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DEFINITION:Any type of device used for
stabilization or retention ofprosthesis -- GPT
RETAINERS
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Retainer for an FPD
That component of an FPD whichtakes support from the abutmenttooth and provides retention tothe prosthesis
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SELECTION OF RETAINERS
Retainer selection for abutment is criticaland is dictated by the followings:
1) Age
2) DMF rate3) Edentulous space-Partial veneer crown
contraindicated in long span FPD
4) Periodontal support5) Arch position of the tooth
6) Skeletal relationship
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7) Inter occlusal & intraocclusal
condition such as crown length8) Oral hygiene of the patient
9) Vitality of the abutment teeth---endodontically treated teeth mayhave to be restored with core &
post before designing theretainer
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10) Condition of the abutment teeth
11) Cost12) Preservation of the tooth
structure----Buccal surfaceshould be conserved. Partialveneer crown is more
conservative than full crown . Allceramic crowns are leastconservative
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Types of retainers
Classified as:
I. Based on tooth coverageFull veneer crown
Partial veneer crown
Conservative (minimal prep.)retainers
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II. Based on material used
All metal retainersMetal ceramic retainers
All ceramic retainersAll acrylic retainers
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Full veneer crowns
Covers all 5 surfaces of abutment
Most retentive of the veneer preparations
Compared to partial veneer designs,fullveneer crown exhibits superior resistancend retention
Used on those teeth whose restorationdemands max. retention.
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VariationsMetal ceramic crowns and allceramic crowns used in situations that
requires a good cosmetic results The full veneer crown should be used
when less extensive and less destructive
design have been considered and foundlacking in retention ,resistance ,coverageor esthetics to properly restore the tooth
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Partial veneer crown
Preferred than full veneer crown becausethey requires less tooth reduction
Crown does not cover the entire abutment
Facial surface is left intact for superioresthetics
Used when minimal retention is sufficientand when abutment tooth is healthy
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Contra indications
In long span FPDs
Endodontically treated toothDentition with active caries or
periodontal diseasePoorly aligned abutment tooth
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Advantages
Conservation of tooth structure
Reduced pulpal and periodontalinsult during tooth prep
Improved access for finishing by
dentist & oral hygiene by patient
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Less of margin approximate softtissues subgingivally and henceless gingival involvement than
complete coverage
Remaining intact facial or buccaltooth surface permits electricvitality test
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Disadvantages
Less retention & resistance thancomplete crowns
Some metal displayed in completedrestorationunaesthetic
Tooth prep is difficult because onlylimited
adjustments can be made in the
path of placement
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Resin bonded retainers
(Maryland bridges) Require minimal tooth preparation
Acid etched Esthetically appealing
Economical , conservative ,functional & do not irritate soft orhard tissues
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Indication
As retainers of FPD for abutmentwith sufficient enamel to etch
Splinting of periodontallycompromised teeth
Stabilizing dentition afterorthodontic treatment
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Contraindication
In patients with sensitivity to basemetal alloys
When facial esthetic of abutment
require improvement Inadequate enamel surface to
bond eg;caries,existingrestoration
Incisor with extremely thin facio-
lingual dimension
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Advantages
Non invasive to dentin with lingualand proximal tooth preparationincluding occlusal rest
Conservative with undeniable patientappearance
Tissue tolerant because of
Supragingival margin,without pulpalirritation
Reduced cost and less chair side time
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Disadvantage
Demanding technique and toothprep.
Plaque accumulation Bulky contour
Restricted to single ponticplacement
Graying out of teeth that are thin
labiolingually
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Based on material used
All metal retainers
Metal ceramic retainersAll ceramic retainers
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All metal retainers
Partial or full veneer crown
Require minimal toothreduction
Strong even in thin sections
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Metal ceramic retainers
Indicated on teeth that requirecomplete coverage & esthetic
demand
Can accommodate cast or soldered
connectors Can afford high forcemetal
Require more teeth reduction
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Indication
Extensive tooth destruction as aresult of caries or trauma
Existing previous restoration thatprecludes the use of a moreconservative restoration
Need for superior retention andstrength
Endodontically treated tooth
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Contraindication
Whenever a more
conservative retainer isfeasible
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All ceramic
Primary purpose ---to achievebest possible esthetic results
Risk of reduced restorationlongevitypotential for fracture,inferior marginal adaptation thanPFM retainer
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Telescopic retainers Used when path of insertion of FPD does
not coincide with long axis of abutment
Design involves fabricatin of two copings
one over the other Internal or primary coping function to
modify the morphology of toothpath pf
insrtn changed Secondary coping designed to fit over
primary
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REFERENCES
1. Fundamentals of Fixed Prosthodontics
Herber T.Shillingburg
2. Contemporary Fixed ProsthodonticsRosenstiel,Land,Fujimoto
3. Tylmans Theory and Practice of Fixed
Prosthodontics4. Textbook of Prosthodontics-Deepak
Nallaswamy
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Thanking you..