DIREC

DIRECTT
RETAI
NERS
RETAINERS
(Part
(PartI)I)

Dr. Golam Wakil

CONTENTS

Part I
Introduction
Classification
Parts of clasp assembly
Principles of clasp design
Blatterfein & Ney system
Functions of clasp assembly
Types of retainers:
- occlusally approaching
clasps

Part II
Types of retainers:
gingivally approaching
clasp
other clasp designs
Relative merits &
demerits of cast &
wrought wire clasps
Intracoronal retainers
Summary

Introduction
Retention is that quality inherent in the removable
partial denture that resists the vertical forces of
dislodgement for e.g., the force of gravity, the
adhesiveness of foods, or the forces associated with
the opening of the jaws.

Direct retainer is any unit of removable partial

denture that engages an abutment tooth in such a
manner as to resist displacement of the prosthesis
away from basal seat tissues by
1. Functional means by engaging a tooth undercut lying
cervically to the height of the contour.
2. Wedge principle.
3. Mechanical means

DEFINITION:
Direct retainer is that component of a partial removable dental
prosthesis used to retain and prevent dislodgment, consisting
of a clasp assembly or precision attachment (GPT 8)

Factors affecting the retention in Removable

Partial Dentures:
I. Primary retention :

This is mechanical in

action.
II. Secondary Retention: Achieved by intimate
relationship of the denture base and the rigid
major connector to the underlying soft tissues.
a. Adhesion
b. Cohesion
c. Atmosphere pressure
d. Molding of tissues

Classification of direct retainers

Direct Retainers are of two types:
Extra Coronal
Intra Coronal

Extra Coronal Direct Retainers:

Mechanical resistance to displacement.

They are of three types:

a. Manufactured attachment.
Eg. Dalbo, Spring loaded plungers.
b. Flexible clips/Rings.
c. Clasp
type
retainer.
The flexible area engages a prepared
depression are an undercut area cervical to the
8
area of greatest convexity of the tooth.

 Intra Coronal Retainer:

Which is cast or attached totally within the

restored natural contours of an abutment tooth
Regarded as an internal/precision attachment.
Formulated by Dr.Herman.E.S. Chayes in 1906.
Cast/Attached within the tooth structure
Prefabricated
Frictional resistance.

EXTRACORONAL DIRECT RETAINERS

Occlusally
approaching /
Suprabulge / Ney Type
I clasp /
Circumferential
Gingivally
approaching /
Infrabulge/ Bar/
Roach / Ney Type II
Clasp
10

The basic parts of a clasp assembly :

Rest : It is the part of the
clasp that lies on the
occlusal, lingual or incisal
surface of a tooth and resist
tissue ward movement of the
clasp.

Body of the clasp : It is the

part of the clasp that
connects the rest and
shoulder of the clasp to the
minor connector.
11

Shoulder : It is the part of

the clasp that connects the
body to the clasp terminals.
It must lie above the height
of contour and provide
some stabilization against
horizontal displacement of
the prosthesis.

Reciprocal arm : A rigid

clasp arm placed above the
height of contour on the
side of the tooth, opposing
the retentive clasp arm.
12

Retentive arm : It is the part

of the clasp comprising the
shoulder which is not flexible
and is located above the height
of the contour.

Retentive terminal : It is the

terminal end of the retentive
clasp arm. It is the only
component of the removable
partial denture that lies on the
tooth surface cervical to the
height of the contour. It
possesses a certain degree of
flexibility and offers the
property of direct retention.
13

Minor connector : It is
the part of the clasp that
joins the body of the clasp
to the remainder of the
framework and must be
rigid.

Approach arm : It is a
component of the bar
clasp. It is a minor
connector that projects
from the framework, runs
along the mucosa and
turns to cross the gingival
margin of the abutment
tooth to approach the
undercut from a gingival
direction.

14

15

PRINCIPLES OF CLASP DESIGN

Encirclement:

More than 1800 of greatest circumference of the

tooth must be included passing from diverging
axial surface to converging axial surface.

This may be in the form of continuous contact

when circumferential clasp arms are used.

Bar clasps are used, at least 3 areas of tooth

contact must be embracing more than the tooth
circumference. These are occlusal rest area, the
retentive terminal area and reciprocal terminal area.

16

The surveyed cast clasp embraces about 270 of the

abutment tooth. Its parts are :
Bracing arm
(blue).
Retentive arm (red).
Shoulder and rest

17

 Support:

Property of the clasp that resist the

displacement of the clasp in gingival direction.

Primary support units of a clasp are occlusal,

lingual or incisal rest.

The occlusal rest must be designed so that

cervical movement of the clasp arm is prevented.
The rest should provide only vertical support.
18

 Reciprocation:

Each retentive terminal should be opposed by a

reciprocal arm or element capable of resisting any
orthodontic pressures exerted by the retentive arm.
Reciprocal and stabilizing elements must be rigidly
connected bilaterally.

This arm is positioned on the opposite side of the

tooth from the retentive arm.

19

 In addition to reciprocating stress generated against

the tooth by the retentive clasp, it also play an
important role in stabilizing the denture against
horizontal movement.

20

 Some cases, additional rest is positioned on the

opposite side of the tooth and minor connector will
provide reciprocation.
Reciprocal clasp must be rigid, it is not tapered as the
retentive clasp. Reciprocal arm should be positioned on
the surface of a tooth is reasonally parallel to the
dentures path of insertion and removal.

21

 If it is placed on the surface that is tapered occlusally, a

slight movement of denture will cause the clasp to loose
contact with the tooth and reciprocation and retention is
lost.
It must be positioned above the height of contour at the
junction of the gingival and middle 3rd.
To reciprocate the forms properly, it should contact the
tooth at the same time or before the retentive arm does.

22

 Retention:
The path of escapement of each retentive clasp terminal should be other
than parallel to the path of removal of the prosthesis.
The amount of retention always should be the minimum necessary to resist
reasonable dislodging forces.

Only the terminal third of

an occlusally approaching
clasp (stippled section)
should engage the
undercut.

A gingivally approaching clasp

contacts the tooth surface only
at its tip.
23

The retentive clasp is divided into 3 parts; each

with its arm functional requirement.
The terminal third is flexible and engages the
undercut.
The middle third has a limit degree of flexibility
and may
engage a minimal amount of undercut.
Proximal third, or shoulder, is rigid, and must be24

 Stability / Bracing:

All 3 clasp have reciprocal or bracing arm, which provides

equal amount of stability.
Stability is the resistance to horizontal displacement of a
prosthesis.

All clasp terminal except the retentive clasp terminals

contribute to this property in varying degree.
Eg: Cast circumferential clasp exhibits great amount of stability,
because its shoulder is rigid and it aids in stabilization.

The wrought wire clasp has flexible shoulder .

Bar clasp does not have a shoulder so both provide less
stability.
25

 Passivity:
A clasp in place should be completely passive. The
retentive function is activated only when
dislodging forces are applied to the partial denture.

26

 Bilateral Opposition:
Unless guide planes will positively control the
path of removal, retentive clasp should be bilateral
opposed. i.e., buccal retention on the other or
lingual on one side opposed by lingual on the
other.
In class II situation, the 3rd abutment may have
either buccal or lingual retention.
In class III retention may be either bilaterally or
dimeterically opposed.
27

 Stress Breaking:

Clasp retainers on abutment teeth adjacent to

distal extension bases should be designed so that
they will avoid direct transmission of tipping and
rotational forces on abutments. In effect they must
act as stress breakers either by their design or by
their construction.

This is accomplished by proper location of the

retentive terminal or by use of a more flexible arm is
relation to rotation of the denture under varying
direct forces.
28

 Location of components:
The reciprocal element of the clasp assembly should
be located at the junction of the gingival and middle
3rd of the crowns of an abutment teeth. The terminal
end of the retentive arm is placed in the gingival 3 rd
of the crown.

29

Criteria for Clasp Selection

1.

Surveyline location and degree of undercut.

2.

Requirement of retention and stability

depending on whether upper or lower arch
and configuration of edentulous area or
areas; axis of rotation and selection of
retainers.
30

SURVEY LINE
Blatterfein in 1951 put forth a
simple
and
comprehensive
classification of surveyline with
suggestion on clasp selection.
He divided the buccal and lingual
tooth surface into two halves using a
vertical imaginary line through the
long axis of the tooth. These halves
were described as the nearzone and
farzone depending on its closeness
to the edentulous space.
31

He described four kinds of surveyline:

1.

Typical surveyline or medium

2.

Atypical A or Diagonal

3.

Atypical B or High

4.

Atypical C or Low

32

Typical or medium:
Extends from the occlusogingival midpoint in the
near zone to the junction between the occlusal two
third and cervical one third in the far zone.

Clasps suggested for use where such a survey line

exists include the occlusally approaching and
gingivally approaching clasps.
33

 Atypical A or diagonal:
This runs diagonally across the tooth surface
from a high position in the nearzone to a low
position in the farzone.
- A reverse
recommended.

action

or

hairpin

clasp

is

- Gingivally approaching clasp may also be used.

34

 Atypical B or High Surveyline:

This type of surveyline is parallel to the occlusal surface and
lies close to it.
A wrought occlusally approaching clasp arm may be used.
If accompanied by a low surveyline on the opposite side of the
tooth, a ring, back action or reverse back action have been
recommended.

35

 Atypical C or Low Surveyline:

The low surveyline is parallel to occlusal surface but has just
above the level of the gingival margin.
This type of surveyline contraindicate the placement of a
retentive clasp arm on the tooth surface concerned, as the arm
would need to be placed too close to the gingival margin for
safe application.

36

When all the usable surface of a tooth present the

survey lines of this type, retention may be obtained by:
1. Placement of a crown on the tooth to artificially
develop undercuts.
2. Placement of a class IV gold inlay a dimple is in
the inlay and a ball head on a gingivally approach
arm is positioned to engage the dimple.
3. An extended clasp may be used where the tooth
offers favourable conditions for retention.
4. Undercut may be developed by recontouring the
tooth.
37

Ney System:
3 basic surveyline with an appropriate clasp form:
Class I :
Survey line runs diagonally across the tooth
surface from a low position on the side of the rest
to a high position on the other proximal side.
A cast occlusally approaching arm or its variants,
back action, reverse back action and ring clasps
are recommended called as Ney class I clasps.
38

 Class II:
Similar to Blatterfein atypical A or Diagonal
surveyline.

Here

gingivally

approaching

is

recommended and termed as Ney class II clasp.

Class III:
It is the same as the Blatterfein Atypical B or High
surveyline. The wrought wire arm is used and
termed as the Ney class III clasp.
39

Selection of clasp based on requirement of

retention & stability
A large number of edentulous area, bilaterally placed would
mean more number of clasps and guide planes, thus the
entire prosthesis has greater retention and stability.
Cast circumferential clasp properly designed shows greater
retentive and bracing properties than a bar clasp used in a
similar situation.
Ideal amount of retention is that which will retain the
removable partial denture against reasonable dislodging
forces without placing the undue strain on the abutment
teeth. Thus minimum retention and maximum stability is the
40
ideal.

 Support:

Selection based on nature of support whether

tooth / tissue or tooth and tissue borne and length
of the edentulous span.
In case of long span class I situation
preservation of abutment teeth is important,
where a RPI, RPL clasp is used to prevent torque
on the abutment.

41

 Root size and form of the tooth:

Clinical conditions of supporting structures - alveolar

bone and periodontal ligament should be considered

Abutment teeth with short, conical roots, bone loss, and

periodontal ligament, mild periodontal problem may not be able to
withstand lateral forces that would be within physiologic limits of
a healthy sound tooth. Preservation of such teeth as abutments
would necessitate the use of bar clasps with increased length of
clasp arm of round cross-section, of type IV casting gold alloy or
wrought gold wires.

42

Oral hygiene and caries:

1.

Maintaining oral hygiene is pre requisite to

treatment with cast partial denture.

2.

High caries index contraindicate the use of clasp

with an unprotected tooth surface as with a ring
clasp.

3.

Bar clasp has minimum tooth structure contact and

less interference with natural cleansing action.
Patient education is essential to maintenance of
oral hygiene, proper use of prostheses, its
placement and removal.
43

 Esthetics:

Gingivally approaching claps are generally preferred for

esthetic reason but may be more unestheic than
occlusally approaching clasp if the patient has a high lip
line and exposes the excessive gingiva.
Presence of excessive tissue undercut:

Gingivally approaching clasp is contraindicated in the

presence of excessive tissue undercut.

44

Functions of Clasp Assembly

Retention
Support
Stabilization or Bracing
Reciprocation
Indirect retention

45

Retention
Clasp retention is based on the
resistance of metal to deformation. For a
clasp to be retentive, it must be placed
in an undercut area of the tooth, where it
is forced to deform when a vertical
dislodging force is applied.
It is this resistance to deformation that
generates retention.
46

Factors affecting retention of a clasp

A. Size of the angle of cervical convergence:

When the surveyor blade contacts a tooth on the cast at its

greatest convexity, a triangle is formed, the apex of which
is at the point of contact of the surveyor blade with the
tooth, and the base is the area of the cast representing the
gingival tissues. The apical angle is called the angle of
cervical convergence.
To be retentive a tooth must have an angle of convergence
cervical to the height of contour.
47

 Guiding planes determine the path of placement and

removal of a partial denture. Therefore without the use of
guide planes, clasp retention will either be determined or
practically non existent.

The guide plane moves down the proximal surface

which is
prepared on the distal aspect of the tooth. When the

48

B. Degree of undercut

Relative uniformity of retention will depend on the

location of the retentive part of the clasp arm, which is
not in relation to the height of contour, but in relation to
the angle of cervical convergence.

Retentive clasp arms must be located so that they lie in

the same approximate degree of undercut on each
abutment tooth, despite the variation in the distance
below the height of contour.

The measurement of the degree of undercut by

mechanical means is achieved by the help of an undercut
gauge attached to a dental surveyor.
49

The retentive force is dictated by tooth shape and by clasp

design. Though clasps 1 and 2 are in an undercut of
0.25mm, 1 offers more retention than 2.
50

C. Flexibility of clasp arms

(i) Length of the clasp arm : The
longer the clasp arm, the more
flexible it is, all other factors being
equal. The length of a clasp arm is
measured from the point at which a
uniform taper begins.
A Co-Cr clasp arm engaging
the same degree of undercut will
have different flexibility and
resistance to distortion on the molar
and the premolar because of the
difference in length.

51

Circumferential
Length
(inches)

Bar type

Flexibility
(inches)

Length
(inches)

Flexibility
(inches)

0-0.3

0.004

0-0.7

0.004

0.3-0.6

0.008

0.7-0.9

0.008

0.6-0.8

0.012

0.9-1.0

0.012
52

(ii) Diameter of clasp arm:

The diameter of a clasp arm is inversely proportional

to its flexibility, all other factors being equal.

The average diameter to be considered is at a point

midway between its origin and its terminal end.

The thickness of the clasp arm in the buccolingual

direction is to be considered rather than the width in
the occluso-gingival direction.
53

(iii) Cross-sectional form

Round
cross-sectional
form enables the clasp to
be flexible in all directions
whereas the half-round
form limits the flexibility
to only one direction.

Cast clasps are half round

in form and they flex
away from the tooth, but
edgewise
flexing
is
limited.

If the cross-sectional
area of clasp is
doubled, the stiffness
will be increased 4
times
and
the
flexibility reduced 4
times.

54

(iv) Material used for clasp arm :

Type IV gold alloys and cobalt-chrome alloys

which have different modulus of elasticity.

The modulus of elasticity of cobalt-chrome alloys

is greater than that of cast golds, which have a
higher modulus than wrought gold wires.

55

 The retentive terminal has to be flexible and therefore have

low modulus of elasticity. The reciprocal elements have to
be stiff and unyielding and have high modulus of elasticity.

Therefore a clasp of the same cross-section is stiffer in

cobalt-chrome than in cast gold. This can be overcome by
using longer clasps of thinner section, and by doing
contour modification so as to reduce the degree of
undercut.

56

(v) Structure of the alloy

The alloy may be cast or wrought in nature. Wrought

wires have greater flexibility than a cast structure
due to its grain structure being fibrous.

The tensile strength of a wrought structure is at least

29% greater than that of the cast alloy from which it
was made.

Wrought forms can be used in smaller diameters to

enhance the flexibility and they offer minimum
friction and can have a stress breaking effect.
57

Support

Support is the property of the clasp which enables it

to resist displacement in a gingival direction.

Primary support is obtained by the occlusal or incisal

rest.

Secondary support is obtained by the rigid

components i.e. body and shoulder of the clasp which
are placed above the greatest diameter of the tooth.
58

Stabilization or Bracing:

It is the resistance to horizontal components of

masticatory force (GPT 8)
All of the clasp components, with the exception of the
retentive terminal, contribute this property in varying
degrees.
Bracing elements, united by rigid major connector, are
capable of distributing horizontal forces throughout the
partially edentulous arch.
The components of the cast circumferential clasp offer
better stabilization than either the bar clasp or the
wrought wire clasp, because of greater amount of rigidity
of the clasp material.
59

Reciprocation
Reciprocation (GPT 8) may be defined as the mechanism
by which lateral forces generated by a retentive clasp
passing over a height of contour are counterbalanced by a
reciprocal clasp passing along a reciprocal guiding
plane.

For effective reciprocation clasps should be planned and

designed so that the two arms of the clasps are in balanced.

60

RECIPROCATION

61

Indirect Retention

The reciprocal arm may behave as an indirect

retainer when it rests occlusal to the height of
contour on the abutment tooth, lying anterior to
the fulcrum line.

Lifting of a distal extension base away from the

tissues is resisted by a rigid arm, which is not
displaced cervically

62

TYPES OF CLASP RETAINERS

Circumferential clasps/ Occlusally approaching

Circumferential clasp
Embrasure clasp.
Ring clasp.
Back action clasp.
Reverse action / hair pin clasp.
Multiple clasps.
Half-and-half clasp.
Modificatio
Combination clasp.
n
Onlay clasp.

63

Bar/Roach clasps / Gingivally approaching

clasps.

T-clasp

Modified T-clasp

Y-clasp

I-clasp

RPI concept.

64

Other clasp designs

RPA clasp.

VRHR clasp.
Clasps utilizing proximal undercuts

-Mesiodistal clasp
-Devan clasp.
Movable arm clasp.
Cingulum clasp
65

CIRCUMFERENTIAL CLASP
Circlet clasp.
It is one of the most commonly used clasps with all tooth-supported
partial dentures because of its retentive and stabilizing ability. The
basic design consists of a buccal retentive arm and a lingual
reciprocal arm originating from a common body.

The simple circlet clasp

Design:
It consists of an occlusal rest in the distal fossa of an abutment
tooth adjacent to the distal extension base. The terminal third of the
retentive arm engages a mesiobuccal undercut and the reciprocal
arm is positioned above the survey line on the lingual surface.
66

Circumferential clasp on a molar

67

The reverse approach circlet clasp

It is most commonly used on the mandibular

bicuspids and the retentive terminal engages the
distobuccal undercut.
Design:

It consists of a mesial occlusal rest, a horizontal

reciprocal arm, and a retentive arm engaging the
distobuccal undercut adjacent to the edentulous area.

68

Advantages:
1) The clasp fulfills the requirement of support, stability

reciprocation, encirclement & passivity better than any

other type of clasp.
2) It is easy to construct.
3) It is simple to repair.
69

Disadvantages:
1.

It tends to increase the circumference of the crown.

2.

In is not acceptable in the anterior region.

3.

It covers more tooth surface then the bar clasp and

prone to caries.

4.

Retentive undercuts on some teeth are difficult to reach

with retentive terminal of the clasp
70

EMBRASURE CLASP

Bonwill clasp

Rib clasp

Double a

Back to back clasp

These clasps are used mainly in the fabrication of

unmodified Class II or Class III partial denture situation;
when there are no edentulous spaces available on the
opposite side of the arch to aid in clasping.

71

It should be applied only when the teeth are sound and

retentive areas are available or when multiple restorations are
justified.

Embrasure clasp on a maxillary premolar and

molar

72

Design
The embrasure clasp should have double occlusal rests,
two retentive clasp arms and the two reciprocal clasp arms
either bilaterally or diagonally opposed.
The double occlusal rests prevent interproximal wedging
by the prosthesis, which could cause separation of the
abutment tooth and result in food impaction and clasp
displacement.
In addition to providing support, occlusal rests also serve
to shunt food away from the contact area. Therefore the
embrasure clasp should be used with double occlusal
rests, even when definite proximal shoulders can be
established.
73

An auxillary rest or a bar clasp arm can be

substituted for a circumferential reciprocal arm as
long as definite reciprocation and stabilization is
achieved.

Contra indication:
1. Short and bulboss crown.
2. Not preferred in teeth with more undercuts.

Disadvantages:

Needs adequate cleaness in occlusal surface.

Breakage of inadequate preparation and clearance

Wedging action.

74

RING CLASP

It is that form of a circumferential clasp that

encircles nearly all of the tooth from its point of
origin.

It is usually used when a proximal undercut cannot

be approached by any other means.

75

 This ring clasp permits engagement of this undercut by encircling

almost the entire tooth from its point of origin.
Mandibular molar, clasp encircles the tooth beginning on the
mesiobuccal surface and terminating in an infra bulge area on the
mesiolingual surface.

Because of the length of the clasp, it must be designed with

additional support, usually in the form of an auxillary bracing
arm.

76

 In mandible, bracing arm usually extends from the

acrylic resin retention metal, run across the mucosa and
turns upward to engage the buccal arm of the ring clasp
near the center of the buccal surface.
This can provide reciprocation and some amount of
stability for the denture.
The entire clasp except the retentive terminal shall be
placed above the height of the contour.
An additional occlusal rest can be placed may provide
additional support and prevent mesial migration of tooth.
77

Contra indication:

1. In mandibular molar, where the attachment of

buccinator muscle is so close to the tooth, that the
auxillary bracing arm encroaches on it.

2. When the bracing arm must cross the soft tissue

undercut.
78

Advantages:

1.

Excellent bracing

2.

Decreased leverage

3.

Less stress to abutment teeth.

Disadvantages:

1.

Needs long crown and enough occlusal clearance.

2.

Esthetically objectionable

3.

Difficult to repair.
79

BACK ACTION CLASP

It is a modification of the ring clasp.

It has a rest which is connected to a rigid minor connector.

Indication:
For unilateral and bilateral distal extension partial denture.
80

REVERSE ACTION CLASP OR HAIR PIN

This clasp is essentially a simple circlet clasp in which the

retentive arm after crossing the facial surface of the tooth from
its point of origin loops back in a hairpin turn to engage a
proximal undercut below its point of origin.
The upper part of the retentive arm must be considered to be
minor connector and should be rigid.
The lower part of the clasp arm should be tapered. It is the only
flexible part of the clasp arm.

81

 The crown of the abutment tooth must have sufficient

occlusogingival height to accommodate this double
width of the clasp arm.
The upper and lower arms of the retentive clasp must
also be shaped in such a way that food debris will not be
retained between them.
And there must be enough space between the arms so
that the metal may be adequately finished and polished.

82

Indication:

1.

Distal extension partial denture.

2.

Mesially inclined posterior.

3.

Undercut addition to the edentulous area.

4.

If when proximal undercut must be used on a posterior

abutment and when the tissue undercut or high tissue
attachment prevent the use of bar clasp arm, the reverse
action clasp may be preferable.

5.

If lingual undercut is present which prevent the

placement of a supporting strut without tongue
interference, hairpin clasp is indicated.

83

Contra Indication:

1.

Tight occlusal contact, increase posterior overbite, short

crown,

2.

Clasp cover considerable tooth surface and may trap

debris.

Advantages:

Easier to construct

Adjust

Disadvantages:

Food entrapment

Esthetics

Caries

84

MULTIPLE CLASP

Multiple clasp is two opposing simple circlet clasp joine

at the terminal end of the two reciprocal arms.
85

MULTIPLE CLASP
Indication:
1.

When additional retention is needed.

2.

Tooth borne partial denture

3.

When the partial denture replaces an entire half of the

dental arch.

86

Advantages:

1.

Less metal display

2.

Less tooth coverage

3.

Leaves room for the mesial portion of the denture

base to a larger extent than it would be otherwise.

4.

It braces the abutment on the mesial even if the tooth

is tipped distally.

5.

Marginal gingiva can be left uncovered of the

abutment teeth for better partial denture health.

87

Half-and-half clasp

This clasp consists of a circumferential retention arm

arising from one direction and a reciprocal arm arisin
from another minor connector.
88

 This design provides retention , a principle that should be

applied only to a unilateral denture design.

The buccal arm provides for bracing only.

The lingual arm utilizes an undercut adjacent to the

edentulous space for retention.

89

Indication:

Lingually inclined premolars where lingual undercut

are close to the edentulous space.

Contra indication:

Buccal inclined premolars

If it is used for distal extension RPD a distal rest
should be placed. Mesial rest also can be used in
conjunction with the distal rest.

90

COMBINATION CLASP

This type of clasp consists of a wrought wire retentive

clasp
arm and a cast reciprocal clasp arm.
The retentive arm is usually occlusally approaching,
91
but it may

Uses:

It is used on abutment tooth adjacent to a distal extension

base where only a mesiogingival undercut exists on the
abutment

or

where

large

tissue

undercut

contraindicates a bar type retainer.

The tapered wrought wire retentive arm offers greater
flexibility than does the cast clasp arm and therefore
better dissipates functional stresses.

92

Advantages

Flexibility on account of fibrous grain structure of the

wrought wire retentive arm.
Adjustability : It can be adjusted later to increase or
decrease the retention without danger of breakage.
Esthetic appearance: since it is used in smaller diameters
of round cross-section.
93

A minimum of tooth surface is covered because

of its line contact with the tooth, rather than a

surface contact of a cast clasp arm.

Fatigue failures in service are less likely to

occur with the tapered wrought wire retentive arm.

94

Disadvantages

It involves extra steps in fabrication, particularly when

high fusing chromium alloys are used.
It may be distorted by careless handling on the part of
the patient.
Since it is bent by hand, it may be less accurately
adapted and therefore provide less stabilization above
the height of contour.

95

EXTENDED CLASP ARM

It is similar to the circumferential arm but it covers

two teeth. It remains above the surveyline of the 1st
tooth; crosses the undercut of the adjacent tooth. It
is rarely used as direct retainer.

96

Indications:

Tooth supported RPD.

Tooth next to edentulous space has no buccal and
lingual
undercut.
The occlusion in the embrasure area will not allow
passage
of the clasp arm to an undercut on the second tooth
from

97

Contra Indication:

1. Distal extension dentures because the retentive lies

forward of the axis rotation. Functional forces will
cause rotation around the rest and upward movement
of clasp tip.

Advantages:

1. It has splinting and stabilization action.

2. Distribution of lateral loads over two teeth.

98

Disadvantages:

1.

Tooth structure covered.

2.

Easily distorts.

3.

Breakage of the arm.

4.

If made in gold limited to 2 premolar

in Cr. Ch longer arm can be used.
- 2 molars can be clasped.
99

MESIODISTAL CLASP
Used to clasp canine and central only if little undercut
on buccal surface.
Disadvantage:
Metal displaces alloy made of gold.
If diastema between the lateral incisor and canine,
then the space provides a accommodation for the
mesial part of the clasp otherwise space reaction with
safe side disc, contact point with L.I. is returned when
clasp an position. It is similar to inlay.
100

ONLAY CLASP

1.

Extends from an occlusal onlay into an undercut

located mesio distally.

2.

This clasp is an extended occlusal rest with

buccal and lingual clasp arms.

3.

This clasp may originate from any point on the

onlay that will not create any occlusal
interference.

4.

If the onlay is prepared with chrome cobalt alloy,

and is opposed by natural teeth, the occlusal
surface should be constructed of acrylic resin or
gold, if you use chrome alloy, because of its
extreme hardness will cause rapid wear of enamel

101

Indications:
1.

When the occlusal surface of the

abutment tooth is the occlusal
plane mesially tilted rotated tooth
molar.

2.

Only in caries resistant mouth

unless it is covered by gold
crown.
102

Advantages:

1.

Mesially tilted molars to be used to provide

retention.

2.

3rd molar occlusion may be improved.

Disadvantages:

1.

Difficult to fit clasp to tooth.

2.

Increased contact area, accurate impression

and the resultant cast is difficult to achieve.

103

DEVAN CLASP
Uses proximal undercut and has a small head that
bears on tooth entirely below survey line.
Clasp arises and lies closely against at the periphery
of the denture base.
Denture base is under extended to provide room for
the approaching arm.
It is reciprocated with lingual and palatal strut.
It gives little bracing effect.
104

Devan clasp

105

Advantages:

1. Esthetically acceptable, became of interproximal

location, or it is hidden behind the buccal concavity.
2. The distribution of stress during insertion and
removal is minimal.
3. Increased retention without tipping action on the
abutment.
4. Less chance of accidental deformation because it
doesnt project very far away from the denture base.
106

DALBO EXTRACORONAL
ATTACHMENT
Components consist of :
A, L-shaped male portion that is attached to an abutment
crown;
B, female sleeve that is placed in artificial tooth adjacent to
abutment, and coiled spring that fits into female portion.
Design permits some vertical movement of denture under
force through compression of coiled spring.

107

THANK
YOU
108

Part
II
109

CONTENTS

Part II
Types of retainers:
gingivally approaching
clasp
other clasp designs
Relative merits &
demerits of cast &
wrought wire clasps
Intracoronal retainers
Summary

GINGIVALLY APPROACHING CLASPS

Infra Bulge
Push Clasp
Roach Clasp

This bar clasp approaches the retentive undercut

in a gingival direction resulting in a push type of
retention. This push type of retention is more
effective than pull type retention characteristic of
circumferential clasp- tripping action.

111

 This clasp is termed by F.E.

Roach in 1930 and hence
the name Roach clasp.
The bar clasp is classified
by shape of the retentive
terminal T, modified T, I, Y
forms, all of which
originate from the denture
base frame work and
approaches the undercut
from gingival direction.
112

PARTS OF BAR-CLASP
A, buccal retentive arm engaging
measured undercut
B, stabilizing (reciprocal) elements;
proximal plate minor connector on
distal;
C, lingualiy placed mesial minor
connector for occlusal rest, which
also serves as a stabilizing
(reciprocal) component;
D, mesially placed supporting
occlusal rest.

Advantages:

1.

Minimal tooth contact and minimal

distortion of normal tooth contours,
leading to improved tissue stimulation
and oral hygiene and caries and
periodontal problems.

2.

Improved esthetics if the approach

portion of the arm is not visible as it
crosses the gingiva.

3.

Increased retention because of tripping

action.

4.

Decreased torquing forces applied to

terminal abutments in extension RPDs.
114

Disadvantages:

1.

Cannot be used in the presence of soft tissue undercuts

shallow vestibule and high frenum attachments.

2.

Bracing action provided by bar clasp is considerable less than

that provided by cast circumferential clasps.

3.

The bar clasp will not totally disengage in certain distal

extension cases.

4.

Appearance may be adversely affected if the smile line is high

enough to expose the approach arm as it crosses the gingiva

5.

Food entrapment.

6.

Difficult to fabricate and adjust.

115

Indication:

1.

Class I and Class II distal extension partial dentures to engage

the distobuccal undercut on abutment. It can be employed on
canines and sometimes even on molars.

2.

Where the anterior retention is needed: It is often used on

distobuccal surface of maxillary canines and mandibular
premolar as the retentive arm can be hidden from the vision.
Esthetically this clasp is superior to circumferential clasp, it is
inferior in providing stability because of greater flexibility of the
retentive arm.
116

Guidelines for use:

1.

The approach arm of the bar clasp must not

impinge on the soft tissue. It is not desirable to
provide an area of relief under the arms. But the
tissue side of the approach arm should be
smoothed and polished.

2.

Minor connector that attaches the occlusal rest to

the frame work should be strong and rigid to
provide some bracing.

3.

The approach arm must always be tapered

uniformly from its attachment at the framework to
the clasp terminal.

117

4.

5.

The approach arm positioned over a soft tissue

undercut will collect food and irritates lips or
cheeks.
The approach arm should cross the gingival
margin at a 90 degree angle.

118

6. The bar retentive clasp is used only

when the retentive undercut is
adjacent to the edentulous from
which the approach arm originate.
The approach arm must extend on
the abutment tooth to the height of
contour.
The retentive terminal leaves the
approach at that point and extends
into the undercut area.
The other terminal which is away
from edentulous area is positioned
above the height of contour.
The retentive terminal tip must point
towards the occlusal surface never
towards the gingiva.

119

 The bar clasp should be placed as low as on the tooth

as possible while engaging the height of contour to
reduce the leverage induced stress to the abutment
tooth.

120

TYPES OF BAR CLASP

T Clasp
Modified T Clasp
Y clasp
I clasp

121

T-CLASP
Used

in

combination

with

cast

circumferential reciprocal arm.

The retentive terminal and its opposing
encircling finger projects laterally from
the approach arm to form T.
The retentive terminal must cross under
the height of contour to engage the
retentive undercut, while the other finger
of the T stays on the suprabulge of the
tooth.
122

The approach arm should taper gradually and

uniformly from its origin to the retentive terminal.

The

approach arm contacts the tooth only at the height

of contour.

123

 Indication:
- Most frequently used in distal extension ridge where the
usable undercuts is on the distobuccal surface of the terminal
abutment tooth.

- It can also be used for tooth supported partial denture when

the retentive undercut is located on the abutment tooth
adjacent to the edentulous space.

124

 Contra Indication:
- Should not be used on a terminal abutment adjacent to a distal
extension base if the usable undercut is located on the side of the
tooth away from the edentulous space.

- The T clasp can never be used if the approach arm is in the soft
tissue undercut.

- This clasp cannot be used when the height of contour lies close to
occlusal surface.
125

MODIFIED T-CLASP
It is a T clasp with the non retentive
(mesial) finger of the cross bar of the
T- terminal omitted.
Indication:
- Used on canines or premolar for
esthetic reasons.
- When this type of a clasp is used the
encirclement of the abutment tooth is
sacrificed.
126

Y-CLASP
It

is

basically

configuration

occurs

T-clasp,

its

when

the

height of contour on the facial

surface of the abutment tooth is high
on mesial and distal line angles but
low on the center of the facial
surface.

127

I-CLASP
Used on distobuccal surface of maxillary canine for

esthetic reason.

Disadvantage:

- The contact of the retentive clasp with the abutment

tooth is the tip of the clasp an area
Encirclement,

horizontal

stabilization

of 2-3 mm.
may

be

compromised.

128

RPI System (Rest, Proximal plate, I-bar)

Kratochvil in 1963 developed the early clasp assembly which

consisted of three separate units connected to each other only
through the framework. They were the mesial occlusal rest, a distal
guide plane and an I-bar retainer. He preferred a full length guide
plane that is subsequently relieved in the mouth to prevent torque or
binding.
129

 His purposes were:

Elimination of the V-shaped food trap distal to

the tooth.

A highly polished metal contact with the

marginal gingiva, rather than resin .

Intimate metal-to-tooth contact to minimize

food impaction
130

 This design had certain basic disadvantages:

Physiologic relief was required to prevent

impingement of gingival tissues during function.

Since the proximal plate covers a greater surface

area of the tooth, the functional forces are
directed in the horizontal direction, thus the
tooth is located more than the edentulous ridge.

131

 Krol in 1973 made certain modifications in the design of the

proximal plate and named it the RPI bar clasp design.

He had a 2-3mm of contact of the tooth with the guide plane, the
section below this point being relieved and he felt that the V
shaped space that is left underneath was not as detrimental as the
possible restriction of rotation.

This design however, leaves a region occlusal to the proximal

plate where contact between the abutment and denture must be
made by the replacement tooth.
132

OTHER CLASP DESIGNS

RPA CLASPS
The rest-proximal plate-Akers clasp was
developed and described by Eliason in
1983.
It consists of a mesial occlusal rest,
proximal plate and a circumferential clasp
arm, which arises from the superior
portion of the proximal plate and extends
around the tooth to engage the mesial
undercut.
133

RPL CLASP
The effectiveness of RPI clasp assembly can
be increased if the I-bar is replaced by an Lshaped bar direct retainer.
The retainer has been described as one-half Tbar or a modified T-bar clasp or R- bar clasp.
The mesio-occlusal rest and proximal plate
are designed as in the RPI clasp assembly.
The L- bar crosses the gingival margin of the
abutment tooth in the shortest possible line,
ascends to the survey line and engages the
disto-buccal undercut.

VRHR Clasp

The vertical reciprocal horizontal retentive arm

concept was developed by Grasso in 1980 and is
characterized by:

A distal occlusal rest supported by a minor connector.

A lingual vertical reciprocal component originating from the

major connector.

A horizontal retentive arm attached to either the major

connector or the retention latticework for the denture base.
135

CINGULUM CLASP

Miller in 1972 designed a clasp to satisfy both the mechanical

and esthetic requirements without the shortcomings of the
internal attachment.

The cingulum clasp has 2 lingual clasp arms. The use of this
clasp requires that the lingual surface of the abutment tooth be
covered with a gold casting.

A guiding plane is incorporated into the distal surface of the

crown and the clasp is designed as an integral part of the rigid
metal framework.
136

Advantages

Esthetic
A tooth of short clinical crown can be used.
The young pulp is not imperiled by close proximity to metal
which shows thermal conduction.
Less expensive.

Disadvantage
The clasp arms are vulnerable to breakage.

Use
The cingulum clasp can be used as a retainer on cuspid teeth
when other extracoronal retainers are esthetically unacceptable
137

MGR clasp design

McCartnay described the mesial groove reciprocation clasp
in an effort to use the distofacial surface of the maxillary
canine for retention & esthetic.
Retention is provided by 19 gauges round I-bar and retentive
dimple located at distobuccally on the tooth.
Reciprocation is provided by mesial groove or rest and
distal proximal plate.

Spring Clasp/Twin Flex Clasp

This consists of a wire clasp soldered

into a channel that is cast in the major
connector.

The ability to adjust this clasp and its

conventional path of insertion
provides an excellent design option
for retention to an adjacent edentulous
segment.

Equipoise RPD system

Proposed by J. J. Goodman, it is an esthetic
retentive concept for distal extension
situations.
Rests are placed away from edentulous span.
Vertical inter-proximal reduction of 1 mm
between abutment and adjacent tooth is done.
The unique Class II lever design protects,
preserves and strengthens abutment teeth
while directing all forces down the long axis
of the abutment tooth.

FLEXIBLE PARTIAL DENTURES

Flexible partial dentures are made of a
flexible type of acrylic, which is a
more esthetic option than the metal
framework partials.
They do not have a metal framework,
which improves esthetics, but because
the clasps are acrylic and not metal,
they cannot be adjusted.
This makes it more difficult to get an
ideal fit, and because it cannot be
adjusted, it may not stay in as well as
one with metal clasps, which can be
tightened as needed.

MAGNETIC DENTURE RETAINERS

A new retainer for removable
dentures was designed which makes
use of the concept of sectional
denture and employs a magnetic
attachment.
The use of a neodymium-iron-boron
magnet enclosed in a laser-welded
stainless steel casing is a viable
method of retention for removable
partial dentures.

OCCLUSALLY AND GINGIVALLY APPROACHING

CLASPS:

Relative merits and demerits

Retention : The bar clasp approaches the undercut from
below the height of contour and to resist dislodgement,
the clasp pushes towards the occlusal surface of the
abutment tooth. The circumferential clasp engages the
retentive undercut from above the height of contour
and pulls towards the occlusal surface from the
undercut to resist dislodgement.
143

144

Bracing : The circumferential clasp is rigid in the upper

two-thirds of the retentive arm and offers some bracing or
stabilization against lateral stresses. On the other hand, the
bar clasp is flexible throughout its length and does not
contribute to stability.

145

 Stress breaking effect

: The gingivally approaching

clasp allows a certain degree of functional movement of the

distal extension base which helps to dissipate the stresses
and lessen the load on the abutment. Occlusally approaching
clasps have the potential to torque abutment teeth in distal
extension based partial denture situations.

146

 Contact with tooth structure

: The gingivally

approaching clasp contacts minimum tooth structure and has a

minimum interference with natural tooth contour permitting
maximum natural cleansing action, whereas the occlusally
approaching clasps covers more of tooth structure. This
occlusal approach may increase the width of the occlusal
table.

147

 Damage to oral tissues : The area of food lodgement is

at the neck of the tooth, with the cementum in this area being
more likely to be affected by caries than enamel. Trauma to the
gingiva can also occur with bar claps unless sufficiently relieved.
Mishandling of the clasps by the patients during removal of the
prosthesis can result in deformation of the clasp and damage to
soft tissues.

148

 Esthetics :

Gingivally approaching clasps are more

esthetic than occlusally approaching clasps except in

instances where large amounts of gingiva is visible on
smiling.

149

Relative merits & demerits of cast and wrought

wire clasps
Flexibility : The wrought wire clasp has a high degree of flexibility

which helps to better dissipate functional stress and give a stress

breaking effect.
Adjustability : The wrought clasp is adjustable to the required

retention.
Toughness and resiliency : The fabricating process imparts to the

wrought wire a fibrous structure which accounts for its toughness

and resiliency.
Stabilization : The cast clasp on account of rigid crystalline

structure offers better stability.

150

 Cost : Cast clasp requires less cost as soldering is not required

Fit : The adaptation of a cast clasp to the abutment tooth is
accurate and not subject to variation by the clinicians
adjustment as with wrought wire clasps.
Strength and durability : A solder joint near the origin of a
wrought wire clasp reduces its flexibility and increases the
likelihood of breakage.
Apart from these, cast clasps can be formed to act as a bracing
element, can easily include an occlusal rest and be cast as an
integral part of gold alloy or a cobalt-chrome denture base.
151

INTRACORONAL
RETAINERS

152

 The intracoronal retainer is usually regarded as an internal

attachment or precision attachment.

The Glossary of Prosthodontic Terms - 8 defines intracoronal

attachment as:
any prefabricated attachment for support and retention of a
removable dental prosthesis. The male and female components are
positioned within the normal contour of the abutment tooth.

153

GPT-8 Defines precision attachment as: a retainer consisting of

a metal receptacle (matrix) and a closely fitting part (patrix); the
matrix is usually contained within the normal or expanded
contours of the crown on the abutment tooth/dental implant and
the patrix is attached to a pontic or the removable dental
prosthesis framework.

154

As a direct retainer it must provide :

Support

Retention

Reciprocation

Stabilization

Fixation
155

The precision attachment is the only type of intracoronal

attachment that provides for all three functions of a removable
partial denture system.

Lateral force transmission or bracing from the parallel proximal

walls of the rest against the rest seat.
Occlusal force transmission or support from the flat gingival
floor of the result on the rest seat.
Primary retention from the frictional fit between the rest and
rest seat.
156

Advantages of intra coronal retainers:

1. Esthetically acceptable, because not much of metal

display like extracoronal retainers.
2. It is preferred in many of the situation because of its
vertical support through a rest seat located more
favourable to the horizontal axis of the abutment tooth.

157

3. Horizontal stabilization to some extent. Similar to

internal rest, but extracoronal stabilization is
needed.
4. Stimulation to the underlying tissues greater when
internal attachment are used because of the
intermittent vertical massage.

158

Disadvantages of intra coronal retainers:

1.

They require preparation of abutment tooth and

casting.

2.

Difficult clinical and laboratory procedure.

3.

They eventually wear, result in loss of frictional

resistance to denture removal.

159

4. Difficult to repair and replace.

5. They are effective in longer teeth and least effective
in shorter teeth.
6. Difficult to place completely in the abutment teeth.

160

Limitations of intra coronal retainers:

1.

Large pulp size which is usually related to the age of

patient.

2.

Length of the clinical crown, not used in short or

abraded teeth.

3.

Expensive

4.

Distal extension denture bases.

161

Classification
Classification by Good Kind and Baker in 1976 :
1)Intra coronal
a. resilient
b. non resilient
2) Extra coronal
a. resilient
b. non resilient
162

Gerardo Becerra et al in 1987 classified precision

attachments as :
1) Intra coronal attachments
a. Frictional
- tapered and parallel walled boxes and tubes
- adjustable metal plates
- springs
- studs
- locks
b. Magnets

163

2)

Extra coronal attachments

a. Cantilever attachments
- rigid attachments
- movable attachments
b. Bar attachments

164

Tapered And Parallel Walled Boxes And Tubes

Designed to be used in FPD.
Plastic pre fabricated patterns.
Provides vertical support and lateral stabilization.
Simple pin and tube or rectangular block and boxes.
E.g. : Mc Collum attachments.

165

McCOLLUM ATTACHMENTS

166

Adjustable Metal Plates

Similar to block and box variety .
Provided with a narrow slit in the metal block or male portion of the
attachment to increase the friction.
Provides a simple and effective form of direct retention.
At least 2.5 mm of tooth height is required.
E.g.: Crismani attachment.
Mc Collum attachment.
Stern attachment
Chayes or Rley attachment.

167

CHEYES
ATTACHMENT

CRISMANI
ATTACHMENT

Springs

Incorporated in the male part to control the friction.

Spring activates a plunger rod which protrudes from male part

to engage a depression in the female part.

Approximately 4 5 mm of vertical height is required.

E.g.: Schatzmann attachment.

169

SCHATZMANN ATTACHMENT

170

Studs

A metallic stud can be soldered to post and core and

cemented into an abutment.

Direct retention can be obtained by using a stud which

clips into an flexible ring.

Sufficient clearance is required to arrange the artificial

teeth.

E.g.: Ceka attachment

Rotherman attachment
171

Ceka attachment
The Ceka attachments was developed by Karl Cluytens
in 1951. In 1968 the original attachment was modified to form
the present Ceka attachment system.
The Ceka attachment unit consists of a male pin
engaging the centre of a circular retaining element. The male
retaining pin is attached to the denture and engages the
centre of the retaining element that is joined to the abutment
tooth.

172

Locks

These lock rigidly into the attachments .

The vertical height required for this attachment is at

least 6 mm.

Retained with pins or incorporated in post and core

E.g.: T - block attachment

173

T-ATTACHMENT

174

NEUROHR SPRING LOCK ATTACHMENT

175

Magnets
Small metal keeper is attached to the tooth surface,
usually into the root canal and magnet is incorporated
into the resin.
Alloy in the magnet produces a magnetic force that is
strong .
Magnets are brittle and corrode unless protected in a
stainless steel shelf.
176

CANTILEVER ATTACHMENTS
Rigid attachments

They are pin and tube joints that use a slit in the pin or
multiple pin tubes and slots to enhance retentive friction
between the parts with the natural teeth on the either side of
the edentulous space.

These attachments offer excellent stability and retention

in tooth supported partial dentures.

e.g.: Scott attachment

Thompson dowel rest system.
177

 Movable attachments:
These allow the prosthesis to rotate around a horizontal axis and
transmit occlusal forces to the residual alveolar ridge .
E.g.: Dalbo attachments

178

Bar attachments

These can be connected to

the cast metal crowns or
copings .

Custom made bars can be

cast with a flat upper
surface to support the
prosthesis and parallel sides
that help to stabilize it.
E.g.: Dolder bar.

179

SUMMARY & CONCLUSIONS

180

 Function, esthetics and harmony of the dental structures have become one
entity. To develop an esthetically, technically and functionally adequate
restoration, it is essential to treat and prepare the remaining teeth.

Provision for retention of a prosthesis in a partially edentulous situation

requires a choice between an extracoronal retainer and an intracoronal
retainer.

181

 Direct retainers for distal extension removable partial

dentures should be chosen after careful evaluation of each
individual situation and consideration of the merits and
contraindications of each clasp design. Once the retainer is
chosen,

meticulous

adherence

to proper

designing

principles will ensure a successful distal extension

removable partial denture.

 The clasp was one of the earlier devices of dentistry; it is

still one of our simplest, and can be made one of our most
reliable devices. In conjunction with a correctly made lug,
it is the retaining appliance that can be used in a great
majority of instances, on natural teeth, with the least harm,
either from operative interference with their structure at
the time of application, or from deleterious influence in the
decades that follow. Edward Kennedy 1932.

BIBLIOGRAPHY

Applegate O.C. : Text book of Removable Partial Prosthodontics, St. Louis,

CV Mosby Co.

Becker C.M., Campbell H.C., Williams D.L., The Thompson Dowel-rest

system modified for chrome-cobalt RPD frame works. J. Prosthet. Dent.,
1978; 39 : 384-391.

Brudvik J.S., Morris H.F. Stress relaxation testing. Part II : Influence of wire
alloys, gauges and lengths of clasp behaviour. J. Prosthet. Dent., 1981; 46 :
374-379.

Clayton J.A., Kotowicz W.E. Precision attachments. D.C.N.A., 1980; 24 : 1.

Stewart, Rudd and Kuebker: Clinical removable Partial Prosthodontics ,2 nd

edn, EuroAmerica Inc, publishers Tokyo, 1997
184

Cecconi B.T., Asgar K., Dootz F. The effect of partial denture clasp
design on abutment tooth movement. J. Prosthet. Dent., 1971; 25 : 44-55.

Davenport J.C., Baskar R.M., Heath J.R., Ralph J.P. A color atlas of
RPD, Wolfe Medical Publications Ltd., 1988.

Graber G., Haesler V., Weill P. Color atlas of dental medicine RPD.
Vol.2, Medical Publishers Inc., New York, 1988.

Henderson D., McGivney G.P., Castleberry D.J. : McCrackens

removable partial prosthodontics, 8th Edn. St. Louis ; CV Mosby Co.

Krol A.J. Clasp design for extension base RPD. J. Prosthet. Dent., 1973;
29 : 408-415.

Miller E.L., The cingulum clasp. J. Prosthet. Dent., 1972; 28: 369-372.

185