A new method for recording and reproducing cast orientation on a survey table

Herman B. Dumbrigue, DDM,a and Marianne I. Chingbingyong, DDM, MS, DScb Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas
Cast position on a survey table is determined with an inclinometer, allowing tilt to be measured in 1-degree increments in the frontal and sagittal planes. With this device, cast reorientation is simplified and tilt modifications can be accomplished accurately because of direct visualization of tilt measurements in the 2 planes. (J Prosthet Dent 2003;89:76-8.)

urveying diagnostic casts is an important step in the fabrication of removable partial dentures (RPD). After a suitable path of insertion is determined, the orientation of the cast needs to be recorded to allow repositioning of the cast in the same orientation at subsequent times. 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. Clinical verification of the laboratory product can be achieved if the master cast can be reoriented accurately. 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 3 divergent anatomic areas on the cast.1 These marks define a plane of orientation for repositioning the cast. The scoring method involves making 3 vertical marks along the base of the cast on the posterior and lateral areas.1,2 The analyzing rod of a surveyor is aligned with all 3 marks to reorient the cast. The tripodization and scoring methods are simple and do not require additional instrumentation. However, use of these methods only allows reorientation of the cast on which marks have been placed. Duplicate casts cannot be oriented to the position of the original cast accurately unless the marks are captured in some manner during the duplication process. Several devices have been described to facilitate the recording and reproduction of cast orientation. Kaloyannides3 developed a geometric technique for recording cast orientation that involves using a protractor mounted on a surveyor. Knapp et al4 and Bezzon et al5 described similar methods in which a pin is attached vertically to the cast as a means of reorienting the cast on a surveyor. Steas6 developed a device consisting of 3 adjustable arms attached to a surveyor that contact the cast at 3 divergent points. Ansari7 described the use of a U-shaped plastic impression tray with a vertical stylus


Fig. 1. CAT consists of inclinometer that swivels around metal plate.

attached to a surveyor. The tray was indexed to the occlusal surface of a cast with silicone putty material. The pin method4,5 allows quick and accurate reorientation of a cast on a surveyor.8 However, like conventional methods, cast orientation cannot be reproduced on duplicate casts. Other devices enable the orientation of duplicate casts but require attachment of the device to a surveyor.3,6,7 This article describes a new device and method for recording and reproducing cast orientation.

The cast angle tool (CAT) (Patent pending, Texas A&M University Technology Licensing Office, College Station, Texas) consists of an inclinometer (Pitch & Angle Locator; Johnson Level and Tool Mfg Co, Mequon, Wis.) mounted on the center of a 3.5- ϫ 3.5-inch metal plate with a spring-loaded swivel mechanism (Fig. 1).

Associate Professor and Assistant Program Director, Advanced Education in General Dentistry, Baylor College of Dentistry. b Private Practice, Carrollton, Texas 76 THE JOURNAL OF PROSTHETIC DENTISTRY

3M Dental Products. The inclinometer rotates about the center of the metal plate to 2 terminal positions that are perpendicular to each other. Frontal plane. Measurement of cast orientation. 3. Index the CAT to the cast by applying vinyl polysiloxane (VPS) occlusal registration material (Imprint SBR. Procedure for recording cast orientation 1. VPS occlusion registration material used to index occlusal surfaces of cast to CAT. B. 2. Paul. St. A. A). Minn. The inclinometer provides tilt measurements in 1-degree increments.) to its 77 . Fig. Metal stops limit the rotation of the inclinometer to these 2 terminal positions.DUMBRIGUE AND CHINGBINGYONG THE JOURNAL OF PROSTHETIC DENTISTRY Fig. 2. B. The metal plate has elevated index markers on its undersurface arranged in an arch configuration that allow indexJANUARY 2003 ing of the device to the occlusal surface of a cast (Fig. A. Sagittal plane. Indexing markers on undersurface of metal plate.

and use a surveyor to adjust the tilt until the desired path of insertion is obtained. Knapp JG. 1999.THE JOURNAL OF PROSTHETIC DENTISTRY DUMBRIGUE AND CHINGBINGYONG 2. Louis: Mosby.72:104-7. The recorded measurements are only valid in conjunction with the VPS index used to record cast orientation. Research is currently being conducted to compare the accuracy of the CAT method of cast reorientation with the conventional methods of tripodization and scoring. p. J Prosthet Dent 1976. compared to 3 marks with the conventional methods. Carr AB. 3. 3rd ed. Reprint requests to: DR HERMAN B DUMBRIGUE BAYLOR COLLEGE OF DENTISTRY TEXAS A & M UNIVERSITY SYSTEM HEALTH SCIENCE CENTER 3302 GASTON AVENUE. Modifications to cast angulation in the frontal or sagittal planes may be made precisely and measured in 1-degree increments with this device. Pagnano VO. 5. Rotate the inclinometer counterclockwise to its terminal position. Forgue EG. Designate the measurement as (Ϫ) or (ϩ) (Fig. Ansari IH. also presents an additional expense. Designate the measurement as (Ϫ) or (ϩ) to describe the position of the gauge needle relative to zero degrees (Fig. p.7 Cast reorientation 1. 2. 4. TX 75246 TEL: (214) 828-8347 FAX: (214) 828-8952 E-MAIL: hdumbrigue@tambcd. 10th ed. Attach the VPS index to the undersurface of the CAT. and place it in the appropriate position on the cast. 2 positions are being aligned. J Prosthet Dent 1973. The CAT can orient duplicate casts with the same VPS index and is used independent of a surveyor. Rotate the inclinometer counterclockwise to its terminal position. J Prosthet Dent 1979.edu Copyright © 2003 by The Editorial Council of The Journal of Prosthetic Dentistry. The VPS index can be easily replaced on the device for subsequent cast reorientation. 3. 3. 4.41:352-4. With the inclinometer in the frontal position. Kaloyannides TM. St. and verify that the frontal plane angulation has not been altered. secure the cast on the survey table.30:465-7. A procedure for reorienting a cast on a surveyor. 3. B).35:267-72. 7. Steas AD. Essentials of removable partial denture prostheses. REFERENCES 1. A study of four methods of recording the path of insertion of removable partial dentures. J Prosthet Dent 1994. and loosen the locking screw that holds the table in position.00 ϩ 0 doi:10.1067/mpr. and record the angle of the cast in the frontal plane. 5. Remove the VPS index from the CAT. Lightly tighten the locking screw of the survey table. Applegate OD. Results from this study will be presented in a subsequent article.84:136-8. 2. because both dentist and laboratory will need to have one. Philadelphia: WB Saunders. SUMMARY A new device that is simple to use and that allows cast orientation to be recorded and reproduced has been described. which is transferable between CAT devices. 212-3. After the VPS index has set. J Prosthet Dent 1987. Cast reorientation with the VPS index is simplified since only 78 VOLUME 89 NUMBER 1 . J Prosthet Dent 2000. Secure the cast on a survey table.2003. Lightly tighten the locking screw. Reproduction of tilt of a cast on a surveyor. Ribeiro RF. 6. Bezzon OL. remove the device from the cast. undersurface and seating the occlusal aspect of the cast into the VPS (Fig. 2. 0022-3913/2003/$30. B). 4. Replace the CAT on the cast by use of the VPS index. Rotate the inclinometer clockwise to its terminal position. and carefully tilt the survey table anteroposteriorly to the predetermined sagittal plane position. Kotowicz WE. To reorient a cast to the planned path of insertion.57:121-5. 5. Shotwell JL. Recording and reproducing the tilt of a cast on a surveyor. 1966. and store it with the patient’s casts. loosen the locking screw. Technique for recording dental cast-surveyor relations. The VPS index. tilt the survey table laterally until the predetermined frontal plane orientation is obtained. 3. Record the measurements for cast orientation in the frontal and sagittal planes in the patient’s chart as a permanent record of the planned path of insertion. Disadvantages of this method include the additional cost for the CAT. McGivney GP. McCracken’s removable partial prosthodontics. 108-10. 8. Tighten the locking screw after frontal and sagittal plane orientations have been verified. DISCUSSION The CAT is a new device that allows measurement of cast orientation in the frontal and sagittal planes. Wagner AG. and record the angle of the cast in the sagittal plane. ROOM 601 DALLAS. A). Device for recording the path of insertion for removable partial dentures.

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