Rest and rest seats

Shafli zumi
Final year part 2
CONTENTS

1.INTRODUCTION
2.DEFINITION
3.FUNCTIONS
4.CLASSIFICATION
5.TYPES
6.CONCLUSION
7.REFERENCES
DEFINITION
REST:It is a rigid extension of a removable dental prosthesis
that prevents movement towards the mucosa and transmits
functional forces to the teeth (GP T8).
REST SEATS: The prepared recess in a tooth or restoration
created to receive the occlusal, incisal, cingulum, or lingual
rest (GPT8).
Functions
1.SUPPORT: The primary function of the rest is to provide support to the removable
partial denture, thereby preventing movement of denture towards the tissues.

2.FORCE TRANSFER :The rest aids in transferring the forces along the long axis of
teeth

3.INDIRECT RETENSION :The rests are positioned anterior or posterior to the axis of
rotation to prevent the unsupported distal extension denture base from lifting away
from the edentulous ridge.

4.POSITIONAL MAINTENANCE The rigidity of the rest helps in maintaining the

clasp assembly in position for proper function of the other components of
removable partial denture.
5.STABILITY:The thickness and position of rest reciprocates horizontal
forces generated during function and thus assist in stability of the denture
with other components of removable partial denture.

6.ESTABLISHING OCCLUSAL PLANE:Rest helps in establishing occlusal

plane in situations like tipped molar. An occlusal onlay rest is designed to
establish a more acceptable occlusal plane.

7.PREVENT FOOD IMPACTION:The proximal surface of the abutment teeth

close to the edentulous space is prone for food impaction.

8.PREVENT TOOTH MIGRATION :The smaller partially eden-tulous spaces

which are difficult to restore cause discontinuity of arch and cause tooth
migration problems. The rest placed on the proximal surface of teeth
adjacent to edentulous space prevents tooth migration and thus
maintains small edentulous spaces.
Classification
BASED ON RELATION TO RETAINER
1.PRIMARY REST: These are attached to the clasp assembly and aid in support.
2.SECONDARY REST:These are placed away from the clasp assembly and
primarily aid in indirect retention.
BASED ON AREA OF PLACEMENT
1.OCCLUSAL REST
2.LINGUAL /CINGULUM REST
3.INCISAL REST
Occlusal rest
Definition:A rigid extension of a partial removable dental prosthesis that
contacts the occlusal surface of a tooth or restoration, the occlusal surface
of which may have been prepared to receive it (GPT8).

Characteristics:

Outline form : rounded triangular in shape with the base of triangle

towards the marginal ridge and the rounded apex towards the centre of
tooth.
● It should follow the shape of the mesial or distal fossa of the tooth and
be smooth with gentle curves
Outline of occlusal rest A)occlusal view B) proximal view
The size should be
● Mesiodistal: One-third to one-half the mesiodistal diameter.
● Buccolingual: One-half the buccolingual width between the cusp tips.
● Depth: Deepest part should be in centre of preparation with base
rising gradually to join the occlusal surface (Fig. 23.44A and B),
making it spoon-shaped or saucer-shaped in cross-section. It should
have a minimum thickness of 0.5 mm and at least 1-1.5 mm near the
marginal ridges.
● The angle formed by the occlusal rest and the minor connector from
which it originates must be less than 90° to direct the occlusal forces
along the long axis of the tooth.
● An angle greater than 90° will also produce slipping prosthesis away
from abutment and cause orthodontic movement of tooth due to
inclined plane effect.
A& B Deepest point in the center
A& B Angulation of rest
Extended occlusal rest
● In Kennedy Class II, modification 1, and Kennedy Class III situations
in which the most posterior abutment is a mesially tipped molar, an
extended occlusal rest should be designed and prepared to
minimize further tipping of the abutment and to ensure that the
forces are directed down the long axis of the abut-ment. This rest
should extend more than one half the mesiodistal width of the
tooth, be approximately one third the buccolingual width of the
tooth, and allow for a minimum of 1-mm thickness of the metal, and
the preparation should be rounded with no undercuts or sharp
angles
Cast showing extended occlusal rest on mandibu-lar first molar, designed to
ensure maximum bracing from the tooth. If placed on a mesially inclined
molar next to a modification space (as in Figure 6-7) the extended rest would
ensure that the forces are directed down the long axis of the abutment and
therefore the distal-occlusal rest would not have been needed.
In situations in which the abutment is severely tilted, the extended
occlusal rest may take the form of an onlay to restore the occlusal plane

Intaglio surface of an onlay occlusal rest restoring contour and occlusion for this maxillary molar.
Lingual or cingulum rest
Definition:A metallic extension of a partial removable dental prosthesis framework
that fits into a prepared depression within an abutment tooth's lingual surface
(GPT8).

Characteristics:Indicated if an anterior tooth has a gradual lingual slope rather

than perpendicular,Hence, it is used most often on maxillary canines than on
incisors or mandibular canines
● Lingual rests on incisors are indicated only in case of missing canines but in this
instance multiple incisor teeth must receive rests to distribute the stresses.
● To successfully place lingual rests on enamel (natural teeth), patients caries
index should be low and they should maintain good oral hygiene.
● Lingual rest is preferred to an incisal rest for the following reasons:
○ It is placed nearer the centre of rotation of supporting tooth and so does not tip
the tooth
○ More aesthetic.
○ Less breakage and distortion.
● But whenever possible an occlusal rest is preferred to a lingual rest
because of its mechanical advantages.
● The outline form of lingual rest is half-moon shaped, making a
smooth curve from one marginal ridge to the other, crossing the
centre of the tooth above the cingulum, with the deepest point over
the cingulum (Fig. 21.50A and B).
● The rest seat is V-shaped and has two inclines.
● The labial incline is parallel to the labial surface of tooth while
lingual incline begins at the top of cingulum and converges
labiogingivally towards the centre of the tooth, to meet the labial
incline at the apex of rest seat.
• The lingual view shows a 'broad inverted V' following the contour of the cingulum

• Incisal view shows the rest seat to be broadest at the centre and tapering towards the proximal
surfaces

• Proximal view shows the floor of the seat inclined towards the cingulum

Lingual rests can be placed on cast restorations with great success by just accentuating the cingulum
during wax pattern fabrication.
Incisal rest
Definition: A rigid extension of a removable partial denture that contacts a tooth at the
incisal edge.

Characteristics: Least desirable position for rest placement. Used on sound tooth and
never on cast restorations as lingual rest is preferred.
● They are mainly used as indirect retainers.
● They are frequently used on mandibular canines,rarely on maxillary canines if
aesthetics is not a problem
● In incisors, they are generally not used, but if required multiple incisal rests are placed
to support the abutments.
● They are placed on the mesioincisal or distoincisal angle of the tooth depending on
whether the tooth is to be clasped. If it is not clasped, rest is placed on dis-toincisal
angle for aesthetic reasons.
Outline form :
● It is a small 'V-shaped' notch located 1.5-2 mm from proximoincisal
angle of the tooth
● It should extend onto the facial surface to provide a positive seat
for the rest. It should be bevelled labially and lingually and lingual
enamel should be shaped to accommodate the minor connector.
● It should be 2.5 mm wide and 1.5 mm deep
● The deepest part should be towards the centre of tooth
mesiodistally and it should be smooth.
Preparation of rest seats
Rest seats must always be prepared after preparation of guiding planes.

Procedure for preparation of rests on enamel and restoration is described below:

A)Occlusal rest seat in enamel

Outline form of occlusal rest is triangular with base of triangle at marginal ridge and apex towards
the centre of the tooth (Fig. 25.13).

• A channel of correct depth and desired outline of preparation is created by small round diamond
stone, diameter similar to No. 8 round bur.

• Lower the marginal ridge at either buccal or lingual extent of rest seat to continue inward
towards centre of tooth and then return to marginal ridge.

• Island of enamel which remains within outline form is then removed and the floor is spoon
shaped or saucer shaped
Deepest portion of rest seat is towards the centre of tooth preparation and
raises gradually towards marginal ridge (Fig. 25.15).

• Adequacy of occlusal rest seats can be checked by:

• Visual inspection.

• Direct tactile contact.

• Asking patient to bite on softened bite wax and verifying the imprint

Making a check cast.

• Sharp line angles are removed with a No. 4 round steel bur at slow speed.

• The preparation is smoothed with a rubber disc and polished with pumice.
Fluoride treatment is recommended.
Occlusal rest seat in new cast restoration
● Should always be placed while making wax patterns.
● Sufficient occlusal clearance should be created for rest and
restoration
● A depression is added to the preparation to accommodate rest seat
● Rest seat in wax pattern prepared by using No. 4 round steel bur
and then cast.
Occlusal rest in existing crown restoration

Due to economic reasons, it may be necessary to prepare occlusal rests

on existing crowns. It must be ensured that crown restoration has
adequate marginal integrity and occlusal harmony.
● perforation of crown occurs during preparation, new restoration
must be made. Patient must be warned about this possibility
● Procedure similar to rest preparation on enamel.
Occlusal rest in amalgam restoration
• Less desirable, as amalgam alloy tends to flow under constant
pressure.

• Rest seats are prepared using No..4 round bur, not diamond.

• Proximal portion of amalgam restoration and isthmus should have

sufficient width after preparation to resit fracture.

• Preparation is similar to rest preparation on enamel.

• Polishing is similar to any amalgam restoration.

Occlusal rest for embrasure clasp
Preparation extends over occlusal embrasures of two adjacent posterior teeth
from mesial fossa of one tooth to distal fossa of other tooth (Fig. 25.18).

• Small round diamond stone is used to prepare the outline form for a normal
occlusal rest in both the teeth. Marginal ridges should be reduced equally.

• Contact point between teeth should not be broken.

• Same round diamond stone is used to prepare the buccal and lingual
extension of occlusal rests over buccal and lingual embrasures (Fig. 25.19).
Obtaining sufficient clearance in the embrasures is important.
Same round diamond stone is used to prepare the buccal and lingual
extension of occlusal rests over buccal and lingual embrasures.
Buccal clearance can also be obtained by using a cylindrical diamond stone. It is
held horizontally from buccal surfaces of teeth pointing towards lingual surface

• Clearance can be checked by placing two pieces of 18 gauge side by side in

embrasure and patient should be able to close mouth without contacting metal.
Clearance can also be checked by making patient close on soft bit wax and
measuring thickness with wax calipers.

• Preparation should be 1.5-2 mm wide and 1-1.5 mm deep.

• Procedures for finishing and polishing are similar to occlusal rest

Lingual or cingulum rest
Using flat end large diamond cylinder preparation should begin low on one marginal
ridge, pass over cingulum and pass gingivally to contact opposite marginal ridge (Fig.
25.21A and B).

• For a safe side, 0.25 inch diamond disc can also be used for preparation if space
permits.

• Rest seat must be gingival to contact level of opposing tooth.

• Occlusion should be checked for adequate clearence even before tooth preparation.

• Polishing is done with carborundum-impregnated rubber wheels and points.

• Cingulum rests on cast crown restorations are preferred to those on enamel as they
can be easily made on wax patterns.
INCISAL REST SEAT PREPARATION
It is prepared only on enamel surfaces. If a cast restoration is planned,
cingulum rest is preferred.

• Preparation is made using small safe-sided diamond disc or tapered

cylindrical diamond, parallel to path of insertion
•First cut is made vertically 1.5-2 mm deep in the form of a notch and
2-3 mm inside the proximal angle of the tooth. Enamel walls and base
of notch are rounded with small flame-shaped diamonds (Fig. 25.23).

• The groove must be carried slightly over to labial surface to prevent

facial tipping. Groove must be continued part way down the lingual
surface as indentation to accommodate minor connector (Fig. 25.24).

• Preparation is finished and polished with carborundum-impregnated

rubber wheels and points.
Conclusion
As mentioned previously, prosthetic mouth preparation is done during
phase V of treatment before making the secondary impression. These
preparations should be recorded accurately in the secondary impression
using which, the denture will be fabricated.
Reference
1)McCracken’s Removable partial prosthodontics 11 th edition

2)Textbook of prosthodontics V Rangarajan | TV padmanabhan

3)Textbook of prosthodontics Deepak Nallaswamy veeraiyan