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GUIDING PLANES AND PATH OF

INSERTION IN CPD

AYSHA MOHAMMED ALI KP


IInd YEAR PG 1
CONTENTS
• INTRODUCTION
• DEFINITIONS
• PATH OF INSERTION
• PURPOSE OF SURVEYING
• SURVEY PROCESS
• METHODS OF RECORDING PATH OF INSERTION
• DETERMINATION OF PATH OF INSERTION
• GUIDING PLANES
• FUNCTION OF GUIDING PLANES
• LOCATION OF GUIDING PLANES
• PREPARATION OF GUIDING PLANES
• CONCLUSION

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INTRODUCTI0N
• to overcome financial limitations,
• provisional prostheses
• facilitate hygiene access
• overcome biomechanical and pragmatic issues
associated with dental implants

Stephen D. Campbell; Removable partial dentures: The clinical need for


3
innovation(J Prosthet Dent 2017;118:273-280)
• RPDs are also the best practice therapy for
many clinical scenarios, such as replacing lost
hard and soft tissues, that result in a need for
esthetic support of the orofacial structures,
transitional prostheses for the failing dentition,
and long edentulous spans

Stephen D. Campbell; Removable partial dentures: The clinical need for


4
innovation(J Prosthet Dent 2017;118:273-280)
DEFINITON
• REMOVABLE PARTIAL DENTURE : a
removable denture that replaces some teeth in a
partially edentulous; the removable partial denture
can be readily inserted and removed from the
mouth by the patient
• PATH OF INSERTION: the specific direction in
which a prosthesis is placed on the residual alveolar
ridge, abutment teeth, dental implant abutment(s),
or attachments; syn, PATH OF PLACEMENT

GPT 9 5
• GUIDING PLANES:two or more vertically
parallel surfaces on abutment teeth and/or
fixed dental prostheses oriented so as to
contribute to the direction of the path of
placement and removal of a removable partial
denture, maxillofacial prosthesis, and
overdenture

GPT 9 6
• ; Survey;
• the procedure of locating and delineating the contour and
position of the abutment teeth and associated structures
before designing a removable partial denture

surveying
• an analysis and comparison of the prominence of
intraoral contours associated with the fabrication of a
dental prosthesis

surveyor
• a paralleling instrument used in making a dental
prosthesis to locate and delineate the contours and
relative positions of abutment teeth and associated
structures
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PATH OF INSERTION
• Tilt of a cast that detemines the direction that the partial
denture will take during placement and removal
• The path of insertion is determined with the surveyor
regards to
 height of contours,
 guiding planes,
 interferences
 Esthetics
 FOR ADEQUATE RETENTION, STABILITY,
SUPPORT
Recording the Tilt of a Cast on a Surveyor
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Omid Savabi1 and Farinaz Shirban2,*
OBJECTIVES OF RDP

• can easily seat and remove from the mouth


and yet,
• when seated, the prosthesis will resist the
dislodgment potential caused by masticatory
function, especially mastication of sticky
foods.

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PURPOSES OF SURVEYING
• Determine the most advantageous path of
insertion.
• Locate proximal tooth surfaces - guiding surfaces.
• Locate and measure undercuts.
• Identify hard or soft tissue interferences.
• Determine a path of insertion consistent with
esthetic requirements

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.
• Delineate the height of contour of the
abutment teeth and identify areas of undercut
• Planning restorative procedures.
• Record the most ideal cast position for future
reference.
• Plan for the RPD design and the required
mouth preparation

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DENTAL SURVEYOR
• 1918-A J FORTUNATI
• 1923- J.M.NEY

plan study

design
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PARTS OF A SURVEYOR
• PLATFORM
• CAST HOLDER
• VERTICAL COLUMN
• HORIZONTAL ARM
• SURVEYING ARM
• SURVEYING TOOL

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SURVEYING TOOLS
• Analyzing tool
• Carbon marker
• Under cut guages
• Wax knife

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Survey process
Identification of most favourable tilt
Tilt is described from the view of person from
posterior surface
CRITICAL FACTORS
Elimination of hard
The presence of Creation of
and soft tissue
suitable undercuts desirable esthetics
interferences

Establishment of
appropriate
guiding planes 15
RETENTIVE UNDERCUTS
• Must be present in cast with horizontal tilt
• If not present-Must be created in mouth
• Desirable location-mesiobuccal,
-distobuccal line angle,
-midfacial surface
-apical third 0.010 inch
• Cast clasp

0.015 inch
• Wrought wire
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INTERFERENCES
• Teeth
• Bony prominences
• Soft tissue undercuts
• exostoses

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ESTHETICS
• Metal components should be concealed as
effectively as possible
• Prosthetic teeth selection ,contouring and
polishing

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Advantages of single path of insertion

• Retention
• Bracing and cross arch stabilisation
• Reduces torque on abutments
• Directs force along long axis of tooth

Sarnat, A. E., & Klugman, R. S. (1981). A method to record the path of insertion of a
removable partial denture. The Journal of Prosthetic Dentistry, 46(2), 222–
223. doi:10.1016/0022-3913(81)90313-9 
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PATH OF INSERTION AS PER
KENNEDYS CLASSIFICATION
• Tooth bounded edentulous space (Kennedy
class III) - single path of insertion
•   In Kennedy class II modification cases-
single path of insertion, guided by the
modification space
•   

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• Free ended saddles (Kennedy class I and II
cases) – multiple path of insertion
•   Additional guiding planes on the lingual
surfaces of other teeth may be developed to
control the path of insertion

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methods of recording the path of insertion
(1) tripod marks on maintenance areas,
(2) three vertical marks, or ditches, on the sides
of the base of the cast,
(3) three horizontal marks on the sides of the
base of the cast,
(4) the cemented pin method.

Sarnat, A. E., & Klugman, R. S. (1981). A method to record the path of insertion of a
removable partial denture. The Journal of Prosthetic Dentistry, 46(2), 222–
223. doi:10.1016/0022-3913(81)90313-9 22
DETERMINATION OF THE PATH OF
INSERTION
Cast on cast holding
Surveying rod
device-occlussal
perpendicular to the
plane parallel to the
platform
table of surveyor

Four factors
Cast in this position influencing path of
has zero degree tilt insertion is
considered

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Path of insertion (PI) perpendicular to occlusal plane
(dotted line) that coincides with potential PPD can be used
for RPD if it provides satisfactory undercut surfaces (arrows)
on abutments. These undercuts must be well-defined and of
maximum depth required for type of clasp arm used.

Bezzon, O. L., Mattos, M. G. C., & Ribero, R. F. (1997). Surveying removable partial


dentures: the importance of guiding planes and path of insertion for stability. The 24
Journal of Prosthetic Dentistry, 78(4), 412–418. doi:10.1016/s0022-3913(97)70051-9
Cross-section of retentive clasp arms shown on facial
surfaces of abutments and cross-section of reciprocal clasp
arms shown on lingual surfaces of abutments. Horizontal
marks on distal of abutments indicate position of neutral zone
.
Bezzon, O. L., Mattos, M. G. C., & Ribero, R. F. (1997). Surveying removable partial
dentures: the importance of guiding planes and path of insertion for stability. The 25
Journal of Prosthetic Dentistry, 78(4), 412–418. doi:10.1016/s0022-3913(97)70051-9
Path of insertion (PI) perpendicular When cast table is inclined to
to occlusal plane reveals discrepant right in attempt to distribute
undercut surfaces (large undercut undercuts evenly, apparent
on left and none on right). Survey undercut can be established
line on left abutment is about on right abutment of cast
equidistant shown in previous figure,This
between occlusal surface and requires extreme tilt and
gingiva. Survey line on guiding planes have been
right abutment is near gingiva. ignored.

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• In the patient's mouth, the occlusal plane
would again be in a horizontal position, and
the dislodging force or sticky food could act in
the direction indicated by the PPD illustrated
in Figure

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Inclination of cast holder for distribution of undercut
surfaces of the abutments on cast shown in Figure and
detection of guide planes on lingual surfaces of right and
left Abutments,

Bezzon, O. L., Mattos, M. G. C., & Ribero, R. F. (1997). Surveying removable partial


dentures: the importance of guiding planes and path of insertion for stability. The 28
Journal of Prosthetic Dentistry, 78(4), 412–418. doi:10.1016/s0022-3913(97)70051-9
• When prosthesis illustrated in Figure
undergoes action of PPD in direction
perpendicular to occlusal plane,guide planes
that guide seating of RPD along PI prevent its
dislodgment during function by providing
necessary retention and stability.
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As a general rule, the PI with zero inclination
should be the starting point for the surveying
process. This path,which coincides with or
slightly deviates from the PPD,may be ideal
when it provides a favorable approach to the four
factors that influence the PI.
The PI inclined in relation to the occlusal plane
must necessarily be determined as a function of
guiding planes that will impose such inclination
on the prosthesis, thus reducing the PPD.

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GUIDING PLANES
• Two or more vertical surfaces of abutment
teeth ,so shaped to direct a prosthesis during
placement and removal.
• Guiding planes may be present in natural
crown contours, or they may be formed by
selective grinding of natural crown contours or
contouring of surveyed crowns.

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FUNCTIONS OF GUIDING PLANES

1. retention for a removable partial denture by


directing the path of removal in fewer
directions.
2. To ensure the intended actions of
reciprocal,stabilizing and retentive components
3. Eliminate food entrapments
4. Minimize deep under cuts
5. Improved esthetics

Holt, J. E. (1981). Guiding planes: When and where. The Journal of Prosthetic Dentistry, 32
46(1), 4–6. doi:10.1016/0022-3913(81)90126-8 
Rudd and O’Leary report that, during their investigation, guide plane partial
dentures provided a beneficial stabilizing effect for weakened teeth.

Holmes, J. B. (1968). Preparation of abutment teeth for removable partial dentures. The


Journal of Prosthetic Dentistry, 20(5), 396–406. doi:10.1016/s0022-3913(68)80016-2  33
Guide planes with no rest or clasp may be given
for a posterior isolated teeth with poor prognosis.

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LOCATION OF GUIDING PLANES

• Guiding planes are usually located on


proximal surfaces adjacent to ridges and
lingual surfaces of mandibular teeth

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TOOTH-BORNE REMOVABLE PARTIAL
DENTURES

• guiding planes need only to be considered in


relation to the forces or actions caused during
dislodgement.
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• The larger the number of vertical walls that
can be made parallel to each other, the more
retentive the removable partial denture will be.
• All the forces of dislodgement will be
relatively nondestructive; in fact, these guiding
planes will provide horizontal bracing of the
teeth involved.

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DISTAL-EXTENSION REMOVABLE
PARTIAL DENTURES
• Guiding planes must be considered with
respect to the center of rotation of the
removable partial denture and the consequent
movement of the denture during function .
• distal surface of an abutment tooth must be
free of contact by the removable partial
denture during functional movements.

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• This can be best accomplished by placing a
short vertical guiding plane on the occlusal
one-third of the tooth and then constructing the
guiding plate of the removable partial denture
so that its occlusal edge is at the same level as
the gingival limit of the prepared guiding
plane

Holt, J. E. (1981). Guiding planes: When and where. The Journal of Prosthetic Dentistry, 39
46(1), 4–6. doi:10.1016/0022-3913(81)90126-8 
PREPARATION OF GUIDING PLANE

½ width between cusp tips

1/3 buccoloingual width

Vertically-2/3rd length of crown

Buccal and lingual line angles not involved

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DEVELOPING GUIDING PLANES

 cast with surveyor near operator


 Visualize the relationship between bur and tooth to
be contoured
 Cylindrical bur
 2-4mm/1.5-2 occlusogingival hgt
 Lingual guiding planes
 2-4mmm, in the midddle third

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Lingual guiding planes
• Reciprocation
• Minimise number of pathways
• Maximum resistance to lateral forces

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GUIDING PLANE IN ANTERIOR
ABUTMENT
• Enhance stabilisation
• Decrease space between abutment and
prosthesis
• restablish normal width of edentulous space

Stewarts clinical removable partial denture prosthodontics

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DESIGN

Mark the
Favourable tripodizatio
Survey lines desired DESIGN
tilt n
undercuts

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CONCLUSION
fully mastering the activities of surveying and
designing the framework, as well as the planning
and execution of the alterations in the support
system, results in a rapid and easy, but also
sophisticated, construction of RPDs. This will
result in making esthetically pleasing and stable
RPDs that will significantly contribute to the
health of the stomatognathic system.

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REFERENCES
1. Mc Crackens removable partial denture
prosthodontics-12th edition
2. Stewarts clinical removable patial denture
prosthodontics-fourth edition
3. Removable partial denture prosthodontics-
Ernest L.Miller,Joseph E.Grasso
4. Parial dentures-John Osborne, George
Alexander Lammie

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5.Sarnat, A. E., & Klugman, R. S. (1981). A method to
record the path of insertion of a removable partial
denture. The Journal of Prosthetic Dentistry, 46(2), 222–
223. doi:10.1016/0022-3913(81)90313-9 
6.Stephen D. Campbell; Removable partial dentures: The
clinical need for innovation(J Prosthet Dent
2017;118:273-280)
7. Holmes, J. B. (1968). Preparation of abutment teeth
for removable partial dentures. The Journal of Prosthetic
Dentistry, 20(5), 396–406. doi:10.1016/s0022-
3913(68)80016-2
8. Recording the Tilt of a Cast on a Surveyor
Omid savabi1 and Farinaz shirban,*
47
9. Bezzon, O. L., Mattos, M. G. C., & Ribero, R. F.
(1997). Surveying removable partial dentures: the
importance of guiding planes and path of insertion
for stability. The Journal of Prosthetic Dentistry,
78(4), 412–418. doi:10.1016/s0022-3913(97)70051-9

10.GPT 9
11. Dumbrigue HB, Chingbingyong MI. A new
method for recording and reproducing cast
orientation on a survey table. J Prosthet
Dent. 2003;89:76–8
48
Cross references
1. Rudd, K. D.. and O’Leary, T. J.: Stabilizirlg
Periodontally bveakened Teeth by Using Guide Plane
Removahlr Partial Dentuws: ‘4 Preliminary Report. J.
PROS. DENT. 16: 72 l-727, 1966.
2. Kratochvil, F. J.: Influence of Occlusal Rest Position and
(:lasp Design on Movement of Abutment Teeth, J.
PROS. DEST. 13: 114-124, 1963.
3. Wagner, A. G., and Forgue, E. G.: A study of four
methods of recording the path of insertion of removable
partial dentures. J PROSTHET DENT 35:267, 1976.

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4.  Coy RE, Arnold PD. Survey and design of
diagnostic casts for removable partial dentures. J
Prosthet Dent. 1974;32:103–6.
5. . Miller EL, Grasso JE. Removable partial
prosthodontics. 2nd ed. Baltimore: Williams &
Wilkins; 1981. p. 103-17.
6. Weinberg LA. Atlas of removable partial denture
prosthodontics. St Louis: CV Mosby; 1969. p. 81-4.
7. Coy RE, Arnold PD. Survey and design of
diagnostic casts for removable partial dentures. J
Prosthet Dent 1974;32:103-6.

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8. Shakibamehr AH, Askari N, Abolhasani M,
Moradpoor H, Nejatidanesh F. A procedure for
recording and reproducing the cast position on a
surveyor. Dent Res J (Isfahan). 2013;10:695–6

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NEXT SEMINAR: DIRECT
RETAINERS IN CPD
BY DR NEETHU NP
ON 16/12/19

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