INTRODUCTION

The desire to balance between functional stability and cosmetic appeal in partial dentures gave rise to the development of Precision Attachments, since then, Precision Attachments have always be surrounded by an aura of mystery. The use of Precision Attachments for partial denture retention is a practice builder for the better class of dentistry and helps to elevate the general standard of partial denture prosthetics. This work is not given with the idea of discrediting the usual type of partial denture work, which of necessity, must be used principally because of economic reasons. But it is presented with a feeling it is the finest that can be given in partial denture construction. The precision attachment is sometimes said to be a connecting link between the fixed and the removable type of partial denture because it incorporates features common to both types of construction. According to GPT ! a Precision Attachment is" #. A retainer consisting of a metal receptacle $matrix% and a closely fitting part $patrix%& the matrix is usually contained within normal or expanded contours of the crown on the abutment tooth and the patrix is attached to a pontic or the removable partial denture framework. 'r (. An interlocking device, one component of which is fixed to an abutment or abutments, and the other is integrated into a removable prosthesis to stabili)e and*or retain it.

+re,uently used synonyms are -internal attachment., -frictional attachment., -slotted attachment., -/ey*key way attachment. and -parallel attachment.. The precision attachment is constructed out of several materials and as the terminology implies, the fit of the two working elements is machined to very close tolerances, hence is more precise in construction than is the typical laboratory fabricated attachment. The male portion also called as 0rest1, 0key1 or 0patrix1 most often takes the shape of a -T. or -2. which fits an appropriately shaped slot. The female attachment also called as 0rest seat1, 0key way1 or 0matrix1 is fitted into the restoration in the tooth either by casting the gold to it or by placing it in a prepared receptacle in the restoration and attaching the two together with solder. As with the direct retainer, a Precision Attachment must provide" #. Support 3 4esistance to movement of the prosthesis toward the tissue. (. Retention 3 4esistance to movement of the prosthesis away from the tissue. 5. Reciprocation 3 6ounteraction of the forces exerted by the retentive component. 7. Stabilization 3 4esistance to hori)ontal movement of the prosthesis and

8. Fixation 3 4esistance to movement of the abutment tooth away from the prosthesis and movement of the prosthesis away from the tooth. The precision attachment system is the only type of intracoronal attachment that provides for all three functions of a removable partial denture retainer system" 9ateral force transmission or bracing from the parallel proximal walls of the rest against the rest seat. 'cclusal force transmission or support from the flat gingival floor of the rest on the rest seat and Primary retention from the frictional fit between the rest and rest seat. The precision attachment derives its functional through closely fitting, coupling parts.

DEVELOPMENT OF PRECISION ATTACHMENTS

Prior to the manufacturing of attachments, the early attachments were bent, cut, and soldered into shape by their inventors such as :vans, Parr, Peeso, 4oach, ;organ and 6hayes. The materials employed were gold, platinum and iridioplatinum. <ome of these early intracoronal retainers were named the split bar attachment, tube and split post attachment, solid post and tube attachment, and the winged lug attachment.

Figure 1. =inged lug attachment. The male part is made by doubling on itself a strip of clasp gold gauge no. ((. The female box is made out of platinum gauge no. 7>. The box is inserted into an inlay. An oval shaped plate made out of 5? or 5> gauge platinum. (( carat gold is soldered occlusally on top of the male to prevent food entrapment between the male and female parts. The 4oach Attachment is among the earliest of manufactured attachments. @t is an extracoronal type of device based on the ball and socket principle.

Figure 2. The 4oach attachment an extracoronal type of attachment. Ar. Parr1s removable bridge used a socket attachment at either end. @t was retained by male members fitted into sockets, which were soldered to gold crowns.

Figure 3. Ar. Parr1s movable removable type of bridge retained by male members $B% fitting into female sockets $A%.

Figure 4. Ar. Parr1s bridge in place in the mouth Ar. B.G. ;orey in #??! originated a removable bar bridge attachment. The Gilmore attachment is another bar type attachment. Both types have a section on the removable denture that fits over the bar for retention. Gollobin and Bernstein devised the split bar bridge attachment consisting of a manufactured iridioplatinum split bar with a C shaped flange that fits into a similarly shaped platinum box.

Figure 5. Gollobin and Bernstein1s split bar bridge attachment. Peeso constructed a removable bridge employing the split pin and tube attachment anteriorly with removable telescope crowns posteriorly.

Figure 6. The split post and bar attachment. The ;organ attachment consists of a flattened loop of clasp metal $the keeper% into which fits a two winged section $the anchor%. The keeper is soldered to the abutment restoration.

Figure 7. The ;organ attachment. A precursor of the 6hayes attachment employing a paralleling Eig to parallel and hold the attachments in position while being soldered to the abutment castings. The most important character in the development of precision attachment in dentistry was Ar. 2erman :.<. 6hayes. The 6hayes attachment was originally called bucco lingual attachment. @t was formed from a rectangular box of platinum called the hood with a slot in the side facing the bridge. The anchorage or friction section fits into the hood. The Precision Attachments designed by 6hayes in #F>D are still produced and utili)ed today.

Figure 8. Arawing of an original 6hayes attachment, b. Gey 6hayes attachment, the modern e,uivalent of the original 6hayes attachment.

CLASSIFICATION
@s based to provide an overview of the designs available and to identify the common feature of each class. Precision Attachments may be classified as 0intracoronal1 or 0extra coronal1. An intracoronal attachment is one that is contained within the contours of the crown of the tooth, whereas the extracoronal type may be all or partly contained outside the confines of the crown. The usual reasons for employing the extracoronal type is either that the crown of the tooth is too small to accomodate all of the receptacle or that the pulp of the tooth is so large

that it might be encroached upon by an attachment which was completely housed within the crown. The extracoronal type of retainer often has built into it a movable Eoint of one type or another which permits the base to move independently of the retainer. Geither type of attachment is applicable to all circumstances. <election of an intra coronal or extra coronal attachment is based on design considerations for the prosthesis and the anatomic morphology, location and position of the abutment tooth. @ntra coronal attachments have the advantages of maintaining forces more in line with the long axis of the tooth and having a more desirable resistance to vertical and lateral forces. I) INTRACORONAL ATTACHMENTS This class includes the largest number of attachments. @ntracoronal attachments may be subdivided into two groups to reflect the type of retentive mechanism used to hold the parts together. They are " #% +rictional, with designs that include tapered and parallel walled boxes and tubes, adEustable metal plates, springs, studs, or locks& and (% ;agnetic.

1. FRICTIONAL Tapered and parallel-walled boxe and !"be . These attachments are

designed to Eoin sections of a fixed partial denture. They can be made individually by a dental technician who prepares a deep interproximal occlusal rest or box within the wax pattern of a crown. After the crown is cast, the male section of the attachment is made by flowing wax into the box and this wax pattern is Eoined to the wax pattern of the adEacent crown or pontic. @t is possible to buy plastic prefabricated patterns that can be incorporated into the wax pattern of the fixed partial denture or splint.

Figure 1. Prefabricated patterns. A. @nternal walls of female part (a) are tapered to accommodate male part (b) when assembled. . =alls of male (a) and female (b) parts are parallel.

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The tapered varieties are the simplest of the intra coronal attachments and like a deep occlusal rest, they provide vertical support and lateral stabili)ation. Ad#" !able $e!al pla!e These attachments are similar to the rectangular block and box variety, but are made so that friction between the parts can be increased. A narrow slit is provided in the metal block or male part of the attachment. This slit can be widened with a scalpel blade to enlarge the block and enhance the friction against the sides of the box. This provides a simple but effective form of direct retention" :xamples are 3 ;c 6ollum 6rismani <tern Attachments and 6hayes or Gey Attachments The length of the slit within the block influences the resiliency of the retaining mechanism so that at least (.8mm of tooth height is re,uired to accommodate them. There is a limit to the movement and durability of the metal and eventually these attachments succumb to fatigue.

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Spr%n& <ome manufacturers consider it more efficient to include a small spring within the metal block to control the friction between the male and female parts. The spring activates a plunger rod that protrudes from the block to engage a depression in the wall of the box and it can be replaced when it deteriorates eg" <chat)mann attachment. Approximately 7 8mm of vertical height is re,uired between the occlusal surface and the gingival crest to accommodate these more complex attachments.

Figure 2. A. AdEustable metal plates. ;c6ollum attachment in which width of slit in metal block $b% can be adEusted to increase frictional contact against sides of box $a%. B. <prings. <chat)mann attachment has a male part $a% that contains a spring loaded $b% rod $c%, retained by a threaded ring $not shown%, to engage a hollow within female part $d% when assembled. S!"d Another form of direct retention for a removable partial denture or overdenture is obtained by using a stud that clips into a flexible ring. A metallic stud can be soldered to a post and core and cemented into an abutment tooth,

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while the ring is contained within a cavity in the denture base :gs" 6eka attachment and the Gerber or 4otherman attachments.

Figure 3. <tuds. A. 6eka attachment in which metallic male stud $a% is attached to a cast post and core. +emale part $b% is contained within denture base. B. Hest Anchor attachment has a metallic tube $a% inserted into root canal and a plastic stud and spacer $b% attached to denture base. <pacer is removed to permit movement of assembled attachment. The ring may be adEusted to grip the stud or the head of the stud may have two intersecting slits to increase its circumference, the stud or the ring are replaced when they are no longer resilient. The height of the stud should not interfere with the arrangement of the artificial teeth on the denture and when vertical space is small, the 4otherman attachment, with a height of #.Dmm is particularly useful. A stud attachment is available that can be assembled directly in the mouth without using a cast post and core. @t consists of a metallic funnel shaped tube that is cemented into the root canal of a tooth and a polyethylene stud that is attached to the denture base. The head of the stud s,uee)es past a

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constriction in the neck of the funnel to retain the denture on the tooth and it can be replaced easily when necessary. Lo'( @t is possible to obtain a device with parts that lock rigidly together eg" the T block attachment. <ections of a fixed prosthesis are assembled by the dentist directly on the supporting teeth and held in place by the attachment screw. 2owever, the vertical height re,uired for this attachment is at least Dmm.

Figure 4. T Block attachment consists of a male $a% and female $b% box that can be locked together with a screw $c%.

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2. MAGNETS Although magnets have been used in various forms to help retain complete dentures, they were not effective until a small but strong closed field cobalt samarium $6o8 <m% magnet was developed that would fit onto the surface of a tooth. A metal keeper is attached to the tooth surface, usually into the root canal, and the magnet is contained within the resin of the denture base. The alloy in the magnet produces a magnetic force that is both constant and extraordinarily strong. @t is claimed that the magnets cause no tissue damage and the constant force implies that they never need to be adEusted. Gevertheless, the magnets are brittle and will corrode in the mouth unless protected in a stainless steel shield.

Figure 5. 6obalt samarium magnet. ;etal keeper can be cemented into root canal. $A%. retained with pins $B%, or incorporated within a cast post and core $6% to attach closed field magnet $A% that is placed in denture base.

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II E)TRACORONAL ATTACHMENTS This class of attachment devices may be subdivided into two groups" 6antilever and Bar attachments The cantilever designs may be rigid or mobile and the mobile designs include rotational and resilient types. I) CANTILEVER The limitations placed on the si)e of intracoronal attachment and a desire to provide movement between the abutment crown and the denture base prompted the development of Eoints that proEect from the surface of a cast crown and are cantilevered over the ridges. a) Rigid The design of this group emphasi)es the need for a rigid connection between the parts and movement can occur only along the path of insertion. Therefore the prosthesis becomes a rigid extension of the cantilever& :g" <tabilex or 6onex attachments and the <cott attachments.

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Figure 6. 4igid attachments. A, <pang 6onex consists of a male part that has a housing $a% to contain a threaded $b% and conical pin $c%. +emale part consists of a retentive tube $d%. B, <cott attachment uses a custom made telescopic crown $a% containing internal parallel pins that fit into a metal block $b% soldered to abutment teeth. ;etal block has a recess $c% for an axial rotation Eoint that may be incorporated into design if rotational movement is desired. This extra device will allow axial and slight rotational movement to attachment. :ssentially they are pin and tube Eoints that use a slit in the pin, or multiple pin tubes and slots to enhance the retentive friction between the parts with natural teeth on either side of the edentulous spaces and strong periodontal support. These attachments offer excellent stability and retention to a removable partial denture supported entirely by natural teeth. b) Mobile The cantilever inherent in the rigid attachment can produce destructive force on the periodontium of the abutment teeth. 6onse,uently a variety of attachments have been developed to allow rotation and resilience within the Eoints in the hope of minimi)ing the tor,ue on the teeth. They range from

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relatively simple hinges to complex devices that attempt to combine the rigidity of the intracoronal attachments with some rotation around a movable hori)ontal axis. i) Rotational 2inges allow the prosthesis to rotate around a hori)ontal axis and transmit some of the occlusal forces to the residual alveolar ridge :g" Gerber hinge and the Gaerny hinge. They can be used to attach a unilateral prosthesis to an abutment tooth, but because of the precise fit of the parts it is difficult to align two of them across the arch in bilateral removable denture. A method of anchoring a bilateral distal extension removable partial denture to crown restorations on abutment teeth has been described by Thompson and Becker et al. @t consists of a rest that rotates within an intracoronal box and an extracoronal clasp arm that engages a dimple undercut on the gingival surface of the crown. This arrangement will retain the removable partial denture on the abutment teeth while allowing hori)ontal rotation.

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Figure 7. 4otational Eoint. Thompson dowel rest system is a custom made attachment in which a retentive dimple $a% and box $b% are placed in cast crown on abutment tooth. 4emovable partial denture has a flexible cast arm $c% that engages dimple on lingual surface of crown, and a metallic bloc $d% that seats in the box. The Aalbo attachment is a good example of a ball and socket Eoint in which the ball is cantilevered off the abutment tooth and the socket is attached to the prosthesis. The wall of the metal socket has several small slits to provide a resilient entrance to the socket and offers some direct retention to the attachment when the socket engages the ball over its height of contour.

Figure 8. 4otational Eoint. Aalbo hinge Eoint has a ball $a% at end of a parallel sided metal block soldered to an abutment cast crown. This serves as a retentive rest seat for socket $b% that fits over and engages circumference of ball. <ocket is connected to prosthesis and can rotate around ball and away from metal block.

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ii) Resilient The action of the Aalbo ball and socket Eoint has been expanded with the addition of a spring within the body of the socket to allow a small amount of vertical 0settling1 of the removable partial denture beside the abutment teeth. =ithout this spring, the prosthesis will rotate around the hori)ontal axis through the ball and socket, and the distal extension base will not be evenly supported by the edentulous ridge. @t has been suggested that this uneven pressure is undesirable and possibly destructive to the alveolar bone. A slightly different and more elaborate design is available from the 6rismani attachment. @t consists of a metal block in two parts that rotates around a fixed axis and rests on a spring that is contained within a box on the distal surface of a cast crown. The springs provide axial movement and the split block allows rotation.

Figure !. 4esilient Eoints. A, movement within Aalbo ball $a% and socket $b% hinge Eoint has been expanded by using a spring $c% within socket. B, A more complex design is used in 6rismani resilient Eoint with metal block $a% resting on a spring $not shown% attached to base of box $b% Block consists of two parts that allow rotation around a fixed axis. 6ombined axial movement on spring and rotational movement of block produce a resilient Eoint.

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II) BAR ATTACHMENTS Bars connected to cast metal crowns or copings can be used to support and retain dentures. 6ustom made bars can be cast with a flat upper surface to support the prosthesis and parallel sides help to stabili)e it. They can be obtained in standard forms consisting of a bar with an overlapping matrix. The Ackerman bar may be bent to conform to the contour of the edentulous ridge, and several short matrices rest on the bar to attach the denture base. An oval cross section has been used in the Aolder bar to offer direct retention to a resilient matrix but it must be placed in a straight line between the abutment teeth.

Figure 1". Bar attachments. A, Ackerman bar is circular $a% with short matrices or riders $b% that attach to denture base. B, Aobder bar $a% has an ovoid superior surface around which matrix $b% can clip%.

CHOOSIN* AN ATTACHMENT
@t is the length of the attachment, not its width, that is the main criterion in choosing attachments. There are three si)es of Precision Attachments 3 an

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anterior, a bicuspid and a molar. They differ in the width, not in the length of the Precision Attachment. The width of the Precision Attachment is measured from one side of the rest to the other. +or example a >.>FD <tern1s attachment would be for a molar and a >.>?8 <tern1s attachment would be for a premolar. The full length of a precision attachment is ?mm. +or the full benefit of bracing, support and retention to be obtained from a precision attachment, it must be at least 8mm in height. @f the fabricated crown is less than 8mm hight, another retainer system should be selected. This means that the clinical length of the constructed crown casting must be at least !mm hight. As the attachment is 8mm in length and there must be, in addition, a minimum of (mm between the gingival floor of the attachment and the gingival margin. 'therwise, a periodontal problem may be created.

MATERIALS USED IN ATTACHMENT FA+RICATION

The materials used in the fabrication of Precision Attachments are platinum, iridoplatinum, gold and platinum, gold and palladium $Therma fit% and all gold. The metals are not selected hapha)ardly. The choice of which metals to use depends upon the type of case. @f crown and bridge casting gold type @@@ or type @C 3 is to be used for the crown castings, then there are two alternative ways to construct the crown and the rest seat" #% The rest seat may be cast against the full coverage

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restoration if the metal of the attachment is iridioplatinum, gold and palladium, gold, gold and platinum, or platinum& or (% The rest seat may be soldered into place if gold alloy or any of other alloys are selected. =hen ceramometal alloys are employed it is necessary to solder the rest seat into the crown. Gold and platinum, or gold palladium are the materials of choice. 'ther materials will cause contraction and distortion of the rest seat during backing of the porcelain, as they do not have a high enough fusing temperature. Backer and Preat attachments are not gold palladium, but platinum. @f nonprecious alloys are to be used, high fusing solder, with either platinum or gold palladium, must be employed for the rest seat& otherwise contraction will result. Gold can only be used for insertion into a cast gold crown. @t cannot be used with ceramometal alloys. The melting temperature of the attachment must be high enough to avoid distortion of the rest seat during fabrication of the metal used for the restoration and during the baking of porcelain. <election of materials depends upon an abutment constructed from crown and bridge casting gold, wehter of type @@@ or type @C. :ither can be cast against a rest seat of a Precision Attachment. @f the cast against techni,ue is selected, either iridioplatinum or platinum attachment materials are used. Because of the higher melting temperatures of these two materials, they will not distort when casting gold against them. @f the cast against procedure is not used, but the techni,ue of choirce employs the soldering of an attachment rest seat into the abutment gold

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crown casting, either a gold alloy type of rest seat or any of the other metals may be used. =hen ceramometal alloys of 8( per cent gold or silver palladium are utili)ed for the fixed abutment restoration, the rest seat is soldered into the abutment casting. The metals selected for the attachments are platinum, gold platinum, or gold platinum $-Thermafit.%. @f an incorrect attachment alloys is selected, when ceramometals are used, there will be contraction in the gingival portion of the rest seat during baking of porcelain, because a gold alloy with a lower melting temperature than that of the baked porcelain will distort in the gingival third of the rest seat. =hen employing casting with nonprecious alloys, the dentist cannot select an attachment that is mainly a gold alloy. Attachments of choice are fabricated from platinum or gold palladium alloys, which have a higher melting temperature than porcelain, and thus distortion is avoided.

INDICATIONS
The prime indications for use of the Precision Attachment is for all tooth supported partial denture when" #. +our large well formed abutments are available. (. 6lasp arms would otherwise be displayed in the anterior part of the mouth, which would be displeasing to the patient.

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5. 'nly in case of tooth supported partial denture cases i.e. /ennedy 6lass @@@ and 6lass @C situations. 7. @n selected cases it may be employed in preference to conventional retainers, to stabili)e teeth which have been weakened by periodontal disease. 8. They can be used to advantage in the badly misaligned abutment tooth $e.g., the buccally inclined maxillary canine% to eliminate the need for extensive cutting of tooth structure that is re,uired for conventional clasping.

CONTRAINDICATIONS
#. The precision attachment should not be used in the distal extension base type of partial denture, particularly in the mandibular arch. The reason for this contraindication is that some movement of the distal extension base, supported as it is by a displaceable mucosa, is inevitable and since the key*keyway mechanism allows no freedom of movement, other than in a vertical plane parallel to the long axis of the tooth, a great deal of masticatory stress will be transmitted directly to the abutment tooth as tor,ue, this is almost certain to imperil the health of the periodontal apparatus. (. Because the prosthesis with a Precision Attachment must be inserted along one precise path of insertion, the patient must possess at least an average

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degree of manual skill to manage the maneuver with this facility. +or this reason the key*keyway type of construction generally is contraindicated for the senescent individual or for the one with an incapacitating handicap. 5. Because the keyway must be of reasonable length to generate the re,uired frictional resistance to unseating a forces, the clinical crown of the abutment tooth must be of at least average height. Thus it follows that the Precision Attachment will not be successful when used with the tooth which has either a short or a very small crown. 7. @t is contraindicated in case of teeth with large pulp chambers. 8. =hen the facility for repair and maintenance is not available.

ADVANTA*ES,
#% The labial or buccal clasp arm can be eliminated altogether hence this improves the cosmetic excellence of partial denture, particularly one for the maxillary arch. (% @t is less stressful to the abutment tooth than is the conventional clasp. The basis for this reasoning is that, located as it is deep within the confines of the tooth, all stress is directed along the long axis of the tooth. Thus being resisted by virtually all of the fibres of the periodontal ligament. <tress so directed is concentrated nearer to the center of rotation of the tooth than in

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the case with a conventional clasp, which is clearly more ideal from a stand point of leverage. 5% 4eciprocity is assured so that there is no problem of -=hiplash. effect, which the conventional clasp sometimes generates. 7% They allow better cross arch force transmission and stabili)ation than clasps, but this is determined by the type of attachment used, the number of guiding surfaces and the design and adaptation of the framework and attachment.

DISADVANTA*ES,
#. The tooth must be extensively reduced to provide the re,uisite space to accommodate the key way. (. The bulge in the crown, created by the keyway, may deprive the underlying gingival tissue of its customary massage. 5. The two parts of the laboratory type of attachment seldom fit with perfect precision and the presence of even a minute crevice between the two parts raises the specter of uncleanliness of the keyway. 7. The attachment is subEect to wear as a result of the friction between the metal parts and this can create a maintenance problem. As wear occurs the male portion fits ever more loosely in the keyway. Thus eventually

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permitting excessive movement of the base and posing the threat of inEury to the abutment. 8. @f the extracoronal attachment extends outward from the tooth near the gingival border, there is a very real danger of gingival irritation followed by the usual inflammatory se,uelae. D. @t may reduce the space re,uired for artificial teeth. !. @t is expensive. ?. @t cannot be repaired * altered easily. USE OF PRECISION ATTACHMENTS IN FI)ED PROSTHODONTICS Precision Attachments are also used in fixed prosthodontics. They are employed to reduce the si)e of a splint for ease of parallelism and for ease of cementation. A full arch splint can be sectioned between the cuspid and bicuspid with Precision Attachment. 4ationales for employment are as follows" #. Precision Attachments facilitate parallelism of small sections rather than re,uiring attempts to parallel upto #7 teeth. (. Isually the lower anterior teeth are flared& thus it is impossible to obtain a path of insertion between the lower anterior teeth and the (nd molar for a one piece splint that will have a common path of insertion, unless a number of teeth are devitali)ed.

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5. =hen using porcelain fused to metal, the more units the dentists places on the splint, the more contraction occurs when the porcelain is baked and the poorer the fit. 7. =hen the cementing medium washes out, it is usually in the ( nd molar that washes out first. The dentists can then replace a small section instead of remarking a complete dental arch. The rest seat is placed in the strongest section which usually is the anterior section, with the rest in the posterior. The rest and rest seat should be at the desired occlusal height, and no porcelain should be placed occlusally over the attachment. @f porcelain is placed occlusally over the attachment it will fracture.

SEMI-PRECISION ATTACHMENTS
@t is also referred to as the -milled rest. or the -internal rest.. As a rule, this type of retainer takes the form of a dovetail shaped keyway built into the proximal surface of a wax pattern of $usually% a gold crown. The stud or male portion is then fabricated as an integral part of the metal framework. A lingual clasp arm is customarily used with the semiprecision attachment which helps to guide the attachment into place in the tooth. The semi precision type of retainer has an advantage over the manufactured type in the fact that it is somewhat simpler to construct, hence is less time consuming and as a conse,uence, not as costly.

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A disadvantage is that the parts do not fit together with the same degree of machined precision.

CONCLUSION
The decision to use Precision Attachments in removable partial design should be carefully considered. 6lasp type removable partial denture1s should be used whenever practical because of their lower cost, ease of fabrication and maintenance and the predictability of results. 2owever if Precision Attachment removable partial denture is the treatment of choice because of esthetics, abutments alignment or the need for greater cross arch bracing, it must be used with a thorough knowledge and understanding of prosthodontics principles and attachment use as well as an awareness of the intricacies and special problems associated with the Precision Attachments. To end @ would say that its alright to consider such sophestication1s where the facilities for this precise laboratory work is available which is very scanty in developing countries. 2ence its use is limited.

REFERENCES
#. Academy of denture prosthetics " Glossary of prosthodontic terms, :d !, B. Prosthet. Aent., #FFF& ?# " 7# #(D. (. Becerra G., ;acentee ;. " A classification of Precision Attachments. B. Prosthet. Aent., #F?!& 8? " 5(( 5(!.

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5. Burns A.4., =ard B.:. " A review of attachments for removable partial denture design " Part # 6lassification and selection. @nt. B. Prosthodont., #FF>& 5 " F? #>(. 7. Burns A.4., =ard B.:. " A review of attachments for removable partial denture design " Part ( Treatment planning and attachment selection. @nt. B. Prosthodont., #FF>& 5 " #DF #!7. 8. 6aldarone 6.C. " Attachments for partial denture without clasps. B. Prosthet. Aent., #F8!& ! " (>D (>?. D. 6ouncil on dental materials and devices " <tatus report on Precision Attachments. B. Am. Aent. Assoc., #F!D& F( " D>( D>8. !. Graber G " 6olor Atlas of Aental medicine. Col.(, 4emovable partial dentures, Gew Jork, Thieme ;edical publishers @nc., #F??. ?. Grosser A. " The dynamics of internal Precision Attachments. B. Prosthet. Aent., #F85& 5 " 5F5 7>#. F. /oper A. " An intracoronal semiprecision retainer for removable partial dentures 3 The Thompson Aowel. B. Prosthet. Aent., #F!5& 5> " !8F !D?. #>. 9orencki <.+. " Planning precision attachment restorations. B. Prosthet. Aent., #FDF& (# " 8>D 8>?.

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##. ;iller :.9. and Grasso B.:. " 4emovable partial prosthodontics. :d.(, 9ondon, =illiams and =ilkins #F?(& (F5 (FF. #(. Preiskel 2.=. " Precision attachment " Ises and abuses. B. Prosthet. Aent., #F!5& 5> " 7F# 7F(. #5. Preiskel 2.=. " Precision Attachments in prosthodontics " Col.# The applications of intracoronal and extracoronal attachments. 6hicago, Kuintessence Publication 6o., #F?7. #7. 4ay G.:. " Precision Attachments, :d.( Bristol Bohn =right and <ons 9td., #F!?. #8. 4ushford 6.B. " A techni,ue for precision removable partial denture construction. B. Prosthet. Aent., #F!7& 5# " 5!! 5?5. #D. Terrell =.2. " <peciali)ed frictional attachments and their role in partial denture construction. B. Prosthet. Aent., #F8#& # " 5!! 58>. #!. Hahler B.;. " @ntracoronal Precision Attachments. Aent. 6lin. Gorth. Am., #F?>& (7 " #5# #7#. #?. Hinner @.A. " Precision Attachments. Aent. 6lin. Gorth. Am., #F?!& 5# " 5F8 7#D.

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PRECISION ATTACHMENTS
CONTENTS
@ntroduction Aefinition Genesis 6lassification 6hoosing an attachment ;aterials used in precision attachment fabrication @ndications 6ontra indications Advantages Arawbacks Ise of Precision Attachments in fixed prosthodontics <emi Precision Attachments 6onclusion 4eferences

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