A new method for recording and reproducing cast orientation on a survey table

Herman B. Dumbrigue, DDM,a and Marianne I. Chingbingyong, DDM, MS, DScb Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas
Cast position on a survey table is determined with an inclinometer, allowing tilt to be measured in 1-degree increments in the frontal and sagittal planes. With this device, cast reorientation is simplied and tilt modications can be accomplished accurately because of direct visualization of tilt measurements in the 2 planes. (J Prosthet Dent 2003;89:76-8.)

urveying diagnostic casts is an important step in the fabrication of removable partial dentures (RPD). After a suitable path of insertion is determined, the orientation of the cast needs to be recorded to allow repositioning of the cast in the same orientation at subsequent times. The ability to accurately record, communicate, and reproduce cast orientation is critical to the laboratory fabrication of an RPD framework with the same path of insertion as that determined by the dentist. Clinical verication of the laboratory product can be achieved if the master cast can be reoriented accurately. Conventional methods for recording cast position require marking the cast in several areas to establish a plane of orientation. Tripodization is accomplished by placing horizontal marks on 3 divergent anatomic areas on the cast.1 These marks dene a plane of orientation for repositioning the cast. The scoring method involves making 3 vertical marks along the base of the cast on the posterior and lateral areas.1,2 The analyzing rod of a surveyor is aligned with all 3 marks to reorient the cast. The tripodization and scoring methods are simple and do not require additional instrumentation. However, use of these methods only allows reorientation of the cast on which marks have been placed. Duplicate casts cannot be oriented to the position of the original cast accurately unless the marks are captured in some manner during the duplication process. Several devices have been described to facilitate the recording and reproduction of cast orientation. Kaloyannides3 developed a geometric technique for recording cast orientation that involves using a protractor mounted on a surveyor. Knapp et al4 and Bezzon et al5 described similar methods in which a pin is attached vertically to the cast as a means of reorienting the cast on a surveyor. Steas6 developed a device consisting of 3 adjustable arms attached to a surveyor that contact the cast at 3 divergent points. Ansari7 described the use of a U-shaped plastic impression tray with a vertical stylus
a

Fig. 1. CAT consists of inclinometer that swivels around metal plate.

attached to a surveyor. The tray was indexed to the occlusal surface of a cast with silicone putty material. The pin method4,5 allows quick and accurate reorientation of a cast on a surveyor.8 However, like conventional methods, cast orientation cannot be reproduced on duplicate casts. Other devices enable the orientation of duplicate casts but require attachment of the device to a surveyor.3,6,7 This article describes a new device and method for recording and reproducing cast orientation.

TECHNIQUE
The cast angle tool (CAT) (Patent pending, Texas A&M University Technology Licensing Ofce, College Station, Texas) consists of an inclinometer (Pitch & Angle Locator; Johnson Level and Tool Mfg Co, Mequon, Wis.) mounted on the center of a 3.5- 3.5-inch metal plate with a spring-loaded swivel mechanism (Fig. 1).
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Associate Professor and Assistant Program Director, Advanced Education in General Dentistry, Baylor College of Dentistry. b Private Practice, Carrollton, Texas 76 THE JOURNAL OF PROSTHETIC DENTISTRY

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Fig. 2. A, Indexing markers on undersurface of metal plate. B, VPS occlusion registration material used to index occlusal surfaces of cast to CAT.

Fig. 3. Measurement of cast orientation. A, Frontal plane. B, Sagittal plane.

The inclinometer rotates about the center of the metal plate to 2 terminal positions that are perpendicular to each other. Metal stops limit the rotation of the inclinometer to these 2 terminal positions. The inclinometer provides tilt measurements in 1-degree increments. The metal plate has elevated index markers on its undersurface arranged in an arch conguration that allow indexJANUARY 2003

ing of the device to the occlusal surface of a cast (Fig. 2, A).

Procedure for recording cast orientation

1. Index the CAT to the cast by applying vinyl polysiloxane (VPS) occlusal registration material (Imprint SBR; 3M Dental Products, St. Paul, Minn.) to its
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2.

3.

4.

5.

undersurface and seating the occlusal aspect of the cast into the VPS (Fig. 2, B). After the VPS index has set, remove the device from the cast. Secure the cast on a survey table, and use a surveyor to adjust the tilt until the desired path of insertion is obtained. Replace the CAT on the cast by use of the VPS index, and record the angle of the cast in the frontal plane. Designate the measurement as () or () to describe the position of the gauge needle relative to zero degrees (Fig. 3, A). Rotate the inclinometer counterclockwise to its terminal position, and record the angle of the cast in the sagittal plane. Designate the measurement as () or () (Fig. 3, B). Remove the VPS index from the CAT, and store it with the patients casts. The VPS index can be easily replaced on the device for subsequent cast reorientation. Record the measurements for cast orientation in the frontal and sagittal planes in the patients chart as a permanent record of the planned path of insertion.

2 positions are being aligned, compared to 3 marks with the conventional methods. The CAT can orient duplicate casts with the same VPS index and is used independent of a surveyor. Modications to cast angulation in the frontal or sagittal planes may be made precisely and measured in 1-degree increments with this device. Disadvantages of this method include the additional cost for the CAT, because both dentist and laboratory will need to have one. The VPS index, which is transferable between CAT devices, also presents an additional expense. The recorded measurements are only valid in conjunction with the VPS index used to record cast orientation. Research is currently being conducted to compare the accuracy of the CAT method of cast reorientation with the conventional methods of tripodization and scoring. Results from this study will be presented in a subsequent article.

SUMMARY
A new device that is simple to use and that allows cast orientation to be recorded and reproduced has been described.
REFERENCES
1. McGivney GP, Carr AB. McCrackens removable partial prosthodontics. 10th ed. St. Louis: Mosby; 1999. p. 212-3. 2. Applegate OD. Essentials of removable partial denture prostheses. 3rd ed. Philadelphia: WB Saunders; 1966. p. 108-10. 3. Kaloyannides TM. Reproduction of tilt of a cast on a surveyor. J Prosthet Dent 1973;30:465-7. 4. Knapp JG, Shotwell JL, Kotowicz WE. Technique for recording dental cast-surveyor relations. J Prosthet Dent 1979;41:352-4. 5. Bezzon OL, Ribeiro RF, Pagnano VO. Device for recording the path of insertion for removable partial dentures. J Prosthet Dent 2000;84:136-8. 6. Steas AD. Recording and reproducing the tilt of a cast on a surveyor. J Prosthet Dent 1987;57:121-5. 7. Ansari IH. A procedure for reorienting a cast on a surveyor. J Prosthet Dent 1994;72:104-7. 8. Wagner AG, Forgue EG. A study of four methods of recording the path of insertion of removable partial dentures. J Prosthet Dent 1976;35:267-72. Reprint requests to: DR HERMAN B DUMBRIGUE BAYLOR COLLEGE OF DENTISTRY TEXAS A & M UNIVERSITY SYSTEM HEALTH SCIENCE CENTER 3302 GASTON AVENUE, ROOM 601 DALLAS, TX 75246 TEL: (214) 828-8347 FAX: (214) 828-8952 E-MAIL: hdumbrigue@tambcd.edu Copyright 2003 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2003/$30.00 0 doi:10.1067/mpr.2003.7

Cast reorientation
1. To reorient a cast to the planned path of insertion, secure the cast on the survey table, and loosen the locking screw that holds the table in position. 2. Attach the VPS index to the undersurface of the CAT, and place it in the appropriate position on the cast. 3. With the inclinometer in the frontal position, tilt the survey table laterally until the predetermined frontal plane orientation is obtained. Lightly tighten the locking screw of the survey table. 4. Rotate the inclinometer counterclockwise to its terminal position, loosen the locking screw, and carefully tilt the survey table anteroposteriorly to the predetermined sagittal plane position. Lightly tighten the locking screw. 5. Rotate the inclinometer clockwise to its terminal position, and verify that the frontal plane angulation has not been altered. Tighten the locking screw after frontal and sagittal plane orientations have been veried.

DISCUSSION
The CAT is a new device that allows measurement of cast orientation in the frontal and sagittal planes. Cast reorientation with the VPS index is simplied since only

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