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UnitedHealthcare Dental Coverage Guideline
Proprietary Information of UnitedHealthcare. Copyright 2023 United HealthCare Services, Inc.
Fixed Partial Denture Repair (Necessitated by Restorative Material Failure)
Fixed partial denture repair may be indicated when the appliance to be repaired is functional and has a favorable long-
term prognosis.
Precision Attachments
Precision Attachments may be indicated for the following:
When aesthetics need to be considered
For the redistribution of occlusal forces
To minimize trauma to soft tissue
Control of loading and rotational forces
When it is not possible to prepare two Retainers/Abutments with a common path of placement
Connector Bar
Connector Bars may be indicated to brace individual Retainer/Abutment teeth with considerable coronal length for
enhanced stabilization of removable partial dentures, complete dentures and overdentures.
Stress Breaker (A Non-Rigid Connector)
Stress Breakers may be indicated for the following:
When it is not possible to prepare two Retainers/Abutments with a common path of placement
When the prognosis of a Retainer/Abutment is uncertain
Control of loading and rotational forces
Redistribution of occlusal forces
Definitions
Abutment: That part of a structure that directly receives thrust or pressure; an anchorage 2: a tooth, a portion of a tooth, or that
portion of a dental implant that serves to support and/or retain prosthesis. (AP)
Cantilever Fixed Dental Prosthesis: A Fixed complete or partial denture in which the Pontic is cantilevered, (i.e., is retained
and supported only on one end by one or more Abutments). (AP)
Connector Bar: A device attached to fixed partial denture Retainer or coping which serves to stabilize and anchor a removable
overdenture prosthesis. (ADA)
Fixed Dental Prosthesis: The general term for any prosthesis that is securely fixed to a natural tooth or teeth, or to one or more
dental implants/implant abutments; it cannot be removed by the patient. (AP)
Pontic: An artificial tooth on a Fixed Dental Prosthesis that replaces a missing natural tooth, restores its function, and usually
fills the space previously occupied by the clinical crown. (AP)
Precision Attachment: An interlocking device, one component of which is fixed to an Abutment or Abutments, and the other is
integrated into a removable dental prosthesis in order to stabilize and/or retain it. (AP)
Resin-Bonded Prosthesis (e.g., Maryland Bridge): A Fixed Dental Prosthesis that is luted to tooth structures, primarily
enamel, which has been etched to provide mechanical retention for the resin cement. (AP)
Retainers: Any type of device used for the stabilization or retention of prosthesis. (AP)
Tooth Bounded Space: A space created by one or more missing teeth that has a tooth on each side. (ADA)
Applicable Codes
The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive.
Listing of a code in this guideline does not imply that the service described by the code is a covered or non-covered health