These Crazy Little Things – the MultiSafe Latch Attachment

These crazy little things ….
The MultiSafe Latch Attachment

by Ulrich Heker, Master Dental Technician

Where the reduction in dentition consists of more than one tooth, on one side of the jaw, the solution can be difficult, laborious or uncomfortable for the patient. In this article, we report on the possibilities for the treatment of curtailed free end edentulous ridges via removable prosthetics by using key-slides, in particular the ‘Degudent multiSafe latch attachment’.

Monoreductor Definition

A monoreductor is a one-sided prosthesis which is usually only made for one side of the jaw. This fills in free ends of free end edentulous ridges. The prosthesis is not supported by a tooth at its end; the prosthesis rests on the jaw ridge on onehalf of the jaw. The usual situation for a key-slide prosthesis is generally the absence of the first and second molars on one side. If a prosthesis mounted on an implant is not appropriate, then the two premolars are crowned and the molars are replaced by a monoreductor prosthesis. This requires a sufficient vertical sizing of the slide as the construction requires a minimum height for the clinical premolar crowns.

Showing an asymmetrically shortened dental row in the upper jaw.

fig 1: Showing an asymmetrically shortened dental row in the upper jaw.

History

‘spider’ or ‘clasp’ bridges

fig. 2: ‘spider’ or ‘clasp’ bridges

In the past, foreshortened free end edentulous ridges were treated using removable cast metal partial dentures that were far too small.These small removable prosthetic appliances were in the past often retained by double clasps. These were used to provide additional retention to hold the small denture in place. This carried the replacement teeth. These were known as ‘spider’ or ‘clasp’ bridges. Such appliances are contraindicated as they pose a great risk of swallowing or inhalation where there is a malfunction or loose fitting.

Detail showing the key-slide Attachment

fig 3: Detail showing the key-slide mechanism

The multiSafe latch attachment is an extracoronal connective, retention, and support element for partial dentures and for implant superstructures. The fact that the connection can be easily severed by the patient makes the multiSafe latch attachment particularly suited for the fabrication of unilateral denture bases (monoreductor). The saddle of the denture base must be maximally extended.

 
 
A maximum of two premolars and one molar or two molars should be replaced to avoid overloading the latch attachment.The premolar columnar teeth must be stable parodontally and fulfil the requirements of bridge abutments for fixed dental replacement. Note that if the crowns on the premolars are too short, they impede later hygiene, as a slide resting directly on the gingivum is difficult to clean, thus creating the risk of caries around the distal crown periphery. The tissue fit of the denture base must be checked regularly by a dentist and the denture Reliant is needed. 

The secondary construction: lingual view of the Attachment

fig 4: The secondary construction: lingual view


The plan is to fit a channel shoulder pin (RSS solution)The construction principles of this type of prosthesis are based on a precision mechanical attachment element, the keyslide, which is attached to terminal crowns. The removable part of the prosthesis is fixed to this key-slide and prevents accidental removal.

Multisafe – the individual components

A short trip to the technician’s workplace

Mounting of the slide: here with a telescope double crown solution

fig 5: Mounting of the slide: here with a telescope double crown solution

Precision milling of the telescopes, Preparing the Attachment

fig 6: Precision milling of the telescopes

The fixed primary unit is attached externally to the crowns or bridge.There is a small spring-loaded bolt in the removable secondary element, which ensures the firm attachment of the denture base. All that is visible is a small button on the interior
(Fig. 3).Pressed for prosthesis removal, this will spring back into the final position after insertion.



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