precision attachments/ orthodontic seminars

Precision attachments

introductionINDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com

www.indiandentalacademy.com

Defination:• This is said to be a connecting link

between the fixed and removable type of partial dentures as it incorporates features common to both types of construction.

• STEIGER &BOITEL: they mean to be of bodily function for a removable partial denture or bridge.

Nomenclature:

• A retainer consisting of a metal receptacle (matrix) and a closely fitting part (patrix).

• The matrix is usually contained within the normal / expanded contours of the crown on the abutment tooth.

• The patrix is attached to a pontic / the removable partial denture frame work.- glossary of prosthodontic terms.

SYNONYM :• INTERNAL ATTACHMENT• PARALLEL ATTACHMENT• FRICTIONAL ATTACHMENT• KEY AND KEY WAY ATTACHMENT• SLOTTED ATTACHMENT

PRECISION ATTACHMENTS• IMPLIES A PARTLY or fully machined

device consisting of a male and a female components which are used in restorative dentistry to retain a removable /semi removable prosthesis . –D.H. roberts .

• Acc. To G.E.ray ,they are wholly or partially machined accessories used to retain a removable /semi removable prosthesis.

INTRA CORONAL ATTACHMENTS• The bulk of the soldered or cast on

portion of the joint lies within the anatomical contours of the treated teeth.

EXTRA CORONAL ATTACHMENTS• Are used to join a prosthesis to a

retainer , part of all of their mechanisms is outside the contour of the retainer .

Chayes attachment

HISTORY• GEORGE EVANS -1888• PEESO -1898• GILMORE -1913• FOSSUME -1906• BENNET -1904• BROWN , BRYONT,

CONDIT,GOLOBIN ,KELLY , McCOLLUM ,MORGAN , ROACH ,SORENSEN ,SUPPLEE .

RATIONALE

RATIONALE• To be removable and replaceable without stress or

strain on abutment teeth .• To permit normal anatomic contour to the abutment

teeth .• To provide many years of comfortable service .• To be made of materials that are compatible with oral

tissues .• Resistance to abrasion• Resistance to corrosion• To be esthetically acceptable• To require minimal amount of tooth structure to be

removed• To be hygenically clean .

INDICATIONS• Movable joints in fixed movable bridge work .• To stress break , free- end saddles and bridges

.• Intra coronal attachments are effective

retainers for removable partial dentures .• As a connector for sectional dentures .• Sections of a F.P.D may be connected with

intra coronal attachments• To lock a connector joining a saddle in the

opposite side of the arch• to retain hybrid dentures

CONTRA INDICATIONS• SICK AND SENILE PATIENTS-whose

manual skills are diminished.• Periodontosis.• Abnormal caries rate• Inadequate space to employ

them / place them .

ADVANTAGES• The labial or buccal clasp arms can

be eliminated• Precision attachments are less

stressful to the abutment teeth than a conventional clasp arm .

DISADVANTAGES• TOOTH may have to be extensively cut to

place the P.A .• The bulge in the crown , created by the intra

coronal attachment may deprive the underlying gingival tissue of its customary massage .

• The attachment is subject to wear as a result of friction between metal parts .- causing movement & injury to the abutment teeth .

• The extra coronal attachment can cause irritation / inflamation .

LIMITATIONS• The clinical crown of the abutment

tooth should be of adequate length• Size of the pulp tissue .• Fabrication of the P.A is technique

sensitive .• It is expensive .

MECHANISIM OF ACTION• FRICTION – ACTIVE RETENSION

CAN BE ENHANCED BY – spring ,leaf ,ring ,bolts ,rubber devices.

• BINDING• WEDGING of conical bodies• INTERNAL SPRING• ACTIVE RETENSION

MATERIALS USED FOR MAKING THE P. A .• CERAMICOR• ELITOR• OSV• PIVITOR• STAINLESS STEEL• SILVER• LO-CAST• THERMAFIT• 20% IRIDIUM-PLATINUM• CERMACAST• PLATINUM GOLD , etc .

CLASSIFICATION

Good kind &baker -1975

Intra coronal Extra coronal

resilient

Non resilient

resilient

Non resilient

Classification-2

PRECISION ATTACHMENTS

Pre fabricatedSemi precision

Eg;Channel-shoulder-pin attachment

PlasticEg;

Renefert’s unirestB , mortice rest

CLASSIFICATION -3

ACC . TO G.E.Ray

Rigid articulatios Movable articulations

Group-1 (vital teeth)

Group-2 (non vital teeth)

Group-1 –vital teeth Group-2 – non vital teeth

G.E.RAY – CLASSIFIED P. A -• INTRA CORONAL• EXTRA CORONAL –FLECHER , HUSER .• CONJUNCTORS –CUENOD , DALLA BONA ,

CRISMANI• ANCHORS – GMUR SLIDE BLOCK ,DALLABONA

SLIDE BLOCK /DALBO STUD ANCHOR• BARS-DOLDER-BAR• ACCESSORY COMPONENTS –TRANSVERSE

STABILIZERS,LOCKS,STRESS BREAKER.

Harold . W. preiskel classified as

Intra coronal attachments

Frictional – Entirely frictionalMechanical lock

Cross section –H-shaped

T – shapedcircular

R . VALENTINE & EASTMAN DENTAL HOSPITAL - LONDON

CLASSIFIED AS :

RIGID RETAINERS MOVABLE RETAINERS AUXILLARY DEVICES

RIGID ATTACHMENTS( NON VITAL TEETH)

ADJUSTABLE –CHAYES,MC COLLOM ,STREN , CRISMANI

NON ADJUSTABLE –BEYELER , C&M-643

RIGID ATTACHMENTS (VITAL TEETH)

ALL ADJUSTABLE –ECCENTRICBONA ,GERBER

MOVABLE ATTACHMENTS (NONVITAL)DALBO ,CRISMANI

STRESS BREAKERS (PARTIAL DENTURESGERBER HINGE , ANCORVIS HINGE

MOVABLE ANCHORAGES (NON VITAL )BONA DOLDER BAR , ANDREWS BAR .

ACTIVATORS - ISOCLIP LATCHES , BOLTS , SCREWS SCHUBIGER , HRUSKA

Spherical resilience anchors

15.41 – Dr.Dalla bona design – root canal anchor system

15.42 – Prof.Dr. brunner design

Cylindrical snap grip anchors.

anchors

Intra coronal , screwed slide attachment

Anchors – mandibular arch.

Slide attachment

Combi – snap –intra coronal attachment

Shoulder – dalbo joint with over load protection

Shoulder Dalbo – bilateral.

Prospective planning in a bilateral free end saddle

Rest position – dalbo attachment

Physiological translation

Translation and hinge movement

Articulated unilateral free end saddle

Articulated uni lateral free end saddle - mandibular

Pt – snap-intra coronal

Slide attachments – CM interlock &CM plasta

Slide attachments

Prof.Beyeler – slide attachment

Slide attachment – cm interlock & G. crismani

Slide attachments

Snap attachments

w. Wermuth - bioloc

Dr.spang - stabilex

Dr spang mini - conex

Dr.spang mini conex

s. Guglielmetti

Slide attachments

Anchors

Anchors – Dr.Hruska

Resilience anchors

Bar attachments

Resilience attachments

Resilience joints -Roach

Coupled resilience joint

Hinges

Stabilizer

Transversal locks

Transversal lock

Latches

Screws , miscellaneous

PLACEMENT OF PRECISION ATTACHMENTS

TECHNIQUE

DIRECT METHOD INDIRECT METHOD

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