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Maxillary Major Connectors

Maxillary Major Connectors

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Maxillary Major Connectors

Six basic types of maxillary major connectors are

considered:

1. Single palatal strap

2. Combination anterior and posterior palatal strap- type

connector

3. Palatal plate-type connector

4. U-shaped palatal connector

5. Single palatal bar

6. Anterior-posterior palatal bars

➢It is located in the middle of the palate

➢ It does not cover the rugae area which

make it more tolerable to the patient.

Single palatal straps or middle palatal strap

➢It is a wide palatal strap, it could be made

wide to become thinner and helps in the

distribution of the mastication forces over a wide

area, and it is less objectionable by the patient.

➢ Anterior border follows the valleys between

rugae

Single palatal straps or middle palatal strap

• Strap should be 8 mm wide or as wide as the combined width of a maxillary

premolar and first molar.

• Confined within an area bounded by the four principal rests.

Indications:

Bilateral and unilateral edentulous spaces of short span in a tooth-

supported

restoration (CL III & CLIII mod 1).

Contraindications:1. Tooth- tissue supported removable partial denture (RPD).

2. Palatal torus.

3. Extremely long tooth supported edentulous space.

Advantages:1. Very simple design.

2. Anterior border is posterior to

rugae and Posterior border is well

anterior to the hamular notch

vibrating line.

3. Very few metal-tissue edges.

Disadvantage:It covers a considerable portion of

the palate.

Combination anterior and posterior

palatal strap type major connector

It is a rigid palatal major connector.

The anterior and posterior palatal strap

combination may be used in almost any

maxillary partial denture design.

forming a square or rectangular frame and

open in center portion.

➢ Relatively broad (8 to 10 mm)

anterior and posterior palatal

straps. A posterior palatal strap

should be flat and located as far

posterior as possible to avoid

interference with the tongue

but anterior to the line of

flexure formed by the junction

of the hard and soft palates.

➢ Lateral palatal straps (7

to 9 mm) narrow and

parallel to curve of arch;

minimum of 6 mm from

gingival crevices of

remaining teeth.

Indications:

1. In Class I and II arches in which excellent

abutment and residual ridge support exists, and direct

retention can be made adequate without the need for

indirect retention from palate (palatal plate).

2. Long edentulous spans in Class II mod. 1 arches.

Indications:

3. In Class IV arches in which anterior teeth must be

replaced with a removable partial denture.

4. Inoperable palatal tori that do not extend

posteriorly to the junction of the hard and soft

palates.

Contraindications:

The only condition preventing

their use is when there is an

inoperable maxillary torus that

extends posteriorly to the soft

palate.

Advantages:

It covers a minimum of palatal tissues.

Disadvantages:

1. Very complex design.

2. A lot of metal-tissue edges.

Palatal plate major connector (Anatomic

Replica):-➢ palatal plate are used to designate any thin,

broad, contoured palatal coverage

used as a maxillary major connector and covering

one half or more of the hard

palate .

➢ Anatomic replica form for full palatal metal

casting supported anteriorly by

positive rest seats.

Palatal plate major connector

(Anatomic Replica):-

➢ Palatal linguoplate supported anteriorly and

designed for the attachment of

acrylic resin extension posteriorly.

➢ Contacts all of the teeth remaining in the

arch.

➢ Posterior border: at the junction of the hard and soft palates;

It covers a wide area of the palate so it

contributes in the support and retention of the

prosthesis, this coverage permit a wide

distribution of the functional load with very

little movements from the base during

function thus reducing horizontal forces

which are highly destructive specially to

abutment.

➢ Anteriorly it could be with relief or

without relief when splinting of

anterior teeth is needed.

Shape: may be used in any one of three ways .

partial cast plate

Complete cast plate

in the form of an anterior palatal connector

with

a provision for extending an acrylic resin

denture base posteriorly.

Indications:-

1. In Class II arch with large posterior

modification space and some missing anterior

teeth.

2. When relining is anticipated or cost is a

factor.

3. In the absence of a pedunculated torus.

Indications:-

4. In most situations in which only some or all

anterior teeth remain.

5. When the last remaining abutment tooth on

either side of a Class I arch is the canine or first

premolar tooth, especially when the residual

ridges have undergone excessive vertical

resorption.

6. Patient with cleft palate to close any passage

nasal and oral cavities.

Contraindications:

When less than complete palatal coverage is necessary and there are

sufficient remaining natural teeth to use a palatal plate major connector.

Advantages:

1. It permits the making of a uniformly thin metal plate that reproduces

faithfully

the anatomic contours of the patient’s own palate. Its uniform thinness and

the thermal conductivity of the metal are designed to make the palatal

plate more readily acceptable to the tongue and underlying tissue.

Advantages:

2. The corrugation in the anatomic replica adds strength to

the casting; thus a thinner casting with adequate rigidity can

be made.

3. Surface irregularities are intentional rather than accidental;

therefore electrolytic polishing is all that is needed, the

original uniform thickness of the plastic pattern is thus

maintained.

Advantages:

4. By virtue of intimate contact, interfacial surface tension between metal and tissue provides the prosthesis with greater retention.

5. Easy to add prosthetic teeth to framework, and Can be easily converted to an interim complete denture.

Disadvantages:1. Covers more tooth and tissue surface than any other major connector.

2. Design difficulties:

a) The hamular notch vibrating line area must be located on the master cast.

b) Difficult to adjust the metal-tissue contact.

c) Difficult to reline the metal portion of the palatal contact.

4- U-shaped major connector (horse shoe

shaped) maxillary major connector:

From both the patient’s standpoint and a

mechanical standpoint, the shaped palatal

connector is the least desirable of maxillary major

connectors. It should never be used arbitrarily.

Indications:-

a- It is indicated when we have a large

palatal tours that might be extended

posteriorly (in operable tori).

b- Used in Cl I cases but rarely.

c- Class IV partially edentulous arch, a Class

III or Class III mod 1 partially edentulous

arch with an anterior edentulous space, where

cross-arch force distribution is not important.

Contraindications:

1. Where support, retention, bracing, and direct- indirect retention

from the palate is necessary

2. Where cross-arch force distribution is necessary.

Advantages:

1. Minimal coverage of the palate and fewer metal-tooth or tissue

edges than the AP design

2. Fairly simple design.

The disadvantages of this type:

1. It is flexible and not rigid (allows lateral flexure under occlusal

forces, which may induce torque or direct lateral force to abutment

teeth).

2. It has the disadvantages of being bulky for the tongue and thus

interferes with the phonetics causing this comfort to the patient, so it

is objectionable from both, the patients and mechanical stand point.

The disadvantages of this type:

3. Also (gingival irritation) the design may permit impingement

of tissues underline, its palatal border when subjected to occlusal

loads (fails to provide good support).

4. Movement may occur at the open ends.

5. Single palatal bars• To differentiate between a palatal bar and a

palatal strap, a palatal connector component less

than 8 mm in width is referred to as a bar

• Its cross section must be made bulky to obtain

rigidity required for cross arch stabilization. This

bulky cross section may make it objectionable

by the patient’s tongue so it is either be too

flexible or too objectionable to the patient.

5. Single palatal bars

• It is use in a tooth born unilateral or

bilateral limited spaces for cross

arch stabilization.

• The decision to use a single palatal

bar instead of a strap should be based

on the size of the denture-bearing

areas.

Advantages:-

It's tolerated by tongue.

The anterior component is a flat bar

located as far as possible from the

rugae area and tongue interference (6

mm away from gingival margins)

while the posterior bar is a half oval in

cross section located as far as possible.

6. Combination interior and posterior palatal Bar

Type

The anterior and posterior part are connected by two

lingual elements along the lateral slopes of palate giving

a circular configuration provides rigidity..

To be sufficiently rigid and to provide the needed support

and stability, these connectors could be too bulky and

could interfere with tongue function.

Combination interior and posterior palatal Bar

Type

Advantages:

Strong.

Limited soft tissue coverage.

Disadvantages:

Limited support from the palate.

Uncomfortable as it has multiple

borders.

Selection of the type of connector(s) is based on four

factors:

1. mouth comfort

2. rigidity

3. location of denture bases

4. indirect retention.

❖ Connectors should be of minimum bulk and

should be positioned so that interference with the

tongue during speech and mastication is not

encountered.

❖ Connectors must have a maximum of rigidity to

distribute stress bilaterally.

Quiz

Major Connector must be Rigid or

Flexible, and why?

Mandibular Major Connectors

1. Lingual bar.

2. Linguoplate.

3. Sublingual bar.

4. Lingual bar with cingulum

bar (continuous bar).

5. Cingulum bar (continuous

bar).

6. Labial bar.

Note

• The lingual bar and the linguoplate are by far the most common

major connectors used in mandibular removable partial

dentures.

1. Lingual Bar

• Characteristics and location:-

Half-pear shaped with bulkiest portion inferiorly located.

The superior border of a lingual bar connector should be tapered toward the gingival tissue superiorly with its greatest bulk at the inferior border.

The superior border should be at located 3-4mm away from the gingival margin & more if possible to prevent blood constriction.

1. Lingual Bar

Characteristics and location:-

Half-pear shaped with bulkiest portion inferiorly located. The inferior border of

the lingual bar should be slightly rounded. A rounded border will not impinge on

the lingual tissue when the denture bases rotate inferiorly under occlusal loads.

Inferior border located at the ascertained height of the alveolar lingual sulcus

when the patient's tongue is slightly elevated.

Frequently, additional bulk is necessary to provide rigidity, particularly when the

bar is long or when a less rigid alloy is used.

Two clinically acceptable methods may be used to determine

the relative height of the floor of the mouth and locate the

inferior border of a lingual mandibular major connector:-

1- The first method is to measure the height

of the floor of the mouth in relation to the

lingual gingival margins of adjacent teeth

with a periodontal probe. When these

measurements are taken, the tip of the

patient’s tongue should just lightly touch

the vermilion border of the upper lip.

Recording of these measurements permits

their transfer to both diagnostic and master

casts.

Two clinically acceptable methods may be used to determine

the relative height of the floor of the mouth and locate the

inferior border of a lingual mandibular major connector:-

2- The second method is to use an

individualized impression tray for which

lingual borders are 3 mm short of the elevated

floor of the mouth, and then to use an

impression material that will permit the

impression to be accurately molded. The

inferior border of the planned major connector

can then be located at the height of the lingual

sulcus of the cast resulting from such an

impression.

➢Indications:

• The lingual bar should be used for mandibular

removable partial dentures where sufficient space

exists between the slightly elevated alveolar lingual

sulcus and the lingual gingival tissue (at least 8

mm).

• Diastemas or open cervical embrasures of anterior

teeth.

• Overlapped anterior teeth.

➢Contraindications:

• Less than 8mm between the marginal gingival & the activated

lingual frenum & floor of the mouth.

• Only few remaining anterior teeth which must be contacted to

provide a reference for fitting the framework & indirect retention.

And when the future replacement of one or more incisor teeth

➢Contraindications:

• Lingually inclined teeth.

• An undercut lingual alveolar ridge which would result in an

excessive space between the bar & the mucosa.

➢Advantages:

• Covers a minimum of surface area of teeth & tissue therefore

the potential for caries, periodontal & mucositis caused by plaque

being held in contact with teeth & tissues is minimal.

• Esthetic.

➢Disadvantages:

• Less rigidity compared with other types.

• Difficult to add additional prosthetic teeth to framework.

2- Linguoplate

Characteristics and location:-

• Half-pear shaped.

• thin ,follow the contours of the teeth and the

embrasures.

• Thin metal apron extending superiorly to

contact cingula.

• Apron extended interproximally to the height

of contact points (closing interproximal

spaces).

➢ Indications:-

• When the lingual frenum is high or the space

available for a lingual bar is limited (less than 8

mm).

• Class I arch have undergone such vertical

resorption.

➢ Indications:-

• For using periodontally weakened teeth in group

function to furnish support to the prosthesis and to

help resist horizontal rotation of the distal extension

type of denture.

• When the future replacement of one or more

incisor teeth will be facilitated by the addition of

retention loops to an existing linguoplate

➢ Contraindications:-

• Overlapped anterior teeth, that leads to

small gaps between the superior edge

of the plate and the teeth.

• Lingually inclined teeth.

• Diastemas, unless the lingual plate can

have slots in it to avoid the displayed

metal (interrupted lingual plate).

➢Advantages:

• Structurally simple & rigidity more than a lingual

bar.

• Easy to add additional prosthetic teeth to

framework.

➢Disadvantages:• Covers more tissue surface & teeth than lingual bar.

• May be more noticeable to patient than lingual bar.

3- Lingual bar with continuous bar indirect retainer

• Lower part, Conventionally shaped and

located same as lingual bar major

connector component when possible.

• Upper part, Thin, narrow (3mm) metal

strap located on cingula of anterior teeth,

scalloped to follow interproximal

embrasures with inferior and superior

borders tapered to tooth surfaces.

3- Lingual bar with continuous bar indirect retainer

• Originates bilaterally from incisal,

lingual, or occlusal rests of adjacent

principal abutments.

➢ Indications:

When a linguoplate is otherwise indicated but the

open cervical embrasures of anterior teeth and a

linguoplate would objectionably display metal in a

frontal view.

➢ Contraindications:-

• lingually inclined teeth.

• Where a lingual bar or lingual plate will suffice.

• wide diastemata

• Advantages:

• More rigid than lingual bar.

• Covers less tooth & tissue surface than lingual plate.

Disadvantages:• Very complex design.

• May be objectionable to patient because there are four

edges exposed to the tip of the tongue.

• Potential food traps between two bars.

4- Cingulum Bar (Continuous Bar)

• Thin, narrow (3 mm) metal strap located on

cingula of anterior teeth, scalloped to follow

interproximal embrasures with inferior and

superior borders tapered to tooth surfaces.

• Originates bilaterally from incisal, lingual, or

occlusal rests of adjacent principal

abutments.

➢ Indications:-

• When a linguoplate is the major

connector of choice, but the axial

alignment of the anterior teeth is such

that excessive block out of

interproximal undercuts must be

made, a cingulum bar may be

considered.

• .

➢ Indications:-

• Height of activated lingual frenum and

floor of the mouth at the same level as

marginal gingiva.

• Inoperable tori or exostosis at the same

level as the marginal gingiva.

• Severely undercut lingual alveolus.

5- Sublingual Bar

modification of the lingual bar that has

been demonstrated to be useful when the

height of the floor of the mouth does not

allow placement of the superior border of

the bar at least 4 mm below the free

gingival margin.

5- Sublingual Bar

The sublingual bar is essentially the

same half-pear shape as a lingual bar,

except that the bulkiest portion is

located to the lingual and the tapered portion is toward the labial.

➢Indications:

• The sublingual bar should be used for mandibular removable

partial dentures when the height of the floor of the mouth in

relation to the free gingival margins will be less than 6 mm.

➢Contraindications:

1. Interfering with lingual tori.

2. High attachment of lingual frenum.

3. Interference with elevation of the floor of the mouth during

functional movements.

➢Advantages:

• It doesn't contact anterior teeth or lingual

alveolus.

• More esthetic than other lingual major

connectors because of its location.

• More rigid than lingual bar because the metal is

bulk horizontally rather than vertically.

➢Disadvantages:

• Require border molded impression of floor of

mouth for accurate placement of major

connector.

• Difficult to add prosthetic teeth.

• Most patients prefer a lingual plate to a

sublingual bar.

6- Labial bar

• Half-pear shaped with bulkiest portion

inferiorly located on the labial and

buccal aspects of the mandible.

• Superior border tapered to soft

tissue.located at least 4 mm inferior to

labial and buccal gingival margins and

more if possible.

6- Labial bar

• Inferior border located in the labial-

buccal vestibule at the junction of

attached (immobile) and unattached

(mobile) mucosa.

➢ Indications:

• lingual inclinations of remaining

mandibular premolar and incisor teeth

cannot be corrected.

• severe lingual tori cannot be removed

and prevent the use of a lingual bar or

lingual plate major connector.

• severe and abrupt lingual tissue

undercuts

➢ Contraindications:

• Facial tori.

• The facial alveolar ridge is undercut.

• High facial muscle attachments

which would result in less than 3mm

of space between the superior edge

of the labial bar & the marginal

gingival of the teeth.

➢Indication:

1. Missing key abutments: (such

as, a canine).

2. Unfavorable tooth contours

3. Unfavorable soft tissue contours

4. Teeth with questionable

prognoses.

➢Contraindications:

• Poor oral hygiene or lack of

motivation for plaque control by

the patient.

• Presence of a shallow buccal or

labial vestibule or a high frenal

attachment.