Attachments in Removable Prosthodontics

Lecture Outline
• • • • • • • • • • • Why do we use attachments in removable prosthodontics? Retention of removable partial dentures. Definition of attachments. Classification of attachments. Indications for attachments. Contraindications for attachments. Advantages of attachments. Disadvantages of attachments. Other attachments and retention devices. How to choose appropriate attachments for different cases? References.

Attachments • Retention.  Overdentures. .  Implants. support and stability. • Can be used with:  Partial dentures.

Retention of Removable Partial Dentures Retention Neuromuscular control Mechanical Inherent physical forces Clasps Undercuts attachments .

Definition • An attachment is a mechanical device made up of two components. When the two matched parts are linked together they produce very positive retention. . one located in or on the abutments tooth and the other housed in the denture.

Classification Size: Macro or Micro Fabrication: Precision or Semiprecision Attachments Location: Intracoronal or Extracoronal Functional characteristics: Rigid or Movable .

support and stabilise the removable partial denture.Intracoronal Attachments -1 • Two components: Matrix and Patrix. . • Retain. • Sliding joint configuration.

• At least 4 mm vertical space. • At least 3 mm buccolingual space. • Parallelism. .Intracoronal Attachments -2 • Crowns.

• Functional characteristics: Rigid attachments.Intracoronal attachment -3 • Location : Intracoronal. • Fabrication: Precision or semi precision attachments. • Size : Micro attachments. .

. • Sliding joint configuration. • Retain and stabilise removable partial dentures. Dalbo (Patrix) and other component (Matrix) held in denture.g.Extracoronal attachments -1 • Two components: e.

• Need no space within the abutment crown.Extracoronal attachments -2 • Reside entirely outside the normal clinical contour of abutments. • often employed to retain bilateral distal extension prostheses. . • May be employed where buccolingual space is limited.

• Functional characteristics: Rigid or movable attachments. • Fabrication: Precision or semi precision attachments.Extracoronal attachments -3 • Location: Extracoronal. . • Size: Micro attachments.

.Extracoronal attachments -4 • Rigid : only allow movement in one direction. • Movable: movement allowed should be regarded as a safety valve and not as a means of anchoring an unstable prosthesis to natural teeth.

Macro attachments • E. Telescopic crowns .g.

 Join a series of crowns which don’t have common path of insertion.  Implants.  Retain bilateral distal extension prosthesis.  Overdentures.Indications  When neither fixed bridge nor clasp retained denture would be satisfactory.  Small bounded saddles with considerable bone loss. .

 Lack of experience and clinical skills (Extra and Intracoronal attachments).  Large size of pulp (Intracoronal attachments).  Poor periodontal health of abutment teeth (Rigid attachments).Contraindications  Short clinical crowns of abutment teeth (Intracoronal attachments).  Limited buccolingual space of abutment teeth (Intracoronal attachments). .  Bad oral hygiene (Extra and Intracoronal attachments).

 Limit the potentially damaging force imparted to abutments (Extracoronal attachments and Intracoronal attachments).Advantages  Better aesthetic results and more effective retention than clasps.  Diminish rotational movements of abutments (Intracoronal attachments).  More apical functional load transfer to abutments than rests (Intracoronal attachments).  Improved cross arch load transfer and stabilisation of prosthesis. .

 Occupy a lot of space.Disadvantages  Abutment teeth usually have to be crowned.  Relatively expensive. .  Require ongoing maintenance.  Clinical and technical skills are demanding.  Encourage plaque accumulation.

Other attachments and retention devices 1 • Stud attachment • Used with overdentures. .

Other attachments and retention devices 2 • Magnets  No demands on the periodontal tissues of abutment teeth. .

Other attachments and retention devices 3 • Two parts denture • Needs good manual dexterity. .

How to choose appropriate attachments for different cases? -1 • Personal design philosophy • Rigid or movable? • How much resiliency? .

How to choose appropriate attachments for different cases? -2 • Condition of the abutment teeth • Intra or extracoronal attachments? .

How to choose appropriate attachments for different cases? -3 • Condition of the nonabutment supportive structures (periodontal tissues and alveolar ridge) • Rigid or movable ? .

How to choose appropriate attachments for different cases? -4 • Manual dexterity • Intra or extracoronal attachments ? .

"Precision attachments for the partially dentate mouth. • Preiskel. . Chapter 20.References • Stewart’s Clinical Removable Partial Prosthodontics. Attachments for removable partial dentures. H. (1974). pages 507-515. W. Third Edition." Annals of the Royal College of Surgeons of England 55(6): 294-298.

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