What does a clasp prosthesis consist of? List of used literature What parts does the clasp prosthesis consist of?

• Introduction
• Chapter 1. Main part
  • 1. 1. Structural elements of clasp dentures
• Types of clasp dentures
  • 1. 1. 1. Types of clasp dentures
  • 1. 1. 2. Basic and additional components of clasp dentures
• Chapter 2. Manufacturing technology of clasp dentures
  • 2. 1. Clinical and laboratory stages of manufacturing a one-piece clasp prosthesis with clasp fixation
  • 2. 2. Features of modeling and methods of casting the frame of a clasp denture on the upper jaw
  • 2. 3. Assessment of the manufacturing quality of a clasp prosthesis
  • 2. 4. Errors in the manufacture of clasp dentures for the upper jaw
• Chapter 3. Basic and auxiliary materials used in the manufacture of clasp dentures
• Conclusion
• Bibliography
• Annex 1
• Appendix 2
• Application

Cost of unique work

Manufacturing of a clasp prosthesis with a clammer fixation system on a midsection with an end defect in the dentition (essay, coursework, diploma, test)

Relatively new for dentistry are the alloys used for the manufacture of metal-ceramic dentures (palladium and nickel alloys and gold alloys, cobalt-chrome and nickel- and cobalt-based alloys). In the manufacture of fixed dentures in Russia, stainless steels of the 1Х18Н9Т type are widely used (these are alloys resistant to corrosion in the atmosphere, river and sea water, their main components are iron, chromium and nickel). The high technological and physical-mechanical properties of cobalt-chrome alloys have led to the fact that they began to replace gold-platinum alloys in dentistry for the manufacture of solid-cast denture structures. The main components of the alloy are cobalt, chromium and nickel (at least 85%), which ensures its resistance to corrosion in the oral cavity. Chromium-nickel alloys have remarkable physical and mechanical properties, but due to the properties of nickel, which is considered not a completely biocompatible metal, the use of these alloys in dentistry is limited. Properties of alloys. Alloys of gold, platinum and palladium have good technological properties, are resistant to corrosion, durable, and bioinert. The alloy of silver and palladium is similar in physical and chemical properties to the alloy of gold, however, it is inferior to it in terms of corrosion resistance and darkens in the oral cavity. Stainless steel with a nickel content of more than 1% is widely used in the manufacture of dentures, but according to international standards, such steel is considered toxic. The main component of the cobalt-chrome alloy is cobalt (from 66 to 67%), which has high mechanical qualities, and chromium (from 26 to 30%), which is introduced to give the alloy hardness and increased anti-corrosion resistance. Titanium alloy has high physical, chemical and technological properties and it is believed that titanium and its alloys are an alternative to gold. Ceramics. Porcelain is a product obtained by firing a porcelain mass consisting of coal, feldspar, quartz and dyes. Dental porcelain masses in chemical composition are between hard porcelain and ordinary glass. Porcelain masses are used: to create standard artificial teeth in a factory, standard porcelain crowns and blanks for inlays in a factory, to create individual porcelain crowns in a dental laboratory, to create individual porcelain inlays in a dental laboratory, for veneering solid metal fixed frames dentures (crowns, bridges). Glass-ceramic materials are glass-crystalline materials that consist of one or more crystalline phases evenly distributed in a glassy mass. Citales are distinguished by high strength, hardness, chemical and thermal resistance, and toxicological inertness. They are used for prosthetics of the anterior dentition. Polymers are substances whose molecules consist of a large number of repeating units and are produced by polyaddition and polycondensation technology. Classification of polymers: 1. Classification of teeth by origin: natural teeth or biopolymers (proteins, dental nucleic acids, natural dental rubber); synthetic teeth, teeth obtained by polyaddition teeth and polycondensation teeth (polyethylene, polyamides, epoxy resins).2. Classification according to the nature of the substance: organic dental polymers; dental organoelement polymers; teeth inorganic polymers. 3. Classification of teeth according to the shape of the teeth of the polymer molecules: dental linear polymers; "cross-linked" polymers; teeth “grafted” copolymers.4. Classification by purpose: dental base (hard) polymers; elastic dental polymers or dental elastomers; polymer (plastic) artificial teeth; dental polymers for replacing teeth and defects in hard dental tissues; polymeric teeth materials for teeth temporary fixed teeth dentures; dental veneering polymers; dental restoration polymers. Composite materials are divided into veneering composite-based materials., Auxiliary dental technical materials. Impression materials. Impressions are taken to obtain working (main), auxiliary (approximate), diagnostic or control models of the jaws: the working model, the basis of the dentition, is the basis for the manufacture of dentures and devices; basis auxiliary model basis dentition basis is opposite to the prosthetic basis; The basis of the diagnostic (control) model of the basis of the dentition is intended to clarify the diagnosis of the basis and plan the design of the basis of the future prosthesis. Classification of impression materials: 1. Hard impression materials (gypsum; zinc oxide eugenol masses). 2. Elastic impression materials (alginate masses; silicone masses, polysulfide-based impression materials; polyester impression materials).3. Thermoplastic (reversible) impression materials. Modeling materials. Classification of modeling materials: plaster model; metal model (low-melting alloys - brass, bronze, as well as alloys of bismuth, lead, tin, cadmium, with a melting point of 63−115̊C); wax model. Molding materials. The main components of molding compounds are refractory fine powder and binders. Types of molding materials: gypsum molding materials; phosphate molding materials; silicate molding materials. ConclusionAt the moment, clasp prosthetics is one of the most high-tech types of prosthetics used in dentistry. There is a wide variety of designs of clasp dentures that allow you to restore a defect in the dentition with minimal discomfort for the patient. Clasp prosthetics allows you to effectively redistribute the load on the jaw and supporting teeth. Preparation for installation of a prosthesis, as a rule, does not require grinding of the supporting teeth. The removability of the prosthesis makes it easy to carry out hygiene procedures, which helps prevent inflammatory diseases of the oral cavity. A wide range of artificial teeth makes it possible to produce removable dentures in color, shape and size that exactly match natural teeth. In general, clasp prosthetics is a promising, actively developing method of orthopedic dentistry. Conclusions: 1. Acquaintance with the literature allowed us to study the components of the clasp denture, indications for their use, features of the manufacture of a prosthesis with clasp fixation on the upper jaw with end defects, materials used when performing clinical and laboratory stages. 2. We examined methods for modeling clasp dentures on the upper jaw, which have features associated with the anatomical features of the jaw and its changes due to the loss of teeth. 3. When carrying out the clinical and laboratory stages of manufacturing, it is necessary to carefully follow all stages of manufacturing in order to avoid possible errors and complications. List of references Clasp dentures (clinical and laboratory stages of manufacturing): educational method. allowance / S.A. Naumovich et al. - Mn.: BSMU, 2005. - 38 p. Zhulev E. N. Partial removable dentures: (theory, clinic and laboratory equipment): manual. — 2nd ed. - N. Novgorod, 2005. - 425 p. Dental technology: textbook / ed. MM. Rasulova, T.I. Ibragimova, I.Yu. Lebedenko. - M.: Med.inform. agency, 2005. - 445 p. Kopeikin V.N. Guide to orthopedic dentistry: - M.: “Triada-X”, 1998. — 496 p. Lebedenko I.Yu., Peregudov A.B., Glebova T.E., Lebedenko A.I. “Telescopic and locking fastenings of dentures”, 2005. Markskors R. Solid removable dentures / trans. and scientific ed. V.A. Hvatovoy. - M., 2000. - 79 p. - Special issue magazine “New in Dentistry” No. 5/2000 (85). Mironova M. L. Removable dentures: textbook. allowance for honey schools and colleges. - M.: GEOTAR-Media, 2009. - 455 p. Orthopedic dentistry: treatment technology. and prevention of devices: a textbook for students / V. N. Trezubov, L. M. Mishnev, N. Yu. Neznanova, S. B. Fishchev; edited by V.N. Trezubova. - M.: MEDpress-inform, 2008. - 309 p. Orthopedic dentistry. -N.P. Abolmasov, N.N. Abolmasov, V.A. Bychkov, A. Al-Hakim. - 2003. Orthopedic dentistry. Applied materials science. Trezubov V.N., Shteyngart M.Z., Mishnev L.M. 2nd edition, corrected and expanded. St. Petersburg, “Special literature”, 2001; Orthopedic dentistry. Prosthetics with removable plate and clasp dentures. edited by S. A. Naumovich. Textbook manual - 2nd ed. - Minsk: BSMU, 2009. - 212 p. Orthopedic dentistry: textbook / N.G. Abolmasov, N.N. Abolmasov, V.A. Bychkov, A. Al-Hakim. - M.: MEDpress-inform, 2008. - 496 p. Perevezentsev A.P. Designs of lock fastenings from the Bredent company: theory and practice. - M.: Aladent LLC, 2004. - 269 p. Pyasetsky M.I. Prosthetics with clasp dentures. - Moscow: Medicine, 1985. Trezubov V.N., Shcherbakov A.S., Mishnev L.M. Orthopedic dentistry. Faculty course. Edited by Professor Trezubov V.N. 6th edition, St. Petersburg, “Foliant”, 2002. Trezubov V.N., Shcherbakov A.S., Mishnev L.M. Orthopedic dentistry edited by Trezubov V.N. St. Petersburg, “Spetslit”, 2001. Shcherbakov A.S. Orthopedic dentistry: Textbook. - St. Petersburg, 1997. - 565 p. Bushan M.G. Complications during dental prosthetics and their prevention / M.G.Bushan, H.A. Kalamkarov. Chisinau, -1983. - 301s. Gazhva S.I. Errors in prosthetics using locking fastenings of clasp and microprostheses / S.I. Gazhva, R.K. Sobir // Nizhny Novgorod Medical Journal. No. 2 - N. Novgorod, - 2008 - P. 145−146. Izabakarov I.M. Study of immersion of the base of clasp dentures into the mucous membrane of the lower jaw with terminal defects of the dentition / I.M. Izabakarov // Dentistry. -1976. No. 1. - pp. 52 - 54. Ilyina-Markosyan L.V. Some errors in the process of orthopedic treatment of patients / L.V. Ilyina-Markosyan // Proc. report 7 All-Union Congress of Dentists. - M., 1981. - pp. 190−191. Iordanishvili A.K. Clinical orthopedic dentistry / A. K. Iordanishvili. St. Petersburg, - 2001. - 301 p. Nasyrov M.M. Application of average anatomical articulators in dental practice / M.M. Nasyrov // Dentistry for everyone. -2002. -No. 1.-S. 28−30. Panchokha V.P. Solid-cast clasp dentures on fire-resistant models / V.P. Panchokha. - Kyiv, 1981. -192 p. Sosnin G.P. Clasp dentures // G.P. Sosnin. Minsk: Science and technology. - 1981. - 343 p. Method for determining the degree of atrophy of prosthetic bed tissues under the basis of a removable denture / M.I. Sadykov, A.M. Nesterov, M.A. Sirota, A.G. Nugumanov // Materials of the 19th and 20th All-Russian scientific and practical conferences. M., -2008. — P. 405−406. Khvatova V.A. Occlusion and articulation in the practice of orthopedists and dental technicians. / V.A. Khvatova // New in dentistry. - 2001. - No. 1.-S. 43−56. Tsimbalistov A.V. Modern methods of diagnostics and restoration of occlusal relationships in the clinic of orthopedic dentistry / A.B. Tsimbalistov, E.E. Statovskaya //LAB.- 2005. No. 2. -S. 12−16.SchwarzA. D. Biomechanics and occlusion of teeth / A.D. Shvarts. M., 1994.-203 p. Ahlers M.O. Arbeitsgemeintschaft für Funktionsdiagnostik in der DGZMK (AGF) / M.O. Ahlers // Zahnärztl Mitt. -2003. — P. 14- 36. Appendix 1 Table 3 NOBLE METAL ALLOYS FOR MODEL AND CERAMIC PROSTHETICS Name of the alloy Chemical composition of the alloy (in %) AuAgPtCuPdZn others BioMaingold SG 71,012,34, 012.2−0.50.1 IrMaingold SG71,012,2212.31,90.5-Maingold OG 70,013,47,57,61,00,5-Maingold GV78,510,01,07,01,51,5Sn - 0,5 Maingold KF74,011,24−62Sn - 0,5; In - 2; Fe, Ir, Ru - 0.5Mainbond A74.19.08.94.4−2.0In - 1.5; Ir - 0.1Mainbond KF 74.011.24.0−5.951.0Sn - 0.5; In - 2.0; Mn, Ir, Ru - 1.05 Herador NH77,81,39,50,39,0-Sn - 0.6; In - 1.2; Fe, Ir, Ru - 0.2Herador PF77.7−19.5-2.0Ir - 0.5; Ta - 0.3Herador P77.81.39.50.39.0-Sn - 0.6; In - 1.2; Fe, Ir, Ru - 0.2Hera SG55.622.41.014.53.71.0In, Ir, Ru - 0.2Hera PF59.322.94.313.0−0.4Ir - 0.1Herabond51.518.0−0.226, 6-Sn - 2.7; In, Ir, Ru - 0.9Alba KF45,044.9----Sn - 3; In - 5; Ga, Ir, Ru - 2Alba SG10,057,0−10,020,92,0Ir, RuAlbabond U2,0-9,374,60,2Sn - 3,0; In - 7.0; Ga - 3.5; Ru - 0.4Albabond E1.6-10.78.00.2Sn - 0.2; In - 1.3; Ga - 7.5; Ru - 0.4Albabond EH2.0-9,878.67.5Sn - 0.2; Ga - 7.5; Ru - 0.4; Ge - 0.2Albabond GF-19.3−7.560.10.2Sn - 3.0; In - 9.5; Ir - 0.2; Ru - 0.2 Table 4 ALLOYS FOR MODEL PROSTHETICS (FRAMEWORKS OF REMOVABLE CLASS DENTURES) Company. Name of alloy Chemical composition of alloy CoCrMoothersKRUPP. WISILvac. Germany65,028,05,0Si - 2; Mn; СKRUPP. CHROMORUR. Germany62,028,05.5Si - 4.5; Mn; C BEGO.WIRONIUM. Germany63,029,55,0Si - 1; Mn - 0.5; Fe - 0.5; N - 0.3; C - 0.2 BEGO. WIRONIUM. Extra.hard. Germany61,030,05,0Si - 1.0; Mn - 2.0; Fe - 0.5; N - 0.3; C - 0.2BEGO. WIRONIT. Germany64,028,05,0Si - 1.0; Mn - 1.0; Fe - 0.5; C - 0.5BEGO. WIRONIT. Extra.hard. Germany63,030,05,0Si - 1; Mn - 0.5; C - 0.5BEGO.WIROCAST. Germany33,030,05.0Fe - 29.0; Si - 1.0; Mn - 1.5; N - 0.2; C - 0.3DEGUSSA. BIOSIL f. Extra.hard. Germany64.828.55.3less2 – Si; Mn; C DENTAuRUM GM 380. Germany ref. 29.04.5C - 0.6; Si - 0.6; Mn - 0.5 DENTAuRUM GM 700. Germany ref. 32.05.0C - 0.4; Si - 0.7; Mn - 0.7DENTAuRUM GM800. Germany ost.30.05.0C - 0.3; Si - 1.0; Mn - 0.2HERAEUS HERAENIUM CE. Germany63.527.86.5less2 - Mn, Si, N HERAEUS HERAENIUM EH Germany6528.55.5less2 - Mn, Si, NSchutz-Dental. Micronium Exclusive. Germany64,628,06.0Mn - 0.3; Si - 0.6; C - 0.5MAgnum H40. Italy62,028,08,0Mn - 2.0; Si; CDENTKO INTERPRISES DENT 1000. USA64,028,05.9Mn - 3.0; Si; SLEN POLYMER KXC. RF63.027.05.0Ni - 3.0; C - 0.3; Si - 1.0; Mn - 0.2 SUPERMETAL. BYUGODENT SCS. PF63.027.05.0Ni - 3.0; C - 0.3; Si - 0.7; Mn - 0.5STOMMAT. CELLITE B. RF65.028.05.0C; Si; V; Nb. Appendix 2Fig. 4. Frame of a clasp denture for a class II defect in the upper jaw with Bonville clasps at 25, 27, an oral occlusal overlay at 13, a multi-link oral overlay in the front nom department and palatal arch.Fig. 5. Frame of a clasp denture for a class II defect in the upper jaw with rear-action clasps at 15 and 14, Bonville at 26 and 27, a multi-link oral lining in the frontal region, palatal arc, springy connection of the frame with the base of the prosthesis Fig. 7. Frame of a clasp denture for a class II defect in the upper jaw with rear-acting clasps at 14 and 24, Acker clasp at 17, indirect clamps at 13, 23, palatal arch Fig. 8. Frame of a clasp denture for a class II defect in the upper jaw with rear-action clasps at 14 and 24, an Acker clasp at 17, a palatal plate Fig. 9. Frame of a clasp denture for a class I defect in the upper jaw with Bonville clasps at 15, 14, 24, 25, a continuous multi-link clasp in the frontal section and a palatal plate Fig. 10. Frame of a clasp denture for a class I defect in the upper jaw with rear-acting clasps at 15 and 25, a multi-link oral onlay in the frontal section, an annular palatal arch Fig. 11. Frame of a clasp prosthesis for a class I defect in the upper jaw with rear-action clasps at 14 and 24, palatal arch Appendix 3 Table 5 Onlays Occlusal Frontal Unilateral Bilateral Single solid Multi-link oral Short Medium Long Full Double Oral Medial (Swenson clasp) Double-arm support Shoulder pad Narrow Medium Wide Table 6 CAST SUPPORT-RETAINING CLAMPS First group - clasps with shoulders from the side of occlusionFirst subgroup - double-arm claspsSecond subgroup - single-arm claspsAcker claspDouble Acker claspRing clasp with two pads for the upper jawClamp of opposite back actionTwo-link claspClammer of two opposing armsRing clasp with two pads for the lower jawSvenson claspThree links ring claspDouble-arm clasp with an occlusal pad on an adjacent toothRing clasp with a single padOne-arm clasp with an occlusal pad on an adjacent toothTransfer clasp BonvilleMesio-distal claspPosterior action clasp with distal padDouble-arm clasp for the upper jawAmbrasure claspShoulder -pin (fish hook) Posterior action clasp with mesial pad Double-shouldered clasp for the lower jaw The second group - clasps with shoulders from the gum side The third group - combined clasp systems ovClampers with one rod armClampers with one wire armRoach claspClamper with Acker and Roach armsAcker arm and wire armC-shaped rod arm of Roach claspDouble th split clasp Oral lining and wire arm L-shaped rod arm of Roach claspClampers with Acker and Bonigard arms Ring clasp and wire arm L-shaped rod arm Roach clasp Oral lining and Bonigard shoulder Ring clasp and Bonigard shoulder Clammers with Acker shoulders and Fehr rod shoulder

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Bibliography

1. Clasp dentures (clinical and laboratory stages of manufacturing): educational method. allowance / S.A. Naumovich et al. - Mn.: BSMU, 2005. - 38 p.
2. Zhulev E. N. Partial removable dentures: (theory, clinic and laboratory technology): manual. - 2nd ed. - N. Novgorod, 2005. - 425 p.
3. Dental technology: textbook / ed. MM. Rasulova, T.I. Ibragimova, I.Yu. Lebedenko. - M.: Med. info. agency, 2005. - 445 p.
4. Kopeikin V.N. Guide to orthopedic dentistry: - M.: "Triada-X", 1998. - 496 p.
5. Lebedenko I.Yu., Peregudov A.B., Glebova T.E., Lebedenko A.I. “Telescopic and locking fastenings of dentures”, 2005.
6. Markskors R. Solid removable dentures/ lane and scientific ed. V.A. Hvatovoy. - M., 2000. - 79 p. - Special issue magazine “New in Dentistry” No. 5/2000 (85).
7. Mironova M. L. Removable dentures: textbook. allowance for honey schools and colleges. - M.: GEOTAR-Media, 2009. - 455 p.
8. Orthopedic dentistry: treatment technology. and prevention of devices: a textbook for students / V. N. Trezubov, L. M. Mishnev, N. Yu. Neznanova, S. B. Fishchev; edited by V.N. Trezubova. - M.: MEDpress-inform, 2008. - 309 p.
9. Orthopedic dentistry. - N.P. Abolmasov, N.N. Abolmasov, V.A. Bychkov, A. Al-Hakim. -2003.
10. Orthopedic dentistry. Applied materials science. Trezubov V.N., Shteyngart M.Z., Mishnev L.M. 2nd edition, corrected and expanded. St. Petersburg, “Special Literature”, 2001;
11. Orthopedic dentistry. Prosthetics with removable plate and clasp dentures. edited by S. A. Naumovich. Textbook manual - 2nd ed. - Minsk: BSMU, 2009. - 212 p.
12. Orthopedic dentistry: textbook / N.G. Abolmasov, N.N. Abolmasov, V.A. Bychkov, A. Al-Hakim. - M.: MEDpress-inform, 2008. - 496 p.
13. Perevezentsev A.P. Designs of lock fastenings from the Bredent company: theory and practice. - M.: Aladent LLC, 2004. - 269 p.
14. Pyasetsky M. I. Prosthetics with clasp dentures. - Moscow: Medicine, 1985.
15. Orthopedic dentistry. Faculty course. Edited by Professor Trezubov V.N. 6th edition, St. Petersburg, “Foliant”, 2002.
16. Trezubov V.N., Shcherbakov A.S., Mishnev L.M. Orthopedic dentistry edited by Trezubov V.N. St. Petersburg, “Spetslit”, 2001.
17. Shcherbakov A.S. Orthopedic dentistry: Textbook. - St. Petersburg, 1997. - 565 p.
18. Bushan M. G. Complications during dental prosthetics and their prevention/ M.G.Bushan, H.A. Kalamkarov. Chisinau, -1983. - 301s.
19. Gazhva S. I. Errors when using prosthetics using locking fastenings for clasp and microprostheses/ S.I. Gazhva, R.K. Sobir // Nizhny Novgorod Medical Journal. No. 2 - N. Novgorod, - 2008 - P. 145−146.
20. Izabakarov I. M. Study of immersion of the base of clasp dentures into the mucous membrane of the lower jaw in case of terminal defects of the dentition/ I.M.Izabakarov // Dentistry. -1976. No. 1. - pp. 52 - 54.
21. Ilyina-Markosyan L.V. Some errors in the process of orthopedic treatment of patients / L.V. Ilyina-Markosyan // Abstracts. report 7 All-Union Congress of Dentists. - M., 1981. - P. 190−191.
22. Jordanishvili A.K. Clinical orthopedic dentistry/ A. K. Jordanishvili. St. Petersburg, - 2001.- 301 p.
23. Nasyrov M. M. Application of average anatomical articulators in dental practice/ MM. Nasyrov // Dentistry for everyone. -2002. -No. 1.-S. 28−30.
24. Panchokha V.P. One-piece clasp dentures on fire-resistant models/ V.P. Panchokha. - Kyiv, 1981. -192 p.
25. Sosnin G. P. Clasp dentures// G. P. Sosnin. Minsk: Science and technology. - 1981. - 343 p.
26. Method for determining the degree of atrophy of prosthetic bed tissues under the basis of a removable denture / M.I. Sadykov, A.M. Nesterov, M.A. Sirota, A.G. Nugumanov // Materials of the 19th and 20th All-Russian scientific and practical conferences. M., -2008. - P. 405−406.
27. Khvatova V.A. Occlusion and articulation in the practice of orthopedists and dental technicians. / V.A. Khvatova // New in dentistry. - 2001. - No. 1.-S. 43−56.
28. Tsimbalistov A.V. Modern methods of diagnostics and restoration of occlusal relationships in an orthopedic dentistry clinic/ A.B. Tsimbalistov, E.E. Statovskaya //LAB.- 2005. No. 2. -S. 12−16.
29. Shvarts A. D. Biomechanics and occlusion of teeth/ A.D. Schwartz. M., 1994.-203 p.
30. Ahlers M.O. Arbeitsgemeintschaft für Funktionsdiagnostik in der DGZMK (AGF) / M.O. Ahlers // Zahnärztl Mitt. -2003. - P. 14-36.

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State budgetary educational institution of higher professional education

"Bashkir State Medical University"

Ministry of Health of the Russian Federation

Medical College

GRADUATE QUALIFYING WORK

Clinical and laboratory stages of manufacturing a clasp prosthesis with a locking fixation system (attachments)

Specialty: Orthopedic dentistry

Ufa, 2015

INTRODUCTION

CHAPTER 1. APPLICATION OF LOCKING FIXATION SYSTEMS IN ORTHOPEDIC DENTISTRY

1 General characteristics of locking systems

2 Types of locking systems (attachments) used in clasp prosthetics

CHAPTER 2. CLINICAL AND LABORATORY STAGES OF MANUFACTURING A clasp denture with a LOCKING FIXATION SYSTEM

1 General stages of manufacturing a clasp prosthesis with attachments

2 The main stages of manufacturing a clasp prosthesis with rod and extracoronal rail attachments

3 The main stages of manufacturing a clasp prosthesis with spherical or push-button attachments

4 Features of the manufacture of clasp structures using anchor and crossbar locks

5 Features of manufacturing clasp dentures with intracoronal attachments

6 Advantages of orthopedic treatment using clasp dentures with a locking fixation system

7 Evaluation of the use of attachments in the manufacture of clasp dentures in Ufa

CONCLUSION

BIBLIOGRAPHY

APPLICATIONS

INTRODUCTION

One of the pressing problems of orthopedic dentistry is the restoration of dentition defects with partial removable dentures, since patients with partial absence of teeth over 50 years old constitute the largest group of people in need of this type of orthopedic treatment - 40.2%. At the same time, in young people, partial removable dentures are also used quite often - from 15 to 20%. The rational use of innovative technologies and modern materials in most cases makes it possible to increase the effectiveness of dental treatment for patients with this pathology and opens up prospects for choosing the optimal designs of dentures. The most important task facing the creative team, which consists of an orthopedic dentist and a dental technician, is the creation of a complex biomechanical structure that should restore the morphology and function of the dentofacial system to the maximum extent possible.

The success of orthopedic treatment of patients with partial absence of teeth will also largely depend on the compliance of the design of the denture with the indications for use in a specific clinical situation. The presence of large-scale included defects in the dentition reduces the likelihood of using fixed denture structures. Therefore, the need for orthopedic treatment of patients with partial loss of teeth using removable dentures remains high and amounts to 33-65% according to V.N. Kopeikina et al., (1994) S.D.Arutyunova, I.Yu. Lebedenko, (2001), V.P. Tlustenko, (2010).

According to a number of studies, up to 30-40% of patients have unfavorable conditions for prosthetics and up to 20% of patients cannot use removable dentures made again due to poor-quality preliminary orthopedic treatment. The relevance of the work lies in the fact that despite the great achievements in dental science and practice in recent years, restoring the functional and aesthetic integrity of the dentition in patients with partial loss of teeth is a difficult task in orthopedic dentistry. But, the majority of patients who need to restore the integrity of their dentition have formed a preconceived negative opinion about prosthetics with removable types of dentures, due to the problems of insufficient restoration of chewing function and aesthetics, and unreliable fixation of dentures.

Currently, various methods of fixing removable dentures are known, used in the treatment of patients with partial loss of teeth. They can be divided into methods of fixing dentures using clasps and without clasps.

One of the most popular types of removable prosthetics today is clasp prosthetics. Unlike a conventional plastic removable denture, clasp artificial teeth are attached to a narrow metal arch. It puts minimal pressure on the mucous membrane of the palate, which significantly reduces discomfort when wearing a prosthesis. In most cases, the fixing elements of clasp dentures (clasps) can be replaced with locking fasteners (attachments).

However, at present there are no clear indications for the use of various types of locking systems (attachments) in the prosthetic treatment of dentition defects. The lack of literary data on the dental technical aspects of prosthetics with structures with a locking system of fixation, the debatability of this issue, led to the choice of the topic of the final qualifying work “Features and advantages of orthopedic treatment using clasp dentures with a locking system of fixation.” The purpose of the study is to study the features and advantages of orthopedic treatment using clasp dentures with a locking fixation system. In accordance with this goal, the following tasks were set:

· Based on literature data, study the main types of locking fixation systems, indications and contraindications for their use, technologies for manufacturing clasp dentures with attachments in the practice of orthopedic dentistry;

· Conduct a comparative description of modern technologies for manufacturing clasp dentures with locking fastenings, identifying their advantages;

· Having identified the importance of manufacturing technologies for clasp dentures with attachments in the practical activities of a dental technician, formulate conclusions and recommendations.

The object of the study is the professional activity of a dental technician in the manufacture of clasp dentures.

The subject of the study is the design of a clasp prosthesis with a locking fixation system.

Research methods - comparative description, analysis of price lists, dental technicians' worksheets, interviewing.

Information base. When writing the final qualifying work, dissertation materials, catalogs of manufacturers of locking fasteners, articles from professional journals, and literature on orthopedic dentistry were used.

The research bases were the State Budgetary Healthcare Institution of Ufa “Dental Clinic No. 1”, “Dental Clinic No. 6”, “Dental Clinic No. 8”, dental laboratories of network dental clinics “Tabib”, “Family Doctor”, dental laboratory No. 9 of the Medical College and the Library State Budgetary Educational Institution of Higher Professional Education BSMU of the Ministry of Health of Russia.

The theoretical basis of this work was the main methodological principles formulated in the studies of specialists N.N. Abolmasova, I.Yu. Lebedenko, H. Wulfes and others. The practical significance of the work lies in the fact that the conclusions obtained during the development of the topic of the final qualifying work can be used in practical healthcare in order to improve the quality of dental orthopedic care, the accuracy of manufacturing complex combined structures, and improve culture dental production, as well as in the educational process during the training of dental technicians.

Work structure. The final qualifying work consists of an introduction, 2 chapters, a conclusion, 3 appendices, and a list of references.

CHAPTER 1. APPLICATION OF LOCKING FIXATION SYSTEMS IN ORTHOPEDIC DENTISTRY

1 General characteristics of locking systems

Attachments are mechanical devices designed for fixation, retention and stabilization of removable dentures. They are mechanical devices that function as direct retainers and must provide:

Considering the need to improve orthopedic treatment and the increased material and technical base of orthopedic dentistry, it is believed that locking structures are of interest both for practical work and for scientific research.

The design of each lock fastening consists of a matrix and an inlay (matrix) parts. One of these parts is located in the removable denture, and the other becomes part of the dental structure on the fixing tooth.

Research is ongoing to evaluate such designs and new ones are being developed. In recent years, particular attention has been paid to improving the locking system to improve cosmetic prosthetics and for overdentures.

According to one of the orthopedic principles, when using both clasps and attachments in a prosthesis, their forceful effect should be widely distributed over all available tissues of the prosthetic bed. The base of a partial removable denture, supported by teeth and soft tissues, must be expanded and cover the entire existing alveolar ridge within the boundaries of functional mobility of muscle movement along the transitional fold. Both the remaining teeth and the mucosal denture sites must be used to provide support, reinforcement, direct and indirect retention and stabilization. If one of these tissues is not capable of providing these functions, other types of dental structures should be considered. It is important that the frame of the partial removable clasp denture is well connected to the teeth, and the base is well connected to the frame.

The principle is observed if the entire frame and base are rigid and in contact with three or more teeth. Therefore, when using such attachments, additional contact must be created.

There are precise (precision) locking fasteners, which are manufactured in a factory, and semi-precise (semi-precision), which are made in a dental laboratory by individual casting, using factory-made plastic blanks or modeling them in wax.

The retention qualities of semi-precision fastenings are lower than those of precise fastenings, therefore, to enhance the retention of the former, additional lingual clasp arms are used.

Recent developments of such dentures, providing for their fixation on composites, have led to the use of connecting components that attach the locking element using this technique directly to the enamel of the anchoring teeth.

Indications for the use of locking fasteners and their advantages:

· improving the aesthetic results of prosthetics;

· intracoronal fastenings are less traumatic for the periodontium of abutment teeth than conventional clasps, since the load through the fastenings is directed along the long axis of the abutment tooth, concentrating the load closer to the center of rotation of the abutment tooth (there is still no scientific confirmation of these assumptions);

· ensures effective splinting of mobile teeth;

· fastenings provide a constant path for insertion and removal of the prosthesis so that not a single supporting tooth is subjected to excessive load;

· Due to the absence of pressure along the periodontal circumference, the supporting teeth are not subject to constant load. The tooth is subject to load only under the influence of frictional forces;

· an appropriate indication for the use of attachments is the divergence of supporting teeth with a high line of sight (boundary line), since a conventional clasp requires a high placement of the clasp arm on the teeth or a reduction in the line of sight by changing the shape of the tooth and placing an appropriate artificial crown;

· When using attachments, crowns are used, so there is no need to prepare the teeth so that they are parallel to each other. In this regard, the introduction of a removable denture is determined by the parallel arrangement of attachments on artificial crowns, regardless of the parallelism of the crowns themselves;

· It is possible to use fastenings in fixed prosthetics if it is impossible to make all abutment teeth parallel and establish a single path for introducing the prosthesis, as well as if the prognosis of some abutment teeth is questionable for dividing extended fixed structures into separate parts. For these purposes, a fastening has been developed that is not inferior in rigidity to a soldered joint.

Disadvantages of locking fastenings and contraindications to their use:

· the clinical crown of the abutment tooth must be of sufficient length (minimum 6 mm, since most attachments have a vertical distance of 4 mm);

· the abutment tooth must be covered with a crown;

· extracoronal attachments can cause gingival irritation due to their cervical location;

· extracoronal attachments can cause technological and cosmetic problems, since they are located in the space that is intended for an artificial tooth;

· locking fasteners are subject to wear, which leads to loss of retention;

· in the case of a significant terminal defect when using a rigid structure, an adverse effect of the cantilever prosthesis occurs on the supporting teeth, especially on the lower jaw;

· to reduce the load, the supporting teeth must be splinted;

· the location of attachments on the incisors and canines can be difficult due to the limited lingual-labial width of the teeth;

· there is a need for tooth depulpation;

· effective prosthetics are achieved with sufficient clinical and technological experience;

· repair and modification of the attachment is difficult or impossible;

· Biological conditions that would contraindicate the use of traditional partial dentures also preclude the use of attachments. These include the periodontal condition of the supporting teeth, poor coronal root length ratio, as well as endodontic and other causes;

The use of attachments requires a thorough knowledge of basic orthopedic principles, appropriate training and experience in the use of individual attachments, as well as technological proficiency, clinical talent and common sense. If a regular removable denture is made with the same care as locking fasteners, then the results of prosthetics will probably be the same.

Currently, there are more than 100 types of lock fastenings, and there are many classifications. Various concepts and terminology are encountered. Therefore, we present the most common and most logical classification of lock fastenings: . Intracoronal (internal, intercoronal) attachments: Most of them provide fixed connections.

· fastenings in which retention is carried out only due to friction,

· fastenings in which retention is enhanced by mechanical devices; Extracoronal (extracoronal, external) attachments:

· fastenings containing a protruding part:

a) fastenings providing fixed connections;

b) fastenings providing movable connections. Such structures are used in prosthetics of end defects as load crushers,

· connecting elements that connect parts of the prosthesis and provide a certain degree of mobility; Combined structures, which are an extracoronal hinge element connected to an intracoronal fastening; Push-button fastenings: so named because of the shape of the inlay part;

V. Beam fastenings:

· beam joints that provide mobility between the prostheses and the beam,

· beam elements, which are fixed connections;. Auxiliary fastenings:

· screw elements used to connect parts of fixed dentures and telescopic crown components,

· friction designs:

a) plungers used to enhance retention between two parts of a telescopic prosthesis;

b) split pins used in sectional prostheses;

· the latches used to connect the two parts of a sectional denture act like a door latch.

· hinged and movable edges of the dentures, allowing the use of undercuts on the alveolar processes and interdental spaces for retention.

You can use a number of classification characteristics for lock fastenings:

· according to the materials used in the design, one should distinguish: metal and combined (metal/polymer); by the number of guides;

· According to the method of connecting the removable and non-removable parts of the attachment prosthesis, they should be divided into rigid and elastic.

The components of rigid attachments theoretically remain stationary during function. However, even under the best conditions, slight displacement of the prosthesis occurs in the clinic as a result of the influence of occlusal load. The amount of movement increases as the attachment components wear.

Elastic attachments are characterized by the magnitude and direction of displacement of the component parts. They promote movement of the denture base toward the soft tissue during function and also theoretically reduce the amount of force transmitted to the teeth. The elastic attachment is thought to act as a "pressure conductor". It can provide articulated movements, allowing movement along one plane, along many planes, as well as circular movements. Precision intracoronal attachments are usually designed to be rigid, while extracoronal attachments are usually designed to be flexible.

Rigid intracoronal attachments have all the necessary properties of a direct or direct fixator.

Elastic extracoronal ones, on the contrary, do not always provide sufficient support and strengthening of the prosthesis due to their elastic nature. The connection between the components of elastic attachments should only be in the form of contact between the partial denture and the teeth. When these conditions are met, the denture receives no more than retention, while support, strengthening and stabilization depend mainly on the amount of ridge remaining. Therefore, additional components must be introduced into the removable denture to enhance fixation.

The locking device consists of two tightly articulated parts. The part of the structure that has a fixing protrusion is called a patrix, and the part with a recess is called a matrix. One of them is fixed on the supporting tooth using an inlay, a half-crown, but more often a crown, and the other is connected to a removable denture.

Known designs of the non-removable part of locking fasteners are made of metal or are combined.

When using the latter, dental prosthetics are characterized as simple, because no special equipment is required, and orthopedic care is performed by specialists of any qualification.

The mechanism of functioning of the locking fasteners is that the removable denture is removed from the oral cavity in only one direction, and there is a low probability of accurately reproducing the path of removal of the denture by the force (reset) that occurs during operation.

The shedding force on any part of the prosthesis acts most actively on the nearest fastening, while the remaining fastenings will move to a lesser extent, so the prosthesis will tilt and the fastenings will jam. Some designs additionally provide a latch with a different mechanism of action.

1.2 Types of locking systems (attachments) used in clasp prosthetics

Attachments from BEGO. The revolutionary idea of ​​the dentist Wilhelm Herbst to use special gold fillings instead of forged gold fillings made him famous and gave rise to a successful enterprise. So, back in 1890, under the name “Bremer Goldschlagerei”, the Bego company (Germany) appeared to produce alloys for inlays, as well as gold leaves used by bookbinders and gilders. In 1910, an orthopedic laboratory was created, which contributed to the development of new alloys (Wironit, Wiron) and the materials necessary for their use. From the very beginning, Bego adhered to national standards for medical production, and is now certified DIN ISO 9001/46001, the result of which is the use of the Bego prosthetic system in more than 100 countries around the world. - spherical extracoronary activated attachment with a plastic matrix; WiroFix is ​​an auxiliary attachment, used to strengthen retention between telescopic crowns, made of highly elastic plastic. The BegoClip attachment is a rail-mounted extracoronary activated attachment with a matrix made of interchangeable artificial material. The total height of the male along with the matrix of this attachment is only 4.2 mm; WiroConnect - rail-mounted intracoronary activated attachment with split patrix; Rod attachment II is a rail-based extracoronary activated attachment with a plastic matrix.

Bego also produces Bolder bar in rigid and semi-labile versions; articular connection - Roach attachment and Weser hinge. The Weser hinge is connected to the abutment crowns by casting or soldering. This attachment is available in platinum/gold or cobalt/chrome alloys. It is intended for the manufacture of prostheses for terminal defects of the dentition and allows the removable part of the prosthesis to carry out distal rotation towards the supporting tissues. There are two sizes of attachment: length 19 mm and width 7 mm, and length 23 mm and width 7 mm.

Attachments from BREDENT. Bredent was founded in 1975 in Senden (Germany). The company produces and distributes a wide range of dental products. Since 1995, all of the company's products have been certified according to DIN EN ISO and 9001 DIN EN 46001. Bredent was one of the first to introduce a wide range of locking fasteners to the Russian market. In the field of attachments, Bredent offers many solutions tailored to each specific application. These are spherical locking fasteners: Vario Kugel Snap VKSOC/SG, Vario-Soft beam structure; Rail lock fastenings Vario-Soft 3, auxiliary screw elements for fastening implants, collapsible bridges. Bredent produces the Schwenkriegel rotary clamp. The deadbolt spring has a 5-year warranty. This system is ideal for implants.

The males of the Vario Kugel Snap VKSOC/SG system can be placed on crowns, beams, and root caps. The attachment matrices are made of Termoplast High Tech artificial material with several levels of retention, which are distinguished by color code. The retention properties of the matrices are guaranteed by the manufacturer for 6 years.

A new product from Bredent is the plug-in retainer Steckriegel bs1, which is small in size and can be used in many clinical situations (unilateral and bilateral end defects, in beam structures with included defects).

Attachments from SEKA. In 1958, the Belgian dental technician Karel Cluytens patented the principle on which all SEKA locks are based. The SEKA brand and name were registered in 1959. In 1964, Arthur Bax, a dental technician from Antwerp, took over the company and improved the locking system. Under his leadership, SEKA eventually became an international market leader in the locking industry. In 1969, a proprietary unwinding attachment with a split metal patrix first appeared; by 1994, the third generation of similar attachments had already been created. The company's main office is located in Antwerp (Belgium), and its manufacturing plants are in Chaux de Fonds (Switzerland). Currently, SEKA supplies attachments to 56 countries around the world.

The SEKA company offers attachments with a split metal male. The locking matrix is ​​also made of metal. There are several types of attachments:

SEKA Classic - in this system, the matrix can be located on a beam, root cap or on an artificial crown.

The Revax system is an extracoronary attachment. The matrix of these attachments is located on the supporting part of the supporting crown and can have 4 different angles: 15, 30, 45 and 60 degrees, which allows you to achieve the optimal distance between the edge of the attachment and the gingival papilla. SEKA attachments can be rigid or semi-labile. To redistribute the chewing load on the mucous membrane of the alveolar process, in all SEKA systems it is possible to use a special foil that creates a gap between the matrix and the male locking fastening.

Attachments from DEGUDENT. Approximately 130 years ago, Degussa (Germany) began its activity in refining gold and minting gold coins. Purification methods pushed the company to develop and expand their activities in the chemical industry. Among the various specializations of this company are the recovery of metals, the production of 300 carbon black, dyes for earthenware ceramics, aerosols, and pharmaceutical products. Over the course of its hundred-year existence, the dental department has become one of the oldest. Degussa is a world leader in the production of precious metal alloys. In 1964, the Degudent cermet alloy became widespread. In 1993, a new gold alloy system was proposed - the GoldenGate System ceramic coating. Degussa also develops a range of attachments (mainly from noble alloys), implants, ceramic materials, as well as auxiliary equipment. In 2001, the company merged with Dentsply International Inc (USA) and is currently called Degudent. Attachment Joint is an extracoronary hinge attachment, which is preferably used unilaterally. It allows the removable part of the prosthesis to perform a rotational movement relative to the supporting crowns, which is adjusted according to the average compliance of the mucous membrane. The matrices of this attachment come in the following options: 90° and 110°. The 90° matrix is ​​intended for the normal shape of the alveolar ridge, 110° - with its severe atrophy. - extracoronary attachment (plug-in retainer), for the restoration of included defects, short end defects, as well as for implant superstructures. Degusafe is ideal for the production of single-sided dentures (small saddle dentures). Most Degussa/Degudent locking fasteners are made of precious alloys, such as Permador, Degulor, and a wide range of attachments allows them to be used in almost any clinical situation. The company provides a 15-year warranty on all replacement parts of the attachments.

Attachments from HERAEUS KULZER. HERAEUS KULZER Dental (Germany) is part of the private company HERAEUS, which produces high-quality, high-tech products for the medical, aerospace, jewelry and electrical industries.

The history of the dental department of HERAEUS KULZER began in 1903. In 1995, HERAEUS KULZER absorbed Bayer's dental business, making it the third largest dental company in the world.

The HERAEUS KULZER company presents a wide range of attachments, in most cases made on the basis of precious alloys. Anchor System - a system of spherical attachments (based on the push-button principle), consisting of a split metal patrix, the matrix is ​​also made of metal. The system has several modifications to choose from based on the specific case, and can be located on the root cap, the load-bearing part of the abutment crowns or the bar.108 is a rail-based intracoronary attachment with two matrix options and four male options. Thus, this attachment can be non-activated, activated with retention due to the plunger, with a split patrix, with a split patrix with additional activation. Anchor is a labile spherical attachment that allows vertical and rotational movements. Ball Anchor is specially adapted for cases where parallelism is difficult to achieve. The shape of the matrix allows the removable part of the prosthesis to be correctly attached, even with several attachments. The patrix can be made either from an alloy of precious metals (Maingold P) or from incinerable plastic.

HERAEUS KULZER also produces an intracoronary non-activated attachment in the form of a simple groove (Special attachment), variants of the Roach attachment, and Bolder bar attachments.

Attachments MK-1. Malfred Kipp is a German orthopedist, inventor and manufacturer of this universal attachment. Having appeared on the international market 15 years ago, the MK 1 attachment is distributed by many dental companies. MK-1 - extracoronary rigid attachment. Its transverse axis in relation to the saddle is fixed with a special pin, the extension of which is carried out with a key at the patient’s initiative. The striking simplicity of this system in terms of functionality is especially evident in the ease of use by the patient of the mechanism for closing and opening the attachment.

Attachment MK-1 is a set of mechanical elements that provide a rigid type of fixation of a removable supported prosthesis to supporting structures. This locking connection effectively compensates for the horizontal forces that occur during chewing and eliminates the movement of the denture towards the soft tissues and back. The resulting balanced load on the supporting teeth and the alveolar process allows us to talk about the preservation of the periodontium of the supporting teeth and the prevention or slowdown of resorption of the alveolar process of the jaw.

Attachment MK-1 refers to extra-dental locks with a cantilever or beam arrangement. The primary part of the lock (non-removable) is monolithically connected to the frame of the supporting elements, the secondary covering part of the lock (removable) is located inside the base of the supporting prosthesis. The lock is connected and disconnected using the locking pin using the key included in the kit.

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The scope of application covers a wide variety of cases: prosthetics of included defects, reconstruction of one- and two-sided end defects of the dentition, and even with single-standing teeth on root caps. A broad area of ​​application is implantology. With proper use and timely relocations, it is possible to prevent pathological loads on the implant head and at the same time ensure reliable fixation of supra structures.

Attachments from RHEIN-83. For more than 15 years, RHEIN-83 (Italy) has been producing spherical attachments for dentures. The novelty of the RHEIN-83 project is associated with the replacement of the previously existing “friction” concept with the “retention” concept, achieved through the use of elastic matrices. The RHE1N-83 product range allows you to have all the necessary materials for everyday work at any time at minimal costs. RHEIN-83 products are certified according to ISO 900I/4600, certified by the State Standard of Russia and registered with the Ministry of Health of the Russian Federation.

The company produces various types of spheres for a wide range of applications. The OTCAP system includes flat-head ashless spheres in various arrangements (flat beam, curved beam, single sphere) and four elastic matrix options with multiple levels of retention. OT Strategy - the patrix is ​​a vertical sphere made of ashless blank, a matrix made of elastic material with three levels of retention.

In addition, the company produces a rail extracoronary attachment OT-VERTICAL with a patrix made of ash-free blanks and an elastic matrix; rigid and semi-labile version of the beam attachment (OTBAR multiuse); spheres on root pins (made of ash-free plastic and titanium), movable spheres made of titanium for connection in case of non-parallelism of supports; hollow titanium spheres for replacement and reconstruction of spheres worn out over time in the oral cavity. Attachments from LV-RUDENT company. "LV-RUDENT" is a Russian manufacturer of dental products. The company has been operating since 2005. The production is located at the factory base of high-precision instrumentation of the military-industrial complex in Rostov-on-Don. LV-RUDENT products are manufactured on Swiss equipment with hourly precision. The consultant and developer on dental issues is a practicing dentist with 30 years of experience, who has more than 18 patents for various inventions in the field of dentistry, including the presented products of the company. The company's staff, engineers and technologists have extensive experience. The goal of the LV-RUDENT company is to produce a high-quality product at an affordable cost, which will improve the quality of life of the country's population, and also help dentists and dental technicians save on expensive imported analogues.

The spherical locking device LV-1, LV-2 is intended for fastening clasp dentures, bridges, telescopic, structures on implants, etc. (maxi - D 3.2 L-3.7; mini - D 2.5 L-2 ,7). The locking device Pin e LV-3 (crossbar, non-removable) is intended for fastening the removable part of the clasp prosthesis, as well as the structure resting on implants (D 2.8 L-2.8). Push-button lock fastening LV-4. Designed for attaching the removable part of the prosthesis to the non-removable part (beams and crowns), standard and individual stump inlays, as well as implants with a spherical male (mini - D 1.8 mm; maxi - D 2.5 mm). When installing a locking fastening supported on standard or individual stump inlays, the patricians are aligned parallel to each other in order to create a single landing path.

Attachments from ELEPHANT. Standard metal anchor attachments from this manufacturer are more accurate and durable and allow activation and deactivation of the anchor part during use. Among the most technologically simple types of attachments, the following can be noted: for direct fixation in base plastic, for fixation directly in metal when casting the frame of a clasp prosthesis on a fire-resistant model.

Similar products are presented by the following companies: “ZL” (Germany), “SEKA” (Belgium) and “Servo-Dental” (Germany).

The presented types of anchors were chosen to reduce dental technicians’ costs for additional materials, such as solder and attachment glue, as well as to simplify the production technology of clasp dentures. The color coding of the burnt-out material of the locking fasteners indicates the types of alloys used in the manufacture of prostheses: blue color - for non-precious alloys, yellow color - for noble and non-precious alloys.

Attachments “Delta”, “Gamma” and “Piccolo”, due to the wide range of possibilities for their use as a locking element, with a static effect and the possibility of activation, can be used in all clasp dentures. This represents an alternative to the clasp-retained prosthesis and is widely used in both unilateral or bilateral end-defect prostheses and in prostheses with included defects. In the case of dentures with terminal defects, attention should be paid to ensuring that the forces generated during the mastication function are transferred and perceived periodontally and gingivally as rationally as possible. To do this, it is necessary to make support crowns paired with milled fields and grooves. This makes it possible to resist torsional and rotational forces during function. Depending on the size of the supporting teeth and the depth of the bite, it is possible to use anchors of both standard sizes “Delta” and “Gamma”, and micro-size “Piccolo”.

Attachments from ZL MICRODENT Acrylic - a rail lock, cast in the same metal as the clasp prosthesis, with nylon matrices of three degrees of rigidity. It is possible to install without a shear counter arm due to the guide groove at the base of the attachment. Duolock - T-shaped lock with adjustable retention force. A rigid intracoronary retaining element that provides a certain retaining force to the prosthesis through an activated screw in the male. Can be used with tilt angles at the bottom of the patrix of 30 and 90 degrees. This choice allows the use of this type of lock for various atrophies of the jaw ridge. Matrix - PI/Ir is molded to noble and base alloys. Perspective duolock - a variation of the duolock lock for prolongation of dentures in case of unreliability of the outer teeth. In the future, you can install a removable denture without removing the crowns with the matrix. There is also a clinical and laboratory system for transmitting the attachment situation in the oral cavity without removing the non-removable part in case of loss of the prosthesis or breakage. The degree of friction is guaranteed to last for 5 years (18 thousand putting on and taking off). Anchor locks. An anchor is a retaining element that secures a partial denture in a “snap” fashion. It can be used as a purely holding element or in combination with other connecting elements, for example: beam structures. The latching action is accomplished by a detachable, activated male part. The total height when installed is 4.5 mm, with a maximum shortening of 3.8 mm. There is an option for an anchor lock with a guide. This option can be used without a shear arm. The T-Anchor is a rigid holding and supporting element that has outstanding shear resistance properties. It consists of three parts: a matrix (PI/Ir) with an intracoronary direction of the locking fastening and an extracoronary direction of the anchor clamping, as well as a male (PI/Ag) locking fastening with a replaceable and activated anchor. Combilok is a supporting element of the prosthesis with adjustable friction. Included in designs primarily for friction in telescopic work, cone fittings and RS locking fasteners or between two adjacent veneered teeth. The total height after maximum shortening is 3-4 mm, diameter is 2.2 mm. Robolock - automatic crossbar locking is used for end defects of both the upper and lower jaw.

The automatic crossbar locking Robolock, as a rigid retention element, is indicated for prosthetics with one- and two-sided end and included prostheses and removable bridges. The connection of the PI/Ag matrix, located in this case on the removable part of the prosthesis, into a block with the PI/Ir male matrix is ​​made by a rod pressed by a spring, a rod that snaps into the body of the male body. The loosening (unscrewing) pin and its guide cartridge can be screwed into the matrix, either lingually or buccally. Because of this design, a deadbolt lock requires only one type of die and patrix in all four quadrants. To separate the male and the matrix, this rod is pressed into the matrix by an opening mechanism screwed into the side of the matrix, which is also pressed by a spring, and thus frictionless separation occurs. Screw plugs are installed on unused threaded connections for reliability.

The matrix of the Robolock lock fastening is made of Pt-Ir alloy with a melting period of 1830-1830 O C, which allows it to be added to both noble and non-noble alloys.

Multilock is a small tube-shaped spherical attachment for smooth frictional construction of telescopic and conical crowns.

Securolok is a small ball-shaped attachment to improve the friction of telescopic crowns. Can be installed after the use of prostheses; also used with implants.

Ventrolock is a rigid intracoronary lock that provides a certain holding force of the prosthesis due to the activated male screw; it is indicated in the absence of anterior teeth for end and included defects with a unilateral or bilateral removable part.

CHAPTER 2. CLINICAL AND LABORATORY STAGES OF MANUFACTURING A clasp denture with a LOCKING FIXATION SYSTEM (ATTACHMENTS)

locking fixation clasp prosthesis

2.1 General stages of manufacturing a clasp prosthesis with attachments

After the necessary preparation of the hard tissues of the supporting teeth (treatment of caries, depulpation if necessary, restoration of the coronal part using anchor pins), the preparation of the supporting teeth is carried out according to the method described above. Next, a two-layer or single-layer (monophasic) impression is taken with silicone impression material, and the prepared teeth are covered with temporary crowns. Central occlusion is determined with the formation of a prosthetic plane.

In the laboratory, a dental technician makes a collapsible model from supergypsum, plasters the models into an articulator and models the frame of the crowns of the abutment teeth with a patrix or attachment matrix installed in a parallelometer. A prerequisite for using rigid locking is the milling of the support crowns.

The clinic fits the frame of the crowns of the abutment teeth in the oral cavity. Determine the color of the ceramic cladding.

After the dental technician has applied the ceramic veneer, the clinic fits the metal-ceramic crowns of the abutment teeth. Check occlusal contacts and color.

After glaze firing, the crowns are fixed in the oral cavity using a corrective impression material to avoid displacement, and an impression is taken to make the removable part of the combined prosthesis. It is possible to use an individual tray made from a preliminary alginate impression. The supporting crowns with locking fastenings go into the impression.

In the laboratory, the abutment crowns are filled with wax and a working model is made from the resulting impression.

A complementary part or its analogue is attached to the locking fastening installed on the supporting crowns. Depending on the type of locking fastening and the design of the removable part of the prosthesis, the model is duplicated or the frame is modeled on a working model using ash-free plastic. After casting, the manufactured frame is fitted to the model. Then the final finishing of the frame is carried out, the installation of teeth on wax, the replacement of wax with plastic, and the final finishing of the prosthesis. For many designs of locking fastenings, it is at this stage that the second part of the attachment is fixed in the frame of the removable part of the prosthesis.

At the final stage, the finished prosthesis is checked in the oral cavity. The accuracy of the attachment is assessed and the occlusal contacts are corrected. Check the functions of the attachment (it should not be activated initially).

Cementing of a fixed structure is carried out under the control of the removable part being put on. Vaseline should be placed between the patrix and the matrix to prevent cement from entering.

2 The main stages of manufacturing a clasp prosthesis with rod and rail extracoronal attachments

The simplest plastic rod attachments are widely represented on the dental market. The design features of these rod plastic attachments have the advantage for dental technicians and patients that they are cheap and have no problems in manufacturing, as well as when used by the patient at home. The difference between these attachments is only in the configuration of the male part and the material from which the matrix part of the lock is made. The matrix can be made of Teflon, nylon, lavsan and other wear-resistant materials. This type of attachment is a rigid extracoronary clasp.

The dental technician first models the abutment crowns and then, using a parallelometer, the male rod is fixed to the wax-up. To rationally use rod attachments, two teeth are taken under the supporting crowns and a place is milled on the distal support for a stabilizer, which is necessary for adequate pressure transfer in partial unilateral and bilateral structures.

The stabilizer protects the attachment from the effect of torsion-rotation and “lever” action. The stabilizer and attachment must be mutually parallel. In order for the attachment rod and stabilizer to become a functional unit, the stabilizer and the attachment rod must be connected by a molded tab.

Next, the rod for fixing the lock, using a parallelometer, is separated at the level of its own lock fastening. If there is no space in the bite for the entire size of the male rod, it is permissible to reduce the size of the attachment by 40% in height without loss of retention.

This is followed by packaging, casting and casting processing. Treatment of the male surface should be gentle in order to avoid changes to the rod part of the lock, which could lead to the matrix losing its locking function. The top of the male rod is processed along the edge at 45 degrees in order to further avoid damage to the matrix part when fixing the prosthesis. After polishing, fit the matrix onto the profile rod and block the lower part of the lock with special wax before duplicating.

The next step is to duplicate the model using silicone or agar-agar-based gel material and obtain a fire-resistant model for the manufacture of a cast clasp prosthesis. We make a wax modeling around the fireproof copy of the profile rod with the matrix. If the attachment protection located in the clasp frame is lined with a plastic tooth or composite, then “pearl” retentions or crystals are used on its surface. Ceramics lining is possible if you use Bredent bonding for cobalt-chromium alloys.

After casting, the prosthesis frame is processed and polished. Further stages of work do not differ from the generally accepted ones.

Rail (vertically sliding) attachments in the shape of the male part resemble a rail installed vertically on artificial tooth crowns on the side of the defect. The patrix should follow the contour of the gingival papilla of the tooth and be 1 mm away from it; the size of the patrix depends on the height of the clinical crown of the tooth. The matrix, most often elastic, is reinforced in the base of the removable denture.

After examining the patient and making a diagnosis, a treatment plan for the patient is drawn up. An obligatory stage of the examination is the production of diagnostic models and determination of the constructive bite to assess the vertical distance required for the location of the attachment male, the size and shape of the supporting teeth, the topography of the defect, and the nature of the atrophy of the alveolar process.

Preparation of teeth for cast or metal-ceramic abutment crowns. Taking working (double) and auxiliary impressions, casting plaster models.

This is followed by determining the central occlusion and plastering the models into the articulator. Modeling the frame of the abutment crowns with wax and installing an ashless blank of the attachment patrix using a parallelometer or a parallel cutter, milling additional guide grooves on wax for the stabilizer and its shoulder (interlock) using a parallel cutter.

The frame of the crowns of the supporting teeth in the oral cavity is fitted, the color of the veneer layer is selected, and ceramic veneer is applied by a technician.

The fitting of metal-ceramic crowns to the prepared teeth and the taking of impressions with elastic impression compounds are carried out by a doctor.

Installing an elastic matrix on the attachment male, drawing a pattern of the prosthesis frame and preparing the model for duplication (closing undercuts with wax, insulating the saddle-shaped parts of the prosthesis with clasp wax), duplicating the model using silicone mass, obtaining a fire-resistant model, modeling the clasp prosthesis frame with wax, casting on a fire-resistant model do not differ from generally accepted technology.

The next stages of manufacturing are: fitting the frame of the clasp prosthesis on the model, fitting the frame of the clasp denture in the oral cavity, placing artificial teeth in the articulator, checking the design of the prosthesis in the oral cavity, replacing wax with plastic according to the usual method, grinding and polishing the prosthesis. It is necessary to secure an elastic matrix in the finished removable denture. The matrix is ​​installed in a metal bed in the frame of a removable denture using a special key. When making a removable denture without a metal frame and a matrix bed, the latter is fixed in the base during the polymerization of the plastic. However, the possibility of subsequent easy replacement of the matrix when it is worn out is impossible. The matrix is ​​replaced directly in the mouth using self-hardening plastic, which can get into the undercuts of the attachment and make it difficult to remove the prosthesis.

At the last stage, the prosthesis is fitted in the mouth. The fixed part of the attachment is fixed using composite or glass ionomer cement; before final crystallization, excess cement is removed, the removable part of the structure is applied, and the patient closes the dentition in the position of central occlusion. Removal of the removable structure is carried out after the final crystallization of the cement; sometimes the prosthesis can be removed the next day after application of the prosthesis.

Patients must maintain oral hygiene, brush teeth and dentures after each meal, and store in a special closed container at high humidity. It is necessary to come for control examinations once every 6 months to timely replace matrices and determine the need for relining the saddle part of the prosthesis, since atrophy of the alveolar processes leads to uneven distribution of the load and can cause deformation of the locking fastening and overload of the periodontium of the supporting teeth.

2.3 The main stages of manufacturing a clasp prosthesis with spherical or push-button attachments

Spherical or push-button attachments can be attached to artificial crowns, root caps, implants and bars, their patrix resembles a sphere, or can be modified within this shape. The elastic matrix is ​​fixed in the plastic base of the removable denture or is located in a metal matrix matrix, which is produced by companies as a standard, or is cast together with the metal frame of the removable denture. Manufacturing stages:

.Examination, selection of abutment teeth and clasp denture design. Preparation of teeth for metal-ceramic crowns (using at least 2-3 supports.) Taking double, working, silicone and auxiliary impressions.

.Casting a combined working and auxiliary model, modeling from wax the supporting caps connected to each other with attached males on the sides facing the dentition defect. Replacing wax with metal.

.Fitting of solid metal caps, with male caps, on abutment teeth. Coating of supporting metal caps with ceramics or plastic. Making wax templates.

.Fitting metal-ceramic or metal-plastic crowns with males in the oral cavity. Determination of central occlusion. Obtaining double working impressions without removing the supporting elements from the teeth.

.Casting the working model. Plastering into the articulator, necessary milling of males and adjustment of elastic matrices. Modeling the frame of a clasp prosthesis from wax, replacing it with metal.

.Final fitting of supporting metal-ceramic (metal-plastic) structures, Fitting of the metal frame of the clasp denture in the oral cavity.

.Selection and placement of artificial teeth on wax bases.

.Checking the design of a clasp denture with a wax base in the oral cavity. Error correction.

.Replacing wax with plastic. Installation of polyvinyl chloride matrices in special boxes.

.Fixation of abutment crowns with cement. Handing over the clasp denture, snapping the locking joints onto the teeth. Operating advice.

.Design correction.

4 Features of the manufacture of clasp structures using anchor and crossbar locks

First, wax caps of the abutment crowns are modeled using standard technology. It is better to take technology using “adapts” as a basis, which subsequently makes it possible to accurately control the thickness when milling unloading shoulders on support crowns. Then, using a parallel gauge and a tool for installing locks on the model (depending on the type of locks, an AME or PME tool is used), the anchor matrix is ​​fixed. The gating system is formed with an additional one-millimeter feeder connected to a ring enclosing the metal matrix. After casting, the matrix metal rings must not be sandblasted or machined. Ready-made abutment crowns with anchor elements are tried on in the oral cavity and a new impression is taken. In the laboratory, using these casts, a working plaster model is obtained, which then must be prepared for duplication, isolating the undercut and the inside of the matrix. The contours of the dies and the milled parts of the abutment crowns must be clearly visible. Then the plaster model is duplicated with silicone materials.

The next step is to obtain a fire-resistant model and model the wax structure of the clasp prosthesis. The wax modeling should end at the top edge of the matrix. After casting, processing and polishing the clasp frame, the male part of the anchor is installed in the prosthesis. Then the production of the prosthesis is completed using standard technology.

The OT KLASS attachment is a mechanism that is a flexible structure, the parts of which are completely made of metal and connected according to a special principle. It appeared as a result of joint long-term research and numerous tests by Rhein , 83 (Italy) and Servo Dental (Germany). The results of laboratory tests and subsequent practice confirm the viability of the new development.

While remaining committed to elastic retention in locking fastenings, the developers of the new design also achieved the necessary characteristics:

· elasticity is achieved by choosing the shape and type of titanium application;

· special treatment of titanium that does not disrupt the intramolecular structure and eliminates the fatigue phase;

· The patrix, due to special thickenings, provides a more durable connection with the matrix.

The design, therefore, constitutes a high-precision, flexible, dismountable connection in which the matrix is ​​attached to the supporting crowns, and the male is attached to the metal frame of the clasp prosthesis.

The principle of operation of the attachment consists of four phases, and the force required to remove the patrix is ​​greater than to insert it.

Introduction phase. The connection is made by pressing the patrix. Due to the conical tips, the patrix parts easily fit into the grooves of the matrix. Planting phase. The elastic parts are compressed during landing, and the guides are lowered along the walls of the matrix.

The last stage of introduction. Having reached the bottom, the patrix with its thickenings falls into special niches of the matrix. The final connection is accompanied by a characteristic click.

Attachment assembled. All parts are locked by a special wedge-shaped ledge of the matrix and are in a pressed state due to the flexible parts of the matrix.

The matrix is ​​secured to the supporting crowns using a GUAINA-BOX cast container, a locking pin - stopper and composite, as well as by soldering to the finished product with solder or laser.

For correct installation and successful further operation of the attachment, it is necessary to use parts from the kits: 800KR45; 800KR90; 800KL45; 800KL90 purchased from official distributors and their regional dealers.

Attach the matrix to the key to the parallelometer and lower it into the GUAINA-BOX, which is attached with wax to the crowns in the desired position. A ceramic locking pin is inserted into the side hole.

Finish modeling and milling. The thickness of the container is designed to produce a durable gold casting. If the casting is made of stronger alloys (TITANIUM, KHS), the wall thickness can be reduced without much risk.

Upon completion of the simulation, it is necessary to remove the ceramic locking pin, remove the OT KLASS matrix from the container, and install the pin back on the container.

Next, sandblast the casting; If necessary, use an appropriate acid or tool to remove the ceramic post. Insert the matrix into the cast container and insert the stopper pin, making sure that the lock is achieved. Blocking occurs when the groove on the matrix and the container coincide. If it is necessary to veneer and polish crowns, the matrix inside the container should be reinforced with a composite and a metal locking pin. The pin handle is broken off and the ends are polished.

Preparing the model for duplication: you need to create a gap around the titanium casing by pouring 0.02 mm thick wax over it, or instead of applying wax, remove the titanium casing and install a larger GUAINA “COPING” brass casing.

When modeling the frame, it is possible to close the attachment entirely or partially, modeling areas for guaranteed attachment.

When modeling the veneer with a composite, it is necessary to ensure that the composite does not fall into the male slot, otherwise the elasticity of the connection will disappear and the fit of the prosthesis will become difficult or impossible.

Attachment MK-1 effectively compensates for horizontal forces arising during chewing and eliminates movement of the prosthesis towards soft tissues and back. The resulting balanced load on the supporting teeth and the alveolar process allows us to talk about the preservation of the periodontium of the supporting teeth and the prevention or slowdown of resorption of the alveolar process of the jaw.

For supporting crowns, two teeth with unchanged periodontal tissue are often used, on which a bed is milled for the stabilizer - the removable part of the prosthesis. According to generally accepted rules, a cervical ledge is formed from the oral surface in the lower third of the crown, turning into a parallel surface in the middle third, ending with an occlusal bevel at an angle of 45 O to the tooth axis. An additional retention element for fixing the removable part of the prosthesis is the guide channel between the supporting crowns.

In cases where one tooth is used for supporting crowns, for example in class II, the structure is reinforced with a metal arch (clasp), connecting it to the balancing side using various fixing elements, including clasps. When replacing defects of no more than 3-4 missing teeth on one or both sides of the dentition with dentures with MK-1, especially with a gag reflex or inability to adapt to traditional removable dentures, the use of a metal arch (clasp) is excluded.

If there were several defects in the dental arch, for example I and IY, belonging to different classes, then the larger class of defect is compensated with bridges, and the smaller (main) with dentures with the MK-1 attachment. The presence of class I-III in one dentition allows us, in some clinical cases, to embed the lock-MK-1 into the beam system between artificial crowns on the side of the included defect, and its generally accepted location on the side of the end defect. The removable part of the prosthesis is located on both sides of this defect, combining sagittal and parasagittal stabilization of the dentition. The use of a metal arch (clasp) is advisable in that it ensures the distribution and transfer of lateral load from the supporting teeth of the end defect replaced by the prosthesis to the replaced included defect of the dentition.

When there are defects in the dentition of a large extent or with insufficiently reliable distal support, a collapsible removable denture is used using an MK-1 attachment in the area of ​​the medial support, and an attachment of another system in the distal support, which additionally serves as a guide. In this case, when there is divergence or convergence of the abutment teeth, there is no need to prepare the abutment teeth to make them parallel to each other. The path of insertion of a removable denture is determined by the parallel placement of attachments on the supporting artificial crowns, regardless of the parallelism of the teeth themselves.

2.5 Features of manufacturing a clasp prosthesis with intracoronal attachments

These attachments make the prosthesis easy to handle. Well assessed by the patient. A favorable direction of insertion is set on the measuring device.

The plastic males used in the primary design are very easy to work with. Males are attached parallel to each other to the wax crowns, modeled in full anatomical form.

In this case, it is necessary to ensure that the males are installed in the middle of the jaw ridge. To prevent periodontal diseases, the male of the extracoronal attachment is located 1.5 mm above the dental papilla.

To fulfill this condition, the clinical crown must have the required height. A gap is left in the area of ​​the dental papilla to allow flushing. The male parallel holder with a 90 degree angle is cut with a hot modeling tool. After casting, the male is only slightly rounded on the occlusion side. Matrix processing may result in loss of fixation. This prevents large losses of material and makes it easier for the patient to insert the prosthesis.

Before duplicating, a yellow patrix is ​​installed, and the gap between the comb is filled with wax. The matrix serves to save space and makes it possible for the duplicate model to individually decorate this area with wax. During modeling of the housing for the matrix, the patrix is ​​covered from the occlusal side. If there is not enough space, it is recommended to make the chewing surface from metal. At subsequent stages of work, it is necessary to ensure that the housing for the matrix is ​​not damaged during processing. The matrix is ​​inserted with a special key after the frame is already equipped with artificial teeth and plastic.

The removable part of the prosthesis is fixed on a replaceable matrix fixed in the frame body. The matrix consists of durable plastic that retains its elasticity for a long time.

These attachments ensure ease of handling of the prosthesis. Well assessed by the patient. Ancora's sliding-type intracoronal attachments guarantee precise central transmission of force to the periodontium.

6 Advantages of orthopedic treatment using clasp dentures with a locking fixation system

Currently, locking fasteners are the main element of fixation in prosthetics on implants, they allow for permanent prosthetics in case of significant non-parallelism of clinical supports, they are a connecting element in the manufacture of prostheses splinted along the arch, and in the case of a doubtful prognosis of the supporting teeth, they make it possible to separate them into fragments. Against the background of the above, attachments significantly improve the aesthetics of prosthetics with removable dentures.

Modern lock fastenings have a number of advantages over clasp fastenings. Firstly, the point of application of force to the abutment teeth is located more apically compared to clasp systems. Secondly, mostly standard, interchangeable parts are used with the possibility of activation, if such is included in their design. And the last thing is the possibility of repairing and replacing worn out elements. Along with the advantages of locking fastenings, there are also some disadvantages that must be taken into account when drawing up a treatment plan. Abutment teeth must be covered with crowns, and in the presence of terminal defects of the dentition, it is necessary to use two or more abutment teeth as support. Space is required for the location of the locking attachment; the clinical crown must be of sufficient height to provide the necessary distance between the mucous membrane and the antagonist teeth. Particular attention should be paid to the size of the console formed by the working part of the lock and the supporting teeth, especially in case of terminal defects of the dentition. In our country, there is currently a rapid development of the need for prosthetics using locking fasteners, however, due to the insufficient amount of information, the use of attachments and the selection of a specific locking connection, depending on the specific clinical situation, still puts the practitioner in a difficult position. And the best way out of it, often, is to use the attachment that is currently available to the dental technician, despite the fact that there are indications and contraindications for the use of this or that type of attachment, developed by extensive clinical experience.

2.7 Evaluation of the use of attachments in the manufacture of clasp dentures in Ufa

Materials and research base. To assess the possibility of developing modern technologies in the manufacture of clasp dentures in the city of Ufa, a study was conducted based on an analysis of orders and price lists of services provided by city municipal clinics and private clinics to the population of the city of Ufa, and an anonymous survey of workers in medical institutions dental technicians. The survey involved three state dental institutions - “Dental clinics No. 1, 6 and 8”, two private network dental clinics LLC “Tabib” and “Family Doctor”.

Research result. Currently, almost all healthcare institutions in Ufa that have dental laboratories on staff produce clasp dentures with locking fixation systems. Over the past years, there has been an increase in the number of dental technicians performing work related to complex combined dentures. Thus, in all five institutions under study, clasp dentures are manufactured with attachments from different manufacturers. Summary data on the used locking fastenings are presented in Table 1.

Table 1. Locking fasteners used in the manufacture of clasp dentures in Ufa

Lock fastenings/institution “Attachments” VKS-SG from Bredent Attachments from Rhein -83 Attachments from LV-Rudent MBUZ No. 1--+MBUZ No. 6+--MBUZ No. 8+-+ “Tabib”+ ++ “Family Doctor”+--

As can be seen from the table, the most popular locks in Ufa are VKS-SG locks manufactured by Bredent. Most likely, this is due to the ease of installation, a large selection of options for components and low cost.

Locking systems from LV-Rudent have a lower cost than their imported counterparts, which is why they are mainly used in municipal dental institutions. Attachments from Rhein-83 are used in prosthetics by only two healthcare institutions. Lock fastenings from all three manufacturers are used only by specialists from the Tabib network of clinics.

Based on the analysis of orders for March-April 2015, the average ratio of the number of clasp dentures with clasp fixation systems to the total number of removable dentures with clasp fixation in the city of Ufa is 2 to 26.2, which is a percentage of 7.63% of total number of manufactured removable dentures.

Table 2. Ratio of the number of manufactured clasp dentures with attachments to the total average number of removable dentures, per month

Health care institutions Average number of clasp dentures with attachments Average total number of removable dentures MBUZ No. 1134 MBUZ No. 6227 MBUZ No. 8230 “Tabib” 318 “Family doctor” 222

The results obtained indicate that in the city of Ufa, in the presence of sufficiently qualified specialists and well-equipped medical institutions, the use of locking systems by specialists in the prosthetics of partial dentition defects with clasp denture designs remains at a fairly low level. It can be assumed that this is due to the high cost of this type of dental orthopedic care, because The average price of a clasp prosthesis with attachments in the city of Ufa is 2.52 times higher than the price of a clasp prosthesis with a clasp fixation system.

CONCLUSION

The presented techniques and possible methods for manufacturing combined prostheses with attachments, recommended by various companies, and proprietary manufacturing methods are being improved to this day. Currently, foreign and domestic manufacturing companies produce more than two hundred different designs of attachments. The new designs of locking fasteners being created increasingly take into account the mechanism of action on the supporting teeth, mucous membrane, compact plate of the jaw bone and tooth sockets in order to optimally utilize the reserve forces of the periodontium and use the potential of the prosthetic bed.

Knowledge of the basics of manufacturing technology, the degree of influence of the prosthesis on the supporting teeth, understanding the nuances of the mechanism of action on the supporting teeth and the tissues of the prosthetic bed will help to correctly plan and manufacture clasp dentures with attachments.

In our country, there is currently a rapid development of the need for prosthetics using locking fasteners, however, due to the insufficient amount of information, the use of attachments and the selection of a specific locking connection, depending on the specific clinical situation, still puts the practitioner in a difficult position. And the best way out of it, often, is to use the attachment that is currently available to the dental technician, despite the fact that there are indications and contraindications for the use of this or that type of attachment, developed by extensive clinical experience.

The results of the study indicate that in the city of Ufa, in the presence of sufficiently qualified specialists and well-equipped medical institutions, the use of locking systems by specialists in the prosthetics of partial dentition defects with clasp denture designs remains at a fairly low level. It can be assumed that this is due to the high cost of this type of dental orthopedic care, because The average price of a clasp prosthesis with attachments in Ufa is 2-3 times higher than the price of a clasp prosthesis with a clasp fixation system.

.In dental healthcare institutions in the city of Ufa, they will gradually abandon the use of partial plate dentures in borderline clinical situations in favor of clasp denture designs.

.To equip dental laboratories of public health institutions with milling-parallelometer equipment for the manufacture of clasp dentures with locking systems.

.Dental technicians need to take part in improving their qualifications within the framework of master classes from dental companies on the manufacture of complex combined structures and clasp dentures with locking fixation systems.

BIBLIOGRAPHY

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APPLICATIONS

Annex 1

Elements of extracoronal locking fixation

Clasp prosthesis on spherical attachments

Appendix 2

Clasp prosthesis with bolt locks

Crossbar lock fastenings

Appendix 3

Self-activating attachment OT KLASS

Rail lock fastenings

Similar work to - Clinical and laboratory stages of manufacturing a clasp prosthesis with a locking fixation system (attachments)

Many people, when they hear about removable dentures, imagine the bulky and unsightly dentures that our grandparents left in a glass of water overnight. Indeed, people of the older generation know what removable dentures used to be like - uncomfortable, sometimes causing irritation when worn. It seemed that their main task was to make life as difficult as possible for its owner. Modern removable prosthetics differs significantly from what was common in the last millennium.

Today new materials and new technologies are used. The materials are durable, flexible and safe. Technologies make it possible to produce new composite materials and combined structures with high precision. This, in turn, makes it possible to create truly individual, highly comfortable removable dentures. The quality of their fastening has also improved, so a prosthesis that falls out on its own is considered a fantasy. The most striking confirmation of these facts is the progressive and popular type of removable prosthetics - clasp prosthetics.

Bugel translated from German means arc. A clasp prosthesis is an arched prosthesis. It is based on an arched metal frame on which artificial teeth are attached. The presence of such a frame makes it possible to minimize the size of the prosthesis, and modern titanium-based alloys make it possible to make clasp prostheses almost weightless. Small size and light weight are an important factor in the process of getting used to the prosthesis. In most clinical cases, the patient does not feel any discomfort on the first day of using the clasp prosthesis.

Clasp prosthetics are used for single or multiple defects of the dentition (end, lateral or anterior), for some periodontal diseases, deep bite, pathological abrasion of teeth.

The possibility of its use depends on many factors: the number of supporting teeth, the condition of the teeth and oral mucosa, etc.

A direct indication for the use of removable clasp dentures in dentistry is an incomplete dentition with a sufficient number of supporting teeth, because The prosthesis rests on the patient’s gums and natural teeth, clinging to them with metal hooks. That is, a clasp denture cannot be used in the absence of teeth.

There are three types of clasp dentures:

• clasp dentures with clasps
• Clasp dentures with locks (attachments)
• clasp dentures on telescopic crowns.

Clasp dentures with clasps are held on the supporting teeth using special hooks (clasps), which tightly cover the supporting tooth without harming the enamel. Clasps must provide strong fixation of the clasp denture, transmit chewing pressure along the axis of the tooth, and not loosen the teeth. This fastening ensures reliable fixation of the prosthesis in the oral cavity, however, under heavy loads it can lead to minor damage to the tooth enamel.

Previously, the main disadvantage of partial dentures with clasps was considered to be insufficient aesthetics. This is quite understandable: a person smiles or opens his mouth, and you can notice that there are some kind of metal brackets on the teeth. Fortunately, the situation is changing. Today, in the era of new materials and technologies, highly aesthetic options for clasp dentures have appeared. True, they also have their drawback - the price. The reason is quite clear - high-precision casting, special materials and fastening technologies for modern clasp prostheses are expensive.

Clasp dentures with locks have a very strong fastening of the prosthesis. According to the principles of fastening, such prostheses resemble bridges. This means that part of the chewing pressure is transferred to the supporting teeth. Special crowns made of metal ceramics are usually put on such teeth, or even a lock (attachment) is inserted into the tooth without any crowns. The fastening is hidden inside the clasp denture, therefore, unlike clasps, it is not visible from the outside that there is a removable denture in the mouth. Clasp prosthetics on telescopic crowns are considered one of the most expensive, since they require jewelry and precision work from the dental technician. Telescopic crowns are a system consisting of two fastening elements: a cone-shaped base (usually a ground natural tooth or an installed dental crown) and a dental crown, which has an internal cavity exactly the same shape as the base. Thus, one part of the crown fits into the other, ensuring reliable fixation of the prosthesis.

Now let's talk about the advantages and disadvantages of clasp dentures.

Advantages of clasp dentures

The advantages of such prostheses certainly include the fact that this is one of the most high-tech methods of prosthetics. These systems make it possible to comprehensively solve the problems of restoring the integrity of the dentition, prosthetics of teeth, their splinting and the prevention of periodontal disease. Arc-shaped structures hold the elements attached to it much more reliably than linear structures. Uniform distribution of pressure spares teeth, allowing you to keep them healthy for a long time, and serves as a prevention of possible tooth loss.

The undoubted advantage of the design is that it does not have to be removed at night and placed in a glass of water; hygiene measures only involve brushing your teeth in the morning and evening.

It is also possible to highlight a number of advantages of clasp dentures over fixed dentures. Clasp dentures in most cases do not require preparation (grinding) of teeth and the manufacture of crowns on abutment teeth, therefore they are less traumatic for the hard tissues of teeth, pulp and periodontium. The removable principle makes it possible to easily remove the prosthesis for hygienic care. The materials used for their manufacture can be easily cleaned with ordinary tap water, and your own teeth can be effectively cleaned with a toothbrush and toothpaste. Such effectiveness of hygienic care for the oral cavity and dentures is impossible with fixed prosthetics, because Between the gums and artificial teeth, niches are formed in which food debris accumulates, tartar is deposited, and microflora develops abundantly. A large assortment of artificial teeth makes it possible to produce removable dentures in color, shape and size that exactly match natural teeth. In addition, artificial teeth in factory-made removable dentures are obviously stronger than laboratory-made artificial teeth in fixed dentures.

Disadvantages of clasp dentures

Clasp dentures are removable and therefore require periodic removal and hygiene measures. Also, a few years ago, the clasp prosthesis looked very ugly due to the fact that the metal plate was visible, but now more aesthetic versions of prostheses have been developed. With the development and introduction of aesthetic options for clasp prostheses, their price has increased, due to which such prostheses are not available to everyone.

In conclusion, it is worth noting that clasp prosthetics has little in common with other types of prosthetics, except perhaps the very essence of prosthetics, which is the installation of artificial teeth.

Clasp prosthetics is an aesthetic and comfortable method of dental prosthetics; the designs for such prosthetics are very durable, have a long service life and practically do not interfere with talking and eating.

Clasp prosthetics is a popular method of restoring dentition, which uses removable dentures with clasps (hooks) and attachments (locks).

Designs with clasps are at least half the price, but they are durable, strong and reliable, and do not require special care. They are also considered a budget alternative to implants and a reliable analogue of bridges and plate prostheses.

Features of clasp dentures on hooks

The structure consists of the following elements:

• arc (in German – bugel);
• artificial teeth (attached to an arch);
• base (gum simulator);
• clasps (hooks that secure the prosthesis to the supporting teeth).

Types of clasp dentures with clasp fixation

According to the design and purpose of the structure, two types of prostheses are distinguished - conventional and splinting.

Conventional clasp dentures with clasps

They are recommended in cases where it is not possible to place implants and there are still teeth in the mouth that can be used as a support for a prosthesis. The design allows you to eliminate such dental defects as:

• absence of three or more teeth in a row (front, side, on one side of the jaw and/or on different ones);
• terminal defects of the dentition (when the last teeth are missing).

Splinting clasp dentures on hooks

They differ from ordinary ones in that in their design they have special retainers (processes on the arch) for supporting teeth. Used to restore dentition in patients suffering from:

• pathological mobility of teeth (the prosthesis fixes loose teeth and protects them from excessive chewing load);
• malocclusion (the design holds the teeth in the correct position, thereby correcting abnormal jaw closure);
• increased abrasion of the upper teeth (the prosthesis covers the chewing surface of worn-out teeth, making them higher and protecting them from further abrasion).

Splinting clasp prosthesis

Depending on the materials, there are 2 types of clasp dentures:

1. Prostheses containing metal. The arc and clasps (and sometimes the base frame) of such structures are made of chromium-cobalt or gold-platinum alloy.
2. Metal-free structures. The so-called Quadrotti prostheses (Quattro Ti) with nylon clasps and a base made of a mixture of nylon and hypoallergenic plastic.

Manufacturing stages and installation

Prosthetics with clasp dentures with clasps includes two main stages - clinical and laboratory. From the moment you contact the clinic until the restoration of the dentition, the following stages occur:

1. Examination. The doctor draws up a prosthetic plan, makes a conclusion about the state of oral health and, if necessary, sends the patient for treatment of caries and/or periodontal disease.
2. Taking an impression of both jaws.
3. Making a prosthesis in the laboratory. Structures with metal elements are made by casting methods, while plastic ones are produced under high temperatures.
4. Trying on the finished design. If necessary, correction is carried out.
5. Installation of the prosthesis.

On average, the clinical and laboratory stages of prosthetics take one week.

Price

The average cost of manufacturing and installing a conventional clasp prosthesis with clasps is 35,000 rubles. Splinting structures are usually a little more expensive - 40,000 rubles.

How to care for a prosthesis?

Clasp dentures with clasps should be cleaned at least twice a day, or better yet, after each meal. Hygienic measures include:

• rinsing the structure under running water after eating;
cleaning with a brush and low-abrasive paste at least twice a day;
• daily disinfection (soaking in solutions of disinfectant tablets Corega, Lacalut, Efferdent, President, Dentipur, Dontodent, etc.);
• professional cleaning (performed by a dentist to remove hard deposits).

It is advisable not to remove the prosthesis at night and to remain in it constantly. Once every six months you need to visit the dentist to reline the structure (correction to evenly distribute the chewing load).

The result of prosthetics depends not only on the quality of the prosthesis, but also on the qualifications and skill of the orthopedic dentist. Our website provides an up-to-date list of clinics that effectively restore dentition using clasp structures.

Introduction

1 Characteristics of clasp dentures

1.1 The concept of clasp prosthetics

1.2 Components of clasp dentures

2 Types of clasp denture designs

Conclusion

List of used literature

Introduction

A denture is necessary in cases where so much tissue needs to be removed from a tooth that installing a filling becomes impossible, or when one or more teeth are completely missing. Dentures perform not only a cosmetic function, but also provide a significant degree of stability and shape of the bite.

Currently, clasp prosthetics is becoming increasingly popular. This is due to a sharp qualitative leap in their production, due to the creation of new materials that help make the design of the clasp prosthesis light, openwork, and, in many cases, invisible to prying eyes. Such prostheses are comfortable, hygienic, and patients use them with pleasure. The bulky and unsightly dentures that our grandparents left in a glass of water overnight are a thing of the past.

The technology of making a clasp prosthesis with the removal of the wax structure from the plaster model and the technology of soldering the prosthesis frame with conventional solders are also becoming a thing of the past. Today, most clasp prostheses are made using fire-resistant models, with laser or hydrogen soldering, where the heating of the prosthesis frame occurs very locally, thus eliminating changes in the properties of the alloy.

The purpose of this work: to define the concept and essence of clasp prosthetics, to characterize the types and designs of clasp prostheses.

Structure of the work: the work consists of an introduction, 2 chapters, a conclusion and a list of references. The total volume of work is 15 pages.

1 Characteristics of clasp dentures

1.1 The concept of clasp prosthetics

Dental prosthetics serves as a therapeutic factor that helps replace persistent defects, restore impaired functions and prevent subsequent changes in the dentition, temporomandibular joint, masticatory muscles and other organs and tissues of the maxillofacial area. When replacing partial defects, mainly two types of dentures are used: fixed and removable.

Removable dentures are used for complete or partial loss of teeth, in the latter case this is especially true for the loss of chewing teeth. Removable dentures can be used even if one chewing tooth is lost. In the arsenal of modern dentistry there are technologies for manufacturing removable dentures that have extraordinary convenience, high wear resistance and aesthetic properties.

Removable dentures can be supported and submerged, as well as combined. Submerged removable dentures are based on the mucous membrane of the alveolar processes. Supported removable dentures, unlike submersible dentures, are based on supporting teeth and the mucous membrane of the alveolar processes and bone palate, which makes it possible to increase their functional value, reduce the boundaries of the prosthetic bed and improve the conditions for using the prosthesis.

Supported types of removable dentures include: removable lamellar dentures with support-retaining clasps, locking, telescopic and beam fastening; removable bridges; soldered and solid-cast clasp (arch) dentures.

Clasp prosthesis - (comes from the German word “Bugel”, which means “arc”). This design of the denture allows you to use not only your gums, but also your own teeth for support. The clasp prosthesis has a more compact appearance, it is quite comfortable, durable and strong. It is used as a more advanced alternative to a partial removable plate prosthesis when, due to the clinical situation, it is no longer possible to manufacture fixed bridges. At the same time, in comparison with plate removable dentures, the clasp denture has a method of transmitting chewing load that is closer to physiological.

Clasp dentures are distinguished by the method of fixation:

Clasp dentures fixed with support-retaining clasps (hooks);

Clasp dentures held in place using micro-locking fasteners (attachments);

Clasp dentures with a telescopic fixation system.

In the first case, these are hooks with springy properties that tightly cover the tooth without harming the enamel. Thanks to these properties, the denture is securely held in the oral cavity. The disadvantage of this prosthesis is that the aesthetics in the area of ​​the supporting teeth are not always acceptable. May be a temporary solution in cases of subsequent implantation, etc.

When fixed using micro-locking fasteners, a much better aesthetic and functional result is achieved. The attachment (lock) consists of two parts. One part is located in the metal-ceramic crown, and the second is inside the clasp prosthesis. This is a combined method of prosthetics, which includes the production of metal-ceramic crowns and the clasp prosthesis itself.

Clasp dentures with a telescopic fixation system are one of the most complex types of clasp dentures, but also one of the longest functioning. It is based on telescopic (double) crowns. One is cemented onto the tooth. The second, the internal contour of which ideally follows the external contour of the first, is located in the clasp prosthesis. Like two glasses, one crown “sits” on the other, tightly holding the prosthesis.

By the same principle, in various clinical situations, bridges of varying lengths can be made on telescopic crowns. Prostheses with a telescopic fixation system can be considered universal. Over the years, the number of supporting teeth may change, but the prosthesis will remain the same, requiring minimal correction in the doctor’s office

The main feature of a clasp prosthesis is the presence of a metal arch connecting the left and right sides of the prosthesis. This arch passes either across the patient's palate (if it is a maxillary denture) or under the patient's lower teeth on the lingual side. The arch, locking fasteners or clasps are part of a cast frame on which a plastic bed with artificial teeth is located. The cast frame is cast from a special high-strength dental alloy and is able to withstand any chewing load.

Functions of a clasp denture:

Replacement of missing teeth with artificial ones and restoration of chewing function.

Splinting of mobile or shifting teeth (for example, with periodontitis, periodontal disease). To perform this function, a splinting clasp prosthesis is used.

Aesthetic rehabilitation. Returning to a partially toothless mouth not only function, but also an aesthetic appearance, when even with a close examination of the teeth, no one will ever understand that half of your teeth are artificial and are removable.

1.2 Components of clasp dentures

Clasp (arch) dentures are a type of partially removable supported dentures. Their name is determined by the presence of a bridge in the form of an arc located transversely on the palate or on the oral side on the lower jaw. Arch prostheses consist of a metal frame, which includes support-retaining and unloading elements, an arch, fastenings for saddles, and a base with artificial teeth.

Based on the technology for manufacturing the frame of a clasp prosthesis, arch-supported prostheses can be divided into:

1. Individual elements are bent from wire, using standard arcs, and then soldered.

2. Individual elements are cast from metal and then soldered.

3. Solid casting: casting with removal from a model or using melted models, casting on a refractory model, casting through a plastic composition.

The clasp prosthesis consists of a prosthesis base, support-retaining clasps (hooks) or locking connections and a connecting arch.

Clasps are the most common way to strengthen clasp dentures. They are produced by casting or bending from wire (stainless steel, gold-based metal alloys).

The shape of the clasp varies depending on the function it performs (support, retention, etc.) and its retention to the tooth. The correct placement of the clasp on the crown of the tooth is based on the rational use of their shape. The line passing along the most convex part of the tooth crown is called the equator. The horizontal equator line divides the tooth crown into two parts: occlusal and retention (gingival), which is located below the equator line. The supporting elements of the clasps are located on the occlusal part, and the retaining elements are located on the retention part.

There are different types of clasps: retaining, supporting, combined (support-retaining).

A prosthesis fixed with retaining clasps settles under vertical load, i.e. moves towards the mucous membrane and plunges into it. As a result, pressure is transferred to the mucous membrane.

When using supported clasps, pressure is transmitted mainly to the supporting teeth, and partially to the mucous membrane of the prosthetic bed.

In clasp dentures with locks, the fastening of the prosthesis is very rigid, almost motionless. Therefore, most of the chewing pressure is redistributed to the supporting teeth, onto which special metal-ceramic crowns are placed. Unlike clasps, the fastening is hidden inside the clasp prosthesis, so no metal elements are visible from the outside.

Clasp dentures with attachments are used today more often than other types of removable prosthetics. This is due to the fact that thanks to clasp prosthetics on attachments, it is possible to 100% solve all the main problems of removable prosthetics:

Full functional rehabilitation (due to the strong fixation to the remaining teeth, such a prosthesis will be wonderful to chew and bite).

Complete aesthetic rehabilitation. Very good fixation, that is, you don’t have to be afraid that the prosthesis will come off at the most inopportune moment. The patient feels confident in any situation.

The clasp prosthesis does not need to be removed at night. It is constantly in the mouth and is removed only to ensure oral hygiene (when brushing teeth).

The clinics offer highly aesthetic prostheses with locking fastenings: from the simplest plastic ones to those individually manufactured for each patient using spark erosion processing technology.

Prosthetics with clasp prostheses on galvanotelescopes without an arch, unlike conventional clasp dentures, do not have a metal arch, which can create inconvenience when talking, eating, as well as psychological discomfort. In most cases, such prostheses do not cause any discomfort. Such a prosthesis feels like your own teeth, does not cause problems with diction or taste sensitivity, and looks like natural teeth, which also do not hurt, do not fall out and do not change color. The ability to remove the prosthesis turns from an inconvenience into a huge advantage, as it allows for more careful hygiene.

The telescopic system consists of several components. The first is a metal crown that hermetically covers the abutment tooth. The second is the so-called “secondary crown”, removable, which is, in fact, a clasp prosthesis. Fixation of the secondary crowns to the primary ones is carried out by frictional force due to a galvano-telescope, which also contains a third crown. This crown is made by galvanization, that is, layer-by-layer, literally molecule-by-molecule, application of liquid metal. And since this metal is high-grade gold, the accuracy of fit of all the components of the prosthesis is simply fantastic.

Arch of a clasp prosthesis.

This is an element of an arc prosthesis that connects its parts. This produces a resistance block that provides a functionally beneficial load on the supporting teeth.

Its main function is to combine all the elements of the supported prosthesis. The arc must be strong, rigid, and have good physical and mechanical properties. The location of the arch on the upper and lower jaw depends on the topography of the dentition defect, the relief of the alveolar process, the shape of the palate, the severity of the torus and other factors.

The most favorable shape of the arch is oval, semicircular, semi-oval. The edges of the arch should be rounded to avoid injury to the tongue and soft tissues. The best rigidity of the arc is ensured by its production by casting from a cobalt-chrome alloy.

The general rule when designing arches on the upper and lower jaw is that the arch should be separated from the mucous membrane by the amount of compliance of the soft tissues of the prosthetic bed.

On the upper jaw, the arch should have a thickness of 0.9 - 1.2 mm, and a width of 8 -10 mm (Sorokin G.P.) 4-6mm (Perzashkevich L.M.). The arch should be 0.5 mm away from the mucous membrane of the upper jaw (Perzashkevich L.M.).

On the lower jaw, the arch is located at a distance of 1-1.2 mm below the necks of the teeth and does not reach the floor of the oral cavity by 2-3 mm. On the lower jaw it is 1-1.2 away from the mucous membrane. When immersed, the arc should not come into contact with the underlying tissues and injure the frenulum. The width of the mandibular arch should not be less than 3 mm, thickness - 1.5 mm (Sosnin G.P.).

According to Kopeikin V.N. the arch of the prosthesis on the lower jaw should be unevenly spaced from the mucous membrane: at the upper edge by 0.5-0.6 mm, at the lower edge by at least 1 mm.

Making a lingual arch can sometimes be difficult or impossible. Their use is contraindicated in the absence of space for an arch, bilateral convergence of premolars, or a significant anterior inclination of the alveolar process.

In such cases, the use of a lingual plate or vestibular arch is indicated. The lingual plate covers the oral surface of natural teeth or alveolar processes from the line of greatest curvature of its slope to the border of the mobile mucous membrane. The vestibular arches are placed in the vestibule of the oral cavity near the labial and buccal alveoli. They are made wider and flatter than lingual ones.

Basis of clasp dentures.

The base represents an element of a removable denture that carries artificial teeth and branches from the metal parts of the supporting denture. The base is strengthened onto the supporting teeth through connecting elements and rests on the alveolar process.

Currently, gold and cobalt-chrome alloys, as well as various plastics, are used to make bases. The advantages of a base made of a cobalt-chrome alloy over a gold one are that the former has a low specific gravity, and over plastic it has high strength. When relining the base: the advantage remains with plastic.

The functions of the base are to hold artificial teeth, transfer the load from applied pressure, and provide resistance to displacement forces.

The shape and size of the base depend not only on the presence of teeth and anatomical conditions of the oral cavity, but also on functional and preventive tasks. The more natural teeth accept chewing pressure and the more they can be loaded, the less area is required for the base of the prosthesis.

The advantages of clasp dentures over removable plate dentures are as follows: they are smaller in size, therefore the patient adapts to them faster; do not cause a foreign body sensation; do not interfere with taste and temperature sensitivity.

When installing artificial teeth in partially removable dentures, it is necessary to comply with the laws of statics and dynamics, i.e. the teeth are placed in the middle of the alveolar ridge. It is also necessary to take into account interalveolar relationships.

The connection of the prosthesis frame with the base can be:

1. Rigid - it is advisable to use when a supported removable denture is installed with a sufficient number of supporting teeth and well-preserved alveolar processes and mucous membrane with little uniform elasticity.

2. Spring mounting - achieved by introducing one or more springs. Spring connections are indicated when it is necessary to reduce the load on the supporting teeth by increasing the functional load on the tissue of the jaw crest. This is necessary when there are a small number of supporting teeth or when the supporting teeth are not sufficiently stable.

3. Hinge joints - designed for rational distribution of chewing load on the mucous membrane and periodontium.

2 Types of clasp denture designs

The decision on the choice of prosthesis design, type and location of clasps is made during a clinical examination of the patient’s oral cavity.

Designs of clasp dentures based on the Kennedy classification:

1 class.

A distinctive feature of clasp dentures for this defect is the presence of two freely ending saddles, rigidly connected to each other by an arch. The saddles of the prosthesis on the medial side rest on the teeth by means of clasps or locking connections, and with their free ends they lie on the mucous membrane of the alveolar process.

Examples of such a design include a prosthesis with two Acker clasps connected by an arc; a continuous oral clasp can be introduced into the design, a load breaker for periodontal tissue disease.

2nd grade.

For defects of this class, clasp dentures have a freely ending saddle, fixed on the medial side on the supporting tooth and lying with the free end on the mucous membrane of the alveolar process. The saddle is connected by a metal arch with clasps fixed on the lateral teeth of the opposite side of the dentition. Fixation of the prosthesis can be carried out using a two-arm Acker clasp, a reverse rear-action clasp, or a double three-arm clasp.

3rd grade.

Clasp dentures for class 3 defects have included saddles with bilateral fixation on the supporting teeth. Bilateral prostheses are used for large defects when it is impossible to manufacture fixed prostheses. Clasps located on the healthy side of the dentition should be rigid and fixed on a large number of teeth (at least 2 teeth). When there is a forceful predominance of the opposite dentition, the vertical load on the supporting teeth should be reduced with the help of spring connections, creating support for a larger number of teeth, expanding the base support area, and reducing the occlusal surface of the dentition. It is especially important not to overload a single abutment distal tooth.

4th grade.

Clasp dentures for class 4 defects have one saddle lying in front of the supporting teeth. The manufacture of prostheses for these defects requires a rigid connection of the clasps with the saddle. Since the clasp line can be the axis of rotation of the prosthesis, it is necessary to place clasps on all remaining teeth to prevent rotational movements. To reduce the torque, wide bases, ring clasps or rear-acting clasps are used.

Conclusion

In the final section of the work it is necessary to summarize the material presented.

The term “clasp dentures” defines those dentures that rely on natural teeth, alveolar processes, the body of the jaw, the palate, and transmit the chewing load through the mucous membrane of the prosthetic bed and the periodontium of the teeth.

The types of clasp dentures are as follows: simple clasp, complex clasp, splinting clasp, clasp with MK lock, solid clasp dentures on gold-platinum alloys.

The main feature of a clasp prosthesis is the presence of a metal arch connecting the left and right sides of the prosthesis. This arch passes either across the patient's palate (if it is a maxillary denture) or under the patient's lower teeth on the lingual side.

Its main function is to combine all the elements of the supported prosthesis.

The most favorable shape of the arch is oval, semicircular, semi-oval.

The variety of designs of clasp dentures is dictated primarily by the type of defect, then by the pliability of the mucous membrane, the number of supporting teeth, the type of prosthesis, etc.

Clasp dentures have a number of advantages over other dentures, these are:

The presence of an arc in clasp dentures strengthens it, and also distributes the load evenly between its sides;

Compared to complete removable dentures, this is a favorable factor, and strong fixation of the prosthesis speeds up the adaptation process.

List of used literature

1. Pyasetsky M.I. Prosthetics with clasp dentures. – Moscow: Medicine, 1985.

2. Sosnin G.P. Clasp dentures. – Minsk: Science and Technology, 1981.

3. http://www.32-zuba.ru

4. http://www.stomatolog.com.ua

5. http://www.zubok.ru