Supports and breaks

The ability of teeth to withstand functional forces and remain stable over time is provided by
through their sophisticated support mechanisms. Studies have shown that displacement and the
recovery after loading is much better for natural teeth than for the oral mucosa. In
consequence, the appropriate use of teeth to help resist functional forces in removable prostheses is
a critical strategy to control the movement of the prosthesis and achieve functional stability.

Role of breaks in the control of prosthesis movement

The proper use of the teeth requires consideration of the best way to engage the teeth to
the supportive qualities they provide.
Because the most effective resistance can be provided if the tooth is stressed along its axis.
long, the prosthesis framework must fit the tooth in a way that stimulates axial loading. The various forms
the remains mainly aim for a shape that allows for axial loading. It is important to realize that
this goal can only be achieved through some form of tooth modification.
Vertical support must be provided for a removable partial prosthesis. Any component of a denture
A partial surface of the tooth that provides vertical support is called a rest. The rests must always be
to be located on adequately prepared tooth surfaces. The prepared surface of a pillar to receive
the rest is called a rest seat. The rests are designated by the surface of the prepared tooth for
receive them (occlusal rest, lingual rest, and incisal rest). The topography of any remnant must restore the
topography of the tooth that existed before the rest seat was prepared.
The main purpose of the rest is to provide vertical support for the partial prosthesis. In doing so, it also does
next:
Keeps the components in their planned positions
2. Maintain established occlusal relationships by preventing the settling of the denture
3. Prevents soft tissue impact
4. Directs and distributes the occlusal loads to the abutment teeth

Therefore, the remains serve to support the position of a partial denture and to resist movement towards the
tissue. They serve to transmit vertical forces to the abutment teeth and direct those forces along the long axes.
of the teeth. In this regard, removable partial dental supports supported by teeth function as
a way similar to the fixed retainers of the pillar. It is obvious that for this degree of stability to exist, the remnants
they must be rigid and must receive positive support from the pillar teeth, which means that under occlusal load, the
The rest and the tooth remain in stable contact and there is no independent movement or sliding occurring.
In a removable partial denture that has one or more distal extension bases, the denture becomes increasingly
tissue as the distance from the pillar increases.
Closer to the abutment, however, more of the occlusal load is transmitted to the abutment tooth through the rest.
The load is distributed between the pillar and the residual crest tissue support.
When the remains hinder the movement of the denture in an apical direction, the position of the retentive portion
The hook arms can be maintained in a designated relationship with the lower cuts of the tooth. Although
passive when it is in its terminal position, the retaining part of the closing arm must remain in contact with
the tooth, ready to withstand a vertical displacement force. So, when a force is applied
Detachment, the hook arm must be activated immediately to resist vertical displacement. If
the settling of the denture results in the hook arms moving away from the tooth, it is possible that some
vertical displacement before the retainer can be functional.
The remainder helps to prevent such sedimentation and therefore helps to maintain the vertical stability of the denture.
partial. The use of an implant can also be considered as a residue. In this application, the implant eliminates the
compression of the supporting soft tissues, controls the vertical movement of the denture base, eliminates or
It alters the fulcrum lines and serves to increase the support and stability of the prosthesis.

Form of Rest and Occlusal Rest

The shape of the outline of an occlusal rest seat must be a rounded triangular shape with the vertex
towards the center of the occlusal surface.
2. It must be as wide as it is, and the base of the triangular shape (at the marginal ridge) must be at least 2.5 mm.
for the molars and premolars. The smaller-sized resting seats do not provide a
adequate volume of metal for the residues, especially if the residue is contoured to restore the
occlusal morphology of the abutment tooth.
3. The marginal rib of the supporting tooth at the resting seat site must be lowered to allow a mass of
metal sufficient for the resistance and rigidity of the rest and the smaller connector. This means that it is usually necessary to have a
reduction of the marginal crest of approximately 1.5 mm.
The floor of the occlusal rest seat must be apical to the marginal ridge and the occlusal surface and must be
concave or spoon-shaped. Care should be taken when preparing a resting seat to avoid the creation
from sharp edges or line angles in the preparation.
5. The angle formed by the occlusal rest and the vertical minor connector from which it originates must be less than 90 degrees.
degrees. Only in this way can the occlusal forces be directed along the long axis of the supporting tooth. A
An angle greater than 90 degrees does not transmit occlusal forces along the vertical axis of support of the supporting tooth.
This also allows the prosthesis to slide away from the stop, which can lead to forces being applied.
orthodontic type to an inclined plane on the top, with possible movement of the tooth.

When an existing occlusal rest preparation is inclined apically towards the reduced marginal ridge and
it cannot be modified or deepened due to fear of enamel perforation or restoration, it must
Use a secondary occlusal rest to prevent the sliding of the primary rest and movement.
orthodontist from The Pillar Tooth.
That rest must pass over the marginal ridge lowered on the tooth side opposite to the primary rest and, if possible,
it should be slightly tilted apically from the marginal ridge. However, two opposing occlusal supports
About the divergent inclinations of the teeth will work to avoid unfavorable forces if all the
Related connectors are sufficiently rigid. In any partial prosthesis with dental tissue support, the
the relationship of the occlusal rest with the abutment should be that of a shallow ball and socket joint, to avoid
a possible transfer of horizontal forces to the pillar tooth. The occlusal rest must provide only
occlusal support. Stabilization against the horizontal movement of the prosthesis must be provided by others
components of the partial prosthesis more than by any effect of occlusal rest blocking, which will cause the
application of leverage to the supporting tooth.

Extended Occlusal
In Kennedy Class II, modification 1 and Kennedy Class III, where the most posterior abutment is a molar with
mesial point, an extended occlusal rest must be designed and prepared to minimize additional tilting of the pillar and
ensure that the forces are directed downward along the long axis of the pillar. This remainder must extend over half of the
the mesiodistal width of the tooth should be approximately one third of the bucolingual width of the tooth, and should
allow a minimum of 1 mm thickness of the metal; The preparation must be rounded without cuts or sharp angles.
In situations where the pillar is severely tilted, extended occlusal rest may take the form of
a onlay to restore the occlusal plane. The dental preparation for this type of extended rest must include the
removal or restoration of cavities, cracks, and grooves; placing a bevel of 1 to 2 mm on the buccal occlusal surfaces
and lingual to allow the extended rest (onlay) to provide stabilization; Allowing the rest to restore the
contour and occlusion of the natural tooth; And ensuring that the rest directs the forces down the long axis of
tooth. The preparation of the tooth must also include a guiding plane of 1 to 2 mm on the mesial surface of
pillar.

Interproximal Occlusal Restoration

The design of a direct retainer set may require the use of interproximal occlusal supports. These
resting seats are prepared as individual occlusal resting seats, with the exception that the
preparations must extend linguistically beyond what is normally done. The adjacent remnants, in
place of a single rest, are used to prevent interproximal blockage by the framework. In addition, the connected remnants
They are designed to divert food away from contact points.
When preparing such rest seats, care must be taken to avoid the reduction or elimination of the
contact points of the pillar teeth. However, sufficient tooth structure must be removed to
allow an adequate volume of the component for strength and to allow the component to have a
in such a way that the occlusion is not altered. Therefore, the analysis of mounted diagnostic models is mandatory for the
evaluation of the areas of interocclusal contact where the remnants will be placed. It must be present or
enough space created to avoid interference with the placement of the remains.
The lingual interproximal area requires only minor preparation. The creation of a vertical groove should be avoided.
to avoid a twisting effect on the stoppers by the smaller connector.

Internal Occlusal Reclusion

A partial prosthesis that is fully supported by teeth using clasp retainers on all teeth.
A pillar can use intracoronal remnants for both occlusal support and horizontal stabilization.
An intracoronary rest is not a retention and should not be confused with an accessory. The occlusal support is derived from the floor.
of the resting seat. The horizontal stabilization is derived from the almost vertical walls of this type of seat.
of rest.
The shape of the remainder should be parallel to the placement trajectory, slightly tapered occlusally, and slightly
dovetailed to prevent dislodging proximally. The main advantages of the internal rest are that it facilitates the
oral removal of a visibly closed arm and allows the placement of the resting seat in a more
favorable regarding the tilt axis (horizontal) of the stop. The retention is provided by an arm of
lingual closure, whether cast or forged wire, that is found in a natural or prepared infrabulge area in the
pillar tooth. The internal remains are carved in wax or eroded spark in the pillar castings. The patterns of
Plastic rests are available and can be waxed in crown or patch patterns, inverted and poured afterwards.
to have been placed parallel to the placement trajectory with a dental plaster surveyor.
Future developments and techniques promise a more widespread use of internal occlusal rest, but only for
dentures with tooth support.

Support for rest

The remnants can be placed over healthy enamel or on any restorative material that has been.
scientifically proven to resist fracture and distortion when subjected to applied forces.
The residues placed on the sound enamel are not conducive to cavities in a mouth with a low index of
caries, as long as good oral hygiene is maintained. The proximal dental surfaces are much more
vulnerable to the attack of caries than the occlusal surfaces that support an occlusal rest. The decision to use the
the coverage of the pillar is generally based on the preparation of the necessary mouth, determined from the
inspection of the diagnostic molds, to accommodate the necessary modifications of the pillar teeth for
to manufacture a removable partial prosthesis. When the precarious fissures are located in areas of occlusal rest in
teeth that are otherwise healthy can be removed and properly restored without the use of a
more extensive protection of the pillar. Although it cannot be denied that the best protection against cavities for a tooth
from the pillar is the full coverage, it is essential that such crowns are properly contoured for
provide support, stabilization, and retention for the partial prosthesis.
When deciding to use unprotected enamel surfaces for resting, one must consider the
future vulnerability of each tooth because it is not easy to produce complete crowns to accommodate remnants and arms of
closure after the partial prosthesis has been made. In many cases, acoustic enamel can be used with
safety for the support of occlusal rests. In such situations, the patient should be informed that the
future
The susceptibility to cavities is not predictable, and it depends a lot on oral hygiene and possible changes.
futures in the susceptibility of caries. Although the decision to use unprotected pillars should logically be
leaving to the dentist, economic factors may influence the final decision. The patient must be informed of the
risks involved and of their responsibility to maintain good oral hygiene and to return periodically
for observation.

The preparations for the resting seats must be made in sound glaze. In most cases, the
Preparation of the proximal surfaces of the teeth is necessary to provide proximal guiding planes and
to eliminate undesirable lower cuts that the rigid parts of the structure must pass through during the
placement and removal. The preparation of occlusal rest seats must always follow proximal preparation.
never precede it. Only after the alteration of the proximal surfaces of the teeth has been completed.
It will be possible to determine the location of the occlusal rest seat in relation to the marginal ridge.
When the proximal preparation follows the preparation of the occlusal rest seat, the inevitable consequence is
that the marginal rim is too low and too sharp, with the center of the floor of the resting seat
too close to the marginal ridge. Therefore, it is often impossible to correct the preparation of the rest without
make it too deep, causing irreparable damage to the tooth.
The occlusal rest seats in the sound enamel can be prepared with burs and polishing points that
leave the surface of the enamel as smooth as the original enamel (Figure 6-14). The largest round bur is
use it first to lower the marginal crest and to establish the contour shape of the resting seat. The
The resulting occlusal rest seat is then complete, except that the floor is not sufficiently
concave. A slightly smaller round router bit is used to deepen the floor of the resting seat.
occlusal. At the same time, it forms the desired spoon shape within the lowered marginal ridge. The preparation is
polish with an appropriately sized and shaped point.
When a small enamel defect is found in the preparation of an occlusal rest seat,
it is usually better to ignore it until the preparation of the rest is complete. Then, with the small strawberries,
the remaining defect must be prepared to receive a small restoration. This can be finished flush with the
rest preparation floor that was previously established.
A fluoride gel should be applied to the pillar teeth after the recontouring of the enamel. If the mold
the main one is made from an irreversible hydrocolloid impression, the application of the gel should be delayed until
after prints are made due to some fluoride gels and irreversible hydrocolloids that can
to be incompatible.
The preparations of the occlusal rest seat in existing restorations are treated in the same way as
the sound enamel ones. Any proximal preparation should be done first, as if the resting seat
The occlusal is placed first and then the proximal surface is prepared, the shape of the contour of the rest seat.
Occlusion can sometimes become irreparably altered.

There is always the possibility of perforating an existing restoration in the preparation process of a
ideal occlusal rest. Although a compromise is allowed, the effectiveness of the occlusal rest seat should not be undermined.
in danger due to fear of perforating an existing restoration.
The resting seat can be widened to compensate for the shallowness, but the floor of the seat
The rest should be slightly inclined apically from the marginal ridge. When this is not possible, it should be
use a secondary occlusal rest on the opposite side of the tooth to prevent the sliding of the primary rest.
When the drilling occurs, it can be repaired, but occasionally the manufacturing of a new restoration is
inevitable. In such a situation, the original preparation must be modified to accommodate the occlusal rest, thus avoiding
the risk of perforating the completed restoration or creating a restoration with a rest seat
inadequate.
The location of the occlusal rest seat in the new restorations must be known when the tooth is
prepare so that enough free space can be provided for the resting seat inside the
preparation.
The final step in the preparation of the tooth must be to ensure that there is such clearance and, if not, to make a
depression to accommodate the depth of the rest (Figure
6 - 15). The occlusal rest seats in crowns and inlays are usually made somewhat larger and more
deeper than those in enamel.
Those made in the support crowns for dentures with dental support can be made slightly more
deeper than those in the pillars that support a base of distal extension; Therefore, they approach efficacy
from the internal rest box. The internal rest seats should also be created first in wax, as
be with suitable strawberries on a handpiece support or waxing around a lubricated mandrel, which is
holds in the surveyor.
In any situation, the preparation of the rest must be finished in the casting with hand-held milling cutters.
or with a precision drill. Plastic and metal shoes that fit over a mandrel are also
available for this purpose. In this way, a smooth casting is ensured and the need for finishing is eliminated.
interior of the inner rest with strawberries. There must be sufficient clearance in the preparation of the stop for
adjust the depth of internal rest.