New Clasp Assembly for Distal Extension Removable

Partial Dentures: The Reverse RPA Clasp

Mohammad Ayham Hakkoum, DDS, MS
Department of Prosthodontics, Faculty of Dentistry, University of Kalamoon, Der Atiah, Syrian Arab Republic

Keywords Abstract
Dental clasps; denture design; denture
retention; removable partial denture.
Several clasp types are used in distal extension removable partial dentures. In some
cases the terminal abutments have only distal retentive undercuts that can be occupied
Correspondence
by bar clasps; however, bar clasps may be contraindicated with no suitable alternative.
Dr. Mohammad Ayham Hakkoum, University This article presents a reasonable solution by introducing a new clasp design as
of Kalamoon – Prosthodontics, a modification to the well-known RPA clasp. The design includes a mesial rest,
Damascus-Aleppo Hwy, Der Atiah 222, Syrian proximal plate, and buccal retentive arm arising from the rest and extending to reach
Arab Republic. E-mail: drayham@yahoo.com the distal retentive undercut.

The author denies any conflicts of interest.

Accepted January 15, 2015

doi: 10.1111/jopr.12313

Retention is an important challenge in distal extension remov-

able partial dentures (RPDs). A direct retainer should provide
good retention, accommodate functional movement of the pros-
thesis, minimize the effect of the lever, and prevent the transfer
of harmful forces to the abutments. For that reason, many the-
ories about retention in distal extension RPDs have arisen, and
various types of clasps have been introduced.
The mesial rest concept is associated with clasps used in dis-
tal extension RPDs to shift the axis of rotation more favorably
and minimize the harmful forces.1-3 Several types of bar clasps
are used.4-6 This clasp reaches the retentive area from a gingival
direction and moves with the denture base movement so it does
not transfer harmful forces to the abutment. The most common
types are T (or modified T) clasps, which are suitable when the Figure 1 RPI clasp on mandibular first premolar.
retentive undercut is located distally.4,7 The I-bar clasp is also
commonly used if there is a retentive undercut at the mesiodistal
prominence of the abutment or to the mesial.8
The I-bar type is frequently used in the RPI clasp (Fig 1),
which consists of a mesial rest, a proximal plate, and an I-bar
retentive arm. The RPI design has the advantage of disengaging
the tooth when excessive load is applied to the distal extension
base, so it acts as a stress breaker.2,9,10 However, it may be im-
possible to use bar clasps in some situations (shallow vestibule,
a large tissue undercut, severe tilt of the abutment).7,11 An RPA
clasp can be used in such cases (Fig 2); it is a modification
of the RPI clasp and consists of mesial rest, proximal plate,
and Akers retentive arm arising from the distal guiding plate.
The retentive tip disengages the tooth when applying excessive
Figure 2 RPA clasp on maxillary second premolar.
load.9,12

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Reverse RPA Clasp Hakkoum

Figure 3 Combination clasp on maxillary first premolar. Figure 4 Reverse RPA clasp on mandibular first premolar (buccal view).

A combination clasp is useful too; it is similar to the Akers

circumferential clasp, except that the retentive arm is wrought-
wire (Fig 3). Its flexibility reduces the lever action and prevents
the transfer of harmful forces to the abutment.13-15 However,
RPA and combination clasps may not be used unless the abut-
ment has a mesial retentive undercut.7 So what if the abutment
has only a distal retentive undercut adjacent to the distal ex-
tension base, with something preventing the use of bar clasps?
Ring clasps and reverse-action clasps have been mentioned for
use in such situations,7 but these clasps have several known
disadvantages. Some authors suggested the use of a reverse cir-
clet clasp.16 However, the existence of a reciprocal arm above
the height of contour may preclude the downward movement Figure 5 Reverse RPA clasp on mandibular first premolar (occlusal
of the retentive tip. So it would not disengage the tooth when view).
an excessive load is applied to the distal extension base. More-
over, the role of the mesial rest may be cancelled so the harmful
forces are transmitted to the abutment.
The design introduced in this article addresses the problem
mentioned above with a new clasp type that accommodates
such situations.

Procedures
1. Accomplish diagnostic procedures.
2. Survey the diagnostic cast. Figure 6 Reverse RPA clasp; mesial rest (MR) with minor connector
3. Select suitable clasps. (MC), proximal plate (PP), and circumferential retentive arm (RA) arising
a. If the abutment has a distal retentive undercut, use a from mesial rest.
T- or modified T-bar clasp.
b. If the retentive undercut is located at the greatest (3) Buccal circumferential retentive arm arises from the
mesiodistal prominence of the abutment or to the mesial rest and extends to reach the distal retentive under-
mesial, use an RPI clasp (Fig 1). cut (while the retentive arm in an RPA clasp arises from
c. If bar clasps are contraindicated, use RPA or com- the distal guiding plate and engages a mesial undercut).
bination clasps, provided there is a mesial retentive 4. Perform the necessary mouth preparation.
undercut (Figs 2 and 3). 5. Accomplish the conventional steps of RPD fabrication.
d. If the retentive undercut is located to the distal, use
the new clasp design suggested in this article.
Discussion
The new design (Figs 4 and 5) is a modification of the RPA
clasp, and it may be called a reverse RPA clasp. It consists of The suggested design (reverse RPA clasp) provides a suitable
the following three elements (Fig 6): solution for direct retention in distal extension RPDs when
the abutment has a distal retentive undercut, especially when the
(1) Mesial rest with minor connector as in RPI and RPA bar clasp is contraindicated. As in the RPA clasp, a reciprocal
clasps; arm is not needed, because the minor connector of the rest in the
(2) Distal guiding plate as in RPI and RPA clasps; mesial and the guiding plate in the distal provide reciprocation,

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Hakkoum Reverse RPA Clasp

Summary
The reverse RPA clasp (mesial rest, distal guiding plate, and
buccal retentive arm arising from the rest and extending to
occupy a distal retentive undercut) is a suitable choice for pro-
viding retention in distal extension RPDs when there is distal
retentive undercut, especially if bar clasps are contraindicated.
This clasp disengages the abutment when excessive forces are
applied and prevents its injury.

References
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