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PRECISION AND SEMI PRECISION ATTACHMENTLEC.9Assis.Prof.Dr.Radhwan Himmadi Hasan2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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* Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Clinical application of precision -attachment:1- Crown & Bridge restorations 2- Partial Denture restorations3- Over denture restorations4- Implant restorations
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* Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
What is precision Attachment? An attachment is a connector consisting of two or more parts One part is connected to a root, tooth, or implant and the other part to a prosthesis. Attachments can be divided into two categories: Precision and Semi-Precision
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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Intracoronal attachments are incorporated entirely within the contour of the crown. The advantage of an intracoronal attachment is that the occlusal forces exerted upon the abutment tooth are applied close to the long axis of the tooth. Disadvantages: 1-more tooth structure should be removed,2-These attachments are non resilient.3- Most wear occurs on these attachments during placement and placement.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
* Intracoronal Attachment
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The components can be seen here close up.

Male portion of the attachment on the partial denture
Female portion of the attachment incorporated in the crown
Partial denture in place with the attachment serving the function of the occlusal rest, and the clasp components
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Extracoronal attachments are positioned entirely outside the crown contour of the tooth. The advantages of this type of attachment are that the normal tooth contour can be maintained, minimal tooth reduction is necessary and the possibility of devitalizing the tooth is reduced. Also, the path of insertion is easier for patients with limited dexterity. Disadvantages: It is more difficult to maintain hygiene with extracoronal attachments and patients need to be instructed on the use of hygiene accessories.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
* Extracoronal Attachment
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EXAMPLES OF EXTRA CORONAL ATTACHMENT Ceka Attachments

Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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With two teeth remaining, the choice may be made to use a bar type attachment rather than the intracoronal attachments seen at the upper right. For the edentulous patient two implants may be placed and a bar fabricated to retain the lower complete denture.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017

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Extra coronal precision attachments for removable partial dentures are recommended when:(INDICATIONS) 1-Less tooth reduction is required. Retaining abutments are small to avoid over-contoured intra coronal attachment abutments and/or pulpal exposure. 2-Extracoronal precision attachment are traditionally easier to insert and remove. These are used for patients with limited manual dexterity, or the prosthesis has a difficult path of insertion and removal. 3-The patient does not always wear the removable prosthesis. Intra coronal females in retaining abutments will collect food and present problems when the patient attempts to seat the intra coronal retained prosthesis
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Examples of Intra coronal attachmentUNOR 10802

Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Intra coronal precision attachments for removable partial dentures are primarily selected when:(indications) A. The retaining abutments are large enough for adequate tooth reduction for the attachment female to be incorporated into a normal crown contour. B. Strong or multiple abutments exist as the forces are directed to the retaining abutments. C. A stable occlusal table is desired. D. Often opposing either a full denture or a bilateral free-end removable partial denture.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Advantages of semi-precision and precision partial dentures include: 1. Improved appearance due to the lack of visible clasps; 2. Since no metal components are present to interrupt the continuity between natural teeth and prosthetic teeth, the transition from the partial denture to the real teeth appears very natural. 3. May provide better distribution of force to the remaining natural teeth than is possible with a conventional partial denture with clasps.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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Disadvantages of semi-precision and precision partial dentures include: :1. Increased cost due to technically demanding procedures; 2. Typically require placing crowns on several natural teeth; 3. More difficult to fabricate and adjust; and 4. Periodic replacement of attachment components is typically required.
Assis.Prof.Dr.Radhwan Himmadi Hasan - 2017
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