Attachments

Attachments are used in a variety of ways. Typically they are used in connection with partial abutment crowns either existing or new. Also in implant restorations on bars or used individually. We see mostly free end partials and  where clasping in the esthetic zone is not desirable.

Here are some ideas to follow when designing these restorations.

• What is the condition of the teeth? Is there good bone support? If not, teeth can be splinted
• What is the condition of the edentulous ridge? Any resorption? You may choose not to use a resilient attachment if significant bone loss exists. Resilient attachments put more stress on the ridge.
• How many abutments? What are their sizes and positions?
• How much vertical space does the patient have from the ridge to the opposing dentition?
• What about the patient’s manual dexterity. What can they handle? Some attachments can be difficult to insert and remove. Extracoronal attachments are the easiest for the patients.
• What alloy should the attachment be made of?  Use a Vickers hardness of at least 200.

Laboratory protocol

• Start with mounted study models and information on the condition of possible abutment teeth. We will return these to you with our ideas for a treatment plan.

• The laboratory will suggest the type of prep needed for the attachment and if we need a pre-op bite registration prior to fabrication of crowns.
• We will design the crowns and decide if they can be permanently cemented or if they need to be returned to the laboratory in a pickup impression to fabricate the partial.
• Once the crowns and partial framework are made, then we can decide the best plan for finishing the partial. We could place wax rims on the framework or set teeth for wax try in.
• Once the partial is processed and polished, the crowns and partial can be delivered to the patient.
• Most attachments have a specific impression transfer piece. Some are metal, some are plastic.