Prostho 4

Prostho 4 (24-2-2022) 5th year Sara Atiyah
Fixed Removable Restorations

In fixed removable restorations, we use attachments.
Attachments in dentistry:
we can make attachment in bridge, or in metallic RPD.
We can make attachment on one side and clasp on the

other side (combined clasp attachment RPD design)
As in cases of Class II Kennedy classification
Also used in cases of PFM or zirconia crowns of upper 6

anteriors (patient refuses to put clasps and put
attachments instead for aesthetic considerations)
Attachments can be used also in cases of implants.
2 implants in place of lower canines with attachments

(very stable and retentive; implant-supported RPD or implant-supported over-denture)
Patients with cancers and need resection of nose or palate; you can place attachments to restore intra-
oral or extra-oral prosthetic appliance.
Clasp design RPD:

Partial denture retained with clasps (metallic RPDs)
Page |1
Limitations of RPD:
1. RPD is considered as non-hygienic appliance

2. One of side effect of RPD: cervical caries; inflammatory process; calculus formation and
gingival recession
3. It is not a primary treatment of choice.
4. Esthetics problems (due to presence of clasps and metal display)
Nowadays the primary choice of treatment for partially edentulous patients is implants followed by
fixed appliances
Clasp design RPD must have enough nb of

abutments that are properly distributed (clasp
configurations) = I have bilateral or tripod or
quadrilateral distribution? According to number of
abutments.
Tissue coverage: as you cover tissues more, the

case becomes more non-hygienic (connectors affect
the tissues)
Tolerance: try to avoid covering anterior area of

the palate to avoid speech problems and patient
intolerance when touching the area with his
tongue.
To overcome these several limitations, treatments shifted to Attachment design RPD
Page |2
Ideal treatment implant but for example the patient is immuno-
compromised, or have uncontrolled diabetes, or cardiac and liver
diseases (contraindication)
Alternative solution: attachment design RPD
These are advantages superior to conventional clasp-

design RPD.
Attachment is more retentive (male and female; key

and key lock)
Clasp is related to undercuts in the abutments (some

abutments are short and with minimum undercut or no
enough undercut)
Retention of clasp depend on configuration or contour

of the tooth, while retention in attachments depend on types of attachments.
Clasp can make torque on abutment since it is extended externally, whereas attachments receive vertical
loads that can resist forces and stresses (no torque)
Page |3
Forces are along long axis of tooth.
Male and female; sometimes called matrix and patrix
Male projection is patrix while female is matrix (found

inside partial denture)
Cast retainers (bridge must be present; no single crowns)
Page |4
Precision nowadays is very rare (prefabricated in companies made

from precious alloys and very expensive) very accurate but very
difficult to use.
Most common is semi-percision.
Rare to be used; made from gold with male and female parts.
No wearing and abrasion (made from precious alloys)
Less time
(no
casting)
Page |5
Plastic pattern and I make casting for it (cheap)
Contraindicated to use attachments on 1 crown (minimally 2

crowns splinted)
Semi-precision: casting and degree of accuracy is weak
Alloy must be appropriate with no wear (for better

retention)
most common attachment used is: semi-precision.
Page |6
T-shaped box inside the crown prosthesis (matrix)
When to use intra-coronal attachment:
1. Bulky tooth (good abutment with proper crown length)

2. Mostly used in endo-treated long teeth.
3. Can’t be made in young ages due to risks of pulp
exposure.
4. Tooth should not have periodontal involvement.
Characteristics of
intra-coronal attachment:
1. More stress distribution (near long axis of tooth)

2. Esthetics.
Page |7
Page |8
Attachment is outside the contour of the tooth.
Female matrix (in denture base) + male patrix (in bridge)
Disadvantages: forces away from the long axis of the tooth = torque./ non-hygienic so leave space
underneath between it and gingival margin 2 mm
Advantages: no cut inside tooth structure.
Page |9
less commonly used (focus on 1st 2 types up)
2 copings (metal covering) cemented to teeth and 2nd

coping in bridge = not common since needs large
inter-arch distance and make torque on abutments
and difficult in construction.
Thimble crown: the crown (2nd coping) that will be
Patient having severe class III so we made

overdenture instead of fixed bridges and we
put on it the 1st metal coping.
We need enough inter-arch distance in order to

make coping on tooth and then coping in RPD to be
fitted together.
P a g e | 10
coping in upper teeth using zirconia and metallic coping in
lower arch.
Telescopic RPDs upper and lower.
P a g e | 11
2 crowns present and between them space.
Splints the 2 teeth together; 2 parts of attachment: bar

itself + sleeves (grooves) that are fixed on the bar.
If cross section of bar is rectangular and rigid = bar unit

(no movement allowed = very bad since distribute all load
on abutments)
Better one is the bar joint.
Rounded cross section and fitted on it a plastic

sleeve.
Stress
breaking and distribution + decrease forces since allow
movements.
1. 2 mm space at least under bar for oral hygiene

maintenance
2. Enough inter-arch distance
Both bar and telescopic needs large inter-arch distance.
P a g e | 12
Bar joint and no need to put clasps on

abutment teeth.
P a g e | 13
STUD means projections.
Remaining tooth (post and coping; covering without any

crown contour)
P a g e | 14

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Prostho 4 (24-2-2022) 5th year Sara Atiyah

Fixed Removable Restorations

We can make attachment on one side and clasp on the

As in cases of Class II Kennedy classification

Also used in cases of PFM or zirconia crowns of upper 6

Attachments can be used also in cases of implants.

2 implants in place of lower canines with attachments

Clasp design RPD:

1. RPD is considered as non-hygienic appliance

Clasp design RPD must have enough nb of

Tissue coverage: as you cover tissues more, the

Tolerance: try to avoid covering anterior area of

To overcome these several limitations, treatments shifted to Attachment design RPD

Alternative solution: attachment design RPD

These are advantages superior to conventional clasp-

Attachment is more retentive (male and female; key

Clasp is related to undercuts in the abutments (some

Retention of clasp depend on configuration or contour

Male and female; sometimes called matrix and patrix

Male projection is patrix while female is matrix (found

Cast retainers (bridge must be present; no single crowns)

Precision nowadays is very rare (prefabricated in companies made

Most common is semi-percision.

No wearing and abrasion (made from precious alloys)

Contraindicated to use attachments on 1 crown (minimally 2

Semi-precision: casting and degree of accuracy is weak

Alloy must be appropriate with no wear (for better

most common attachment used is: semi-precision.

T-shaped box inside the crown prosthesis (matrix)

When to use intra-coronal attachment:

1. Bulky tooth (good abutment with proper crown length)

1. More stress distribution (near long axis of tooth)

Female matrix (in denture base) + male patrix (in bridge)

Advantages: no cut inside tooth structure.

2 copings (metal covering) cemented to teeth and 2nd

Thimble crown: the crown (2nd coping) that will be

Patient having severe class III so we made

We need enough inter-arch distance in order to

Telescopic RPDs upper and lower.

2 crowns present and between them space.

Splints the 2 teeth together; 2 parts of attachment: bar

If cross section of bar is rectangular and rigid = bar unit

Better one is the bar joint.

Rounded cross section and fitted on it a plastic

1. 2 mm space at least under bar for oral hygiene

Both bar and telescopic needs large inter-arch distance.

Bar joint and no need to put clasps on

STUD means projections.

Remaining tooth (post and coping; covering without any

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