DEFINITION:

1

RETAINERS

• DEFINITION
• Any type of device used for stabilization or
  retention of prosthesis -- GPT

dr shabeel pn
2

• Retainer for an FPD
• That component of an FPD which takes support from
  the abutment tooth and provides retention to the
  prosthesis

3
(No Transcript)
4
SELECTION OF RETAINERS

• Retainer selection for abutment is critical and
  is dictated by the followings
• Age
• DMF rate
• Edentulous space-Partial veneer crown
  contraindicated in long span FPD
• Periodontal support
• Arch position of the tooth
• Skeletal relationship

5

1. Inter occlusal intraocclusal condition such as
   crown length
2. Oral hygiene of the patient
3. Vitality of the abutment teeth---endodontically
   treated teeth may have to be restored with core
   post before designing the retainer

6

• Condition of the abutment teeth
• 11) Cost
• 12) Preservation of the tooth
  structure----Buccal surface should be conserved.
  Partial veneer crown is more conservative than
  full crown . All ceramic crowns are least
  conservative

7
Types of retainers

• Classified as
• Based on tooth coverage
• Full veneer crown
• Partial veneer crown
• Conservative (minimal prep.) retainers

8

• Based on material used
• All metal retainers
• Metal ceramic retainers
• All ceramic retainers
• All acrylic retainers

9
Full veneer crowns

• Covers all 5 surfaces of abutment
• Most retentive of the veneer preparations
• Compared to partial veneer designs,full veneer
  crown exhibits superior resistance nd retention
• Used on those teeth whose restoration demands
  max. retention.

10

• VariationsMetal ceramic crowns and all ceramic
  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 found lacking in retention
  ,resistance ,coverage or esthetics to properly
  restore the tooth

11
Partial veneer crown

• Preferred than full veneer crown because they
  requires less tooth reduction
• Crown does not cover the entire abutment
• Facial surface is left intact for superior
  esthetics
• Used when minimal retention is sufficient and
  when abutment tooth is healthy

12
Contra indications

• In long span FPDs
• Endodontically treated tooth
• Dentition with active caries or periodontal
  disease
• Poorly aligned abutment tooth

13
Advantages

• Conservation of tooth structure
• Reduced pulpal and periodontal insult during
  tooth prep
• Improved access for finishing by dentist oral
  hygiene by patient

14

• Less of margin approximate soft tissues
  subgingivally and hence less gingival involvement
  than complete coverage
• Remaining intact facial or buccal tooth surface
  permits electric vitality test

15
Disadvantages

• Less retention resistance than complete crowns
• Some metal displayed in completed
  restorationunaesthetic
• Tooth prep is difficult because only limited
• adjustments can be made in the path of
  placement

16
Resin bonded retainers(Maryland bridges)

• Require minimal tooth preparation
• Acid etched
• Esthetically appealing
• Economical , conservative , functional do not
  irritate soft or hard tissues

17
Indication

• As retainers of FPD for abutment with sufficient
  enamel to etch
• Splinting of periodontally compromised teeth
• Stabilizing dentition after orthodontic treatment

18
Contraindication

• In patients with sensitivity to base metal alloys
• When facial esthetic of abutment require
  improvement
• Inadequate enamel surface to bond
  egcaries,existing restoration
• Incisor with extremely thin facio-lingual
  dimension

19
Advantages

• Non invasive to dentin with lingual and proximal
  tooth preparation including occlusal rest
• Conservative with undeniable patient appearance
• Tissue tolerant because of Supragingival
  margin,without pulpal irritation
• Reduced cost and less chair side time

20
Disadvantage

• Demanding technique and tooth prep.
• Plaque accumulation
• Bulky contour
• Restricted to single pontic placement
• Graying out of teeth that are thin labiolingually

21
Based on material used

• All metal retainers
• Metal ceramic retainers
• All ceramic retainers

22
All metal retainers

• Partial or full veneer crown
• Require minimal tooth reduction
• Strong even in thin sections

23
Metal ceramic retainers

• Indicated on teeth that require complete coverage
  esthetic demand
• Can accommodate cast or soldered connectors
• Can afford high forcemetal
• Require more teeth reduction

24
Indication

• Extensive tooth destruction as a result of caries
  or trauma
• Existing previous restoration that precludes the
  use of a more conservative restoration
• Need for superior retention and strength
• Endodontically treated tooth

25
Contraindication

• Whenever a more conservative retainer is
  feasible

26
All ceramic

• Primary purpose ---to achieve best possible
  esthetic results
• Risk of reduced restoration longevitypotential
  for fracture ,inferior marginal adaptation than
  PFM retainer

27
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 tooth path pf insrtn changed
• Secondary coping designed to fit over primary

28
REFERENCES

• Fundamentals of Fixed Prosthodontics
• ?Herber T.Shillingburg
• Contemporary Fixed Prosthodontics
• ?Rosenstiel,Land,Fujimoto
• Tylmans Theory and Practice of Fixed
  Prosthodontics
• Textbook of Prosthodontics-Deepak Nallaswamy

29
Thanking you..
dr shabeel pn