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Table of Contents   
TECHNICAL NOTE  
Year : 2014  |  Volume : 25  |  Issue : 2  |  Page : 260-262
Reorientation simplified: A device for recording and reproducing the path of insertion for removable partial dentures


1 Department of Prosthodontics, VSPM's Dental College and Research Center, Nagpur, Maharashtra, India
2 Saraswati Dhanvantri Dental College, Parbhani, Maharashtra, India

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Date of Submission15-Feb-2013
Date of Decision13-Sep-2013
Date of Acceptance03-Dec-2013
Date of Web Publication4-Jul-2014
 

   Abstract 

Aim: The record of path of insertion on the dental cast is part of the dentist's work authorization to the dental laboratory technician. The path of insertion record enables the dental technician to replace the cast on a surveyor in the same position that the dentist selected. Analysis of factors that influence the path of insertion should determine a path of insertion that will reduce the potential for dislodgement and promote stability of removable partial denture (RPD).
Materials and Methods: The recording of the relation of a cast to a dental surveyor and the transfer of this relationship to the dental laboratory may be done by tripodization, by scoring the base of the cast, or by cementing a reference pin on the cast.
Conclusion: Recording the established path of insertion can be difficult when the procedure uses a cemented pin and the casts are mounted in an articulator. This article describes a procedure for innovative dowel pin and sleeve device to record the path of insertion of RPDs, which serves the same purpose as the cemented pin but can be easily removed and replaced.

Keywords: Dental surveyor, dowel pin and sleeve, tripodization

How to cite this article:
Kamble VD, Parkhedkar RD. Reorientation simplified: A device for recording and reproducing the path of insertion for removable partial dentures. Indian J Dent Res 2014;25:260-2

How to cite this URL:
Kamble VD, Parkhedkar RD. Reorientation simplified: A device for recording and reproducing the path of insertion for removable partial dentures. Indian J Dent Res [serial online] 2014 [cited 2019 Nov 12];25:260-2. Available from: http://www.ijdr.in/text.asp?2014/25/2/260/135939
Despite the evolution in treatment resources available for partially edentulous patients, removable partial dentures (RPDs) continue to be the treatment of choice for patients, especially those with distal extension bases, financial concerns, and technical and biologic conditions that contraindicate treatment with fixed prostheses or implants. [1] Many disadvantages attributed to restoration with RPDs are a consequence of inadequate planning and metal framework fabrication, which serve as supports for artificial teeth. When performing oral rehabilitation with RPDs, the objective should be to make a prosthesis that the patient can easily seat and remove from the mouth and yet, the prosthesis resists the dislodgement caused by masticatory function, especially of sticky foods. The problem involves an interaction of engineering and biologic elements. Therefore, a biomechanical approach should be used for its solution. [2] Correct planning for the metal framework in RPD requires an appropriate analysis of the diagnostic casts with a dental surveyor to determine the best path of insertion and, consequently, the preparation of axial surfaces of the abutments to receive the components of the metal framework. [2],[3],[4] A diagnostic cast should be surveyed for three major reasons: (1) determination of the path of insertion to obtain efficient and esthetically pleasing retentive clasps, (2) tracing the survey line to enable positioning of the rigid parts of the prosthesis, and (3) analysis of the contour of soft tissues to prevent the occurrence of lesions that result from seating the prosthesis. [5] The use of a dental surveyor permits the dentist to plan, study, and design an RPD that will provide adequate retention, support, stability, and esthetics. Because surveying is an individual process for each RPD, specific influencing factors must be analyzed and conditions developed by mouth preparation to accommodate the desired path of insertion. These factors include: (1) guiding planes, (2) tooth contours, in general, and more specifically, undercuts on the teeth and soft tissues, (3) esthetic appearance, and (4) interferences. [3],[4] After the diagnostic cast has been surveyed and a path of insertion determined, it is imperative that the path of insertion be recorded as a reference for the sequence of steps needed to fabricate the RPD to allow repositioning of the cast in the same orientation. The ability to accurately record, communicate, and reproduce cast orientation is critical to the laboratory fabrication of an RPD framework with the same path of insertion as that determined by the dentist. [6] Conventional methods for recording cast position require marking the cast in several areas to establish a plane of orientation. Tripodization is accomplished by placing horizontal marks on three divergent anatomic areas on the cast. [7] The scoring method involves making three vertical marks along the base of the cast on the posterior and lateral areas. [8] Of the available means of recording the path of insertion and repositioning the cast on the surveyor, one method is to cement a pin into the base of the cast. [9] This cemented pin may sometimes present difficulties in the mounting of casts in a correct relationship in an articulator, especially when two frameworks for the same patient are being made simultaneously. This article describes the fabrication of an innovative dowel pin and sleeve (Dental Dowel pin; CORI DENT,Daegu, South Korea) device for recording the path of insertion that incorporates the fidelity of the cemented pin and makes it possible to easily remove and replace the dowel pin.


   Procedure Top


The dowel pin and sleeve device is depicted in [Figure 1]. The internal diameter of sleeve corresponds to the dowel pin and there is some friction and retention.

  1. On the basis of the factors that determine the path of insertion, select the best path of insertion; lock the cast on the surveyor table in this position.
  2. Make a perforation, 6 × 6 × 4 mm deep, centred between the ridges of the cast where there will be no interference with the planned framework design [Figure 2].
  3. Assemble the dowel pin and sleeve device, and lock the dowel pin in the surveying mandrel (spindle) of the surveyor with the sleeve down [Figure 3].
  4. Centre the surveying table with the cast secured to it under the spindle of the surveyor and lower the recording dowel pin assembly into the perforation made until the top of sleeve is leveled with the surface of the cast [Figure 3].
  5. Fill the perforation in the cast with water, and when it absorbs, make a mix of type III gypsum product (Kalstone; Kalabhai Karson, Mumbai, India). With a small instrument, tease some of the mix around the assembly to fill the perforation and allow it to set [Figure 4].
  6. Separate the assembly, as the set type III gypsum product will hold the sleeve firmly in place [Figure 5]. As the dowel pin has smooth shank, the mandrel can be removed with a straight pull and can be easily replaced [Figure 6].
Figure 1: Dowel pin and sleeve path of insertion registration device (dowel pin, sleeve and assembled device)

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Figure 2: Perforation made deep, centred between the ridges

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Figure 3: Lowering down the recording dowel pin and sleeve assembly into the perforation

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Figure 4: Device held in place on the cast waiting for dental stone to set

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Figure 5: Sleeve fastened in cast with dental stone and dowel pin is removed

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Figure 6: Reorientation of cast with dowel pin and sleeve assembly on recorded tilt

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   Discussion Top


The guiding planes and other prepared contours on the abutment teeth are intended to improve the stability and retention of a RPD and to reduce the forces on the abutment teeth. These prepared surfaces will serve their purposes best if the denture is constructed in accordance with the path of insertion that the dentist selects. The dentist's path of insertion record, therefore, should enable the dental laboratory technician to position the cast on the surveyor properly in preparation for denture construction. [9] This device for registering the path of insertion for RPDs takes advantage of the precision of cemented pins and eliminates the disadvantage of not being able to use an articulator to study the occlusal masticatory pattern. [1] This procedure is simple, easily executed, and can be done with materials that are readily accessible. The positioning of the casts on the dental surveyor can be performed quickly when new analysis is necessary. This method allows for the precise registration of the path of insertion for the patient. In addition, the procedure permits the analysis of the occlusal relationships of the casts on the articulator without any interference caused by fixed registration pins, especially when two RPDs are made simultaneously.


   Conclusion Top


This article presents a procedure for dowel pin and sleeve device to record the path of insertion of RPDs, with the same purpose as a cemented pin. However, with this device, the pin can be easily removed and replaced, which permits correct assembly of the casts in an articulator for occlusal function analysis.


   Acknowledgement Top


The author thanks Dr. Sana Naqvi for her valuable support during fabrication of device and application along with preparation of the manuscript

 
   References Top

1.Bezzon OL, Riberio RF, Pagnano VO. Device for recording the path of insertion for removable partial dentures. J Prosthet Dent 2000;84:36-8.  Back to cited text no. 1
    
2.Bezzon OL, Mattos MG, Ribero RF. Surveying removable partial dentures: The importance of guiding planes and path of insertion for stability. J Prosthet Dent 1997;78:412-8.  Back to cited text no. 2
    
3.Miller EL, Grasso JE. Removable partial prosthodontics. 2 nd ed. Baltimore: Williams and Wilkins; 1981. p. 103-17.  Back to cited text no. 3
    
4.Lavere AM, Freda AL. A simplified procedure for survey and design of diagnostic casts. J Prosthet Dent 1977;37:680-3.  Back to cited text no. 4
[PUBMED]    
5.Weinberg LA. Atlas of removable partial denture prosthodontics. St Louis: CV Mosby; 1969. p. 81-4.  Back to cited text no. 5
    
6.Dumbrigue HB, Chingbingyong MI. A new method for recording and reproducing cast orientation on a survey table. J Prosthet Dent 2003;89:76-8.  Back to cited text no. 6
    
7.McGivney GP, Carr AB. McCracken's removable partial prosthodontics. 10 th ed. St. Louis: Mosby; 1999. p. 212-3.  Back to cited text no. 7
    
8.Applegate OD. Essentials of removable partial denture prostheses. 3 rd ed. Philadelphia: WB Saunders; 1966. p. 108-10.  Back to cited text no. 8
    
9.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.  Back to cited text no. 9
[PUBMED]    

Top
Correspondence Address:
Vaibhav D Kamble
Department of Prosthodontics, VSPM's Dental College and Research Center, Nagpur, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.135939

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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    Abstract
   Procedure
   Discussion
   Conclusion
   Acknowledgement
    References
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