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

Major Connectors

BDS III yearRPD Lecture

Timing- 12-1 PM

Dr Deeksha AryaAssociate ProfessorDepartment of prosthodontics

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 ofa clasp assembly)• 6. Indirect retainers (if the prosthesis has distal extension

bases)• 7. One or more bases, each supporting one to severalreplacement teeth

• 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.

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 because the distal extension denture rotates in function.

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 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 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. 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 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 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 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 the palate in

an unobtrusive manner.

It should not be less than 8mm 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

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 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 and

extending onto the palatal tissues for 6-8mm.

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 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 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 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 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 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 a minimum of 8 mm wide.

Posterior palatal connectors should be located as far posteriorly as

possible to avoid interference with the tongue

INDICATIONSKennedy’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 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 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 the 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 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 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 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 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 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

connectors. Structural requirements of mandibular major

connectors.

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 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 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 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 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 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 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 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.• 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 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 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 tapered to soft tissue.• Superior border located atleast 4mm 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 be considered. Atleast 8mm 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 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 3mm 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 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 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)

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 half-pear 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 a study to investigate the design and cross-sectional 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 cross-section proved to be the most rigid major connector.

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, 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 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 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 with wide embrassures and diastema.

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

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 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. McHenry, 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 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 free gingival margin is less than 6mm.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 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 3mm 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 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 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 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 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 treated anterior teeth with 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 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 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

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 LocationThin 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, 3mm 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 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 or buccal aspect. Superior border tapered to soft tissue and 4mm

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 22-24 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 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 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 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 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

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 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 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 <8mm 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 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

• McCracken’s Removable Partial Prosthodontics. A.B. Carr, G.P. McGivney,

D.T. Brown. 11th edition.

• Stewart’s Clinical Removable Partial Prosthodontics. Rodney D. Phoenix,

David R. Cagna, Charles F. DeFreest. 3rd 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.

• McCracken 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

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 two-

mandibular major connector designs: The sublingual bar and the

lingual plate. J.P.D. 1985; 54: 805-808.

• Kenneth R. McHenry, 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.

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