partial retainer in fpd dr vikas
TRANSCRIPT
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DR VIKASAGGARWAL
PARTIALRETAINERS
IN FPD
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IN FPD
Covers only part of the cl n cal!Incl"#es all tooth s"rfacese$cept the %"ccal or la% al &alln the preparat on!
Whenever feas %le' a part al(covera)e restorat on sho"l# %eselecte# ' rather than aco*plete veneer ' %eca"se tpreserves *ore of the toothstr"ct"re!+o&ever' the preparat on s*ore #e*an# n) an# s notro"t nely preferre# %ypract t oners!
Tho")h less retent ve an#res stance than co*plete cro&n&hen prepare# caref"lly ) veslon) last n) restorat on
INTR,D-CTI,N
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Part al veneer cro&n s #e.ne# as arestorat on that restores all %"t one
coronal s"rface of a tooth or #ental*plant a%"t*ent' "s"ally not cover n)the fac al s"rface!/ G!P!T 0 t h e#1
DEFINITI,N
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S n)le restorat on for poster or teeth!o W th *o#erate loss of tooth str"ct"re
/%"ccal &all ntact an# &ell s"pporte#%y so"n# #ent n1!
o S"%2ecte# to avera)e or %elo&avera)e forces!
o W th lon) an# %"l3y coronal str"ct"re!o W th nor*al anato* c cro&n for*' e
& tho"t cerv cal constr ct on!Reta ner for short span FPD!Restorat on or alterat on of occl"sals"rface!Re(esta%l sh anter or )" #ance an# tospl nt teeth
INDICATIONS
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+ )h car es rate an#4or act veper o#ontal # sease!Reta ners for lon) span FPD!Poor al )ne# a%"t*ent teeth!
Teeth & th Short cl n cal cro&n Teeth & th th n cro&n!
Non v tal an# have e$tens vecore restorat ons!Pro$ *ally %"l%o"s /severecerv cal constr ct on1!
C,NTRAINDICATI,NS
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Retent on an# res stance s lessthan that of co*plete veneer
cro&n!Re6" res #e$ter ty of the operator!L * te# a#2"st*ents can %e *a#e
n the path of place*ent!So*e *etal # splay *ay %e"naccepta%le to pat ents!
DISADVANTAGES
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A"$ l ary feat"res /Grooves' 7o$es 5P nholes1 S"%st t"te for a$ al &all8l * t free#o* of # splace*ent!
Increase s"rface area!C rc"*ferent al rre)"lar ty!Re#"ce the ra# "s of rotat on!
RESISTANCE AND RETENTI,N F,R9
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RESISTANCE AND RETENTI,N F,R9
Depen#s on total s"rfacearea of the a$ al &alls& th restr cte# taperretent on of a co*pletecro&n s *ore than#o"%le that of part al(covera)e restorat ons
A## n) )rooves or %o$esto a preparat on & th al * te# path ofplace*ent #oes not*ar3e#ly a:ect tsretent on' %eca"se thes"rface area s notncrease# s )n .cantly!
+o&ever' &here thea## t on of a )roove
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RESISTANCE AND RETENTI,N F,R9
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Pot ts RG, Shi l l ingburg HT & Duncanson MG (1 !" 1 con#"cte#a st"#y to eval"ate the e:ect of preparat on #es )ns on retent onan# res stance! F ve preparat on #es )ns &ere "se# na*ely 'three(6"arter part al veneer cro&n & th an# & tho"t a$ al )rooves 'seven(e )hths part al veneer cro&n & th an# & tho"t a$ al )rooves '
an#co*plete veneer cro&n & tho"t )rooves !All preparat on #es )ns &ere teste# for retent on an# res stanceval"es! They concl"#e# that retent on val"es for al l part al veneer cro&ns&ere s )n .cantly lo&er than those for the co*plete veneer cro&n!
Res stance val"es ncrease# s )n .cantly & th the a## t on of)rooves an#4or e$tens on of a$ al s"rface covera)e!A## t on of )rooves an#4or e$tens on of a$ al s"rface covera)epro#"ce# s*al l ncreases n retent on val"es %"t *ar3e# ncreasesn res stance val"es!
POTTS RG, SHI$$ING% RG HT &D NCANSON MG (1 !" 1
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' ishi oto M, Shillingburg HT & Duncanson MG(1 !)* con#"cte# a st"#y to sho& the n;"ence ofpreparat on feat"res on retent on an# res stance ofthree 6"arter cro&n!
A n c3el(chro*e test # e &as *a#e for each of fo"rthree(6"arter cro&n #es )ns & th the follo& n)var at ons n retent on4res stance feat"res8
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They concl"#e# that the preparat ons & th %o$es orfo"r )rooves &ere the *ost retent ve of all t he#es )ns' &hereas' l n)"al place*ent of pro$ *al)rooves enhance# the retent on!
they also concl"#e# that the three(6"arter cro&ns& th V(shape# )rooves &ere the least res stant ofthe preparat on #es )ns & th retent on4res stancefeat"res!
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Narro& /appro$ *ate ly @!0**1 ' ro"n#( t ppe# ' tapere## a*on# / re)" lar or coarse)r t1Re)" lar(s e /appro$ *ate ly
tapere# # a*on# / .ne ) r t1or car% #eFoot%all (shape# or &heel(shape# # a*on# / re)" lar ) r t1
Tapere# an# st ra )h t car% #e. s s" re %"rsS*al l ' ro"n# car% #e %"r
S*al l (# a*eter t& st #r l lInver te#(cone car% #e %"rF n sh n) stones9 rrorE$plorer an# per o#onta lpro%eCh sels
AR9A9ENTARI-9
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POST+RIOR ANT+RIOR
A* THR++ ART+R
A* THR++ ART+R
%* R+-+RS+ THR++
ART+R
%* PIN AND $+DG+
C* S+-+N.+IGHTS CRO/N
D* PRO0IMA$ HA$
CRO/N
T PES ,F PARTIAL VENEER CR,WN
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9A ILLAR P,STERI,R >4? CR,WN
Three 6"arter cro&ncovers three s"rfaces/a$ al &all1 of thecro&n leav n) ones"rface ntact!
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9ar3 propose# o"tl ne of the prep! & th penc l!,ccl"sal re#"ct on 5 F"nct onal c"sp %evel!A$ al re#"ct on8
Palatal4L n)"al re#"ct on! Pro$ *al re#"ct on!
Pro$ *al Groove or %o$ place*ent!,ccl"sal o: set place*ent!7"ccal contra%evel!
F n sh n) the preparat on!
PREPARATI,N STEPS (MA0I$$AR2PR+MO$AR 3 CRO/N*
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9ar3 the propose# locat on of the *ar) n of theco*plete# preparat on!
9ARK PR,P,SED ,-TLINE
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Depth )rooves are c"t on theanato* cal r #)es an# )rooves ofoccl"sal s"rface!A*o"nt of occl"sal re#"ct on
nee#e# 8
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,CCL-SAL RED-CTI,N
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Place )rooves for a$ al al )n*entn the centre of the l n)"al
s"rface an# n the *es ol n)"alan# # stol n)"al trans t onal l ne
an)les! They sho"l# %e parallel to thelon) a$ s of the tooth!H(
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Cha*fer . n sh l ne8@!>(@! ** a$ al #epth!@! ** s"pra) n) val!Even a$ al #epth ' s*ooth an#cont n"o"s!Th4 cha 54r 6lac47su8 ci4ntl9 c4r:ical to6ro:i74 8";< o5 cl4aranc4 =ith th4a7>ac4nt tooth;A?ial =all allo=ing 5or a6ro?i al groo:4 o5 at l4ast @
;
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Stop the proximal reduction well short of the pencilmark.Initial reduction with short needle diamond.Follow up with chamfer/torpedo diamond.
Avoid:Damage to adjacent tooth.xcessive axial reduction.
PR, I9AL RED-CTI,N
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As apart of pro$ *al re#"ct on5 n or#er to *proveRESISTANCE AND RETENTI,N feat"re of thepreparat on pro$ *al )rooves sho"l# %e place# oneach pro$ *al &all
It sho"l# %e parallel to the lon) a$ s of the tooth orpath of nsert on'5 parallel to each other! Tapere# Car% #e . ss"re %"r s "se# to place these)rooves!
PR, I9AL GR,,VES
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R4 uir4 4ntsBIt sho"l# c"t to f"ll # a*eter of car% #e %"r No!< < tocreate #e.n te l n)"al &all!Depth of )roove nee# not %e *ore than
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V shape# )rooves once & #ely "se# p rov #e# H0J ofretent on an# J of res stance of ro"n#e# orconcave )rooves
The cr ter on that nee#s to %e *et cons sts of the
follo& n)8 The )rooves sho"l# res st l n)"al # splace*ent of aper o#ontal pro%e or e$plorer!
The &alls of the )roove sho"l# not %e "n#erc"trelat ve to the selecte# path of & th#ra&al!
It sho"l# for* a #e. n te step rather than fa# n) o"t The &alls sho"l# %e ; are# to&ar#s the ntact %"ccals"rface of the tooth!
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7o$ shape#8 Destr"ct ve %"t *ore retent ve!-se# only n8
Pro$ *al car es or prev o"s restorat on!Sol#er 2o nt s re6" re#!Prec s on attach*ent s re6" re# !
7, ES
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The %evel sho"l# re*a n & th n the c"rvat"re of thec"sp t p rather than e$ten# to %"ccal &all!
The %evel' %oth ; ares an# the cha*fer sho"l#connect s*oothly to for* one cont n"o"s . n sh l ne!
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Ro"n# all sharp nternall ne an)les to fac l tates"%se6"ent proce#"res! A. ne()r t # a*on# or
car% #e can %e "se# to%len# the s"rfacesReval"ate the ; ares'pay n) part c"lar attent onto any re*a n n)
"n#erc"ts' &h ch *"st %ere*ove#!A * n *"* clearance of@!H ** s reco**en#e#
FINIS+ING
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9A ILLAR PRE9,LAR CR,WN
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+as *any feat"res fo"n# n the prep! of *a$ llaryteeth #escr %e# earl er!
The *a n # : erence s the %"ccal c"sps of poster or*an# %"lar teeth s the f"nct onal c"sps8
The locat on of the occl"sofac al . n sh l ne on the%"ccal s"rface ) n) val to occl"sal contacts!F n sh l ne sho"l# %e %eve lle# sho"l#er or accent"ate#cha*fer87"l3 of *etal!
T e the )rooves!Re nforc n) tr"ss4staple!No nee# for ,: set on the l n)"al ncl ne of %"ccalc"sps!
MANDI% $AR POST+RIOR 3ART+R
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,ccl"sal re#"ct on 5 F"nct onal c"sp %evel!,ccl"sal sho"l#er!A$ al Re#"ct on 5 F n sh L ne!Pro$ *al Groove !Pro$ *al ;are 5Fac al %evel!F n sh n) the preparat on!
PREPARATI,N STEPS /9ANDI7-LAR9,LAR CR,WNS1
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,CCL-SAL S+,-LDER
W #th of the
sho"l#er s < !@@**
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A IAL RED-CTI,N AND FINIS+ LINE
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FACIAL 7EVEL
9ar) nal nte)r ty
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C,9PLETED PREPARATI,N
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In th s preparat on the%"ccal s"rface s ncl"#e# nthe preparat on nstea# ofthe l n)"al s"rface!
-se#Restorat on of *an# %"lar*olar & th #a*a)e# %"ccals"rface an# ntact l n)"als"rface to preserve ntact
l n)"al s"rface!9an# %"lar *olars & thsevere l n)"al ncl nat onsto %e "se# as %r #)ereta ners !
REVERSE T+REE -ARTER CR,WN
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4 0 Cro&n ncl"#es na## t on to s"rfaces covere#%y > 4 ? Cro&n' # stal half of7"ccal s"rface!*es al aspect of th spreparat on rese*%les for athree 6"arter cro&n an# the# stal aspect rese*%les that ofa co*plete cro&n!
-se#8
When tooth s %a#ly #estroye#'%"t 97 c"sp ntact an# &ells"pporte# %y so"n# #ent n!When >4? cro&n lac3sa#e6"ate res stance an#retent on for* /FPD a%"t*ent1!
9A ILLAR 9,LAR 40 CR,WN
PREPARATI N STEPS /9A ILLAR
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,ccl"sal re#"ct on 5 F"nct onal c"sp %evel!A$ al Re#"ct on 5 F n sh L ne!9es al an# %"ccal Grooves 5 Flare!,ccl"sal ,:set 5 Contra%evel!
F n sh n) the preparat on!
PREPARATI,N STEPS /9A ILLAR9,LAR 40 CR,WN1
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,CCL-SAL RED-CTI,N ANDF-NCTI,NAL C-SP 7EVEL
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A IAL RED-CTI,N AND FINIS+LINES
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Prepare the *es al )roove l 3e the three 6"artercro&n!Place the %"ccal )roove parallel to the *es al )roovean# perpen# c"lar to the %"ccoa$ al &all! The %"ccal
)roove sho"l# res st *es o# stal # splace*ent of apro%e!A ; a*e # a*on# an# car% #e %"r s "se# to *a3e the*es al an# fac al ; ares &h ch are narro& at the) n) val en# an# & #er occl"sally
9ESIAL AND 7-CCAL GR,,VESAND FLARES
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,ccl"sal o: set( No8 < < %"r s "se# to pro#"ce a
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,ccl"sal F n sh n) 7evel8 A ; a*e # a*on# or no8 < @%"r s "se# for creat n) an occl"so fac al . n sh n)%evel! It connects the ; ares of t&o )rooves & th as*ooth contra%evel that follo&s the r #)e of the*es o%"ccal c"sp! A#e6"ate clearance *"st %eesta%l she# nterpro$ *ally "pon co*plet on7evel s *a#e r )ht an)le to path of nsert on an# s@! ** n & #th
,CCL-SAL ,FFSET ANDC,NTRA7EVEL
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Depth or entat on )rooves are place# on # stals"rface /
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7e) n the a$ al re#"ct on %y *a3 n) the path ofnsert on of *es al s"rface parallel & th the lon) a$ s
of pre*olar a%"t*ent!Cont n"e c"tt n) *es al s"rface t ll the torpe#o
contacts the &hole *es al s"rface an# a cha*fe r.n sh l ne s pro#"ce#!
9ESIAL A IAL RED-CTI,N
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Fac al an# l n)"al a$ al re#"ct on s #one "s n)torpe#o # a*on#!En# the e$tens on
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,ccl"sal sth*"s an#co"nters n3 prepare# "s n)no! < < %"r!
The a## t on of an occl"salsth*"s ncreases %"l3 an#
r ) # ty n the cast n) as &ellas prov # n) *"ch nee#e#retent on!A co"nters n3 s a##e# to the# stal fossa & th the no! < (**(#eepp nhole s *a#e n the otherle#)e that s on c n)"l"*9 n *"* & #th of le#)e @!** aro"n# p n hole
PIN +,LE PREPARATI,N
INCISAL 7EVEL
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The an)le %et&een the fac al&all of the o: set an# thenc sal e#)e of "nc"t tooth
str"ct"re s %evelle#!All the *ar) ns are . n she#an# sharp an)les are ro"n#e#o: !
INCISAL 7EVEL
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S 99AR
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Part al veneers can %e "se# as s n)le toothrestorat on or serve as reta ner for . $e# part al#ent"res!
They can %e "se# for %oth anter or an# poster orteeth!
They prov #e a#vanta)e of %e n) conservat ve nnat"re' %"t the r preparat on s a challen) n) re6" rese$cellent s3 lls of #ent st! A part al covera)e restorat on sho"l# %e cons #ere#. rst &hen a cast restorat on s nee#e#! A f"ll covera)e cro&n sho"l# %e chosen only &henthe covera)e or retent on a: or#e# %y a part alcovera)e cro&n s na#e6"ate!
S-99AR
T H AN
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THANKYOU
T H A N
2 O &