RETAINERS IN FPD

SUBMITTED BY: PRIYANTHI.A,FINAL YEAR

 TABLE OF CONTENTS

▪ What is a FPD?
▪ Component parts of FPD
▪ Retainer-Definition
▪ Classification of Retainers in FPD
▪ Criteria for Selection of Retainers
 FIXED PARTIAL DENTURE

A dental prosthesis that is luted,screwed or

mechanically attached or otherwise securely retained to
natural teeth, tooth roots and/or dental implant
abutments that furnish the primary support for dental
prosthesis.
- Commonly referred to as bridges, cannot be
removed by patient.
COMPONENT PARTS OF FPD

 Retainer
 Pontic
 Connector
RETAINER-DEFINITION

▪ Retainer is the part of a fixed

partial prosthesis that unites
the abutments(s) to the
remainder of the restoration.
(GPT8)

*It is used for the stabilization or

retention of prosthesis.
CLASSIFICATION OF RETAINERS

*BASED ON AMOUNT OF TOOTH COVERAGE

*BASED ON MECHANISM OF RETENTION

*BASED ON MATERIAL USED

BASED ON AMOUNT OF TOOTH COVERAGE

 Complete coverage or full veneer retainers

 Partial coverage or partial veneer retainers

 Conservative retainers(RESIN-BONDED)
 COMPLETE COVERAGE OR FULL VENEER
REATINERS

DEFINITION: A restoration that

covers all the coronal tooth
surfaces(mesial,
distal,facial,lingual and occlusal)
(GPT8)
It covers all the surface of the
abutment tooth and are IDEAL
retainers as they provide • Is one of the commonly indicated restorations for
MAXIMUM retention. badly damaged posterior teeth
• Preparations for a complete cast crown requires
adequate tooth structure to be
removed to allow restoration of the
tooth to its original contours.
 ADVANTAGES DISADVANTAGES
 More retention • Extensive removal of tooth
structure that can have
 More resistance form than adverse effects on pulp and
partial coverage periodontium

 Superior strength • Inflammation of gingival

tissues due to its proximity
 Allows operator to modify axial to gingival margin
tooth contour

 Allows better access to

furcations for improved patient
oral hygiene
 Permits easy modification of
occlusion
 INDICATIONS CONTRA INDICATIONS
 Indicated on teeth that  Contraindicated when
exhibit extensive coronal treatment objectives can
destruction by caries or be met with a more
trauma conservative restoration

 Restoration of choice  When intact buccal or

when maximum retention lingual wall present,
and resistance are needed partial coverage indicated

 Maybe used to support a  Poor oral hygiene

RPD
 Y0ung adults where pulp
 On endodontically chambers are large
treated teeth
 PARTIAL COVERAGE RESTORATIONS

DEFINITION:
A restoration that restores all but
one coronal surface of a tooth or dental
implant abutment, usually not covering the
facial surface (GPT8)
 TYPES OF PARTIAL VENEERS

For anterior teeth

For Posterior teeth
 Three-quarter crowns
 Three-quarter  Pinledges
 Seven-eighths
PARTIAL COVERAGE RESTORATIONS

-Commonly buccal/facial surface is left

intact for better aesthetics

-It is called three-quarter crown as it was

traditionally used in anterior teeth and it
involved preparing 3 out of 4 surfaces and
incisal edge was not considered

-Usually made of cast metal and gold alloys

are preferred as they can be burnished

-Can be used as single-unit restoration or

as retainer for FPD
 MODIFICATIONS OF PARTIAL VENEERS FOR
ANTERIOR TEETH
• Pinhole placed in cingulum
PIN-MODIFIED • Placed in centre or off-centre
-
ANTERIOR 3/4TH • Improves resistance and retention
CROWN

• Labial and one or more proximal

PINLEDGE PARTIAL surfaces not prepared
VENEER • Retention augmented by making
PREPARATIONS pinholes on ledges
 ADVANTAGES DISADVANTAGES
 More conservative  Less resistance to
dislodgement
 Optimal periodontal response  Advanced skill required

 Optimal aesthetics  Limited application

 INDICATIONS CONTRAINDICATIONS
 Anterior teeth with low caries  Poor oral hygiene and high caries rate
activity

 As a single restoration to re-  Large pulp chambers in young adults

establish the anterior guidance

 Retainers for short span fpds  Nonvital teeth

 Splinting of periodontal weak tooth  Long span fpds

 Lingual abrasions of incisors and  Thin or abnormal teeth

canines
 MODIFICATIONS OF POSTERIOR PARTIAL
VENEER CROWN

PARTIAL VENEER CROWN REVERSE THREE-

WITH PROXIMAL BOXES QUARTER CROWN

 Proximal boxes can be  It’s a partial veneer

used instead of grooves in crown that does not
case the proximal surfaces cover the lingual surface
of the tooth are instead of buccal.
extensively damaged or if  Indicated when
additional retention is abutment has severe
required. lingual inclinations.
 They are less conservative
and hence not preferred.
 MODIFICATIONS OF POSTERIOR PARTIAL
VENEER CROWN
(contd…)
SEVEN-EIGHTS CROWN
PROXIMAL HALF CROWN
 All surfaces except half of
buccal surface(usually
 Does not cover distal part of
mesiobuccal cusp) are covered
tooth.
by restoration.
 Indicated in mesially tilted
 Usually used in maxillary molars
mandibular molars.
but also used in mandibular
 Used only in patients with
molars and premolars.
excellent oral hygiene; distal
 Indicated when distal cusp or
surface must be caries free.
distal surface covered due to
restorations,caries,fracture,etc.
 Aesthetically acceptable.
 Better retention than 3/4th
crown
INDICATIONS:
• Often used to restore posterior teeth that
have lost moderate amounts of tooth
structure, provided buccal wall is intact
and well supported by sound tooth
structure.
• Commonly used as retainers in FPDs or
where restoration or alteration of occlusal
surface is needed.

As retainer for: * Short-span fixed prosthesis

* Resin-bonded fixed partial
dentures
*Average or below-average
occlusal forces
CONTRAINDICATIONS:

 Contraindicated in teeth that have short

clinical crown because retention may not
be adequate.
 Contraindicated as retainers in long-span
FPDs.
 Not suitable for endodontically treated
teeth.
 Contraindicated in extensively damaged
teeth.
 Not suitable in proximally bulbous/poorly
aligned abutment teeth.
 ADVANTAGES DISADVANTAGES

 Conservation of tooth Less retention and resistance as

structure. compared to complete crowns.

 Reduced pulpal and periodontal Tooth preparation is

insult during tooth preparation. complicated.

 Accessible margins for operator Some metal may be visible

to finish and for patients to which may be unacceptable by
maintain good oral hygiene. patients with high cosmetic
expectations.
 Cementation is easy
 Seating can be verified
 Pulp testing possible through
unrestored part
 Consists of one or more pontics supported by thin metal retainers placed lingually and
proximally on the abutment teeth
 Rely partly on adhesive bonding between etched enamel and metal casting
 Held in place by resin which locks mechanically into chemically etched enamel
 Useful in treating younger patients as less tooth reduction is required
 3 principles:
*Proper patient selection
*Correct enamel modification
*Framework design
I. EXTRACORONAL RETAINERS:
Obtain retention from external
surface of the coronal part of the
abutment teeth.
eg:- Full veneer crowns
Partial veneer crowns

II.INTRACORONAL RETAINERS:
Obtain retention from within the
coronal tooth structure.
eg:- Inlays,Onlays

III.RADICULAR RETAINERS:
Obtain retention from within
the root(Post and core)
I.ALL METAL RETAINERS

-Can be either partial or full coverage

-Possess good strength
-Commonly used in posterior abutments
-Require minimal tooth preparation

II.METAL-CERAMIC RETAINERS

-Most commonly used

-Ceramic can either be a facing or full coverage
-Require more tooth preparation than all-metal
III.ALL CERAMIC RETAINERS

-Most aesthetic
-Need maximal tooth preparation
-Strength in long-span FPDs is questionable

IV.ACRYLIC RETAINERS

-Used for temporary fixed partial dentures

-Not used for definitive FPDs because:
*Poor strength
*Colour instability
*Inadequate wear resistance
*Poor tissue response
CRITERIA FOR SELECTION OF RETAINERS

 ABUTMENT ANGULATIONS

 CONDITION OF ABUTMNET

 AESTHETICS

 PRESERVATION OF TOOTH
STRUCTURE

 RETENTION

 COST
ABUTMENT ANGULATIONS

Abutments parallel to each other Full veneer retainer

Unfavourable tooth positions Partial veneer retainer along

with another partial or full
veneer retainer

CONDITION OF ABUTMENT
Abutment teeth in good health Partial veneer retainer

Endodontically treated/damaged Full veneer retainer

Periodontally weak with exposure Conservative resin-bonded retainers

of root surface
AESTHETICS

• Partial veneers in anterior/aesthetic zone questionable when teeth are thin and
metal may be reflected

• Secondary caries – Full veneer retainers

• Inadequate Pontic space – full veneer retainer

PRESERVATION OF TOOTH STRUCTURE

• Partial veneer retainers – more conservative

• Buccal/facial surfaces should be preserved for aesthetic reasons

• Etched cast retainers - conservative alternative

RETENTION

 Molar exerts more force as compared to a premolar hence more retention required

 Longer the span greater the retention required

 In both the above cases full veneer retainer indicated

COST

 Full veneer ceramic retainers are costlier than metal-ceramic retainers.

CONCLUSION:

The success of a fixed dental prostheses relies on proper retainer selection

and placement as per the indications. Since retainers aid in the retention and stability of
the prostheses it is essential that we carefully select an appropriate retainer for the
specific FPD.
REFERENCES:-
TEXTBOOK OF PROSTHODONTICS-DR.V.RANGARAJAN
FUNDAMENTALS OF FIXED PROSTHODONTICS-DR.HERBERT.T.SHILLINGBURG