Retainers used for

Fixed Prosthodontics
 Definition
Artificial restoration which rebuild the prepared
abutment tooth or teeth by which, the bridge is
connected to the abutment and to which the
pontic is connected.
Requirements of ideal retainer
1. Provides maximum retention.

2. Gives maximum esthetics.

3. Preserves vitality of the prepared abutments.

4. Needs least amount of abutment preparation.

5. Biologically acceptable to surrounding tissue.

6. Withstands masticatory forces.

7. Easily constructed.
 Objective of tooth preparations
1. Cervical diameter should be wider than occlusal
diameter to allow proper path of insertion.

2. Provide adequate retention and resistance form

to the retainer.

3. Provide sufficient bulk for restoration material.

4. Provide definite finish line to ensure marginal

adaptation.
● Factors affecting selection of retainers

1. Retention.

2. Esthetics.

3. Age of the patient.

4. Existing caries.

5. Caries susceptibility.

6. Amount and direction of stress.

● Factors affecting selection of retainers

7. Size and position of the abutment.

8. Condition of abutment.

9. Type of occlusion and opposing restorations if

present.

10. Musculature of the patient.

11. Length of edentulous span.

12. Biological aspect.

 1) Retention:
•Retainers should be self retentive i.e. not depending on
the cement.
Role of cement →increase retention of resin bonded
bridges. →seal the space between retainer and the
abutment.

N.B In case of cantilever → full coverage is indicated

 1) Retention:
•The amount of retention needed depend on → remaining
sound tooth structure………………….how???

1. If badly destructed teeth or with large core

restoration→ full coverage is indicated.

2. If small restoration existing proximally → partial

coverage (3/4) with box shaped grooves can be used.
 1) Retention:
•The amount of retention needed depend on → remaining
sound tooth structure………………….how???

3. If short clinical crown → crown lengthening/ or

intentional root canal treatment → full coverage is
indicated.

4. If intact enamel and normal occlusion → resin bonded

retainer is indicated.
 1) Retention:
•To increase retention:
i) Teeth with extensive caries →R.C.ttt →post & core to
↑retention & resistance form to the preparation.

ii) Crown lengthening → without affecting biological width.

iii) Additional retention by → grooves e.g. 7/8, 3/4

→ Pins e.g. pin ledge retainer.
 2) Esthetics:
●Factors affecting esthetics treatment options:
1. Reduced available pontic space due to drifting of
teeth → full coverage retainer with reshaping the teeth.

2. Long clinical crowns due to surgical crown lengthening

→ full coverage retainer with gingival pink porcelain.

3. In case of large diastema before extraction→ full

coverage retainer with palatal loop connector.
 2) Esthetics:
●Factors affecting esthetics treatment options:
4. Ridge defect due to trauma/developmental
abnormalities/ severe periodontal disease.→ ridge
augmentation or conventional F.P.D with pink porcelain
(less hygienic) or the use of precision attachment.

5. Laminate veneers can be used as an alternative to full

veneer crown to mask discoloration.
 2) Esthetics:
●Factors affecting esthetics treatment options:
6. All ceramic crowns can be used as an alternative to
metal ceramic restoration.

7. Precision attachment can be used as an alternative to

partial denture→ to prevent clasp display.
 3) Age of the patient:
• In young patient →minimum age is 18-20 y why?

Because

→ a) large pulp size therefore exposure may occur

during preparation.
→ b) high gingival level around the tooth → when passive
eruption occur (normal gingival recession) → exposure
the restoration margin→ partial coverage is indicated.

• In aged patient → periodontal condition should be

carefully considered.
 4) Existing caries:
* ↑ Caries → indicated for full coverage restoration.

* Minimal caries or sound tooth structure → indicated for

partial coverage with U shaped or box shaped grooves.
 5) Caries susceptibility & oral hygiene:

•↑ Caries index & poor oral hygiene → full coverage

restoration.
 6) Amount & direction of stress:

e.g. Deep bite → full coverage restorations.

Partial and complete denture create less forces than

natural dentition.
7) Size and position of the abutment:
* Long / large tooth → partial coverage.

* Thin / short tooth → full coverage.

* The angulation of the tooth → must allow paralleling of

the abutment.
7) Size and position of the abutment:
In case of tilted abutment, FPD is some time made with
modified preparation design or with non-rigid connector,
the tooth can be uprighting orthodontically or telescopic
crown can be used.
8) Condition of the abutment:
1. Abutment color → if severe discoloration → full
coverage is indicated as partial coverage can’t be
used.
2. Crown form → if short teeth → full coverage → If thin
teeth → full coverage → If constricted cervical neck
→ partial coverage.
3. In case of tilting lower second molar → precision
attachment or ½ crown on the mesially tilted molar or
telescopic crowns.
8) Condition of the abutment:
4. Large pulp horns → partial coverage is indicated.

5. Minimal C/R (1:1) → full coverage is indicated with

added abutment.

6. Pulp vitality → in non vital teeth → post and core +full

coverage is indicated.

7. In case of pier abutment → full coverage indicated

with precision attachment.
9) Type of occlusion & opposing restoration
if present
If opposing occlusion is:
→ R.P.D or complete denture (less force on opposing
teeth).
→ F.P.D.
→ Natural teeth.
10) Musculature of the patient

→ Male is subjected to more forces than the female

→ Molar region is subjected to 200-890 N

→ Premolar region is subjected to 225-445 N

→ Cuspid region is subjected to 133-324 N

→ Anterior region is subjected to 85-111 N

Classification of retainers
 1. According to the position of the retainer:-

Intra-radicular Extra- coronal

Full coverage
Post crown
Partial coverage
Intra-coronal
e.g. Inlays
Onlays
INLAY RETAINED
BRIDGE
 2. According to the material of the retainer:-

Metallic Combination
All metal Veneered &
Post crown Full veneered
Non- Metallic
All- ceramic &
Temporary acrylic
crown
3. According to mode retention of the retainer:-

A. By complete encircling the preparation

e.g. Full metal crown
Veneered and full veneered crown
Temporary acrylic crown.

B. By post in root canal

( post only, post &collar , attached, detached, all
metallic and combination).

D. By grooves e.g. 3/4. 1/2 and 7/8 retainers.

E. By Dowel pins e.g. Pinledge retainers.

4. Resin bonded retainer
 I. Extra-coronal retainers
Def: it’s restoration that encircles all or part of
the remaining tooth structure
So it can strengthen and protect a tooth that
weaken by caries or trauma.
Full coverage retainers
A. full metal retainer
Advantages:
1. High retention
2. High resistance than partial coverage restorations.
3. High strength
4. It allow for modification of the axial tooth contour
as in case of ma-laligned teeth
5. It allow easy modification of the occlusion
6. Embrasure area can be enhanced

Disadvantages:
1. It is less conservative to the tooth structure
2. It may cause inflammation of the gingival tissues
3. Display of metal make it restricted to posterior teeth
 Indications
1. It is indicated whenever maximum retention and
resistance are needed.
2. Malaligned teeth.
3. Retainer for removable partial denture.
4. Endodontically treated teeth.
5. Patient with history of high caries index.
6. Short clinical crown.
 Criteria of tooth preparation

1. The occlusal reduction should follow the normal

anatomical configuration of occlusal surface.
2. Minimum clearance on non centric casps 1mm
3. Minimum clearance on centric casps 1.5 mm
4. Chamfer finish line allow 0.5 mm of thickness of wax at
margins
5. Reduction performed parallel to the long axis.
 B. Metal -ceramic retainer
The restoration consists of a complete-coverage cast
metal crown (coping, or substructure ) that is veneered
with a layer of fused porcelain to give appearance as a
natural tooth. The extent of the veneering material
varies;
If it covers the labial, incisal , and part of the
proximal surface , it is called labial ( Facial )
veneered crown.
* If it covers all the surfaces it called full veneered
crown.
Advantages
1. It combines the strength of cast metal crown with the
esthetics of all-ceramic crowns.
2. Retentive quality are excellent.
3. It provides better marginal fit than all-ceramic crowns.
4. It is more conservative to tooth structure than all-
ceramic crown.
5. Ease in fabrication than all-ceramic crowns .
6. Easier preparation than of partial coverage
restorations.
disadvantages
1. Excessive tooth reduction than complete cast crown.

2. Difficult shade matching ( inferior esthetics than all-

ceramic crown).

3. Possibility of fracture of the veneering material .

4. difficult to obtain accurate occlusion in glazed porcelain.

5.Expensive.
Indications
1. It is indicated in areas with high esthetic requirements
where a more conservative restoration would be
inadequate.
2. endodontic treated teeth.
3. Discolored anterior teeth .
4. Malformed, malposed, or rotated tooth.
Contraindications
1. When more conservative restorations can be used.
2. Patient with short clinical crowns.
3. In cases of unfavorable distribution of occlusal load
(deep bite or edge to edge ).
4. long span fixed prosthodontic.
5. In younger patient with large vital pulp .
 Criteria of tooth preparation
1. Minimum clearance on non centric casps 1.5 mm.

2. Minimum clearance on centric casps 2 mm.

3. Buccal Shoulder must extended at least 1mm lingual

to proximal contact area.

3. the lingual chamfer blend with the interproximal

shoulder . This area is called wing or half groove(
wing or flange type).

4.Wingless preparation : It doesn’t exhibit the distinct

transition from chamfer to shoulder. The shoulder
gradually narrow toward the lingual side.

.
 Porcelain-alloy bonding

- The formation of strong bond between porcelain and the

cast alloy is essential for the longevity of metal ceramic
restoration.

- Base metal alloy during casting form oxides and contribute

to chemical bonding to metal-ceramic adherence.

- Noble metal alloy, the principle elements for porcelain

adherence are iron, tin, indium and gallium.
- Base metal alloys, the principle elements for porcelain
adherence are nickel, cobalt and chromium whereas
titanium oxide fulfill this role for titanium casting alloy.

- Airborne particle abrasion with aluminum oxide is

routinely performed on the alloy casting to create surface
irregularities and to provide mechanical interlocking with
the opaque dental porcelain.

- The linear coefficient of thermal expansion for the metal

and ceramic must closely much to achieve strong
interfacial bond.
C. All ceramic retainers
Advantages
1. Superior esthetic as its translucency is similar to natural
tooth structure.

2. Good tissue response.

Disadvantages
1. Reduced strength than metal-ceramic crowns.
2. less conservative to tooth structure than other types of
restorations.

3. Difficult to obtain well-fitting margin.

4. Wear has been observed in the functional surface of the

natural opposing teeth.

5. the brittle nature of porcelain require that the connector

of rather large cross sectional dimension be incorporated
in the FPD design. Typically this lead to impingement on
the interdental papilla by connector.

6. expensive.
 Indications
1.It is indicated in areas with high esthetic requirements
where a more conservative restoration would be
inadequate.
2. Favorable distribution of occlusal load
3. Fractured anterior tooth, not involving more than one
third of the inciso-gingival length.
4. Discolored anterior teeth .
5. Malformed, malposed, or rotated tooth
 Contraindications
1. When more conservative restorations can be used.
2. Patient with short clinical crowns.
3. In cases of unfavorable distribution of occlusal load (
deep bite or edge to edge ).
4. In younger patient with large vital pulp .
5. Individuals engaged in contact sports or Vigorous
occupations.
6. Patients with bad habits as bruxism or careless
patients.
 Criteria of tooth preparation
1. 1.5 incisal reduction; perpendicular to long axis of
opposing tooth.
2. 1mm shoulder finish line; 900 Cavo surface angle.
3. Sloping shoulder is not recommended for all ceramic
crown.
4. All surface smooth and continuous, no unsupported
enamel.
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