Rotational path partial denture design: A lo-year clinical

follow-up-Part I
T. E. Jacobson, DDSa
Ilniversity of California, San Francisco, Calif.

A conventional removable partial denture that uses a straight path of placement

requires that all rests and clasps be seated simultaneously. The incorporation of a
dual, curved, or rotational path of placement permits one portion of the framework
to be seated first, followed by the remainder of the framework. This procedure
usually permits a reduction in the number of clasps in the framework without
compromising the biomechanical properties of the prosthesis. Rotational path
designs that eliminate clasps reduce tooth coverage by components and often
enhance esthetics, thereby contributine to imnroved patient acceptance. (J Pros-
THET DENT 1994;71:271-7.i

T he concept of a rotational path of placement has
been described in the dental literature by several authors.
A procedure incorporating a curved path of placement
credited to Hollenback was reported in 1935 by Hum-
phreys.‘, ’ The Hart-Dunn attachment requiring a modi-
fied path of placement for unilateral extension base situa-
tions was described by Mann in 1958.” A similar applica-
tion of the curved path of placement was described later by
Garver.4 King52 fi applied a dual path of placement to con-
ventional clasp type partial dentures. This procedure
incorporated an initial straight path of placement, which
gained access to undercut areas by rigid components of the
prosthesis, followed by a final curved path of placement.
King applied this concept to patients with missing anterior
and posterior teeth primarily in tooth-supported situa-
tions. Further refinement, detailed analysis of specifications
and prerequisites, expanded applications, and evaluation
of problems associated with the rotational path concept
have been described by many authors.7-17 The most com-
prehensive description of this procedure is contained
within a chapter in the text by Krol et al.‘”
REVIEW OF THE CONCEPT
Rotational path designs use rigid direct retainers, each of
which consists of a rest and a minor connector. The gingi-
val extensions of minor connectors serve as the rigid reten-
tive elements. In each situation, one or two rigid retainers
are used on one side of the framework in conjunction with
Presented before the Academy of Prosthodontics annual meetrng,
Vancouver, B. C., Canada.
RAssociate Clinical Professor, Department of Restorative Den-
tistry, School of Dentistry.
Copyright ” 1994 by The Editorial Council of THE JOIJRNAI OF
PROSTHETIC DENTISTRY.
0022-3913/94/$3.00+ 0 10/l/52262
one or more conventional clasps on the opposite side of the
framework. Removable partial dentures that incorporate a
rotational path of placement may be divided into two cat-
egories that depend on the location of the rotational cen-
ters.
Category I
In category I situations, the rotational centers are located
at the termini of extended rests (Figs. 1 and 2). Although
a single rotational center may exist, usually two rotational
centers that define an axis of rotation are present. The ro-
tational centers are seated first, followed by the remainder
of the framework. The gingival extension of the minor con-
nectors that serve as rigid retentive elements (Figs. 1, A and
2, A) engage undercut portions of the teeth as they rotate
into position. Fig. 1 illustrates the replacement of posterior
teeth with the elimination of the most posterior clasps. Fig.
2 illustrates the replacement of posterior teeth with the
elimination of the most anterior clasps.
Category II
In category II situations, both the rotational centers and
the rigid retentive elements are located at the gingival ex-
tension of minor connectors. As in category I, one or two
rotational centers may be present (Fig. 3). Category II de-
signs incorporate a dual path of placement. The initial
straight path of placement serves to seat the rotational
centers. A curved or rotational path then allows the rests
and the remainder of the framework to be seated. The most
common application of the category II design involves the
replacement of missing anterior teeth with elimination of
anterior clasps (Fig. 3).
REQUIREMENT OF CLASP DESIGN
A direct retainer is defined in the Glossary of Prostho-
dontic Terms” as “A clasp or attachment applied to an

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Fig. 1. A, Diagrammatic seating of category I framework eliminating posterior clasps. A,

Rotational center; D, minor connector serving as rigid retentive element; E, minor connec-
tor of conventional clasp requiring relief B defined by arc A’. F, Survey line; and C, reten-
tive clasp tip. (From Krol AJ, Jacobson TE, Finzen JC. Removable partial denture design,
an outline syllabus. 4th ed., San Rafael, Calif.: Indent, 1990, with permission). B, Diagram
of framework seated. C’, Arc, which demonstrates path of dislodgment of rigid retentive
element indicating its effectiveness in providing retention. (see Fig. 1, A, for key to other
letters.) (From Krol AJ, Jacobson TE, Finzen JC. Removable partial denture design, an
outline syllabus. 4th ed. San Rafael, Calif.: Indent, 1990, with permission).

Fig. 1. C, Framework with rigid retainers seated on posterior teeth. D, Framework

rotated to place and locked in position with anterior clasps. E, Bilateral rotational centers
define a rotational axis (pointers).

abutment tooth to retain a removable partial denture in
position.” Conventional clasps are the most common form
of direct retainers. A flexible portion of the clasp engages
an undercut on the abutment tooth to provide retention.
The rotational path concept uses a rigid portion of the
framework for retention. Unlike a clasp, which may be
considered a flexible direct retainer, the rotational path
concept incorporates rigid direct retainers, also referred to
in this article as rigid retainers. The components of a rigid
retainer include a rest and an associated minor connector.
The components of any direct retainer must satisfy six
biomechanical requirements. These requirements include
retention, bracing (stability), support, reciprocation, en-
circlement, and passivity. l5 Rigid retainers provide reten-
tion by intimately engaging the undercut portion of an
abutment tooth with the gingival portion of a minor con-
nector. Support is provided by the rest as with conventional
clasps. Bracing or stability is achieved through the intimate
contact of the rest with the relatively parallel walls of the
rest seat. Bracing is further enhanced through the contact

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Fig. 2. A, Diagrammatic seating of category I framework eliminating anterior clasps. A.,

rotational center; E, minor connector serving as rigid retentive element; D, minor connec-
tor of conventional clasp requiring relief (B) defined by arc A’; F, survey line, and C, par-
allel position of retentive clasp tip. B, Diagram of framework seated. C’, arc, which dem-
onstrates path of dislodgment of E, indicating its effectiveness in retention provided its
gingival extension engages adequate undercut. (see Fig. 2, A for key to other letters.

Fig. 2. C, Framework with rigid retainers on canines engaging distal undercuts. Rota-
tional axis passes through mesial portion of canine rests. D, Intimate contact of rigid re-
tentive portion on distal region of canines and outline form of anterior rests.

6’\

B A
B A

A B :
:
Fig. 3. A, Diagrammatic seating of category II framework eliminating anterior clasps. A,
rotational center seated following initial straight path of placement; B, position of conven-
tional retentive clasp tip when it engages undercut; B’, arc, which demonstrates path of
dislodgment of rigid retentive element. Tooth structure prevents this movement when ad-
equate undercut is engaged. B, Framework rotated into position. (see Fig. 3, A for expla-
nations of letters.)

of the tissue surface of the minor connector with the prox-
imal surface of the abutment tooth. These intimate con-
tacts described for the rest and minor connector also con-
tribute to satisfying the requirement of encirclement,
which prevents tooth movement from within the confines
of any direct retainer. Adequate depth of preparation, an
asymmetrical occlusal outline form, and extension of the
rest seat to include greater than half of the mesiodistal
width of the tooth further ensure that the abutment tooth
is maintained in a stable relationship with the rigid retainer
(Figs. 4 and 5). Reciprocation refers to the resistance to
horizontal forces exerted on a tooth by an active retentive

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 JACOBSON

Fig. 3. C, Framework with rigid retainers on canines being seated. D, Framework rotated
to place and completely seated. E, Bilateral rotational centers define a rotational axis
(pointers).

A B
Fig. 4. A, Outline form of a dovetailed occlusal rest extending greater than one half me-
siodistal width of tooth. (From Krol AJ, Jacobson TE, Finzen JC. Removable partial den-
ture design, an outline syllabus. 4th ed. San Rafael, Calif.: Indent, 1990.) B, Relatively
parallel walls of rest seat perpendicular to occlusal plane extending to depth of 1.5 to 2 mm.

Fig. 4. C, Rigid direct retainer consisting of specially designed rest and minor connector.
Close adaptation of minor connector to undercut portion of tooth can be seen. D, Intraoral
view of rigid retainer.

element and usually applies to a flexible retentive clasp TECHNICAL CONSIDERATIONS

arm. Rigid retainers should demonstrate passivity in their Clinical
relationship to the abutment during and after seating of the The rest seats are prepared to a depth of 1.5 to 2 mm with
framework and therefore do not require reciprocation. facial and lingual walls that are nearly parallel to each other

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Fig. 5. A, Outline form of inverted “U” or “V” cingulum rest extending more than one
half mesiodistal width of tooth. (From Krol AJ, Jacobson TE, Finzen JC. Removable par-
tial denture design, an outline syllabus. 4th ed. San Rafael, Calif.: Indent, 1990.) B, Ad-
equate depth is required to maintain lingual wall of rest seat.

Fig. 5. C, Properly prepared rest seat. D, Rest of rigid retainer in place on rest seat. E,
Rest seat prepared in enamel. F, Cast restoration demonstrates appropriate rest seat. G,
Metal ceramic restoration showing appropriate rest seat. H, Proximal contour of metal ce-
ramic restoration for rigid direct retainer.

and perpendicular to the occlusal plane. The occlusal out- not usually recommended for rotational path designs. To
line form of the preparations should be irregular or dove- enhance proximal undercuts, preparation of the abutment
tailed and should extend greater than half of the mesiodis- tooth may be required. Placement of amalgam, cast alloy,
tal width of the occlusal surface (Fig. 4). Guiding planes are metal ceramic, or bonded composite resin restorations may

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Fig. 6. A, Category I relief; (B’ C’, and D’) demonstrate blockout required for frame-
work components at various distances from rotational center (A). Longer distances require
less relief because radius of arc is greater. A’ Indicates that rigid retentive element has ac-
cess to undercut of tooth with curved path of placement. (From Krol AJ, Jacobson TE,
Finzen JC. Removable partial denture design, an outline syllabus. 4th ed. San Rafael, Ca-
lif.: Indent, 1990.) B, Category II relief; (A’, B’, C’, and D’) indicate blockout required
at various distances from rotational center (A). (From Krol AJ, Jacobson TE, Finzen JC.
Removable partial denture design, an outline syllabus. 4th ed. San Rafael, Calif.: Indent,
1990.)

Fig. 6. C, Dividers used to develop arcs of relief on various teeth. D, Divider scribing arc
of relief on teeth. E, Relief of minor connector for conventional clasp fpointer). F, Absence
of relief of minor connector of rigid retainer (pointer).

be required to provide proper rest seats and/or proximal
tooth contours (Fig. 5).
Laboratory
The tissue surface of the minor connectors that serve as
rigid retainers should not be relieved or abrasively finished
to ensure intimate contact with the adjacent tooth surface.
Any portion of the framework that would interfere with the
rotational path of placement should be relieved. A pair of
dividers may be used to delineate the amount of blockout
required by positioning one end on the rotational axis and
the other against the surface that needs relief (Fig. 6).
Longer edentulous spans require less relief because the ra-
dius of the arc defining the blockout is greater.
Diagnostic and master casts are surveyed, as for any re-
movable partial denture, by placing the cast on the
surveyor at a zero-degree or neutral tilt (that is, with the
analyzing rod of the surveyor perpendicular to the occlusal
plane). At this position or with slight modifications of the
tilt on the surveyor, undercuts for the rigid retentive ele-
ments and conventional clasps are located.
In the category II designs, a second tilt of the cast is re-

276 VOLUME 71 NUMBER 3

JACOBSON
quired to identify the initial straight path of placement.
This path is determined through adjustment of the tilt of
the cast until the undercuts for the rigid retentive elements
are eliminated and allow these elements to be seated. The
absence of interference with seating of the rests for the rigid
retainers must also be confirmed.‘, 8,13-15
Category I designs require additional analysis of the un-
dercut portions of the teeth to be used for the rigid retain-
ers, in addition to that completed with the dental surveyor.
The dividers are used to confirm that the depth of under-
cut is adequate to ensure positive retention (Figs. 1, B and
2, B).
SUMMARY
This detailed explanation of the rotational path concept
for removable partial dentures shows the application to
patients who have the posterior teeth missing with the
usual concomitant tipping forward of the last molar present.
It also shows how it is applied t.o patients with most ante-
rior teeth missing and how these teeth can be replaced
without showing clasps in the anterior part of the mouth.
When made properly, the abutment teeth without clasps
will not change positions because of the unique design of
the occlusal rests and retentive minor connector.
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1. Humphreys K. A unilateral removable bridge using a hook attachment.
J S Calif Dent Assoc 1935;2:332-7.
MARCH 1994
THE JOURNAL OF PROSTHETIC DENTISTRY
2. Humphrey6 K. Removable bridge using a hook attachment in a Tinker
pontic. J S Calif Dent Assoc 1935;2:372-4.
3. Mann AW. The lower distal extension partial denture using the Hart-
Dunn attachment. J PROSTHETDENT 1958;8:282-8.
4. Garver DG. A new clasping system for unilateral distal extension
removable partial dentures. J PROSTHETDENT 1987;39:268-73.
5. King GE. Dual path design for removable partial dentures. J PROSTHET
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9. Brien N, Lamarche C. Tacbe R. Les plans d’insertion multidirection-
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13. Krol AJ, Finzen FC. Rotational path removable partial dentures: part
I replacement of posterior teeth. Int J Prosthet Dent 1988,1:17-27.
14. Krol AJ, Finzen FC. Rotational path removable partial dentures: part
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16. Asher ML. Application of the rotational path design concept to a
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