Use of a silicone transfer index to prepare parallel guide planes

Eva Niu, DDS, MS,a and Daler Tarrazzi, DDS, MSb School of Dentistry, The University of Michigan, Ann Arbor, Mich
Guide planes are vertically parallel surfaces on abutment teeth oriented to contribute to the direction of the path of placement and removal of a removable partial denture (RPD).1 These surfaces seldom occur naturally and must be prepared in the enamel or on the restorations of abutment teeth.2 In 1954, Applegate commented that use of the dental surveyor is the best method to prevent the occurrence of problems related to RPDs.3 Guide planes function to: (1) provide a path of insertion for the prosthesis, aid in retention, stabilize the prosthesis against horizontally directed forces, and eliminate excessive stress on the abutment teeth; (2) ensure the intended action of reciprocating, stabilizing, and retentive components; and (3) eliminate food traps.4-8 Although guide planes are considered essential for RPDs, the preparation of suitable guide planes on abutment teeth during the fabrication of RPDs is dependent on the ability of the clinician.6 When multiple teeth are involved, achieving parallelism between abutment surfaces can be technically challenging, especially in posterior regions. To accurately transfer the orientation of guide planes from surveying instruments intraorally, several devices and techniques have been described. Some paralleling devices have been shown to form exact guide planes, but most of them are either too expensive or complicated for practical use.9 Carr et al5 suggested making an impression which is poured
a

into a quick-setting plaster. The resultant cast can be verified for parallelism on the surveyor prior to making definitive impressions.4 Techniques involving the use of modeling plastic or preparation of acrylic resin require extra chair time. Clinicians find fabricating acrylic resin or modeling plastic impression compound jigs technique sensitive. Both modeling plastic impression compounds and acrylic resins are rigid; therefore, blocking out undercuts on the diagnostic cast is necessary before fabricating the jigs. The polymerization shrinkage of acrylic resin increases the concern that diagnostic casts will be fractured during fabrication of the jig. This article describes a simple, straightforward technique involving the use of a laboratory silicone material to accurately transfer guide planes from a diagnostic cast to the mouth. Because of the flexibility and tear resistance of silicone material, no tooth or soft tissue block-out on the diagnostic cast is necessary. The risk of breaking or marring the diagnostic cast during the jig fabrication procedure is eliminated. The silicone jigs can be adjusted easily for improved intraoral observation. The color applied to the preparation surface of the jigs prevents tooth overreduction during clinical procedures.

PROCEDURE
1. Fabricate a diagnostic cast of the partially edentulous patient using ISO type III gypsum (Microstone; Whip

Mix Corp, Louisville, Ky). 2. Survey the diagnostic cast using a surveyor (Ney Surveyor; Dentsply Ceramco, York, Pa) to complete the definitive design of the RPD and plan the position of the guide planes. Transfer the alignments and locations of the guide planes to the sides of the abutment teeth, both buccally and lingually. Leave the cast on the surveyor table (Fig. 1, A). 3. Mix an adequate amount of the base and catalyst of the silicone impression material (Sil-Tech; Ivoclar Vivadent AG, Schaan, Liechtenstein). Adapt the impression material to the abutment teeth and at least one adjacent tooth. 4. After the impression material has polymerized, trim the silicone index carefully using a no. 25 blade (Carbon Steel Surgical Blade; Miltex, Inc, York, Pa) until it is about 5 mm thick and has a flat, smooth surface (Fig. 1, B). Transfer the marks drawn in step 2 to the buccal and lingual aspects of the silicone index, using an analyzing rod. Connect these 2 lines occlusally, and then trim the index according to the lines. Mark the tooth surface to be prepared on the silicone index with a permanent marker (Sharpie marking pen; Sanford Corp, Oak Brook, Ill) to provide a clear color contrast to the prepared tooth. 5. Evaluate the jig intraorally during the tooth modification appointment. Prepare guide planes using a parallel-sided diamond rotary cutting instrument (FG575; KerrHawe SA,

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Clinical Lecturer, Department of Biologic and Materials Science, Division of Prosthodontics. Clinical Assistant Professor, Department of Biologic and Materials Science, Division of Prosthodontics.

(J Prosthet Dent 2010;104:347-348)

Niu and Tarrazzi

Realign the preparation angle if it is observed that one side of the black mark on the prepared surface has been cut away (Fig.edu Copyright © 2010 by the Editorial Council for The Journal of Prosthetic Dentistry.34:408-14. School of Dentistry 1011 N University Ann Arbor.34:152-5. A laboratory investigation of the role of guide planes in the retention of cast cobalt-chromium alloy partial denture frameworks.348 Volume 104 Issue 5 Bioggio. Igarashi Y. Nairn RI. J Prosthet Dent 2008. 11th ed. or call 800-654-2452 or 407-345-4000 for information on availability of particular issues and prices. Shimura Y. A B 1 A. 155. The glossary of prosthodontic terms. Acrylic resin jigs as an aid to parallel guiding plane preparation. 3. Stern WJ. Preparing guide planes for removable partial dentures. J Prosthet Dent 1975. REFERENCES 1. p. 94:42. O’Sullivan M. Mizutani H. Mattos MG. Ali M. Carr AB. J Prosthet Dent 1972. J Prosthet Dent 2005. McCracken’s removable partial prosthodontics. Waters NE. Sherriff M.78:412-8. Switzerland). 27:654-61. Transfer lines drawn on buccal and lingual aspects of abutments to trimmed silicone index. Please write to Elsevier. Inc until inventory is depleted. Achieving planned parallel guiding planes for removable partial dentures. The Journal of Prosthetic Dentistry Niu and Tarrazzi . 2 Silicone preparation index placed intraorally for tooth modification. Orlando.29:291-9. West F. J Prosthodont Res 2010. Journal Back Issues Available to Subscribers As a service to our subscribers. Inc. 8. 4. Canning T. Guiding planes in clasp reciprocation and retention. 2004. Krikos AA. MI 48109-1078 Fax: 734-764-1481 E-mail: evaniu@umich. McGivney GP. 5. J Prosthet Dent 1975. Corresponding author: Dr Eva Niu Department of Biologic and Materials Science Division of Prosthodontics The University of Michigan. Louis: Elsevier. Jochen DG. Wadachi J. 6277 Sea Harbor Dr. Ribeiro RF.99:162-4. copies of back issues of The Journal of Prosthetic Dentistry for the preceding 5 years are maintained and are available for purchase from Elsevier. Surveying removable partial dentures: the importance of guiding planes and path of insertion for stability. 2). 2. Transfer locations of guide planes on buccal and lingual surfaces of abutment teeth using analyzing rod. 6. Subscription Customer Service. 7. Influence of removable partial dentures on the formation of dental plaque on abutment teeth. Nakamura T.54:29-35. J Dent 2001. 9. J Prosthet Dent 1997. FL 32887. St. Bezzon OL. Brown DT. B.

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