Major Connectors Dr Deeksha Arya Associate Professor Department

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Major Connectors Dr Deeksha Arya Associate Professor Department of prosthodontics BDS III year RPD

Major Connectors Dr Deeksha Arya Associate Professor Department of prosthodontics BDS III year RPD Lecture Timing- 12 -1 PM

Components of a typical removable partial dentures • 1. Major connectors • 2. Minor

Components of a typical removable partial dentures • 1. Major connectors • 2. Minor connectors • 3. Rests • 4. Direct retainers • 5. Stabilizing or reciprocal components (as parts of a clasp assembly) • 6. Indirect retainers (if the prosthesis has distal extension bases) • 7. One or more bases, each supporting one to several replacement teeth

 • The chief functions of a major connector include • unification of the

• The chief functions of a major connector include • unification of the major parts of the prosthesis, • distribution of the applied force throughout the arch to selected teeth and tissue, and • minimization of torque to the teeth.

This component also provides the cross-arch stability to help resist displacement by functional stresses.

This component also provides the cross-arch stability to help resist displacement by functional stresses.

Location • 1. Major connectors should be free of movable tissue. • 2. Impingement

Location • 1. Major connectors should be free of movable tissue. • 2. Impingement of gingival tissue should be avoided. • 3. Bony and soft tissue prominences should be avoided during placement and removal. • 4. Relief should be provided beneath a major connector to prevent its settling into areas of possible interference, such as inoperable tori or elevated median palatal sutures.

 • Major connectors should be located and/or relieved to prevent impingement of tissue

• Major connectors should be located and/or relieved to prevent impingement of tissue because the distal extension denture rotates in function.

§DEFINITION § A MAJOR CONNECTOR IS THE COMPONENT OF THE PARTIAL DENTURE THAT CONNECTS

§DEFINITION § A MAJOR CONNECTOR IS THE COMPONENT OF THE PARTIAL DENTURE THAT CONNECTS THE PARTS OF THE PROSTHESIS LOCATED ON ONE SIDE OF THE ARCH WITH THOSE ON THE OPPOSITE SIDE. § It is that unit of the partial denture to which all other parts are directly or indirectly attached

CONTENTS §Function of the major connector §Desirable characteristics of major connector §Types of major

CONTENTS §Function of the major connector §Desirable characteristics of major connector §Types of major connector §Steps in designing major connector §Metarial used for major connector §Factors affecting the selection of major connector

DESIRABLE CHARACTERISTICS OF MAJOR CONNECTORS 1. Rigid 2. Compatible with oral tissues 3. Does

DESIRABLE CHARACTERISTICS OF MAJOR CONNECTORS 1. Rigid 2. Compatible with oral tissues 3. Does not interfere with and is not irritating to the tongue 4. Does not substantially alter the natural contour of the palatal vault. 5. Does not impinge on oral tissues 6. Covers no more tissue than is absolutely necessary 7. Does not contribute to the retention or trapping of food particles. 8. Contribute to the support of the prosthesis.

TYPES OF MAJOR CONNECTOR SIX BASIC TYPES OF MAXILLARY MAJOR CONNECTORS ARE CONSIDERED: 1.

TYPES OF MAJOR CONNECTOR SIX BASIC TYPES OF MAXILLARY MAJOR CONNECTORS ARE CONSIDERED: 1. SINGLE PALATAL BAR 2. SINGLE PALATAL STRAP 3. U-SHAPED PALATAL CONNECTOR 4. ANTERIOR-POSTERIOR PALATAL BAR 5. COMBINATION ANTERIOR AND POSTERIOR PALATAL STRAP-TYPE CONNECTOR 6. PALATAL PLATE-TYPE CONNECTOR

SINGLE PALATAL BAR §A palatal connector component of less than 8 mm in width

SINGLE PALATAL BAR §A palatal connector component of less than 8 mm in width is referred to as a bar. §It is narrow half – oval with its thickest point at the centre

§A partial denture made with a single palatal bar is often either too thin

§A partial denture made with a single palatal bar is often either too thin and flexible or too bulky and objectionable to the patient's tongue INDICATION §Limited to replacing one or two teeth on each side of arch and placed no further anteriorly than the second premolar position. §Perhaps the only indication for its use is as an interim partial denture until a more definitive treatment can be considered. CONTRAINDICATION § In distal extension situation § when anterior teeth are to be replaced

DISADVANTAGES § Most difficult for the patient to adjust as to maintain the degree

DISADVANTAGES § Most difficult for the patient to adjust as to maintain the degree of rigidity it has to be made bulky. § Due its narrow anterior-posterior width it derives little vertical support from the bony palate and must be therefore supported positively by rests on the remaining natural teeth.

SINGLE PALATAL STRAP §It consists of a wide thin barel of metal that crosses

SINGLE PALATAL STRAP §It consists of a wide thin barel of metal that crosses the palate in an unobtrusive manner. § It should not be less than 8 mm wide or its rigidity maybe compromised. §It can be relatively narrow for small tooth supported prosthesis or wider for larger edentulous spaces requiring support

§ADVANTAGES § Because the palatal strap is located in three planes it offers great

§ADVANTAGES § Because the palatal strap is located in three planes it offers great resistance to bending and twisting forces. §Distribution of stress over a broad area. §Retention of the partial denture is enhanced by the intimate contact between the metal and soft tissue. §The strap also contributes some indirect retention.

§DISADVANTAGES §The patient may complain of excessive palatal coverage. §Another possible disadvantage is an

§DISADVANTAGES §The patient may complain of excessive palatal coverage. §Another possible disadvantage is an adverse soft tissue reaction in the form of papillary hyperplasia. §INDICATIONS §Used only when 1 or 2 teeth are being replaced on either side. §In CLASS III situations §Need for palatal support is minimal §CONTRAINDICATION § Anterior replacements with distal extension bases.

§U-SHAPED PALATAL CONNECTOR §It consists of thin band of metal running along posterior teeth

§U-SHAPED PALATAL CONNECTOR §It consists of thin band of metal running along posterior teeth and extending onto the palatal tissues for 6 -8 mm. §The borders of the horseshoe connector must either be 6 mm from the gingival margin or extend onto the lingual surfaces of the teeth. §The borders should also be placed in the valleys of the rugae. §The lateral palatal borders should be at the junction of the horizontal and vertical slopes of the palate.

§The rigidity can be increased by extending the borders slightly onto the horizontal palate

§The rigidity can be increased by extending the borders slightly onto the horizontal palate surface. INDICATIONS • Can be in case of a large inoperable tori • When several anterior teeth are to be replaced. • In case of patients with exaggerated gag reflex. • When periodontically weakened anterior teeth need some stabilizing support.

§DISADVANTAGES §Its lack of rigidity allows lateral flexure under occlusal forces… induce torque or

§DISADVANTAGES §Its lack of rigidity allows lateral flexure under occlusal forces… induce torque or direct lateral force to abutment teeth. §Bulk to enhance rigidity results in increased thickness in areas that are a hindrance to the tongue.

§ANTERIOR AND POSTERIOR PALATAL BAR-TYPE CONNECTORS § The flat anterior bar is narrower than

§ANTERIOR AND POSTERIOR PALATAL BAR-TYPE CONNECTORS § The flat anterior bar is narrower than the palatal strap…borders are positioned in the valleys between the rugae. §The posterior bar is half-oval, similar to the single posterior palatal bar connector but less bulky. §The two bars are joined by flat longitudinal elements on each side of the lateral slopes of the palate providing an L beam effect

§INDICATIONS §when support is not a major consideration and when the anterior and posterior

§INDICATIONS §when support is not a major consideration and when the anterior and posterior abutments are widely separated. §Presence of torus palatinus. §The patient's mental attitude: the a-p bar may be used as a compromise for the patient who strongly objects to the greater bulk or area coverage of the full palatal connector. CONTRAINDICATIONS In reduced periodontal support of the remaining teeth that necessitates additional support from the palate.

§ADVANTAGES §The main advantage is its rigidity. In comparison to the amount of soft

§ADVANTAGES §The main advantage is its rigidity. In comparison to the amount of soft tissue coverage, it is by far the most rigid maxillary major connector §DISADVANTAGES §it is frequently uncomfortable. §Derive very little support from the palate. §May interfere with speech- especially the anterior bar.

§ANTERIOR AND POSTERIOR PALATAL STRAP-TYPE CONNECTOR §A posterior palatal strap should be flat and

§ANTERIOR AND POSTERIOR PALATAL STRAP-TYPE CONNECTOR §A posterior palatal strap should be flat and a minimum of 8 mm wide. § Posterior palatal connectors should be located as far posteriorly as possible to avoid interference with the tongue

§INDICATIONS §Kennedy’s Class I and CLASS II arches. §CLASS II modifications I arches. §Class

§INDICATIONS §Kennedy’s Class I and CLASS II arches. §CLASS II modifications I arches. §Class IV arches. §In case of inoperable tori. §DISADVANTAGES §Even though the metal over thin rugae area may be thinner than in some other major connectors, interference with phonetics may occur in some patients. §In addition, the extensive length of borders may cause discomfort to the tongue

§PALATAL PLATE-TYPE CONNECTOR §The full palate connector should be thin, with the natural anatomy

§PALATAL PLATE-TYPE CONNECTOR §The full palate connector should be thin, with the natural anatomy of the palate reproduced. . §The anterior border must be kept 6 mm from the marginal gingiva or must cover the cingula of the anterior teeth. § The posterior border of the complete palate normally extends to the juncture of the soft and hard palate. §The posterior border can be fabricated of either metal or acrylic resin.

§If it is made of metal, the border must be precisely established, because if

§If it is made of metal, the border must be precisely established, because if overextended it will quickly induce soreness, and the metal is difficult to alter satisfactorily. §A slight bead should be provided in the metal by lightly scraping the refractory cast, prior to forming the wax pattern for the framework. §The acrylic resin border is preferred when maximum adhesion and atmospheric seal is needed

§ADVANTAGES §It reproduces the anatomic contours properly. §uniform thickness and thermal conductivity of the

§ADVANTAGES §It reproduces the anatomic contours properly. §uniform thickness and thermal conductivity of the metal are readily acceptable to the tongue and underlying tissues. §DISADVANTAGES §Adverse soft tissue reaction in the form of inflammation or hyperplasia may occur §Problems with phonetics may occasionally occur

§INDICATIONS §CLASS I AND CLASS II arches §When the last remaining abutment tooth on

§INDICATIONS §CLASS I AND CLASS II arches §When the last remaining abutment tooth on either side of a Class I arch is the canine or first premolar tooth, §In individuals with a full complement of mandibular teeth §When flat or flabby ridges or a shallow vault is present. §Cleft palate patients §CONTRAINDICATION §Presence of tori which cannot be surgically removed a full palatal coverage cannot be given.

§DESIGN OF MAXILLARY MAJOR CONNECTORS § In 1953 blatterfein described a systematic approach to

§DESIGN OF MAXILLARY MAJOR CONNECTORS § In 1953 blatterfein described a systematic approach to designing maxillary major connectors. §STEP 1: OUTLINE OF PRIMARY BEARING Areas. The primary bearing areas are those that will be covered by the denture base(s) §STEP 2: OUTLINE OF NONBEARING AREAS. The nonbearing areas are the lingual gingival tissues within 5 to 6 mm of the remaining teeth, hard areas of the medial palatal raphe (including tori), and palatal tissues posterior to the vibrating line.

§STEP 3: OUTLINE OF CONNECTOR AREAS. §STEP 4: SELECTION OF CONNECTOR TYPE §Connectors must

§STEP 3: OUTLINE OF CONNECTOR AREAS. §STEP 4: SELECTION OF CONNECTOR TYPE §Connectors must have a maximum of rigidity to distribute stress bilaterally. § Connectors should be of minimum bulk §When edentulous areas are located anteriorly, the use of only a posterior strap is not recommended. § By the same token, when only posterior edentulous areas are present, the use of only an anterior strap is not recommended. §The need for indirect retention influences the outline of the major connector. §STEP 5: UNIFICATION. After selection of the type of major connector, the denture base areas and connectors are joined. §

§ MATERIALS USED FOR MAJOR CONNECTORS § THE VARIOUS ALLOYS THAT CAN BE USED

§ MATERIALS USED FOR MAJOR CONNECTORS § THE VARIOUS ALLOYS THAT CAN BE USED IN CONSTRUCTING REMOVABLE PARTIAL DENTURE FRAMEWORK ARE: 1. TYPE IV GOLD ALLOY 2. NICKEL CHROMIUM 3. COBALT-CHROMIUM 4. CO- CR- NI 5. TITANIUM AND ITS ALLOYS

§FACTORS AFFECTING SELECTION OF THE MAXILLARY CONNECTOR §RIGIDITY §THE PRESENCE OF PALATAL TORI §THE

§FACTORS AFFECTING SELECTION OF THE MAXILLARY CONNECTOR §RIGIDITY §THE PRESENCE OF PALATAL TORI §THE NEED FOR ANTERIOR TOOTH REPLACEMENT §THE REQUIREMENT FOR INDIRECT RETENTION §THE NEED TO STABILIZE WEAKENED TEETH §PHONETIC CONSIDERATIONS §THE MENTAL ATTITUDE OF THE PATIENT

MANDIBULAR MAJOR CONNECTORS

MANDIBULAR MAJOR CONNECTORS

Contents Introduction Definition Desirable characteristics of major connectors. Criteria for selection of mandibular major

Contents Introduction Definition Desirable characteristics of major connectors. Criteria for selection of mandibular major connectors. Structural requirements of mandibular major connectors.

 Types of mandibular major connectors. Lingual bar major connector. Sublingual bar major connector.

Types of mandibular major connectors. Lingual bar major connector. Sublingual bar major connector. Double lingual bar or Kennedy bar major connector. Cingulum bar or continuous bar major connector. Linguoplate major connector. Labial bar major connector. Hinged continuous bar major connector. Design of mandibular major connector. Materials used for major connector. Summary and Conclusion. References.

“No component of a Removable Partial Denture should be added arbitrarily or conventionally. Each

“No component of a Removable Partial Denture should be added arbitrarily or conventionally. Each component should be added for a good reason and to serve a definite purpose”. - Mc Cracken

Introduction • Choosing one of the possible procedures for restoring partially edentulous arch involves

Introduction • Choosing one of the possible procedures for restoring partially edentulous arch involves border line decisions. • If the relationship between the biologic behaviour of the oral structures and the mechanical influence of the denture is recognized we can provide a partial denture…. . • The major connector may be compared with the frame of an automobile or with the foundation of the building. • Major connector must be rigid………. • It is the dentists responsibility to ensure appropriate design and fabrication.

Definition • A major connector is the component of the partial denture that connects

Definition • A major connector is the component of the partial denture that connects the parts of the prosthesis located on one side of the arch with those on the opposite side. • It is that unit of the partial denture to which all other parts are directly or indirectly attached.

Desirable characteristics of major connectors • The major connector should be rigid to effectively

Desirable characteristics of major connectors • The major connector should be rigid to effectively distribute stress… • Impingement of free gingival margin should be avoided. • Borders of major connector should run parallel to the gingival margin of teeth. • Adequate rests must be provided for the major connector. • Should not create food traps. • Should not cause discomfort to the tissues.

 • Should not alter the natural contour of the palatal vault or the

• Should not alter the natural contour of the palatal vault or the lingual surface of the lower alveolar ridge. • Should be non-interfering and non-irritating to the tongue. • Should not interfere with speech and phonetics. • Should not cover more tissue than absolutely necessary. • Should be made of a material compatible with the oral tissues.

Criteria for selection of mandibular major connector • Although the maxillary connector is able

Criteria for selection of mandibular major connector • Although the maxillary connector is able to contribute substantially to support the prosthesis, the mandibular connector has the very limited capacity for support. Indirect retention is needed to stabilize the mandibular partial denture. – The requirement of indirect retention. – Horizontal stability and stress distribution. – Anatomical considerations. – Periodontal considerations. – Esthetic considerations. – Patient comfort.

Structural requirements for mandibular major connectors • Most of the mandibular major connectors are

Structural requirements for mandibular major connectors • Most of the mandibular major connectors are long and relatively narrow because of space limitation caused by the height of the floor of the mouth, position of lingual frenum. • For these reasons considerations must be given to maintain rigidity of the connector without making it so bulky. • The slope of the lingual tissue and tissue that slope towards tongue requires relief.

Types of major connector • Lingual bar major connector. • Sublingual bar major connector.

Types of major connector • Lingual bar major connector. • Sublingual bar major connector. • Lingual bar with cingulum bar major connector (continuous bar). • Cingulum bar (continuous bar) major connector. • Linguoplate major connector. • Labial bar major connector. • Hinged continuous labial bar.

Lingual bar major connector The basic form of a mandibular major connector is a

Lingual bar major connector The basic form of a mandibular major connector is a half-pear shape, located above moving tissue but as far below the gingival tissue as possible. Advantages: Lingual bar connector has minimal tissue coverage and has minimal contact with oral tissues. It does not contact the teeth, so decalcification of the tooth surface is minimized. Disadvantages: It may be flexible if poorly constructed. Rigidity is less compared to a well constructed lingual plate.

 Indications: It should be used for mandibular removal partial denture where sufficient space

Indications: It should be used for mandibular removal partial denture where sufficient space exists between the slightly elevated alveolar lingual sulcus and lingual gingival tissues. Contraindications: Inoperable lingual tori. Highly attached lingual frenum. Interferences to elevation of the floor of the mouth during functional movements.

Characteristics and location • Half-pear shaped with bulkiest portion inferiorly located. • Superior border

Characteristics and location • Half-pear shaped with bulkiest portion inferiorly located. • Superior border tapered to soft tissue. • Superior border located atleast 4 mm inferior to gingival margins. • Inferior border located at the ascertained height of the alveolar lingual sulcus when the patients tongue is slightly elevated.

 • Availability of space for connector is one of the important factor to

• Availability of space for connector is one of the important factor to be considered. Atleast 8 mm of vertical space between the active tissues of the floor of the mouth and the gingival margins of the teeth is required. • There are two clinically acceptable methods to determine relative height of the floor of the mouth to locate the inferior border of the major connector.

 First method: Patients tongue should touch the vermillion border of the upper lip

First method: Patients tongue should touch the vermillion border of the upper lip and measurements were made in relation to the lingual gingival margins of the adjacent teeth using a periodontal probe. The readings are transferred to the master cast. Second method: This method uses an individualized impression trays having its lingual border 3 mm short of the elevated floor of the mouth is molded with an impression material during functional movements of tongue.

Blockout and relief of master cast • All tissue undercuts parallel to path of

Blockout and relief of master cast • All tissue undercuts parallel to path of placement. • An additional thickness of 32 -gauge wax when the lingual surface of the alveolar ridge is either undercut or parallel to the path of placement. • No relief is necessary when the lingual surface slopes inferiorly and posteriorly. • One thickness of base plate wax over basal seat areas.

 Waxing specifications Six-gauge, half-pear shaped wax form reinforced by 22 -24 gauge sheet

Waxing specifications Six-gauge, half-pear shaped wax form reinforced by 22 -24 gauge sheet wax adapted to the design width. Long bar require more bulk than short bar. Finishing lines Butt joints with minor connectors for retention of denture bases.

Z. Ben-Ur, S. Matalon, I. Aviv and H. S. Cardash (J. P. D. 1989)

Z. Ben-Ur, S. Matalon, I. Aviv and H. S. Cardash (J. P. D. 1989) Conducted a study to check the rigidity of five lingual bar type mandibular major connectors with different cross-sections a micrometer microscope and a system of pulley and weights were used and torsion forces were measured to compare rigidity. They concluded that the lingual bar type with halfpear shaped cross section showed the highest degree of rigidity. Among the conventional lingual bars the wide semielliptical bar showed the highest degree of rigidity and narrow semielliptical bar was most flexible.

Zee Ben-Ur, Eitan Mijiritsky, Colin Gorfil, and Tamar Brosh (J. P. D. 1999) Conducted

Zee Ben-Ur, Eitan Mijiritsky, Colin Gorfil, and Tamar Brosh (J. P. D. 1999) Conducted a study to investigate the design and crosssectional shape of major connectors most favorably influencing rigidity and flexibility. Five lingual bar major connectors of different cross-sectional forms were cast in chrome-cobalt alloy. Vertical and horizontal forces were applied to each point while the opposite side was gripped in Instron. They concluded that the half-pear shaped crosssection proved to be the most rigid major connector.

Anthony K. Kaires (J. P. D. 1958) Conducted a study using Electronic means to

Anthony K. Kaires (J. P. D. 1958) Conducted a study using Electronic means to know the effect of partial denture design on functional force distribution in a mandibular bilateral distal extension denture as it is related to the supporting tissues and also to determine what effect the variations of partial denture designs has on masticatory performance. They concluded that the effect of partial denture design on masticatory performance did not reveal any significant relationship. Generally they stated that a rigid design is more desirable than a flexible one in withstanding horizontal stresses.

Linguoplate mandibular major connector • If the rectangular space bounded by the lingual bar,

Linguoplate mandibular major connector • If the rectangular space bounded by the lingual bar, the anterior tooth contacts and cingula, and the bordering minor connectors is filled in, a lingual plate results.

 Advantages: The linguoplate is a rigid mandibular major connector and it provides more

Advantages: The linguoplate is a rigid mandibular major connector and it provides more support and stabilization when compared to other connectors. Can be used in stabilizing the periodontally-weakened teeth. When it is supported at each end by a rest it contributes to the action of indirect retention. When properly contoured and fabricated, it will not cause interference with tongue movements and will be more comfortable to the patient. Disadvantages: It covers the tooth structure and the gingival tissue. The metal coverage of the free gingival tissue prevents physiological stimulation and self-cleansing of these areas by saliva.

 Indications: It is indicated in cases where alveolar lingual sulcus so closely approximates

Indications: It is indicated in cases where alveolar lingual sulcus so closely approximates the lingual gingival crevices such as high lingual frenum attachments. If residual ridges in Class I arch have undergone severe vertical resorption that they will offer only minimal resistance to horizontal rotation. It can be used to stabilize periodontally weakened teeth. When future replacement of one or more incisor teeth will be facilitated by the addition of retention loops to an existing linguoplate. Contraindications: In lingually inclined mandibular anterior teeth. Mandibular teeth wide embrassures and diastema.

 Characteristics and location: Half-pear shaped with bulkiest portion inferiorly located. Thin metal apron

Characteristics and location: Half-pear shaped with bulkiest portion inferiorly located. Thin metal apron extending superiorly to contact cingula of anterior teeth and height of contour of posterior teeth. Scalloped contour of apron as dictated by interproximal blockout. The superior border finished to continuous plane with contacted teeth. Inferior border at the ascertained height of the alveolar lingual sulcus when patients tongue is elevated.

 Blockout and relief of master cast: All involved undercuts of contacted teeth parallel

Blockout and relief of master cast: All involved undercuts of contacted teeth parallel to the path of placement. All involved gingival crevices. Lingual surface of alveolar ridge. Waxing specifications: Inferior border 6 -gauge, half pear shaped wax form reinforced with 24 -gauge sheet wax. Apron 24 -gauge sheet wax. Finishing lines: Butt-type joints.

Larry D. Campbell (J. P. D. 1977) conducted a study to evaluate the multiple

Larry D. Campbell (J. P. D. 1977) conducted a study to evaluate the multiple removable partial denture designs by test patients. 8 major connector designs were evaluated during speaking, chewing and swallowing and for general comfort by 12 dentists. They concluded that the mandibular lingual bar was chosen over the lingual plate by a 3: 1 ratio. Metal borders parallel to tongue movement were better tolerated than those lying transverse. In general, patients adapted best to major connectors that covered the least amount of soft tissues.

 Kenneth R. Mc. Henry, Owe E. Johansson (J. P. D. 1992) conducted a

Kenneth R. Mc. Henry, Owe E. Johansson (J. P. D. 1992) conducted a clinical trial using the experimental gingivitis model developed for periodontal clinical research to evaluate the effect of removable partial denture mandibular major connector design on surrounding gingival tissues. A comparison between the linguoplate (control) and cingulum bar (test) major connectors were made at 7 day intervals for 21 days. Results showed a greater increase in mean gingival inflammation with the control than with the test suggesting that cingulum bar has fewer detrimental effects on gingival tissues than linguoplate.

Sublingual bar major connector: A modification of the lingual bar that has been demonstrated

Sublingual bar major connector: A modification of the lingual bar that has been demonstrated to be useful when the height of the floor of the mouth does not allow placement of superior border of the connector at least 4 mm below free gingival margin.

 Indications: The height of the floor of the mouth in relation to the

Indications: The height of the floor of the mouth in relation to the free gingival margin is less than 6 mm. If it is desired to keep the free gingival margins of anterior teeth exposed and there is inadequate depth of the floor of the mouth. Contraindications: Lingually tilted remaining natural teeth. Inoperable lingual tori. High attached lingual frenum.

 • Characteristics and Location: – It is same as lingual bar except that

• Characteristics and Location: – It is same as lingual bar except that the bulkiest portion is located to the lingual and the tapered portion is towards the labial. – The superior border of the bar should be atleast 3 mm from the free gingival margin. – Inferior border is located at the height of the alveolar lingual surface.

 • Blockout and relief of master cast: – All tissue undercuts parallel to

• Blockout and relief of master cast: – All tissue undercuts parallel to the path of placement. – Additional thickness of 32 -gauge wax when the lingual surface of alveolar ridges either undercut or parallel to the path of placement. • Waxing specifications: – 6 -gauge, half-pear shaped wax form reinforced by 22 -24 gauge sheet wax. – Longer bar bulkier than shorter bar. • Finishing lines: – Butt-type joints.

 Karl A. Hansen and Donald J. Campbell (J. P. D. 1985) conducted a

Karl A. Hansen and Donald J. Campbell (J. P. D. 1985) conducted a study to evaluate patient acceptance of the sublingual bar when compared with lingual plate major connector and to determine the preferred design. They concluded from the final data that the sublingual bar compares favorably with the lingual plate in patient acceptance and should be considered as a variable design alternative when a lingual plate is not indicated.

Mandibular lingual bar with cotninuous bar (cingulum bar) or double lingual bar) This type

Mandibular lingual bar with cotninuous bar (cingulum bar) or double lingual bar) This type of major connector is also called “Kennedy bar” it distribute stresses to all of the teeth with which it comes in contact there by reducing the stresses to the underlying tissues. It is also referred as “continuous lingual clasp” major connector, because of series of clasp arms connected on the lingual surfaces of lower anterior teeth.

 Advantages: The double lingual bar effectively extends indirect retention in an anterior direction

Advantages: The double lingual bar effectively extends indirect retention in an anterior direction is supported by adequate rest. It also contributes to horizontal stabilization. It helps in minor amount of support to the prosthesis. The gingival tissues and inter-proximal embrassures are not covered by the connector, which helps in free flow of saliva. Disadvantages: Patient may feel discomfort because it alters the normal position of the tongue. If connector does not maintain intimate contact with tooth surface there will be food entrapment.

 • Indications: – It is mainly used as a major connector in periodontally

• Indications: – It is mainly used as a major connector in periodontally treated anterior teeth wide inter-proximal embrassures. – When linguoplate is contraindicated due to poor axial alignment of anterior teeth. • Contraindications: – In severely crowded anterior teeth.

 Characteristics and location: Shaped same as lingual bar. Thin narrow metal strap located

Characteristics and location: Shaped same as lingual bar. Thin narrow metal strap located on cingula of anterior teeth scalloped to follow interproximal embrassures. Blockout and relief of master cast: Same as for lingual bar. No relief for continuous bar except blockout of interproximal spaces. Waxing specifications: Same as lingual bar. Continuous bar pattern found by adapting two strips of 28 -gauge sheet wax over the cingula and into interproximal embrassures. Finishing lines: Butt joints.

 Mansuang, Hisashi, Takashi (I. J. P. 2001) conducted a study to investigate the

Mansuang, Hisashi, Takashi (I. J. P. 2001) conducted a study to investigate the vibration characteristics of 3 different designs of mandibular major connectors in vitro by observing model animation, decay rate and maximum amplitude. Three removable partial denture frameworks (lingual bar, Kennedy bar and lingual plate) were studied. They concluded that all three designs demonstrated no elastic deformation in terms of vibration analysis a lingual bar demonstrated the maximum decay rate indicating that it will dissipate the energy through vibration faster than the other designs. Hence the possibility of creating harmful effects to the oral tissue is lesser.

Mandibular continuous bar (Cingulum bar) Improper axial alignment of the anterior teeth will necessitate

Mandibular continuous bar (Cingulum bar) Improper axial alignment of the anterior teeth will necessitate excessive blockout of interproximal undercuts. These types of cases indicates continuous bar major connector. Contraindications: In lingually tilted anterior teeth. Wide diastema between mandibular anterior teeth.

 Characteristics and Location Thin narrow metal strap located on cingula of anterior teeth,

Characteristics and Location Thin narrow metal strap located on cingula of anterior teeth, scalloped to follow interproximal embrassures. Originates bilaterally from rests of the adjacent principle abutments. Blockout and relief of master cast: No relief for cingulum bar except interproximal spaces. Waxing specifications: A cingulum bar pattern formed by adapting two strips of 28 -gauge, 3 mm wide over the cingula and into interproximal embrassures. Finishing lines: Butt-type joint.

Mandibular labial bar major connector The labial bar has a limited application in cases

Mandibular labial bar major connector The labial bar has a limited application in cases where large inoperable lingual tori and severely lingually inclined lower anterior and premolars prevents the use of other mandibular major connectors.

 Characteristics and Location: Half-pear shaped with bulkiest portion inferiorly located on the labial

Characteristics and Location: Half-pear shaped with bulkiest portion inferiorly located on the labial or buccal aspect. Superior border tapered to soft tissue and 4 mm inferior to labial gingival margins. Inferior border located in the labial buccal vestibule. Blockout and relief of master cast: All tissue undercuts parallel to path of placement and when the labial surface is either undercut or parallel to the path of placement. No relief if labial surface of alveolar ridge slopes inferiorly.

 • Waxing specifications: – 6 -gauge half-pear shaped wax form reinforced with 22

• Waxing specifications: – 6 -gauge half-pear shaped wax form reinforced with 22 -24 gauge – Long bar more bulkier than shorter bar. – Minor connector joined with occlusal or other superior components by a labial approach. • Finishing line: – Butt-type joints.

Hinged continuous labial bar • This type of major connector is the modification of

Hinged continuous labial bar • This type of major connector is the modification of linguoplate which is incorporated in the “Swing-lock” design consists of labial or buccal bar i. e. connected to the major connector by hinge on one end and latch at the other end. • Support provided by multiple rests on the remaining natural teeth. Stabilization and reciprocation provided by a lingual plate. Retention is provided by bar type retentive clasp arms projecting from the labial or buccal bar and contacting the infrabulge areas on the labial surfaces.

 • Indications: – Missing key abutments. – Unfavorable tooth contour. – Unfavorable soft

• Indications: – Missing key abutments. – Unfavorable tooth contour. – Unfavorable soft tissue contours. – Teeth with questionable prognosis. • Contraindications: – Poor oral hygiene. – Shallow buccal labial vestibule. – High frenal attachment.

Design of mandibular major connectors The basic principles of major connector design includes: Step

Design of mandibular major connectors The basic principles of major connector design includes: Step I-Outline the basal seat areas on the diagnostic cast. Step II-Outline the inferior border of the major connector.

 Step III-Outline the superior border of the major connector. Step-IV-Connect the basal seat

Step III-Outline the superior border of the major connector. Step-IV-Connect the basal seat area to the inferior and superior borders of the major connector and add minor connectors to retain the acrylic resin base.

Materials used for Major connectors • Various alloys that can be used in constructing

Materials used for Major connectors • Various alloys that can be used in constructing removable partial denture are: – Type IV gold alloy. – Nickel-chromium. – Cobalt-chromium. – Co-Cr-Ni. – Titanium and its alloys.

 • Base metal alloys have relatively high elastic modulus. This property suggest that

• Base metal alloys have relatively high elastic modulus. This property suggest that the thickness of partial denture frameworks can be thinner than those of other metals. • The ductility of titanium is greater than that of the others. • Base metal alloys have higher hardness compared with tooth enamel which causes in vivo wear. • Alloys for partial denture frameworks have high melting points and they exhibit high casting shrinkage with potential for casting defects.

Summary Various major connector designs that can be useful in the successful construction of

Summary Various major connector designs that can be useful in the successful construction of a removable partial denture has been discussed. For a tooth supported removable partial denture the lingual bar is the suitable major connector. Long span edentulous ridges in which there is posterior abutment and indirect retention is needed, the lingual plate is indicated. When anterior teeth are periodontally treated and needs support and stabilization, the lingual plate or double lingual bar may be used. When the tissue of the floor of the mouth are active and <8 mm space available between tissue and marginal gingiva, a lingual plate is preferred. Labial bar is rarely used.

Conclusion • Major connectors by uniting the other components of a removable partial dentures

Conclusion • Major connectors by uniting the other components of a removable partial dentures acts like a foundation bringing about bilateral distribution of forces which depends on the rigidity of the connector. • Utmost care should be taken to prevent a major connector from interfering with normal functions or having any damaging effects to the remaining oral structure. • Although there are many variations in major connector, a thorough comprehension of all factors influencing their design will lead to the best design for each patient.

References • Mc. Cracken’s Removable Partial Prosthodontics. A. B. Carr, G. P. Mc. Givney,

References • Mc. Cracken’s Removable Partial Prosthodontics. A. B. Carr, G. P. Mc. Givney, D. T. Brown. 11 th edition. • Stewart’s Clinical Removable Partial Prosthodontics. Rodney D. Phoenix, David R. Cagna, Charles F. De. Freest. 3 rd edition. • Removable partial prosthodontics. Ernest L. Miller, Joseph E. Grasso, Second edition. • Bert T. Cecconi : Lingual bar design. J. P. D. 1973; 29: 635 -639. • Mc. Cracken W. L. : Contemporary partial denture designs. J. P. D. 2004; 92: 409 -417.

 • Z. Ben-Ur, S. Matalon, I. Aviv : Rigidity of major connectors when

• Z. Ben-Ur, S. Matalon, I. Aviv : Rigidity of major connectors when subjected to bending and torsion forces. J. P. D. 1989; 62: 557 -562. • David Henderson : Major connectors for mandibular removable partial dentures: Design and function. J. P. D. 1973; 30: 530 -549. • Mansuang, Hisashi, Takashi : Rigidity of 3 different types of mandibular major connector through vibratory observations. I. J. P. 2001; 14: 510 -515. • Carl A. Hansen, Donald J. Campbell : Clinical comparison of twomandibular major connector designs: The sublingual bar and the lingual plate. J. P. D. 1985; 54: 805 -808.

 • Kenneth R. Mc. Henry, Owe E. Johansson : Effect of removable partial

• Kenneth R. Mc. Henry, Owe E. Johansson : Effect of removable partial denture framework design on gingival inflammation – a clinical model. J. P. D. 1992; 68: 799 -803. • Larry D. Campbell : Subjective reactions to major connector designs for removable partial denture. J. P. D. 1977; 37: 507 -515. • Anthony K. Kaires : A study of partial denture design and masticatory pressures in a mandibular bilateral distal extension case. J. P. D. 1958; 8: 340 -350. • Zeev Ben-Ur, Eitan Mijiritsky, Colin Gorfil : Stiffness to different designs and cross section of maxillary and mandibular major connectors of removable partial dentures. J. P. D. 1999; 81: 526 -531.

Thank you

Thank you