INDICATIONS – HIGH YIELD

Maxillary Major Connector Indications

Mandibular Major Connector Indications

MAXILLARY MAJOR CONNECTORS

1. Single Palatal Bar

• Palatal connector having less than 8 mm width, referred to as a palatal bar.
• Least logical of all palatal connectors.
• It has to be made bulky, in order to maintain rigidity.
• Derives least support from the palate.

Indication:

• For interim partial dentures.

Disadvantages:

• Cannot be used anterior to the premolar region due to interference with the tongue.
• Used only in Kennedy’s Class III.

2. Palatal Strap

• Should be at least 8 mm wide for adequate rigidity.
• Has suitable rigidity, without excessive bulk.
• Width can be increased as the edentulous span increases in length.

Indications:

• Best suited for short-span edentulous spaces in tooth-supported prosthesis (Kennedy’s Class III).

Advantages:

• Provides good resistance, due to minimum volume of metal.
• Provides excellent resistance against bending and twisting forces on the denture.

Disadvantages:

• Causes papillary hyperplasia.
• The posterior border should end before the junction of hard and soft palates.

3. Anteroposterior Palatal Bar (Double Palatal Bar)

• It is a combination of anterior palatal strap and posterior palatal bar.
• Most rigid palatal major connector due to limited soft tissue coverage.
• Posterior bar is half-oval and has a width equal to a single palatal bar but is less bulky.

Indications:

• Long edentulous span in Class II modification I arch.
• Indicated in presence of tori, that is not planned to be removed.

Advantages:

• Rigid.
• Strong.
• Limited soft tissue coverage.

Disadvantages:

• Not indicated in high narrow palatal vault and periodontally weak teeth.

4. Anteroposterior Palatal Strap (Closed Horse Shoe Shaped)

• Structurally, it is a rigid palatal major connector.
• Indicated in almost any maxillary partial denture design.
• Anterior border should be located posteriorly in valleys, between the rugae crests.
• Posterior border located at the junction of hard and soft palates.
• Considered the best-designed palatal major connector.

Indications:

• In Kennedy’s Class I and Class II cases.
• When numerous teeth are to be replaced, and torus is present.

5. Horse Shoe Shaped (U-Shaped Connector)

• Least desirable palatal major connector.
• Poorest design because it lacks rigidity.
• Used when anterior teeth are to be replaced.
• Also used in presence of tori, extending to the posterior border of the hard palate or prominent median suture.
• This design leads to increased flexibility and movement at the open ends.
• The wider the coverage, the more it resembles a complete palate.

6. Complete Palate (Palatal Plate)

• Covers entire palate.
• Provides the greatest retention.
• Due to accuracy and stability of cast metal, posterior palatal seal is not necessary.
• Posterior border extends to the junction of hard and soft palate.

Indications:

• When anterior or posterior teeth are to be replaced bilaterally.
• Kennedy’s Class I cases.
• For patients with well-developed muscles of mastication.
• Cases with flat ridges and shallow vaults, where high stability is required.
• In cleft palate cases.

MANDIBULAR MAJOR CONNECTORS

1. Lingual Bar

• It is the most commonly used mandibular major connector.
• Basic form: Half pear-shaped bar, with the broadest portion at the inferior border.
• At least 8 mm of vertical space should be present between the active tissues of the floor of the mouth and gingival margins. More inferior placement reduces tongue interference.
• Minimum height: 5 mm.
• Made from thick (6 gauge) half pear-shaped wax pattern.
• It is the first preference in selecting lingual major connectors.
• Surgical removal of tori is usually required for a successful prognosis.
• It has minimal contact with oral tissues and no contact with teeth.
• The sulcus must be relieved.

2. Lingual Plate

• It is a half pear-shaped lingual bar with a thin solid metal piece extending upward from the bar onto the lingual surface of teeth.
• Superior border must be scalloped and knife-edged.
• Chrome metal is used because it is very rigid in thin dimensions.
• Anteriorly, the lingual plate should be supported by a rest located on the mesial fossa of the 1st premolar when indirect retention is required.

Indications:

• When most posterior teeth are lost and additional indirect retention is required.
• To stabilize periodontally weakened teeth (acts like a splint).
• In Kennedy’s Class I cases when residual ridges have undergone excessive vertical resorption.
• When one or more incisor teeth have to be replaced in the future.
• For patients with wide spacing of anterior teeth, step-back design can be made to prevent metal display. This is called an interrupted lingual plate.

3. Kennedy Bar (Double Lingual Bar)

• Also called a lingual bar with cingulum bar or continuous bar retainer.
• Differs from a lingual plate as the middle portion (of material) is taken off.
• The lower part is pear-shaped, similar to a single lingual bar.
• The upper bar should not run straight but should dip into the embrasures. This makes it more esthetic than the lingual plate if a wide anterior diastema is present.
• Rests must be placed at the end of each part in the mesial fossae of the 1st premolars.
• It is indicated primarily when indirect retention is required and when periodontal disease has resulted in large interproximal spaces.

4. Labial Bar

• Similar to the lingual bar but placed on the labial surface.
• Runs along the mucosa, labial to the mandibular teeth.
• Indicated in cases of extreme lingual inclination of anterior teeth and premolars, which prevent the use of a lingual bar.
• Also indicated when the mandibular torus interferes with the placement of a lingual bar.