Survey and design of diagnostic casts for

removable partial dentures

Richard E. Coy, D.M.D., M.S.,* and Paul D. Arnold, D.M.D., M.D.S.**

Southern Illinois University School of Dental Medicine,
Edwardsville, Ill.

0 ften the removable

ticipated because of inadequate
partial denture prosthesis falls short of the objectives an-
diagnosis, faulty treatment planning, and/or poor
design.
It is the dentist’s responsibility to make a complete diagnosis of the oral con-
ditions that are present in order to establish a treatment plan involving a removable
partial denture prosthesis design that will be biomechanically sound while fulfilling
functional and esthetic requirements.
The surveyor (parallelometer) is a diagnostic tool which should be used by
every practicing dentist who provides removable partial denture prosthesis service
for his patients. Learning to use the surveyor avoids many of the problems that
could arise. A knowledgeable study of diagnostic casts furnishes the clinician with
much beneficial information used in preparing the mouth for the reception of a re-
movable partial denture prosthesis. Among the considerations may be surgical al-
terations of hard- and soft-tissue structures as well as alterations of existing teeth
to accommodate the prosthesis.

PROCEDURES
1. Place the cast on the tilting table of the surveyor in a horizontal position. Tilt
the table anteroposteriorly at an angle which places the proximal surfaces of the
abutment teeth parallel to the diagnostic rod which is in the spindle. The minor
connectors extending from the major connector must be flush against the proximal
surfaces to act as guide planes for the insertion and removal of the partial denture
prosthesis as well as to provide mesial and distal support (Fig. 1).

*Professor and Chairman, Department of Prosthodontics.

**Associate Professor and Head, Section of Complete Prosthodontics, Department of
Prosthodontics.

103
104 Coy and Arnold .J Ptosthct. Dent.
.Jnly. 1971

Figs. 1-3.

Figs. 4-6.

2. Tilt the table laterally guiding the lingual surfaces of .the abutment teeth as
nearly parallel as possible. No exaggerated tilt in any direction should be used. Tilt-
ing is not dictated by which teeth are missing. Instead, the health of the supporting
structures of the remaining teeth, the character of the residual alveolar ridge pres-
ent, the edentulous span, and masticatory requirements which the prosthesis must
provide are among the primary critical factors to consider (Fig. 2).
3. Securely tighten the set screw of the tiltin, o table, and mark three orientation
lines on the sides of the casts by placing the rod against the cast and scribing along-
side it with a red pencil (Figs. 3 and 4).
4. Remove the diagnostic rod from the spindle, and repiace it with the metal
shim and lead point, which has been altered by grinding the end at an angle on a
piece of sandpaper (Fig. 5).
5. Scribe the abutment teeth with the side of the lead point. This will indicate
the survey line at the height of contour of the unaltered teeth (Fig. 5).
6. Use a blue pencil to indicate alterations of the abutment tooth. Mark the
areas indicated for placement of rest preparations. If a circumferential clasp is sug-
gested, it should encircle the abutment tooth in a manner which will place only the
terminal one third of the direct retainer portion into an undercut (the area below
Volume 32 Survey and design of diagnostic casts 105
Numhrr I

08

Figs. 7-8.

the survey line). The reciprocating portion should be directly opposite the direct
retainer portion on the tooth and above the survey line in its entirety. The blue lines
on the buccal and lingual surfaces will indicate alterations to the contours of the
abutment tooth surfaces which allow the survey line to be lowered, thus providing
more ideal contours (Fig. 6).
7. Outline the clasps, major connectors, minor connectors, indirect retainer, and
acrylic retainer mesh in red to show the metal framework design (Fig. 7).
8. Return the diagnostic casts to the articulator so that occlusal interferences
are noted when the cast is in place as planned. Indicated in blue are the occlusal
alterations that are necessary to provide interocclusal space for the casting. Soft-
tissue undercuts, bony projections, tissue attachments, areas of bone with thin mu-
cosal coverings, character and extent of residual alveolar bone, interridge space,
hypererupted teeth, tilted and rotated teeth, and occlusal planes are also noted on
mounted diagnostic casts. These notations may be made directly on the diagnostic
cast (Fig. 8).

SUMMARY
When following the suggestions incorporated in this discussion, analysis of a
diagnostic cast will present the:
( 1) most favorable retention areas ;
( 2) heights of contours of remaining teeth as they may affect the design
of the prosthesis;
( 3) path of insertion most favorable to control induced stresses (along the
long axis of the teeth) ;
( 4) location of and amount of preparation necessary for rest seats;
( 5) interlocked occlusion;
( 6) malposed teeth;
( 7) necessity for alveolectomy and/or alveoloplasty;
( 8) problems in occlusion to be solved;
( 9) modification of the occlusal vertical dimension if contemplated;
(10) the treatment plan to the patient;
( 11) progress for reference of work;
106 Coy and Arnold .I. I’, osthrt. Dent.
July. 194

(12) fabrication of individual trays; and

( 13) design of the casting.

Reference
1. Bowman, J. F., Charlebois, H. J., Coy, R. E., and Bickel, P. E.: Removable Partial Pros-
thodontics-Clinical Procedures and Technology, Pittsburgh, 1966, University of Pitts-
burgh.

DRS. COY AND ARNOLD

SOUTHERN ILLINOIS UNIVERSITY
SCHOOL OF DENTAL MEDICINE
EDWARDSVILLE, ILL. 62025