MAJOR CONNECTORS CONTENTS DEFINITION INDICATION OF RPD KENNEDY’S CLASSIFICATIONS APPLEGATE’S MODIFICATIONS APPLIGATE’S RULES TYPES & STEPS OF RPD COMPONENTS OF RPD IDEAL REQUIREMENTS MAJOR CONNECTOR DESIGNING CONSIDERATION OF MAJOR CONNECTORS MAXILLARY MAJOR CONNECTORS MANDIBULAR MAJOR CONNECTORS Specific learning objectives; At the end of the class student should be able to; Define Major connector. Enumerate the types and function Enumerate indications of major connector. Definitions 1. Removable partial denture (RPD): A partial denture that can be removed and replaced in the mouth by the patient. 2. Interim denture (provisional; temporary): A denture used for a short interval of time to provide esthetics, mastication, occlusal support and convenience & conditioning of the patient to accept the final prosthesis. Indications for RPD's 1. Lengthy edentulous span (too long for a fixed prosthesis) 2. No posterior abutment for a fixed prosthesis 3. Excessive alveolar bone loss (esthetic problem) 4. Poor prognosis for complete dentures due to residual ridge morphology 5. Reduced periodontal support of remaining teeth (won't support a fixed prosthesis) 6. Cross-arch stabilization of teeth 7. Need for immediate replacement of extracted teeth 8. Cost/patient desire considerations Kennedy’s classification CLASS I-Bilateral edentulous areas located posterior to the remaining natural teeth CLASS II-Unilateral edentulous area located posterior to the remaining natural teeth CLASS III- Unilateral edentulous area with natural teeth both anterior and posterior to it CLASS IV-Single, bilateral edentulous area located anterior to the remaining natural teeth Applegate Modification-to expand the Kennedy system by adding classes V and VI, however, acceptance has not been universal. CLASS V- is described as an edentulous area bounded anteriorly and posteriorly by natural teeth in which the anterior abutment (the lateral incisor) is not suitable for support. CLASS VI- is an edentulous situation in which the teeth adjacent to the space are capable of total support of the required prosthesis. TYPES & STEPS IN FABRICATION OF REMOVABLE PARTIAL DENTURES 1-INTERIM 1.DIAGNOSIS AND TREATMENT PLANING 2.PREPROSTHETIC MOUTH PREPARATION 3.PRIMARY IMPRESSION 4.DUAL IMPRESSION ( SECONDARY ) 5.JAW RELATION 6.TEETH ARRANGMENT AND WAXUP,CARVING 7.DENTURE PROCESSING 8.DENTURE INSERTION 9.POST INSERTION FOLLOW-UP 2-DEFINITIVE OR PERMANENT 1.DIAGNOSIS AND TREATMENT PLANING 2.PREPROSTHETIC MOUTH PREPARATION 3.PRIMARY IMPRESSION 4.SURVEYING 5.REMOVABLE PARTIAL DENTURE DESIGN 6.PROSTHETIC MOUTH PREPARATION 7.DUAL IMPRESSION ( SECONDARY ) 8.FRAMWORK TRY-IN 9.JAW RELATION 10.TEETH ARRANGMENT AND WAXUP,CARVING 11.DENTURE PROCESSING 12.DENTURE INSERTION 13.POST INSERTION FOLLOW-UP COMPONENTS OF RPD Major connector Minor connector Direct retainer Indirect retainer Major Connector A part of removable partial denture which connects the components on one side of the arch to the components of opposite side of the arch. Ideal Requirments• Should be Rigid • Provide vertical support • Should be comfortable • Should not allow any food accumulation • Should be self cleansing Designing Consideration• • • • • • • • Border should be 6 mm away from gingiva margin in maxilla & 3 mm away in mandible Border should be parallel to gingival margin Border should be rounded Not extend over bony prominence ( Tori) Avoid to cover rugae or border end in the belly of rugae not at crest of rugae Should be symmetrical Metal framework should cross the gingival margin only at right angles. Part of the framework that adjoining the teeth should be hidden in the embrasures to avoid discomfort A-MAXILLARY MAJOR CONNECTORS 1-SINGLE POSTERIOR PALATAL BAR -Is narrow, half oval & thickest at the center. Indication- interim RPD or Class III (Short span) 2-PALATAL STRAP is the most versatile maxillary major connector. It consists of a wide, thin band of metal that run across the palate & it should be 8 mm wide. Indication- Class II & III ( Short span) 3- SINGLE BROAD PALATAL OR PALATAL PLATEIt is slight broader then palatal strap Indication- Class I, U or V shape palate. 4-ANTEROPOSTERIOR, OR DOUBLE, PALATAL BAR Combination of anterior & posterior palatal strap Indication- Class II mod 1, Class IV, Tori, Avoid complete palatal coverage. 5-HORSESHOE, OR U-SHAPED, CONNECTOR It consists of a thin band of metal running along the palatal surface of the posterior teeth and extending onto the palatal tissue for 6-8mm. Anteriorly thin plate cover the cingula of teeth. Indication-Class IV, Tori on post. Palate, Prominent midpalatine suture, Overbite of anterior teeth. 6-CLOSED HORSESHOE, OR ANTEROPOSTERIOR PALATAL STRAP Structurally strong and rigid major connector that may be used in most maxillary partial denture designs. It is same as U shape except post. strap. Indication- Class I & II with Some anterior tooth replace, If midpalatine tori present. 7-COMPLETE PALATE Cover the full palate, Anteriorly 6 mm away from gingiva or extend upto cingula of teeth, posteriorly till PPS as round beading. Indication- Class I with ant. Teeth missing, IV, II & III with long edentulous span, Cleft palate, flat ridge. TYPES OF MANDIBULAR MAJOR CONNECTORS Lingual bar Lingual plate Double lingual bar or Kennedy bar Labial bar B-MANDIBULAR MAJOR CONNECTORS 1-LINGUAL BAR This is half pear shape, Thicker at inferior border, minimum of 8 mm vertical clearance from floor of the mouth, 5-6 mm in minimum thickness & height. This is most frequently used mandibular major connector. Indication- Class I & II, III condition 2-LINGUAL PLATE It is similar to the Lingual bar but the superior border of the bar onto the lingual surfaces of the teeth. Indication- Class I & II condition with remaining teeth are not periodontally sound, Chances of over eruption of mandibular ant. teeth. 3-DOUBLE LINGUAL BAR OR KENNEDY BAR This differs from the lingual plate in the middle portion is taken off. Indication- Class I,II & III with large embrasures or diastema in anterior Teeth. 4-LABIAL BAR ( Swing lock) It is same as lingual bar but thicker & runs across the mucosa labial to the mandibular anterior teeth. Indication- Class III & IV, Teeth are lingually placed or inclined, Tori present, 5-SUBLINGUAL BAR It is same as lingual bar but placed more inferiorly & posteriorly than lingual bar. Indication- Class I, II, III with Anterior lingual undercut, sulcus depth is too little 6- CINGULUM BAR It is located on or slightly above the cingula of anterior teeth. It may be Used alone or with a lingual bar. Indication- Class I, II & III with large embrasures or diastema in anterior Teeth. REFERENCES1.Carr A.B, Mc Givney G.P, Brown D.T. Mc Crackens Removable Partial Prosthodontics. 11th Edition 2005 India; Pg -271- 299. 2. Deepak Nallaswamy. Textbook of Prosthodontics. 1st Edition 2003 India; pg.327-340.