to the abutment teeth
and brackets. Here the sharpening of the gingival part of the tooth should be carried
out especially carefully. This is due to the fact that the body of the bracket, located on the
contact side, prevents the artificial tooth from being placed close to the abutment. In
addition to being located in this place above the crest of the edentulous alveolar part, the
appendix of the
clasp can also interfere with the accurate installation of the artificial tooth. Under these
conditions, the turning of the plastic should be carried out especially carefully due to the danger
of violation of the anatomical shape of the tooth. In the same cases when abutment teeth are
visible at a smile or conversation, in addition there is a problem of preservation
of aesthetics. Decision of the application questions can be shortened side wire containing
klamerov body which can be derived from the area podnutren Mr. I on the outside of
invisible plastic base. No less important in the installation of artificial teeth is the diligence of
making occlusal contacts. The best results are achieved after pre-recording the movements of
the mandible in the patient intra- or extraoral method using the facial arch and the subsequent
reproduction of individual movements of the mandible with an articulator.

After the installation of artificial teeth, the basis of the future prosthesis is
modeled . To do this, first check its thickness, compliance with the boundaries marked on
the plaster model, the tightness of the wax base to the model.
Once again check the accuracy of the elements of the brackets on the abutment
teeth, remove the wax reproduction of the removable prosthesis from the model, round the edge
of the base, re-install it on the model, give the wax surface the necessary smoothness with a
flame soldering iron or gas burner and send the model to the doctor to check the design.
Partial dentures - partial removable dentures, part of the base is replaced by a metal arc
(arc - bugel whence and the name ). Stomatology and prosthetic
dentistry prosthetics called yet , prostheses , which lean . There are other names
of clasp prostheses : arc , frame , skeletal , which characterize their design features .
The design of the clasp prosthesis. A characteristic feature
of Partial dentures are combined mode of transmission chewing load through
the teeth for tissue periodontal and soft tissues , which cover
the toothless alveolar processes . The clasp prosthesis consists of a metal frame
on which plastic bases with artificial teeth are attached . The frame formed by the
connection was iznyh clasps, sometimes springs, hinges and arches, which are bearing the
design of all the prosthesis.
Brief description of the main elements of the prosthesis , which lean .
1.Saddles - Saddle or base, is a part of the prosthesis, which is
based , carrying on a artificial teeth and lost part .

2. retention elements - devices , which hold the prosthesis

in its place during a movement of the lower jaw and prevents its displacement in the
vertical direction by Dr. iyeyu own weight, vertical and horizontal components of
the forces that arise during the time of the act of chewing or as a result of the action of the
pressure of food . Retention of prostheses , that lean , carried out by means
of devices fixed species , clasps, attachmenyi in .
3. The elements , which stabilize - serve to prevent displacement of the prosthesis
in a horizontal direction under the influence of lateral load .
They contribute to the distribution of horizontal components of
force pressure on perhaps more than the number of teeth , which were , increasing by the
same stability of the
prosthesis. In quality elements , which stabilize , using continuous and bahatolankovi clasps ,
as well as extended shoulder clasps, which are carts, Hold . Retention elements tend
to contribute to stabilizing the prosthesis Mr Eid time the act of chewing .
The main part of the clasp prosthesis is the support- holding clamp, which provides
a dual way of transmitting masticatory pressure . With the help of clasps ,
the masticatory pressure is distributed between the teeth and the mucous membrane of
the alveolar processes .
Advantages of clasp prostheses over plate ones.
1.Clasp dentures transfer part of the functional load to the abutment teeth, thereby
reducing the pressure on the mucous membrane of the edentulous areas of the alveolar
process and the prosthesis is slightly immersed in the mucous membrane and almost does
not fall.
2. The functional efficiency of clasp prostheses significantly exceeds the efficiency of
plate and it reaches 70-80%.
3. With the help of a system of brackets you can adjust the distribution of vertical pressure
between the abutment teeth and the mucous membrane of the alveolar process, it reduces the
functional load on the mucous membrane and underlying bone tissue, which is important to
slow bone atrophy and maintain alveolar process height.
4. Clasp prostheses do not violate diction, taste, temperature sensitivity
oral cavity, do not injure the mucous membrane of the gums.
5. The arch prosthesis does not adhere to the necks of the teeth and does not have a
detrimental effect on their stability.
6. Clasp dentures have a splinting effect on the remaining teeth and contribute
increasing the functional value of the periodontium of the abutment teeth.
7. Clasp dentures do not have a negative effect on the gingival margin
essential in the orthopedic treatment of periodontitis .
8. These prostheses help to reduce the harmful effects of the horizontal component
forces exerting pressure on the abutment teeth and on the alveolar processes.
9. Supported prostheses are more hygienic than plate ones.
Indications to replacement of defects of
dental rows clasp prostheses. Clasp prostheses are shown :
1.When any where topography defect teeth, but the size of the defect is not more than 3-
4 teeth in the side area of not less than 6 teeth in the frontal area .
2. At multiple included defects of a dentition.
3. When the mobility of the teeth (I, II degree due
to illness periodontal], clasp prosthesis can not only unite the separate groups of
teeth in function blocks, but also eliminate functional overload ( items , that tire ,).
4. At poor adaptation of the patient to a plate prosthesis and intolerance by the patient
of acrylic plastics .

In testimony considered state of the tissues of the teeth , dental formula, the height
of the crowns supporting teeth , used for clasps, type of bite
and compliance mucous membranes .
The following conditions are required for indications for clasp prosthetics :
1. In the area of the periapical tissues of the remaining teeth (especially for braces )
there should be no pathological changes.
2 The fissure on the abutment teeth intended for occlusal overlays should be "deep.
3. Crowns of abutment teeth should have more or less pronounced equator .
4. In the dentition must be at least 5-6 teeth standing near or teeth shall be
so located , that could have been bridges prosthetics a specified position in the dentition
( This requirement applies mainly to the lower jaw ).
5. Crowns supporting teeth , which are used for klamernoho attachment , not have to be low .
6. The bite should not be deep .
7. On the lower jaw should be a deep location of the bottom of the mouth.
8. The mucous membrane in the area of missing teeth should differ normal
pliability .
The second, third and fourth conditions can be created in case
of their absence by means of orthopedic interventions .
The choice of clasp prosthesis design takes into account the type of defect, its length ,
the condition of abutment teeth , the condition of the mucous membrane , the patient's age,
the condition of the alveolar ridge , the type of bite, the individual characteristics of the patient.

Requirements for clasps for clasp prosthetics :

1. Ensure fixation of the clasp prosthesis in the oral cavity.
2. Rational distribution of masticatory pressure between abutment teeth and mucosa
shell of the alveolar processes.
3. The support-holding clamp must transmit masticatory pressure along the axis
tooth.
4. In diseases of periodontal tissue should be used multi- link
clasps with hooking loops for splinting teeth .
5. Clamps should not overload the periodontal tissue and loosen the teeth .

Requirements for abutment teeth in .

1 . The greater the number of teeth that support the brackets, the
more masticatory pressure is transmitted to the teeth.
 2. At arc prosthetics the mucous
membrane is unloaded to a certain extent and teeth are loaded, it is necessary to accept
preferential flat
fastening, and at a choice of a bracket - to prefer those leaning and
combined brackets with stable or semi-labile connection with a
prosthesis.

Requirements for the use of occlusal surfaces .

Deep fissures and a pronounced equator in the crowns of abutment teeth can be
achieved by artificially deepening the fissures and making a crown with an equator.
Fissures are prepared and form semicircular notches in the form of a figure for free sliding
of the occlusal foot during lateral movements of the prosthesis.
At the end saddle, the bottom of the fissure in the abutment tooth is formed with a slope
in the distal direction, at the intermediate saddle - the bottom of the fissure is flat.

Staple system
To strengthen Partial dentures often use clasps . Their form depends on what tasks are set
before the specialist. By function, paper clips are divided into:
- supporting
- retaining
- oporno- trymuvalni .
According to the method of fixation on:
1. stable
2. semi- stable
3. labile.
Clamps used for the manufacture of clasp prostheses must meet the
following requirements:
- To provide fixation and stabilization of the clasp prosthesis in the
oral cavity.
- During chewing, rationally distribute the pressure between the abutment
teeth and the mucous membrane of the alveolar processes.
- The support- retaining clamp must transmit pressure during
chewing along the axis of the tooth.
- In case of periodontitis, it is necessary to use multi- link clamps with
hooking loops for splinting teeth.
- Clamps should not overload periodontal tissues and
loosen teeth.
- At rest, the bracket should not press on the tooth, otherwise it
will act as an orthodontic spring.
These requirements are satisfied oporno- utrymuvalnyy (combined) clasps, which consists
of:
- two shoulders
- occlusal pad
- bodies
- appendix (with which it connects to the prosthesis frame
).
Some paper clips consist of all the specified parts, others contain only part of them.
The surface of the tooth crown is divided into two parts -
occlusal and retention (gingival). The boundary between them is the equator of the tooth.
If the clamp arm is placed on the retention surface, it will not slip out of the tooth, as it is
held only by the part of the equator of the protruding tooth. Such clasps and their shoulders are
called retaining ( retention ). The part of the tooth between the equator and the occlusal surface is
considered to be the support. Clamps or their parts located in this area do not move in the direction
of the gums, because this is prevented by those areas of the tooth that protrude. Such parts of
the clip are called support. Clamps , the details of which lie on both parts of the tooth crown
(support and retaining ), are called combined, or support- retaining . Schematically , there are three
zones in the support- retaining bracket : support, covering and retaining ( retention ), ie zones of
support, coverage and retention .
The support zone involves the transfer of pressure to the tooth during chewing, reducing
the pressure of the prosthesis on soft tissues, the coverage area - preventing the displacement of the
prosthesis to the side, the retention zone - fixing the prosthesis in place, preventing the movement
of the clip up - down.

Shoulders of the support and holding bracket .

The upper, or clasp , shoulder is the part of the clasp that prevents the prosthesis from
moving in the oral or vestibular direction. The lower arm, or clasp spring process, is the part of
the clasp arm that falls below the equator and reaches the gingival retention fields. Thus, the
spring process of the bracket ensures its retention in the vertical direction on the abutment tooth
of the mandible. The shoulders of the support- retaining clamp are located on the vestibular and
oral surfaces of the tooth. The shoulders of the clasp protect the prosthesis from displacement
during horizontal loads and at the same time help to stabilize it. Oral arm away from the
body clasps at oklyuziynoi pads on the contact surface of the tooth, gradually spus - repent for
oral surface to the equator, crosses it and ends up between the gum and the equator in
the retention area of the tooth. The vestibular shoulder also departs from the body of
the clamp near the occlusal lining and lies on the vestibular surface of the abutment tooth. Due
to this arrangement of the shoulders, the paper clips perform a supporting and holding function. If
the supporting part of the clamp is well expressed, the occlusal overlay may be minimal or
absent.
The retaining part of the shoulder should be long and thin to maintain
elasticity. Beginning with the thickened part near the body and the lining, the shoulder gradually
thins, crosses the equator, narrows to half its thickness, acquiring a pointed shape at the end.

Overlay
The part of the brace that lies on the occlusal surface of the tooth is called the
overlay. Purpose of occlusal overlay:
1. Transfer of vertical load to the abutment tooth during chewing.
2. Prevention of sagging of the prosthesis under load.
3. Restoration of occlusal contact with antagonist teeth and establishing contact of
the prosthesis with abutment teeth.
4. Restoration of height of crowns.
The occlusal pad can be part of a clip or an independent element of a clasp prosthesis.
When designing a clasp prosthesis, the occlusal pads are placed so that the load is
oriented along the axis of the abutment teeth.
Improper placement of the occlusal pad often leads to overload of the periodontium in
the horizontal direction, which causes loosening and loss of abutment teeth. On abutment teeth
the occlusal overlay is placed in:
- natural fi suras and pits;
- artificially created recesses in the abutment teeth ;
- fi surah , stamped in metal crowns, which cover the abutment teeth;
- in tabs.
Features of load transfer to the abutment tooth through the occlusal pad depend on its
location, size, shape, as well as the shape of the bed. If the teeth in the position of the central
occlusion close tightly and there is no place for the occlusal overlay, create an artificial bed on the
masticatory surface of the abutment tooth. The shape of the artificial bed should be spherical, and
the bottom of the cavity - perpendicular to the axis of the tooth. Length - not less than 1/3 of
the occlusal surface and depth - 1.5 mm. This shape allows the occlusal pad to slide under the
action of a horizontally directed force that occurs during chewing, which prevents the tooth from
loosening. If the artificial bed has a rectangular shape, the occlusal pad of this shape will turn into a
tab and the displacement of the prosthesis during chewing will lead to loosening of the abutment
tooth.
The occlusal pad must be thick enough (up to 2 mm) to counteract the pressure that occurs
during chewing and to prevent deformation.
Most often, the occlusal pad is placed in the fissure of the tooth from the side of the
defect of the dentition. But it is not required " if omitted . It is better to transfer an overlay on a
medial surface of a basic tooth or in a groove of the next. In the case of restricted distal defects
should devel - tashovuvaty occlusal pad on the medial surface of the abutment teeth to it while
eating his weight prytyskuvala abutment tooth to tooth, standing in front rather than the side of his
nahylyala defect not challenged it.
The choice of location for the occlusal pad is influenced not only by the nature of the
occlusal relations, but also by the method of distribution of forces acting on the prosthesis, their
intensity, the ratio to the axis of the tooth. Sometimes occlusive cover transformed into pillars,
which in some designs stickers - do not give to the occlusal surface of the tooth, and for any
speech on the boundary line.
Properly placed occlusal pad helps to fix the clasps and the entire prosthesis. When the
design of the prosthesis includes a sufficient number of occlusal plates, the base of the prosthesis
can be reduced and vice versa. In the case of included defects, the linings almost completely
transfer the vertical load on the abutment teeth, as a result of which the clasp prosthesis is
structurally close to a bridge .
Staple body .
The fixed part that lies between the equator and the masticatory surface of the abutment
tooth on its proximal surface (near the contact tooth). The body may be different in different types
of clasps.
Process.
The body of the clamp passes into the process, which connects it with other parts of the
metal frame.
Located at a distance of 3 mm from the marginal periodontium (so as not to injure
it). This rigid and strong element lies on the proximal surface in order to be covered with an
artificial dentition.
Indirect clamps that prevent the prosthesis from turning over. These are auxiliary clasps in
the form of finger-shaped processes ( compaiders ). At the end, they have a small foot that is
adjacent to the oral surface of the teeth. Like the arch, the finger-like processes should not touch
the mucous membrane of the palate. Holders are placed in the area of the hard palate so that they
do not interfere with pronunciation. However, this is not always possible, so their use is
limited.
Appoint holders to provide stability to the prosthesis in the vertical direction, in the
absence of distal supports on the upper jaw, in the presence of a defect of the dentition of
significant size, flat palate.
Saddles. The ends of the arch are included in the lattice or mesh for attaching the base of
the clasp prosthesis. Lattices and grids are placed in the middle of the plastic base so that the
mucous membrane of the alveolar process is not adjacent to the metal and plastic. They lie within
the defect on the alveolar process and repeat it in shape. They are 1-2 mm thick, depart from
natural teeth by 1-2 mm, and from the mucous membrane by 1-2 mm.
The basis of the clasp prosthesis. An element of a removable prosthesis that contains
artificial teeth and branches from its metal parts. The basis of the clasp prosthesis is a saddle-
shaped plate, which covers the edentulous alveolar processes and:
- serves to strengthen artificial teeth;
 - restoration of the shape and size of the jaws;
- transmits to the alveolar processes the pressure that occurs during
chewing;
- limits the displacement of the prosthesis in the horizontal direction.

The main types of support and retaining brackets.

Clamps in clasp prostheses have different shapes, designs, are made of different
materials, by different methods, and they perform different functions. Each of them has certain
advantages and disadvantages.
The most rational in form are the clamps of the Ney system . This system of staples was
developed in 1956 in Frankfurt am Main by a group of specialists, which included dentists, dental
technicians, metallurgical engineers. The authors of the system divided the paper clips into 5 main
groups and developed indications for their use.
Stapler №1 ( Akkera ) - two - shoulder stapler with occlusal pad. It is also called saddle-
shaped. It consists of two shoulders and an occlusal overlay, which are connected monolithically,
as well as the body located on the side of the defect of the dentition, and the process (Fig. 1).
The shoulders of the bracket cover 3/4 of the tooth surface, perform support, stabilizing
and fixing functions. The occlusal lining is contained in the fissure , performs a supporting
function.
Acker clamp is used in the case of the middle location of the boundary line. The
supporting elements of the bracket do not interfere with the occlusal ratio, and
the holding zones of the abutment teeth are quite well expressed on the vestibular and oral
sides. This is possible in the absence or minimal inclination of the abutment teeth.
In the case of end defects of the dentition, the presence of hard the connection of the clamp with
the base of the prosthesis promotes the transfer of pressure during chewing, mainly on the
abutment tooth, which brings it closer to fixed cantilever prostheses. The latter leads to functional
overload of the periodontium of the abutment teeth. Because of this, the Acker clamp is most
often used when it is necessary to replace limited defects of the dentition and erect, not inclined or
with a minimum inclination (up to 0.5 mm), molars and premolars with a well-defined
equator.
The rigid part of the bracket is 2/3, and the elastic - 1/3 of the shoulder length. To
determine the end of the retaining part of the bracket on the abutment tooth requires
a parallelometer , which uses the caliber № 1 or № 2.

Clamp №2 - split, T-shaped, stapler (Fig. 2). It has a strong occlusal pad that passes into the body,
and two T-shaped shoulders attached to the saddle, lingual or palatine arch. T-shaped splits provide
good retention through the use of distal-proximal sides of the crown.
Clamps are used when the low crowns of the teeth, the distal slope of
the canines , premolars and molars, as well as at an atypical location of the boundary line -
when it lies high in the area closest to the defect and lowered in the distance.
As a result, there is almost no support surface on the side of the tooth inclination. Only
the occlusal overlay of the paper clip can be placed above the boundary line .
It is impossible to place the body and the hard part of the paper clip , such as Acker . In the case of
modeling these elements in the holding area to impose a ready-made bracket on the abutment
tooth is not possible. The use of a split Roach clamp is also appropriate for the medial slope of
the molars and the high location of the boundary line. This clip is quite effective, well fixes the
denture saddle located near the neck of the tooth, is best masked and is the most cosmetic among
all other types of cast braces. Having a long shoulder, the bracket springs well and acts gently on
the abutment tooth during the movement of the prosthesis.
To determine the retention area on the basic tooth using paralelome trom and sizes №2 and
number 3.
Clasp № 3 combined. It consists of a rigid arm (same as that of the clamp № 1), which is
connected to the occlusal pad, and a second elastic arm (as in the T-shaped split clamp № 2),
not connected to the first part and directed to the arch of the prosthesis ( Fig . C ). The combined
bracket is used in case of vestibular or oral tilt of the teeth. The boundary line in the case of
inclination to the vestibular side will be raised on the vestibular side of the tooth, where it is
proposed to place a T-shaped shoulder with a horizontal deviation of 0.5 mm (caliber № 2). On the
oral side of the tooth, where the boundary line, on the contrary, will be low, place the shoulder of
the Acker clamp . In this case, it will be completely in the support zone and will play only a
stabilizing role. When tilted to the oral side, the opposite is done : where the boundary line
is raised , the coverage is applied on the elastic shoulder (clamp № 2), and on the side of its
lowering - the shoulder of the clamp № 1.

The combined bracket is used mainly when the abutment teeth are tilted or rotated, limited
by end defects. If a combined brace is used on the canines and incisors of the upper jaw, the T-
shaped shoulder is placed only on the vestibular surface of the teeth. The place of the end of the
shoulder of the retaining parts is determined using the caliber № 1.

Clamp № 4 - one- shoulder , reverse , with one occlusal pad There are two versions of it. One of
them is a paper clip posterior action, used for short crowns or y
case of vestibular tilt of the premolars and anterior teeth, which
limit the defect of the dentition without distal support.

The process of this clamp departs from the clasp arc

prosthesis, passes into the body and the occlusal lining and ends with a retaining shoulder on the
vestibular surface of the abutment tooth. At a vestibular inclination the boundary line on oral
the wall of the abutment tooth is lowered, and (one- shoulder reverse ), on the vestibular - slightly
raised. Then on the oral side you can put the rigid elements of the clip (part of the process and the
body).
The long retaining shoulder thus covers the vestibular wall, crossing the boundary line, is
located in the holding zone. The horizontal deviation should not be greater than 0.25 mm (caliber
№ 1). The second version of the clamp № 4 works in the opposite way, it is used when the
premolars are tilted toward the tongue. From the previous clasps it differs primarily in that departs
from the base of the frame (seat) with vestibular side and lies on the vestibular surface of the tooth
reference boundary line that tumor - schena through oral slope. The retaining arm of the bracket
wraps around the distal contact wall of the tooth, and then the oral and after crossing the boundary
line is located in the holding zone on the oral wall. Since in both cases the clamp № 4 has only one
shoulder, it is advisable to strengthen the fixation of the prosthesis due to the
auxiliary retaining clamp on the same or on the opposite side. Since the stapler provides one-
sided retention , it is shown to use a similar stapler on the other side to enhance the locking action
of the stapler . The end of the shoulder of the retaining part is determined using the caliber № 2.

Clamp №5 - ring, odnoplechovyy , consists of a long arm,

which covers almost the entire surface of the tooth, and two occlusal overlays in the medial and
distal fissures ). From a medial occlusal overlay a basic part of a shoulder

goes on the surface of the tooth, opposite to the slope, at the level of the boundary line and,
covering the distal surface, gives the chewing surface of the tooth another occlusal pad.

Going down slope on the side of the tooth under the boundary line ends in the shoulder deterrent
( odnoplechovyy ,, ring). zone and creates a point of retention , but rather weak.
 The clamp provides good resistance, and its ability to fix is weak. Therefore, it is planned
to strengthen the fixation with a clasp on the other side. To increase the rigidity of the
annular clasp , a second arm is created, which extends from the arch or from the saddle and departs
from the gingival margin by 1.5–2 mm.
The ring clip is used on individual molars that limit the defect of the dentition and on the
upper jaw inclined towards the cheeks , and on the lower - the tongue.
Occlusal pads provide uniform transmission of pressure that occurs during chewing, along
the axis of the tooth, even when the tooth is inclined toward the defect. To determine the location
of the retaining part of the shoulder of the ring bracket use caliber № 2 in the case of included
defects of the dentition and caliber-rod № 3 - in the case of combined.
In addition to the described types of clamps of the Ney system , other types of cast clamps are
used for the construction of clasp prostheses.

Jackson's paper clip is a folding support- holding paper clip with a double shoulder. The double
shoulder can perform stabilizing and

retention function. Clamps are used on lateral teeth and, above all, on adjacent areas. On the cheek
side, a ring is formed, which covers the vestibular surface of the abutment tooth. Used in the case
of a continuous dentition and in the presence of space for the location of the tilting part of
the bracket without increasing the height of the bite. To determine the retention use the caliber №
1.Bonville's clamp is a double two - shoulder clamp with occlusal overlays in the fissures
of adjacent teeth. Apply for prosthetics in case of unilateral defects final denture is placed in Safety
of - the continuous tooth row, between the molars. Caliber № 1 is used to determine retention .

Reichelmann's clamp is a transverse clamp with an occlusive lining in the form of a transverse
septum, which passes through the masticatory surface in the vestibular-oral direction, which
connects the two shoulders.

- vestibular and oral.

Indications for its use: unilateral end defects. Indications are narrowed due to the need for special
preparation of the tooth: on the chewing surface you need to create a place for the transverse
overlay. To determine the retention use the caliber № 1.

The clamp of the Roach system has the form of elastic T- shaped processes which depart
from a skeleton framework and settle down in deepenings. The originality of their design is that the
fixation of clasp dentures requires minimal retention zones on the abutment teeth. Clamps have a
branched shape and protrude from the clasp frame in the form of spikes and paws. Since they touch
the tooth surface with a minimal area, they contribute less to the development of caries. Prostheses
fix well, meet aesthetic requirements. But due to the fact that they are difficult to place, they
are rarely used , but are widely used as separate parts of staples.

Klammer system Baltersa . Balters suggested delicate clasps that allow you to use the smallest
anatomical ryetentsiyni items to perform functions tooth support and maintenance.

The Bonihart clamp consists of a T-shaped shoulder with an elongated body in the form of a
spring, which joins the clasp and is located on the vestibular side in the neck of the tooth. The
shoulder is part of the bracket that mounts to the bumps of the front teeth. To determine
the retention use the caliber № 2.
A continuous (multi-link) stapler has the form of interconnected: the shoulders of several
staples. Placed orally or vestibularly, adjacent to each natural tooth in the area of the hump or
equator. Continuous staples have

width almost 3 mm, thickness - 1 mm. Their shape is semi-oval . As the degree of coverage teeth
bahatolankovi clasps can have a narrow (multilink clasps Kennedy} or wide strips ( splinting bar)
or ambrazurnymy claws (clasps cross Shre - dera). They can be used for conn connection between
the components of the prosthesis and stabilization, and at the same time perform both functions.
Of continuous clasps spanning from 2 to 8 teeth or dentures half to stabilize the prosthesis, if
necessary to restore lateral and terminal defects denture teeth and mobilization with the disease
tissue periodontal .

Berezovsky's clamp provides load transfer to 2-3 teeth, which limits the defect of the
dentition. The supporting shoulders of the bracket cover the tooth on the oral
side. Occlusal overlays are placed in the interdental grooves medially from the defect.

The shoulder of the clasp covers the contact surface of the tooth and passes to the
vestibular, ending below the boundary line in the retention zone. The clamp appendage joins the
arch on the lower jaw or the frame on the upper. Thanks to the supports located medially from the
defect, this bracket distributes pressure on several teeth during chewing, and also prevents tooth
dislocation, which limits the defect.

The telescopic clip consists of telescopic crowns - internal and external. The first covers the
abutment tooth and has the form of a metal cap of cylindrical shape, the second - a pronounced
anatomical shape and normal occlusal relations with antagonists. The outer crowns are soldered
to the prosthesis frame, thus providing a stable connection. According to the principle of
transmission during chewing pressure on teeth supporting telescopic crowns should be attributed to
oporno- utrymuvalnyh . Telescopic crowns used in case of low clinical crowns when conventional
support-in trymuvalni clasps do not provide satisfactory denture and when there is no possibility to
produce Solid frame clasp prosthesis.

Parallelometry of the working model.

Parallelometry is the study of a model in a parallelometer in order to determine:
1. Direction input and output of the prosthesis, ie finding
the average parallel teeth selected for placement onthem support - utrymuvalnyh clapper.
2. Surveying the line (support - Hold and l ny clasps placed in
particular under this line).
3. Retention zone - the recesses on the cervical part of the tooth
(niche), where the retaining elastic part of the clip is located . The depth of the niche depends on
the length of the retaining part of the shoulder, and accordingly - the type of bracket and the
design of the prosthesis.
Since there is no parallel between the patient 's abutment teeth, a special device - a parallelometer -
is required so that the clasp prosthesis with a complex system of clasps can be fixed and removed
from the abutment teeth without obstacles .

Determination of retention (restraint) depth zones.

If the parallelometer rod is installed so that it touches the equator to the tooth of the
gypsum model installed and fixed on the parallelometer table , a niche (depth) is formed between
the rod of the device and the tooth crown below the equator, which goes around the tooth. When
designing clasps along this niche is used as a retention tooth surface to place it utrymuvalnyh of the
shoulder clasps s . Teeth with same location equator may have different severity of depression. The
deepening zone is a gap bounded by the rod of the device, the surface of the tooth from the defect
and the mucous membrane of the gums. These areas are significantly increased in the case of
convergence of the teeth.
The depth of the recess (niche) is determined by special tools - calibers-rods with different
diameters of the disk: № 1-0.25 mm, № 2-0.5 mm, № 3-0.15 mm.
Each type of bracket corresponds to a rod to determine the end of the retaining arm of the
abutment tooth.
The selected rod is fixed in the collet device and brought closer to the model. Moving the
rod up and down, on the boundary line choose the position when the caliber rod and its measuring
disk simultaneously come into contact, touch the abutment tooth. The place of contact of the disk
with the tooth and is the place of the end of the bracket shoulder or its beginning. Having thus
marked the depth of the retention end of the clasp with a pencil, you can start drawing the frame
of the clasp prosthesis.
Therefore, with the help of a parallelometer we can estimate the shape of the coronal part of the
abutment teeth, their position (inclination), draw a boundary line and after determining the depth
of retention to place the abutment - retaining bracket.
The most common are the five main types of boundary line, namely:
1. The boundary line passing through the middle of the proximal surface of the tooth 1 rises
vestibular to the point of contact with the adjacent tooth.
This arrangement of the boundary line allows you to conveniently place on the tooth support
and retaining clip Acker . The place where the end of the retaining clip should be , is determined
by the caliber of the a-rod №
2. The boundary line begins at the level of the contact point of the tooth from the defect of the
dentition and descends along the vestibular surface to the middle of the proximal surface near
the adjacent tooth.

Use the caliber-rod №2. In this case shown clasps long in trymu thick shoulders,
like clasps number 2 in Neh or clasps Boniharta .
3. Diagonal location of the equator on the abutment tooth. The equator passes near the masticatory
surface in the area of the defect of the dentition, obliquely intersects the vestibular surface 1 ends
with the whitish tooth on the opposite side.
The niche for the location of the end of the retaining arm of the clasp is determined using
the caliber - the rod № 3.
If it is a premolar , then a clamp with a long shoulder (clamp № 2 according to Ney ) is used,
when a molar is a circular clamp Ney .
Both brackets have long shoulders, thanks to which they are elastic and easily pass through the
equator of the abutment tooth, providing good fixation of the prosthesis 1 pressure transfer during
chewing along the axis of the tooth.
4. In the case of abrasion of the teeth, there is a high location of the equator. It passes at the level
of the masticatory surface. Such teeth should be covered with artificial crowns, which restore the
anatomical shape.
5. Low outline of the boundary line occurs on teeth that have the shape of a truncated cone. The
equator passes at the level of the tooth neck. Such a tooth can only be
used ldya reference clasps . To apply oporno- utrymuvalnoho clasps to restore the tooth shape
using artificial crown.
EI Gavrilov and EN Zhulev (1984) propose to identify seven main types of atypical direction
of the boundary line:
- has the form of a loop, the convexity of which is shifted to the gingival margin or
to the masticatory surface;
- has the form of a wide loop, the top of which is offset to one of the - contact surfaces;
 - step - shaped ;
- has the form of a high or low straight line;
- has the form of a wave.
The use of standard forms cast clasps Ney for atypical location of boundary lines are not
always justified, and therefore should construct such kinds of support- trymuvalnyh clasps that
would achieve reliable fixation and stabilization byuhelnoho prosthesis.
The authors developed and proposed several options for support-structures
in trymuvalnyh clasps for personal use depending on the type and direction boundary line, the size
of the planes bearing and utrymuvalnoyi zones.
In the first variant of an atypical location, the loop of the boundary line has a slope to the
neck of the tooth in the middle part of the labial or lingual surface.
The narrowed holding area, located near the neck of the tooth and its contact surface, makes it
difficult to design the bracket shoulder . The use of one or two shortened T-shaped shoulders, the
connection of one of them with the shoulder in the form of a process allows to achieve a reliable
fixation of the removable prosthesis.
in the case of the second variant of the atypical position of the boundary line, which is more
common when turning the abutment teeth around the axis, its contour has the opposite direction -
the loop is inclined to the chewing surface.
At first glance, it seems that in this case it is necessary to use a clamp № 1 of
the Ney system , because the holding surface is quite wide. But at the same time there is a
deep holding zone. Therefore, the retaining part of the bracket arm must be elastic, which is hardly
possible in the case of a cast bracket . For hard klamyera it to pass through the efforts boundary
line, while others clasps from frequent use rozhynatymutsya, losing contact with the tooth
in utrymuvalniy area.
In the third variant of the atypical location of the boundary line, the bearing surface is
shortened on the side of the defect or next to the adjacent tooth.
In the case of a high location of the boundary line on the contact surface facing the defect, the
reference zone may not be. The rigid part of the bracket should be placed on the opposite side of
one of the surfaces of the abutment tooth - labial or lingual - closer to the adjacent tooth, where
there is a wide abutment area. Here you should use one of the options of the cast clip .
If the boundary line rises steeply to the masticatory surface from the side of the defect,
where there is a wide support zone, you can use a clamp № 1 Ney system .
The stepped boundary line, as well as its third type, provides good conditions for the location of
the support element of the shoulder of the cast bracket in one part of the support part of the tooth
and unsatisfactory - in another. However, in this case, the support and holding zones are expressed
approximately equally. The choice of bracket type depends on the location of the boundary line on
the side of the defect. If it passes here closer to the contact surface, preventing the placement of the
support element, you can use one of the structures of the cast bracket . The elastic part of
the bracket shoulder should be placed on the half of the tooth where the boundary line passes
closer to the chewing surface.
But with the use of a clamp № 1 the retaining part of the shoulder will be small, so it should be
strengthened by a process in the cervical part of the tooth.
In the fifth and sixth types, the boundary line runs horizontally, near the masticatory
surface or, conversely, near the neck of the tooth. This is observed in pathological abrasion or
abnormalities in the shape and position of the teeth. Such teeth should be covered with
crowns. When modeling crowns with wax, a parallelometer should be used, which makes it
possible to obtain the optimal pattern of the boundary line in the future, which provides
a better function of the supporting and retaining elements of the cast bracket .
If the Boundary line has a narrow loop difficulties in constructing cast clasps on the
' lang nor of its undulating napryamkom.Zony support and retention narrowed, because it is
difficult to place as a strong and utrymuvalnu of clasps . Provide secure fit byuhelnoho prosthesis
can only be in support- trymuvalnyh clasps consisting of a truncated shoulder clasps number 1 and
№ 2.

Connection of a bracket with a prosthesis.

The connection of braces with a prosthesis is one of the main problems
of clasp prosthetics. The difficulty lies in the design of clasp prostheses due to the difference in
the flexibility of the periodontium and soft tissues of the alveolar processes during vertical
pressure. Supporting tissues respond differently to the load during chewing. Through
the ligament and hydrodynamic way, the periodontium transmits pressure to the alveolar process
and the body of the jaw. At the same time there is a load amortization.
The periodontium has a natural vertical mobility of 0.01-0.03 mm. The pliability of the soft tissues
that cover the alveolar process during compression is 0.3–0.9 mm, ie 10–30 times greater than the
pliability of the tooth. Under these conditions, the tooth begins to move before the mucous
membrane begins to limit the functional load. Therefore, when choosing the design of the
prosthesis, you should consider:
- type and size of the defect;
- the number and condition of abutment teeth in ;
- the severity of the alveolar ridge;
- pliability of the mucous membrane of the prosthetic bed, etc.
In case of insufficient number of abutment teeth or in case of their unsatisfactory stability,
it is necessary to think about how to unload them and redistribute a significant part of the pressure
on the alveolar process.
The ability to transfer the pressure that occurs during chewing to the alveolar process
depends on its shape and degree of atrophy, the condition of the mucous membrane. Acute knife-
shaped or mobile alveolar process may not be a good basis for pressure transmission, so you have
to put more strain on the remaining teeth.
To distribute the pressure during chewing between the alveolar processes and abutment
teeth, there are:
1. Hard (stable).
2. Elastic ( semi-labile ).
3. Hinged (labile) connection of the bracket with the base of the prosthesis.
In the case of a rigid connection, the bracket is fixed to the prosthesis, and the masticatory
pressure on the prosthesis is transmitted to the abutment teeth through the bracket. Rigid fixation is
used when the defects are limited by teeth on two sides - medially and distally. In the case of
bilateral support, the masticatory pressure is transmitted to the jaws in the most physiological way,
through the periodontium of the abutment teeth, and the planar fixation system provides stability
of the prosthesis and the best conditions for the operation of both prosthesis and remaining
teeth. The defect must be limited on two sides. A rigid joint is appropriate when
the clasp prosthesis is located on a sufficient number of abutment teeth, well-preserved alveolar
processes and mucous membrane with a small uniform elasticity.
In the case of end defects, a rigid connection is also possible with an appropriate method
of load distribution on the periodontium and the tissues of the alveolar ridge,
For rigid connection clasps with a frame with all kinds of defects dentition
using klamernu system Ney . The elastic connection of the bracket with the prosthesis is shown
when it is necessary to reduce the load on the abutment teeth by increasing the functional load on
the tissues of the jaw crest. This is observed when there are few teeth left to hold
the clasp prosthesis, or when the teeth are not stable enough, or there are changes in
the periodontal area . Elastic connection should also be preferred when the alveolar processes are
covered with a thinned mucous membrane that has low elasticity.
The shoulders of the clasp are connected to the prosthesis through a long elastic
process. In this case, part of the pressure of the prosthesis is transmitted to the teeth, the second
part is extinguished by an elastic lever.
Through the elastic connection, the load is transmitted to the mucous membrane of the alveolar
process a little later, when the periodontium of the tooth is already in the appropriate tension. The
efficiency of the spring depends on its length, cross-sectional profile, the nature of the material and
its heat treatment. The best elastic properties have a process of wire (from alloys of gold or steel)
with a diameter of 1-1.8 mm. Processes up to 1.5 mm in diameter should not be used.
The elastic process should not be too hard, otherwise it loses its elastic properties and the
connection will be rigid. In addition, too elastic appendage leads to greater mobility of the
saddle. Flat or semi -round cast steel appendages and even exposed on the edge are not elastic
enough.
The hinged connection of the clasp prosthesis is used when there are conditions for the
transfer of pressure during chewing, ie with a well-defined alveolar process, significant flexibility
of its mucous membrane in the case of a large defect of the dentition.
A hinge is a connection of two bodies which allow within their limits the corresponding
regulating movements of one or both parts. If such a movement is possible only around one axis, it
is a hinge joint, which in its simplest form has the form of a cylindrical body rotating around its
axis.
Such a hinge has a certain degree of freedom. If movements are possible around two axes,
the hinge has two degrees of freedom, and so on . For example, a human hand has 16 degrees of
freedom.

5. Plan and organizational structure of the lesson.

№ Methods Materials of
s/ Stages of the lesson Objectives of control and methodical Time
n training maintenance
1. Preparatory stage 15
min.
1.1. Organizational issues
1.2. Formation of motivation
1.3. Control of the initial level of training ─ letters ─ textbooks on the
testing, subject
─ oral ─ methodical
examination recommendatio
for ns
standardized ─ situational
list of tasks
questions
2. The main stage Phantom models
 m ─ practical
of ehanichn first processing and frame skills
byuhelnoho prosthesis .
 of
claim iskostrumenn first processing an
d frame byuhelnoho prosthesis.
55
 conducting electrolytic
min
polishing.
 carrying out about spraying
of foundries .
 carrying out fitting of
a framework on a working model .
 m aterialy that are used
for mechanical processing frame
 byuhelnoho prosthesis .
 t apographho-anatomical
features of partial defects of the
dentition.
 features of artificial teeth in
clasp dentures.
 features of artificial teeth on
the inflow in the frontal area in the
manufacture of clasp dentures.

3. The final stage 20

min
3.1. Control of the final level of training ─ structured - situational tasks
written work - questions
3.2. General assessment of the student's
educational activity
3.3. Informing students about the topic of
the next lesson

6. Materials of methodical providing of employment.

6.1. Theoretical questions for the lesson.
1) What methods are used to city ehanichn first processing and frame byuhelnoho
prosthesis ?
2) What is the essence of the claim iskostrumenn first processing and frame byuhelnoho
prosthesis?
3) How is electrolytic polishing?
4) How is the pouring of foundries ?
5) How is the fitting of the frame to the working model ?
6) Machining technology and?
7) Which of aterialy used for mechanical processing frame byuhelnoho prosthesis ?
8) Name the main ways to replace partial defects of the dentition.
9) Name the indications and contraindications to the replacement of partial defects of the tooth-
n their number and in clasp prostheses.
10) Name the basic rules of artificial teeth in the frontal area
depending on the clinical condition of the oral cavity.
11) Name the basic rules of artificial teeth in the side
area in the manufacture of clasp prostheses.
12) Name the laboratory stages of manufacturing clasp prostheses.
13) What mistakes and complications are possible when setting artificial teeth
clasp dentures?
14) Features of teeth placement in different types of occlusion.
15) Types of artificial teeth used in the manufacture of clasps
prostheses.

6.2 . Practical tasks performed in class:

 Discussion stages, tools and materials for m ehanichn first processing and frame
byuhelnoho prosthesis .
 Examination of a patient with partial loss of teeth.
 Be able to make artificial teeth in partial removable dentures in different clinical
situations.
 Know the possible mistakes when placing artificial teeth in
partial removable dentures and methods of their removal.
  Be able to make the installation of artificial teeth with a defect of the dentition in
the frontal area.
 Be able to assess the correct placement of artificial teeth with various defects of the
dentition.

7. Recommended literature:

Basic:
1. Mc Cracken’s Removable Partial Prosthodotics. Twelfth Edition.
2. Lectures.
Internet-resource
1. https://www.mouthhealthy.org/en/az-topics/d/dentures-partial
Additional:
M.D.Korol. Propedeutics of Orthopedic Stomatoplogy

Author: Denysiuk A.V.