MAJOR AND MINOR CONNECTORS

INTRODUCTION Major connector may be compared with the frame of an automobile or with the foundation of a building. The design

details are fundamentals to all major connectors. The importance of each requirement depends on the type of partially edentulous arch that it being treated. Therefore the type of major connector is selected on the basis of individual needs.

Minor connectors are the connecting link between the major connector and base of a removable partial denture and the other units of the prosthesis

COMPONENTS OF A REMOVABLE PARTIAL DENTURE It has the following components namely Major connectors Minor connectors
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 Rests Direct retainer Indirect retainer One or more denture bases and replacement teeth DEFINITION Major connector is that part of an RPD that connect the parts of the prosthesis located on one side of the arch with those on the opposite side. directly or indirectly. All other parts are attached to it either

REQUIREMENTS All major connectors must Be rigid Protect the gingiva and soft tissues Provide vertical support. Provide indirect retention when intended. Provide an opportunity of positioning dentures bases where needed. Maintain patient comfort, Speech or phonetics

MAXILLARY Two types of major connector MANDIBULAR

MAXILLARY MAJOR CONNECTORS All maxillary major connector borders that contact soft tissues have a specially prepared seal or bonding.

Beading scribed on the surface of the master cast before duplication in investment material Prepared instrument Depth and width of 0.5 to 1.0mm. Fades out approximately 6mm from gingival margin Prevents food debris under the connector and provides excellent finish line Enhances retention and stability with a small spoon excavator or a cleiod

TYPES OF MAXILLARY MAJOR CONNECTOR Single posterior palatal bar Palatal strap Anteroposterior, or double palatal bar Horseshoe or U- shaped Closed horseshoe or anteroposterior palatal strap Complete palate

1. SINGLE POSTERIOR PALATAL BAR Is a narrow half-oval with its thickest point at the centre Bar is gently curved and should not form a sharp angle at the juncture with the denture base

Advantages: Used as an interim partial denture until a definitive treatment can be rendered. Disadvantages Most difficult for the patients to adjust

 Derives little support from bony palate limited in replacing one or two teeth on each side of the arch Teeth should be present anterior and posterior to the edentulous spaces. Not placed anterior to the 2 n d premolar because it interferes with tongue action. Should never be used in distal extension cases or used when anterior teeth replacement.

2.

PALATAL

STRAP :

(most

versatile

maxillary

major

connector) Consists of a wide, thin band of metal that crosses the palate in an unobtrusive manner. Width should not be less than 8mm, otherwise its rigidity is compromised. Width increases as the edentulous space increase in length.

 Wide palatal strap may be used for a unilateral distal extension cases, rarely used in a bilateral situation.

Advantages Since it is located in 3 planes, if offers great resistance to bending and twisting forces Increased patient comfort and less interference to tongue action. Distribute stress over a broad area Enhances retention Disadvantages Excessive palatal coverage Adverse tissue reaction- papillary hyperplasia

3. DOUBLE PALATAL BAR Is a rigid major connector that receives little vertical support form hard palate. Flat anterior bar is narrower than palatal strap and positioned in the valleys between the rugae. Posterior bar is half-oval and less bulky
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 Two bars are joined by flat longitudinal elements on each side of the lateral slopes of the palate. Two bars produce a strong L-beam effect.

Advantages Most rigid maxillary major connector. Used when anterior and posterior abutments are widely separated In cases of large palatal tori present this is major connector of choice.

Disadvantages Derives little from the bony palate. Cannot use in cases where periodontal health of the remaining teeth is reduced. Cannot use in high narrow palate. Borders of bar often irritates tongue action.

4. HORSE-SHOE OR U-SHAPED CONNECTOR

 Consists of a thin band of metal extending over the lingual surface of teeth and then on the palatal tissue upto 6-8mm (covers rugae area). Lateral palatal borders should be at the junction of vertical and horizontal slopes. Connector should be symmetric with the palatal borders extending into same height on both sides.

Advantages Useful for replacement of anterior teeth. Can be used in conditions of inoperable tori or the presence of hard median suture.

Disadvantages Tends of spread apart as force applied to artificial teethcan damage the abutment teeth. Cannot use in distal extension cases, if where cross arch stabilization is required.

5.

CLOSED

HORSE

SHOE

OR

ANTEREOPOSTERIOR

PALATAL STRAP : Is a rigid major connector that is indicated for class I or II arches when anterior teeth to be replaced and tori is present. Borders are kept 6mm away from gingival margin or extended on to gingival surfaces of the teeth. If anterior teeth not be replaced the anterior strap should not cover the rugae area. Posterior strap should be as posterior as possible not contacting the soft palate.

Advantages The circle effect of the anterior and posterior straps provides rigidity of a definite L-beam effect.

Disadvantages

 Interferences in speech/phonetics causes discomfort for some patients.

6. COMPLETE PALATE Most rigid major connector when maximum support from palate is needed. Connector can be made in 3 forms

i) All acrylic resin - entire connector is made of acrylic ii) Combination of metal and acrylic resin Anterior portion covering rugae in metal Posteriorly covered by acrylic to the junction of hard and soft palate iii) All cast metal: - entire palate covered by a thin metal casting.

Advantages Indicated when posterior teeth to be replaced bilaterally, and when anterior teeth require replacement with

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bilaterally,

and

also

when

anterior

teeth

require

replacement with bilateral distal extension cases In individuals with well developed muscles of

mastication and full set of lower teeth present. When flat ridges or a shallow vault present provides best stabilization. In cleft patients cast complete palate is most often the connector of choice. They enhance transfer of temperature changes to produce more natural sensation during eating and drinking.

Disadvantages Adverse soft tissue reaction in the form of inflammation or hyperplasia. Occasional problem with phonetics encountered. DESIGN In 1953 , Blaterfein described a systematic approach in designing. It involves 5 basic steps which is applicable in most cases. They are: Outline of primary bearing areas
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 Outline of nonbearing areas Outline of strap areas Selection of strap areas Unification STRUCTURAL REQUIREMENTS Borders are placed a minimum of 6mm from gingival Margin or positioned on the lingual surfaces of the teeth. Relief normally not required, is directly proportional in displace ability of tissues. Anterior borders follow the valleys between the crests of rugae Posterior component is half-oval in AP palatal bar or a closed horse shoe; or strap-like should have a minimal width of 8mm. All borders should taper towards the soft tissue Anterior/Posterior border should cross the midline at right angels, never diagonally The lateral borders are positioned at the junction of the vertical and horizontal surfaces of the palate.

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 Thickness of metal should be uniform throughout the palate. The finished borders of metal should be gently curved, never angular. Metal should be smooth but never polished on tissue side. The borders of the soft tissue are beaded.

INDICATIONS If periodontal support of remaining teeth is weak a wide palatal strap or a complete palate indicated. If remaining teeth has adequate periodontal support a palatal strap or double palatal bar indicated. For long-span distal extension bases a closed horseshoe or complete palate indicated. When anterior teeth must be replaced horseshoe, closed horseshoe or complete palate indicated. If torus present and not removed a horse shoe closed horseshoe or AP palatal bar may be used. MANDIBULAR MAJOR CONNECTORS
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TYPES 1. Lingual bar 2. Lingual plate 3. Double lingual bar of Kennedy bar 4. Labial bar.

LINGUAL BAR :- Most frequently used due to its simplicity. Characteristic features and location Half-pear shaped with bulkiest portion inferiorly located Superior border tapered to soft tissue 4mm inferior to gingival margins. Inferior border located at the ascertained height of the alveolar lingual sulcus when the patients tongue is slightly elevated. Two clinically acceptable method to determine the relative height of floor of the mouth to locate the inferior border. In 1 s t method, patients tongue tip touches the upper vermillion border which raises the anterior floor of mouth. Then a periodontal probe is used to measure lingual to canines and between the central incisors. The readings are

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taken at the most inferior point of the gingival tissues. The readings are transferred to the diagnostic/master cast. In 2 n d method, individualized impression tray having

lingual borders about 3mm short of the elevated floor of mouth of an impression is made as a patient licks the lips. The inferior border can then be located at the height of lingual sulcus on the resulting cast.

Indications When sufficient space exists between elevated alveolar lingual sulcus of the lingual gingival tissue.

Block out and relief - All tissue undercuts parallel to path of placement and additional 32- gauge wax sheet to block out lingual undercuts. - One thickness of base plate wax over basal seat areas.

Working specifications

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 6 gauge, half- pear shaped wax, reinforced by 22-24guage sheet wax, cross sectional shape unchanged.

Finishing lines Butt-type joints with minor connectors for retention of denture bases.

Modification: Sublingual bar Bar remains the same as lingual bar, but placement is inferior and posterior lying over and parallel to the anterior floor of the mouth Used along with a lingual plate if the lingual frenum does not interfereor in the prescence of an anterior lingual undercut Contraindicated in lingual tori present, high lingual frenal attachment and high elevation of mouth during functional movements

LINGUAL PLATE Characteristics and location

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 Half-pear shaped with bulkiest portion located inferiorly. Thin metal apron extending superiorly to contact cingula of the anterior teeth and lingual surfaces of posterior teeth at their height of contour. Apron extended interproximaly to height of contour closing interproximal spaces. Superior border finished to continuous plane with

contacted teeth. Inferior border at the ascertained height of lingual sulcus when patients tongue elevated slightly.

Indications inadequate lingual space present high lingual frenum present class I arch with vertical resorption of ridge offering little resistance to horizontal rotations future replacement of one or more incisor teeth to an existing linguoplate

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Blockout and relief All undercuts of contacted teeth, gingival crevices,

parallel to the path of placement

Waxing specifications Inferior border -6-guage half pear shaped reinforced with 24-guage wax sheet. Apron 24 guage wax sheet.

Finishing lines : - Butt-type joint with minor connector for retention of denture bases. Modifications In wide spacing/diastemas or large interproximal

embrasures a series of step-backs of lingual plate design effectively prevent unnecessary metal display Incisal rests added to mandibular anterior teeth to prevent over eruption of these teeth.

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DOUBLE LINGUAL BAR OR KENNEDY BAR Characteristics and location The lower bar is same as lingual bar It differs from lingual plate in that it has no sheet of metal extending from below the superior border of the plate to the pear-shaped lingual bar. Thin, narrow (3mm) metal strap located on cingula of anterior teeth, scalloped to follow inter proximal

embrasures with inferior and superior borders tapered to tooth surfaces. Originates bilaterally from incisal, lingual or occlusal rests of adjacent principal abutments.

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Indications When excessive blackout of inter proximal undercuts required in lingual plate. When wide diastemas exist between mandibular anterior teeth.

Block out and relief Lingual surface of alveolar ridge and basal seat areas. No relief for continuous bar retainer except blockout of inter proximal spaces parallel to path of placement.

Working specifications 6-guage half pear wax reinforced with 24-guage 2 strips (3mm) of 28-guage wax sheet over the cingula and into inter proximal embrasures.

Modifications A step-back can be designed for upper bar of double lingual bar if anterior teeth are spaced widely.

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 Minor connector joining upper bar to lower bar must be rigid and positioned in interproximal spaces usually

between canine and 1 s t premolar. Rests placed at each end of upper bar no farther posterior than mesial fossae of 1 s t premolar to prevent orthodontic movement of anterior teeth.

LABIAL BAR Characteristics of location Half pear shaped with bulkiest portion inferiorly located on the labial or buccal aspects. Superior border located 4mm inferior to buccal or labial gingival margins and tappered to soft tissue. Labial border located at the juncture of attached and unattached mucosa.

Block out and relief - All tissue undercuts blocked parallel to path of placement.

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Waxing specifications 6-guage half-pear shaped reinforced with 22-24-guage wax sheet, cross-sectional shape unchanged. Minor connectors joined with superior and base

components by a labial or buccal approach.

Modifications * Hinged labial arm of swing lock is less bulky. * Swing lock partial denture is a variation of labial bar.

Design A systematic approach to designing lingual bar and lingual plate connectors are Outline of the basal seat areas on the diagnostic cast Outline of the inferior border of the major connector Outline of the superior border of the major connector Unification

STRUCTURAL REQUIREMENTS
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 They are relatively long and narrow because of space limitations. Relief is routinely required between connector and soft tissue, especially for distal extension partial dentures because it tends to rotate during function. Beading is never indicated.

INDICATIONS For tooth-supported RPD- Lingual bar is the choice. For long span edentulous ridge with no posterior abutment teeth and indirect retention required- lingual plate is the choice. Anterior teeth with reduced periodontal support Lingual plate or double lingual bar used. When floor of mouth are active with less then 8mm available, high lingual frenum with inoperable lingual tori is present lingual plate used. Large anterior interproximal spaces / diastemas -double lingual bar indicated.
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MINOR CONNECTORS Minor connector (gpt-7) The connecting link between the major connector and base of a removable partial denture and the other units of the prosthesis, such as the class assembly, indirect retainers, occlusal rests or cingulum rests.

Functions The primary function is to join other units of the prosthesis such as clasps, rests, indirect retainers and denture bases to the major connector. It distributes the stresses that occur against certain

components of the partial denture to other components.

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Types There are four types. They are which Join the clasp assembly to the major connector Join indirect retainers or auxiliary rests to the major connector Join the denture base to the major connector Serve as an approach arm for a vertical projection or bartype clasp I. Join the clasp assembly to the major connector 1. It should be rigid as it supports the Active component of the prosthesis Component of the prosthesis which prevents the vertical movement toward the tissue, the rest. It should be sufficiently bulk to be rigid 2. Minor connectors that support the clasp assembly are located on proximal surfaces of teeth adjacent to edentulous area. They are broad buccolingually and thin mesiodistally. The thickest portion buccolingually is at the lingual line angle of

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the tooth and it taper evenly to its thinnest point at the buccal line angle of the tooth. 3. Minor connector is sometimes placed in the embrasure between two teeth, using the triangular space to give bulk for the minor connector. 4. It is never placed on the convex lingual surface of the tooth.

II. Join indirect retainers or auxiliary rests to the major connector It arises from the major connector. It forms a right angle junction with smooth curve and beveled where it contacts the tongue. The relief is given for marginal gingiva. III. Join the denture base to the major connector Minor connectors that join the denture base to the major connector may be Lattice work construction Mesh construction Beads, wire or nail-head minor connectors

Requirements

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 Strong enough to anchor the denture base secure Rigid enough to resist breakage or flexing It should not interfere with arrangement of artificial teeth In class I situation the minor connector extends to the entire length of the residual ridge to cover the tuberosity in maxilla and it extends two-thirds the length of the edentulous ridge in mandibular arch.

I. Lattice work construction It consists of two struts of metal 12 16 gauge thick extending longitudinally along the edentulous mandibular arch, positioned buccal and lingual to the ridge crest (not on the ridge to avoid interference with artificial teeth placement).

In the maxillary arch the lingual strut is replaced by the border of the major connector. Smaller struts 16-gauge thick connects the struts and forms the lattice work. One smaller strut between each tooth is recommended.

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Placing the longitudinal strut will interfere with the placement of artificial teeth and fracture of denture base is a common finding.

The space formed between the struts or mesh and the underlying ridge due to provision of relief space will be filled by the acrylic denture base and the locking mechanism of the acrylic resin around and through the lattice work provides the retention.

Advantages It is used when multiple teeth are to replaced It provides the strongest attachment Easiest denture base retainer to reline Gives more space for placement of artificial teeth Recommended for routine use

II. Mesh construction It is a thin sheet of metal with multiple small holes that extends over the crest of the residual ridge. Used when multiple teeth are used
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 Used only when abundant inter ridge space is available (as it is bulkier)

Disadvantages It does not provide strong attachment (smaller the openings weaker the attachment) It needs more pressure while packing the resin

Tissue stops A provision made to stabilize the frame work during the acrylic resin packing and processing procedure It is made by removing approximately 2 sqmm of the relief wax (used to create space between lattice and edentulous ridge) at a point where the posterior end of the minor connector crosses the center of the ridge During waxing of the framework the depression is waxed as a projection and in the framework after casting the projection contact the cast and it prevents the distortion of framework during resin packing.

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III. Bead, wire, nail head retention minor connectors It is used with metal denture base which fits directly to the ridge without relief.

The denture base is attached only on the outer or superior surface and the retention is gained by beads (acrylic beads waxed, invested, burned out and casting these beads) wire projecting from metal base, nail heads.

Advantages Hygienic due to better soft tissue response

Disadvantages Difficult to reline Weakest attachment Indication Used on tooth supported, well healed ridges when the interarch is limited and acrylic resin is not sufficient to withstand the forces of occlusion.

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Attachment to major connector It should be bulk at the joint (to avoid breakage due to occlusal forces) It should be as smooth joint and a butt joint

These butt joints are called finish lines. It is classified into External finish line Internal finish line

a. Internal finish line The relief wax usually 24 26 gauge creates the space that is needed for the acrylic resin denture base under lattice work or mesh minor connectors.

Too much metal thinning is also avoided The margins of the relief wax become the internal finish line. The ledge created by the margin of the wax must be sharp and definite.

b. External finish line

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It is sharp, definite and should be slightly undercut to help lock the acrylic resin securely to the major connector. The finish line is less than 90 0 .

It is formed by placement of the wax during the waxing and carving procedure.

It begins at the lingual extent of the rest seat and continues down the lingual aspect of the minor connector on the proximal surface of the tooth. It has to avoid metal fracture or overlapping feather edge of acrylic.

IV. Serve as an approach arm for a vertical projection or bartype clasp It supports a direct retainer which is gingivally approaching It is not required to be rigid (rigidity is needed for bracing) It should have a smooth, even taper from its origin to its terminus. It must not cross a soft tissue undercut.

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 The flexibility of the clasp depends on taper and length of approach arm (increased length, increased taper

increased flexibility) One tooth extension base is not recommended The approach arm extends up to the height of contour on the abutment teeth

REFERENCES 1. Clinical removable partial, prosthodontics 2 n d Edition K.L. Stewart, K.P. Rudd & William A. Kubekar. Pg:19-42. 2. Mc Crakens removable partial prosthodontics, 8 t h edition. G.P. McGiveney , D.J. Castleberry. 3. Removable partial prosthodontics, 2 n d Edition, EL miller, JE Grasio 4. Advanced removable partial dentures. JS Brudvik, Quintessence publishing co.

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