Application of the rotational path design concept to a

removable partial denture with a distal-extension base

Marshall L . Asher , DDP
Fort Benning, Ga.

Biomechanical considerations for use of the rotational path design concept to

construct a remova.ble partial denture for a patient with a tooth-bounded ridge on
one side and a distal-extension ridge on the opposite side are presented. The
various axes and arcs of rotation that occur during masticatory function are
identified and their effects on the prosthesis and supporting structures are ana-
lyzed. Sequential steps in the necessary surveys of the master cast are enumer-
ated. Critical details for the most effective and least deleterious placement of the
rigid retentive element on the mesial surface of the posterior molar abutment (on
the tooth-bounded ridge) are described. (J PROSTHET DENT 1992;68:641-3.)

T he concepts of “dual path” and “rotational path”
removable partial dentures were published in the late
1970s.rS3These approaches to removable partial denture
design used precisely fitting minor connectors to engagethe
infrabulges of abutment proximal surfaces and thereby
provide retention without a conventional retentive clasp
arm. These concepts resulted in improved esthetics and
stability. In the ensuing years, inadequate understanding
of the mechanics of rotational path removable partial den-
ture design sometimes produced removable partial den-
tures that were actually detrimental to the health of the
dentition. In response, a number of articles that provided
definitive guidelines to avoid potential errors in design
were published.4-8
It is widely recognized that in a rotational path design,
there is a potential for unfavorable mechanical leverage
when a rigid retentive component is used in a distal-exten-
sion base situation. However, there is an undercut area on
the molar abutment of a mandibular Kennedy class II
(modification 1) removable partial denture that may be
used for rotational path retention. The following design is
presented for consideration.
DESIGN
Occlusal rest seats are prepared mesially on the terminal
abutment on the distal-extension side, distally on the an-
terior abutment on the tooth-supported side, and mesially
on the molar abutment (Fig. 1). The rest seat on the molar
should be as long as possible, and oriented exactly along the
planned axis of rotation for the framework (Fig. 1, line B).
The floor of the preparation must be rounded to produce
The opinions or assertions contained herein are the private views
of the author and are not to be construed as official or as reflect-
ing the views of the Department of the Army.
aLieutenant Colonel, U.S. Army, DC; Assistant Director, Ad-
vanced Education in General Dentistry.
10/1l39926
a rest seat that will allow unimpeded rotation. Care must
be taken to ensure that this rest seat preparation is not un-
dercut with respect to the initial path of placement. As with
certain rotational path designs, the master cast is surveyed
and tripodized at both the initial path of placement and at
the final (fully seated) path of placement. The exact area
to be engaged by the rotational path retentive element
must then be determined and marked by use of the follow-
ing step-by-step procedure:
1. Place the master cast on the surveyor so that the occlusal
plane is perpendicular to the surveying rod.
2. On the master cast, place a straight edge along the axis
of rotation and use the surveyor to draw a vertical line
from the axis of rotation down the mesiolingual cusp of
the molar (Fig. 2, line E).
3. Place a straight edge against the mesiolingual cusp par-
allel to the plane of occlusion and at right angles to the
axis of rotation (Fig. 1, line C). Mark the point at which
the straight edge contacts the tooth. Draw a vertical line
through this tangent point on the mesiolingual cusp
(Fig. 2, line F).
The survey line that marks the height of contour of the
molar abutment at the final path of placement is the coro-
nal limit of the retentive area (Fig. 2, line D). The area that
can be contacted by the rotational path retentive element
has now been demarcated (Fig. 2, area C). The framework
should be cast to contact this entire area without any re-
lief. The clasp assembly for the molar is completed by add-
ing a bracing arm that extends around the buccal surface,
with its gingival edge on the survey line and its tip termi-
nating precisely on the axis or rotation. A clasp assembly
that avoids lateral stress during rotational movement is
placed on the terminal abutment on the tissue-supported
side.
The positive retention provided by the rotational path
retentive element makes clasp placement unnecessary on
the anterior abutment of the tooth-supported segment.
This tooth need only provide vertical support and indirect
retention through a properly designed rest.

THE JOURNAL OF PROSTHETIC DENTISTRY 641


Fig. 1. Design features. A, Rotational path retentive ele-
ment; B, axis of rotation; C, line perpendicular to B and
tangent to the tooth; D, bracing arm.
When a distal-extension base is loaded in function, the
removable partial denture tends to rotate. The rotational
movement of any part of the prothesis anterior to the axis
of rotation may have some movement occlusally. It is for
this reason that the framework must not contact the
infrabulge area anterior to the vertical line drawn through
the axis of rotation (Fig. 2, line E). All portions of the
prosthesis distal to the axis of rotation will move in a me-
siogingival arc. Should the framework contact the tooth
distal to the tangent point (Fig. 2, line F), this rotational
movement would impinge on the tooth and cause me-
siobuccal torque. Between these two lines (Fig. 2, area C),
the mesiogingival rotational movement would result in a
very slight disengagement of the framework. Therefore,
during function there are minimal forces applied to the
tooth by a rotational path retentive element that is limited
to this area. The buccal bracing arm is not designed to pro-
vide reciprocation, but simply to prevent horizontal move-
ment of the framework, thereby ensuring that the rota-
tional path retentive element remains in contact with the
tooth when the prosthesis is not in function. When the di-
stal-extension base is depressed in function, the buccal arm
will rotate occlusally and disengage. However, the extreme
tip will show no perceptible movement because it is placed
precisely on the axis of rotation
It is apparent that a long channel-type rest seat, guiding
plane, SO-degree encirclement, or any feature recom-
mended to prevent drifting of the molar abutment has not
been included in this design. Because of the rotation that
will occur in function, each of these design items would
cause torque on the tooth and therefore should not be used.
642
ASHER
Fig. 2. View of the molar abutment as seen from the
mesiolingual surface. A, Bracing arm; B, occlusal rest; C,
area contacted by the rotational path retentive feature; D,
height of contour; E, vertical line through the axis of rota-
tion; F, vertical line through the tangent point.
Clinical use of this design over many years has not caused
failure due to molar drifting. Perhaps this fortuitous lack
of failure is because of the presence of the rotational path
rigid retentive element in the mesiolingual undercut. The
casting contact actually provides passive resistance to the
tendency of the lower molar to drift in a mesiolingual di-
rection in response to occlusal forces.
This design is most applicable when the modification
space requires the replacement of at least one premolar and
one molar. It allows adequate space for the rotational path
of placement without excessive blockout on the anterior
abutment.
Although the framework design allows rotational move-
ment to occur without torque on the abutment teeth, an
altered cast impression technique is recommended for the
distal-extension base to ensure optimum tissue support
and stability of the prosthesis. Its objective is to reduce ro-
tational movement when masticatory forces are applied to
the distal extension base.
CONCLUSION
By including a rotational path rigid retentive element in
a design that accommodates rotational movement in func-
tion, exceptional stability is achieved with minimal stress
to the abutments. In addition, the total absence of lingual
retentive or bracing clasp arms renders the prosthesis more
hygienic and comfortable for the patient. The primary dis-
advantage is the need for direct communication with
knowledgeable laboratory personnel. For best results, each
prosthesis should be discussed with the technicians who
will construct the framework. This may become less neces-
sary once the technicians become familiar with the concept.
OCTOBER 1992 VOLUME 68 NUMBER 4
RPD WITH DISTAL-EXTENSION BASE

REFERENCES
6. Firtell DN, Jacobsen TE. Removable partial dentures with rotational
1. King GE. Dual path design for removable partial dentures. J PROSTHET paths of insertion: problem analysis J PROSTHET DENT 1983;50:8.
DENT 1978;39:392. 7. Daniel RE, Granata JS. The rotational path removable partial denture.
2. King GE, Barco MT, Alson RJ. Inconspicuous retention for removable Compend Contin Educ Dent 1985;6:716.
partial dentures. J PROSTHET DENT 19’78;39:505. 8. Bauman R. Rotational path partial dentures: problems and potential.
3. Garver DG. A new clasping system for unilateral distal-extention Compend Contin Educ Dent 1986;7:356.
removable partial dentures. J PROSTHET DENT 1978;39:268.
4. Jacobson TE, and Krol AJ. Rotational path removable partial denture Reprint requests to:
design. J PROSTHET DENT 1982;48:370. DR. MARSHALL L. ASHER
5. Jacobsen TE. Satisfying esthetic demands with rotational path partial 508 WICKER~HAM AVE.
dentures. J Am Dent Assoc 1982;105:460. FORT BENNING, GA 31905

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