Statement of problem. Although removable partial dentures are a favored option for the restoration of
many situations that involve partial tooth loss, some patients are not satisfied with a removable partial
denture, especially when it is not stable during mastication. A dental surveyor can be used to prevent
countless problems related to the production of removable partial dentures. Many professionals working
with oral rehabilitation fail to take advantage of the many uses of a surveyor in planning and designing
chromium alloy and other metal removable partial denture frameworks.
Purpose. This article uses an academic approach to describe the criteria used to determine the path and
removal of a removable partial denture. A fundamental requirement for understanding the correct use of
the dental surveyor is to prevent indiscriminate use of a path of insertion perpendicular to the occlusal
plane, and extreme inclinations of the cast in the attempt to create undercuts on some teeth. (J Prosthet
Dent 1997;78:412-18.)
When
performing oral rehabilitation with rcmovable partial dentures (RPDs), the objective o f the
dentist should be to make a prosthesis that the patient
can easily seat and remove from the mouth and yet, when
seated, the prosthesis will resist the dislodgment potential caused by masticatory function, especially mastication o f sticky foods. The problem involves an interaction o f engineering and biologic elements, so a biomechanical approach should be used for its solution. On
this basis, it is imperative that diagnostic casts for all
RPDs be analyzed with a dental parallelometer (surveyor), the instrument that permits accurate planning
o f each structural detail o f the prosthesis.1
A diagnostic cast should be surveyed for three major
reasons: (1) determination o f the path o f insertion to
obtain efficient and esthetically pleasing retentive clasps;
(2) tracing the survey line to enable positioning o f the
rigid parts o f the prosthesis, so they will seat without
interference; this procedure provides information about
the need to recontour the abutments and other teeth
and to improve the functioning o f rigid parts and the
esthetic aspects related to it; and (3) analysis o f the con~Associate Professor.
bAssistant Professor.
412
AND REMOVAL
The RPD path o f insertion and withdrawal is the direction in which the prosthesis moves in relation to the
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NUMBER 4
Fig. 2. When functioning, RPD is pulled by sticky food in direction perpendicular to occlusal plane. This direction, defined as potential path of dislodgment (PPD), indicated by
arrows in this schematic drawing, does not depend on direction of insertion selected by dentist.
Fig. 1. Parallelometer (surveyor).
UNDERCUT
GUIDING
PLANES
The flat axial surfaces in an occlusal-gingival direction on abutments are referred to as guiding planes. They
should be prepared to be parallel to one another and to
the path of insertion as determined by the surveying
stylus. These surfaces very seldom occur naturally and
need to be prepared directly on enamel or on cast or
composite restorations. 8 During insertion, the rigid parts
of the prosthesis contact with these surfaces, which direct the movement of the RPD until it is seated securely
in the predetermined terminal position in the mouth.
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ESTHETIC
SURFACES
APPEARANCE
OF THE PATH OF
Pi
Pi
Pi
Pi
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VOLUME 78 NUMBER 4
Pi
Pi
Pi
"PI _
Pi
Pi
Pi
Fig. 6. When cast table is inclined to right in attempt to distribute undercuts evenly, apparent undercut can be established
on right abutment of cast shown in Figure 5. This requires
extreme tilt and guiding planes have been ignored.
Pi
Pi
Pi
Clinically, the situation should be resolved by changing the facial contour o f the tooth on the right side to
create an undercut necessary to facilitate proper positioning o f the clasp arms and the correct functioning o f
the prosthesis. The surface could be changed by making
a surveyed crown; reshaping the enamel, provided it is
thick enough; or placing a suitable restoration.
415
Pi
Pi
Pi
[Pi
Pi
/
Fig. 8. When RPD illustrated in Figure 7 is acted on by dislodging force, PPD pull illustrated will be perpendicular to
original position of occlusal plane not in direction of PI; therefore, there will be no retentive effect by clasp on right side
and partial will be easily rolled off abutments. RPD will loosen
with every masticatory stroke.
Pi /
Pi
Pi
Pi
/
Fig. 9. Different cast than in Figures 5 through 8 with facial
surfaces same as those abutments and different inclinations
of lingual surfaces.
10) to parallel the guiding planes with the PI, these guiding planes would direct the movement o f insertion and
removal o f the prosthesis more favorably. The positions
o f the retentive and reciprocating clasp arms are shown
in Figure 11. Thus, if dislodgment occurs along the PPD
during function (Fig. 12), the lingual guide plane on
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VOLUME 78 NUMBER4
the right side, aided by the one on the left side, should
bind against the abutment to resist the dislodgment o f
the prosthesis from the support system if the direction
o f the dislodgment is perpendicular to the occlusal plane.
This should provide the stability necessary for efficient
function.
Obviously, the inclined PI described for the theoretical case in question would still depend on the analysis o f
esthetic factors such as the occlusal positioning o f the
retention clasp on the right side and on the detection o f
possible anatomic interferences with the correct placement o f the prosthesis. In any situation, it is necessary
to understand that the distribution o f the degree o f retention is not the only definitive condition for the determination o f the PI.
DISCUSSION
Despite the significant evolution o f materials and procedures for oral rehabilitation, cobalt-chromium alloys
continue to be the alloy o f choice for RPDs. The option
to restore with an RPD permits the resolution o f complex clinical problems, including extensive modification
spaces, distal extensions, and so forth, and to do so in a
relatively rapid manner and at an operational cost substantially lower than that o f other treatment modalities.
However, failures are observed with a number o f patients who are dissatisfied with this type o f dental prosthesis.
A critical analysis has revealed that dissatisfaction could
be avoided in many instances if the prostheses were made
in such a way as to satisfy the basic requirement o f minimal dislodgment during mastication or speech, with dissatisfaction about esthetic appearance being relegated
to a second plane.
Many RPDs are made without essential elements for
correct functioning, with the excuse o f producing a better esthetic appearance. Often these prostheses are esthetic but lack stability. Furthermore, unstable prostheses may significantly impair the prognosis o f treatment
because o f the irritation they provoke in the support
system.
The fabrication o f an RPD as a viable treatment modality for oral rehabilitation must be based on mastering the use o f the dental surveyor, starting with the understanding o f the aspects involved in the dynamics o f
insertion and withdrawal o f the prosthesis. A correct
analysis o f the factors that influence the PI prevents the
occurrence o f two frequent errors in the construction o f
these prostheses: (1) the indiscriminate use o f the PI with
zero inclination, and (2) excessive inclinations o f the cast
on the assumption that undercut surfaces can be "created" by tilting the cast.
As a general rule, the PI with zero inclination should
be the starting point for the surveying process. This path,
which coincides with or slightly deviates from the PPD,
may be ideal when it provides a favorable approach to
OCTOBER 1997
Pi
IPi
Pi
Pi
/
Fig. 12. When prosthesis illustrated in Figure 11 undergoes
action of PPD in direction perpendicular to occlusal plane,
guide planes that guide seating of RPD along PI prevent its
dislodgment during function by providing necessary retention
and stability.
REFERENCES
1. Miller EL, Grasso JE. Removable partial prosthodontics. 2nd ed. Baltimore:
Williams & Wilkins; 1981. p. 103-17.
2. Weinberg LA. Atlas of removable partial denture prosthodontics. St Louis:
CV Mosby; 1969. p. 81-4.
3. Lavere AM, Freda AL. A simplified procedure for survey and design of
diagnostic casts. J Prosthet Dent 1977;37:680-3.
4. Coy RE, Arnold PD. Survey and design of diagnostic casts for removable
partial dentures. J Prosthet Dent 1974;32:103-6.
5. Applegate OC. Essentials of removable partial denture prosthesis. Philadelphia: WB Saunders; 1954. p. 17-35.
6. Leeper SH. Dentist and laboratory: a "love-hate" relationship. Dent C[in
North Am 1979;23:87-99.
7. Wagner AG, Forgue EG. A study of four methods of recording the path of
insertion of removable partial dentures. J Prosthet Dent 1976;35:267-72.
8. Boitel RH. The parallelometer. A precision instrument for the prosthetic
laboratory. J Prosthet Dent 1962;12:732-6.
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