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Varna Medical Forum

Combined Partial Dental Prosthesis With Bar Attachment

Svetlana Angelova, Maksim Simov, Natalia Atanasova, Margarita Nikodimova, Heli Kuuse, Minko Milev


It is thought that, in 1913, Gilmore was the first to suggest a bar as a fixing and stabilizing apparatus in a partial dental prosthesis. This is a bar, which is placed 1-2 mm over the mucosa and directly connects, in a straight line, two outlying crowns, which are glued to the abutment teeth. Since then the technology has evolved immensely and now bars are attached to dental implants as well. There are indications for bar attachment when there is at least one limited area in which teeth can be connected in a straight line. However, if the abutment teeth are depulped, with imprecisely filled root canals, or with periapical changes and with lost reserve strength of the periodontium, such fixing and stabilizing construction is not suitable. The disadvantage of metal bar systems with ovoid profiles is that with time (1-1.5 years) the elasticity of the saddle decreases, the spring wears out and the prosthesis sinks. In our country, bar systems with changeable saddles from flexible plastic, which enfold the bar completely, have been created. A change of the saddle is recommended after a certain period of time in order to extend the functional fitness of the prosthesis. In addition, nonmetal technologies have gained popularity in the field of prosthodontics. The aim of the current article is to present two clinical cases related to placing prostheses on patients with the help of combined constructions with bars over implants in the upper and lower jaw. The plastic saddle, due to elastic deformation and the fact that it is free and not fixed in the partial prosthesis, allows the development of bilateral micromovements. An excellent esthetic effect is achieved because the bar remains hidden. Despite the indicated advantages of this type of dental prostheses, the problem with the accumulation of dental plaque and food particles around the bar and the saddle remains. This creates conditions for inflammation of the mucosa. There is a possibility of the existence of an air chamber with decreased pressure between the bar and the alveolar ridge, which may lead to mucosal proliferation.


combined partial denture, clinical case, bar, saddle, esthetics

Full Text


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