Aesthetic Clasp Design For Removable Partial Dentures: A Literature Review
Aesthetic Clasp Design For Removable Partial Dentures: A Literature Review
Aesthetic Clasp Design For Removable Partial Dentures: A Literature Review
net/publication/7692572
Article in SADJ: journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging · July 2005
Source: PubMed
CITATIONS READS
19 19,486
2 authors:
Some of the authors of this publication are also working on these related projects:
Patient-based outcomes comparing neutral zone and convential complete dentures. A systematic review. View project
Neutral zone or conventional mandibular complete dentures: a randomised crossover trial comparing oral health-related quality of life View project
All content following this page was uploaded by Dr Saadika Begum Khan on 31 May 2014.
27
is not to be seen. In this case a rigid
clasp with increased flexibility and limit-
ed length emerges from a mesial minor
Figure 3b. Labial view of a different RPD with an equipoise clasp on tooth 22, satisfying the aesthetics as
the clasp assembly is inconspicuous. connector or proximal plate. With this
clasp, however, the abutment needs
to be crowned. The rest seats are pre-
pared within the crown. Disadvantages
include that of cost (due to crowns)
and the fact that its use is limited to the
mandible only. (Figure 5)
. Ball-clasp
8
This clasp engages the undercut in the
embrasure between two teeth, which
is useful when teeth have short clinical
crowns or if no natural buccal undercut
is present. The clasp also acts as a rest
because it passes over the occlusal
embrasure. It has very little flexibility
and both teeth need to be reciprocat-
19
ed. The clasp may provide adequate
retention although no evidence has
been reported in the literature.
Figure 5. Schematic illustration of the Flexible Lingual Clasp. a = clasp engaging the undercut; b = rest
prepared within the crown; c = crowned tooth. B. Infrabulge clasps
1, 6, 10, 28, 29
1. Bar-clasp
An example would be the I-bar as part
of the RPI-system for the distal exten-
sion RPD. Less metal is displayed
than with an occlusally-approaching
clasp. The approach arm must not be
visible as it crosses the gingiva. It is
not recommended in a patient with a
high smile-line and for patients with a
prominent canine eminence. Hansen
and Iverson describe a modification of
the conventional I-bar to be used on
the canine. A distofacial ridge is cre-
ated on the canine (a) by acid-etching
and adding composite or (b) within the
design of an indirect ceramic restora-
Figure 6. Palatal/ Lingual I Bar. Schematic illustration of the clasp with an unobtrusive occluso-buccal tion. This ridge provides the required
extension. a = mesial rest, b = palatal/ lingual I-bar, c = proximal plate extending onto buccal surface for
retention as well as resistance against
reciprocation.
www. sadanet.co.za
www.
www.
sadanet.co.za
sadanet.co.za
June 2005
June
June
2005 Vol. 60
2005 Vol.Vol.
60 No. 5
60 No. No.
5
5 SADJ 101
SADJ 192
101
_review
Clasp material
193
101
101 SADJ
SADJ June
June 2005
2005 Vol.Vol. 60 No.
60 No. 5 5 www.
www. sadanet.co.za
sadanet.co.za
_review
critical, one could consider the elimination ponents of the RPD can be visible and
of a visible clasp. Alternative paths of inser- may not be acceptable to the patient. In
tion, e.g. rotational, dual or curved, have view of the importance of aesthetics, crea-
been advocated which address aesthetic tive clasp design offers the possibility of
3
concerns. These alternative paths allow reducing the visibility of clasp assem-
one part of the framework to be seated blies, rendering them more acceptable to
first, followed by the remainder with the the patient. However, the clinician must
resultant decrease in clasps, but without be careful in his or her choice of clasp
compromising the biomechanical princi- designs as many articles are published
3,6,45,46
ples of the RPD. The rotational path based on clinical experience of the authors
of insertion originated in the 1930s and has rather than research. Therefore, readers
10, 29, 47-54
been described extensively. are encouraged to be critical in their inter-
Figure 9. A Circumferential Technopolymer clasp on pretation of the literature and the applica-
tooth 21 engaging the mesial undercut.
It is indicated most often for the replacement tion of published information in their clinical
of missing anterior teeth as well as posterior practices.
tooth-bound spaces and some Kennedy
Class II situations. It is contraindicated for REFERENCES
Kennedy Class I and II cases with anterior
1. Beaumont, AJ. An Overview of Esthetics with
modifications due to the potential torqueing RPDs. Quintessence Int 2002; 33:747-755.
55,56
action on abutments. Jacobson mentions 2. Mazurat, NM. Mazurat, RD. Discuss Before
that the Academy of Prosthodontics states Fabricating: Communicating the Realities of Partial
that it is not generally used by dentists and Denture Therapy. Part I: Patient Expectations. J
Can Dent Assoc 2003; 69:90-94.
dental technicians due to the lack of under-
3. Budtz-Jørgensen, E. Bochet, G. Grundman,
standing of the concept, although in recent M. Borgis, S. Aesthetic Considerations for the
46
years it has gained popularity. Success Treatment of Partially Edentulous Patients with
in cases followed up for 10 years and Removable Dentures. Pract Periodont Aesthet Dent
Figure 10a. Diagrammatic representation of seat- longer has been demonstrated.
45,46
Rigid 2000; 12:765-772.
ing of the RPD framework, eliminating anterior 4. Kokich, VO. Kiyak, HA. Shapiro, PA. Comparing the
clasps. [From Jacobson: JPD 1994; 71:271-7]. a = direct retainers of the framework are initially
Perception of Dentists and Lay People to Altered
long anterior rest acting as the rotational centre for seated into the proximal undercuts of the Dental Esthetics. J Esthet Dent 1999; 11:311-324.
insertion of RPD. abutment teeth adjacent to the edentulous 5. Owen, CP. Fundamentals of Removable Partial
area and then rotated to seat the poste- Dentures 2nded. Cape Town: UCT Press 2000; 69.
3,45 6. McGivney, GP. Carr, AB. McCracken’s Removable
rior clasp assemblies. (Figure 10a) The
Partial Prosthodontics 10thed. St Louis: Mosby
denture cannot be dislodged by a force
10 Year-Book 2000; 206-207.
perpendicular to the plane of occlusion. 7. Owen, CP. Fundamentals of Removable Partial
(Figure 10b) The disadvantage is that the Denture 2nd ed. Cape Town: UCT Press 2000;
33
rigid retainer cannot be adjusted and 41.
that the rest preparations are extensive. 8. Sato, Y. Hosokawa, R. Proximal Plate in
Conventional Circumferential Cast Clasp Retention.
Guide planes are important to secure pas-
J Prosthet Dent 2000 Mar; 83(3):319-322.
sive retention for RPDs and decrease the 9. Cowan, RD. Gilbert, JA. Elledge, DA. McGlynn,
57
Figure 10b. RPD rotated in position. No anterior
need for visible clasps. Correctly prepared FD. Patient Use of Removable Partial Dentures:
clasp. a = minor connector relieved following the parallel surfaces on abutment teeth provide two- and four-year Telephone Interviews. J
1, Prosthet Dent 1991 May; 65:668-670.
curve of insertation. b = Minor connector providing a definitive path of insertion and removal.
retention 3, 6-8 10. Donovan, TE. Derbabian, K. Kaneko, L. Wright,
Ahmad et al state that a good fit of the
R. Esthetic Considerations in Removable
framework to the guide plane is important, Prosthodontics. J Esthet Restor Dent 2001;
ment and increased cost. Research results but this fit is made more difficult in the pres- 13:241-253.
state that deformation of acetyl resin direct 57
ence of clasps. The length of the guide 11. McGivney, GP. Carr, B. McCracken’s Removable
retainers was significantly greater than plane and its continued contact with the Partial Prosthodontics 10thed. St Louis: Mosby
their metal alloy counterparts. This may proximal plate is critical.
8 Year-Book 2000; 106.
adversely affect their clinical performance 12. Owen, CP. Fundamentals of Removable Partial
Dentures 2nded. Cape Town: UCT Press 2000;
and lead to the loss off some of their reten- A labial undercut can be utilized to establish
42 28.
tive characteristics. a compromised path of insertion. This can 13. Davenport, JC. Basker, RM. Heath, JR. Ralph,
1 JP. Glantz, PO. Retention. Br Dent J 2000;
only be used if a flange is indicated. In this
REDUCING OR ELIMINATING CLASPS way, the denture flange assists in the reten- 189:646-657.
14. Hebel, KS. Graser, GN. Featherstone, JD.
tion of a denture as well as providing neces- Abrasion of Enamel and Composite Resin by
For the construction of RPDs, the Academy sary lip-support.
1, 3, 28, 56
However, the amount Removable Partial Denture Clasps. J Prosthet
of Prosthodontics defined 8 standards, of this retention has never been quantified. Dent 1984; 52:389-397.
including retention, that are important in 15. Applegate, OC. Essentials of Removable Partial
43 Denture Prosthesis 3rded. Philadelphia: Saunders
preserving oral tissue health. Aesthetic CONCLUSION 1965; 189.
aspects of RPD design were not part of 16. McGivney, GP. Carr, AB. McCracken’s Removable
these standards. Frank, Brudvik et al could Partial Prosthodontics, 10th ed. St Louis: Mosby
Several options, including the use of RPD, Year-Book 2000; 113./
not relate any of these standards to patient are available for the treatment of partial
44 The rest of this article's references (17 - 57) will
satisfaction. Hence, when patient satis- edentulism. Patient expectations need to be published in the online June SADJ, www.
faction from an aesthetic point of view is be established before treatment, as com- sada.co.za
www. sadanet.co.za
www.
www.
sadanet.co.za
sadanet.co.za
June 2005
June
June
2005 Vol. 60
2005 Vol.Vol.
60 No. 5
60 No.No.
5
5 SADJ 101
SADJ 194
101
View publication stats