SURVEYING - Copy.pptxxxxxxxxxxxxxxxxxxxxx

surveyinggggggg

1. DENTAL SURVEYOR AND SURVEYING IN PROSTHODONTICS PRESENTER DR T KAVYA II MDS

2. Introduction Definition Terminologies Types of surveyor Uses of surveyor Objectives of dental surveyor

3. Parts of a surveyor & surveying tools process of surveying - path of insertion & factors influencing it -block out of master cast Conclusion Review of literature References

4. Introduction A partial denture will not succeed unless it is designed and constructed in harmony with all the physiologic and mechanical problems present in patients mouth. A well secured design serves as blue print for fabrication of the removable partial dentures. An essential key to success in the practice of removable partial denture prosthodontics is thorough, knowledgeable planning of each structural detail of the prosthesis.

5. DEFINITION: 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; - GPT 9. Surveying- It is an analysis and comparison of the prominence of intraoral contours associated with the fabrication of a dental prosthesis

6. Survey line A line produced on a cast by a survey or marking the greatest prominence of contour in relation to the planned path of placement of a restoration.GPT-8 Height of contour A line encircling a tooth and designating its greatest circumference at a selected axial position determined by a dental surveyor .

7. Suprabulge It is that portion of a tooth or crown that converges towards the occlusal surface,i.e.,above the height of contour. Infrabulge It is that portion of the crown of a tooth apical to the survey l ine .

8. Guiding planes Vertically parallel surfaces on abutment teeth or/and dental implant abutments oriented so as to contribute to the direction of the path of placement and removal of a removable dental prosthesis. Undercut The portion of the surface of an object that is below the height of contour in relationship to the path of placement

9. TYPES OF SURVEYORS Types of surveyors MECHANICAL Neys surveyor Jelenko surveyor Williams surveyor ELECTRONIC Microanalyser Stress-o- graph RECENT ADVANCES OPTICAL/ LASERS CAD/CAM

10. Types Ney surveyor The Original Ney Surveyor Developed by NEY in 1923. It featured a convenient palm rest on the top of the vertical arm. Designed by Weinstein and Roth, Ney’s Surveyor This is the currently used surveyor, designed and developed in 1937. FIXED – HORIZONTAL ARM.

11. Jelenko surveyor The main components of the jelenko surveyor are basically the same as those for the ney surveyor except that by releasing the nut at the top of the vertical arm, the horizontal arm may be made to pivot. It is also known as wills surveyor.

12. Retentoscope it is produced by the saddle lock company. it is a surveyor with undercut gauge. the cast attached on the table can be raised and lowered vertically and eliminates the need for movement in vertical rod.

13. The ticonium surveyor one of the modern instrument. the marking point will make vertical line on the abutment tooth until depth has been reached.

14. Stress o graph Also produced by ticonium company. Consists of vertical holders/horizontal arms. One for measuring undercut. Second for measuring survey line

15. Broken arm cast surveyor featuring the gimbal stage table. can be adjusted to any tilt/direction. spring loaded survey arm. straight handpiece could be easily clamped with surveying arm.

16. Microsurveyor Handy storage and could easily fit in a lab pocket.

17. Recent innovation The laser light is visible only above the height of the contour, whereas the undercut below the height of the contour is cast in a dark shadow

18. Electronic surveying TECHNIQUE 3-D surface capture 1.Obtain a 3-D computer model of a cast of a patient using an optical surface capture device 2. Align and combine the data points from each of these scans using CAD software to provide a single coherent data set of the entire object. Use the resultant data points (termed a “point cloud”) to create a 3-D surface model. 3. Produce a solid 3-D computer model on screen using a triangular-faceted polygon mesh.

19. 3-D computer-aided design -Electronically survey the scan using the MatLab software package described previously. The depth of undercut can be copied from the definitive cast to determine clasp termination. -Model the shape of the components of a removable partial denture framework on the scanned surface model using 3-dimensional CAD software (Surface Studio; Alias-Wavefront, Inc). - Use an RP (stereolithography) machine (SLA 250/ 40; 3D Systems Inc, Valencia, Calif) to produce a plastic ( WaterClear 10110 Epoxy Resin for Stereolithography; DSM Somos , New Castle, Del 33 physical model of the components described above. - Use RP (rapid prototyping) processes to create a sacrificial pattern of a removable partial denture framework, to be incorporated directly into existing casting procedures found in the typical dental laboratory.

20. A, Program used to identify survey line on 3-D scan of model of large tooth—distobuccal view. B, Lingual view of electronically surveyed tooth

21. PARTS OF DENTAL SURVEYOR 1.SURVEYING PLATFORM 2. A VERTICAL ARM 3. A HORIZONTAL ARM 4.A SURVEYING ARM 5.A MANDREL 6.A SURVEYING TABLE.

22. 1. SU R V E YING PLATFORM It is a metal plate parallel to the floor where a cast holder can be placed. It forms the base of a surveyor onto which all the components are attached and supported

23. 2. CAST HOLDER/ SURVEYING TABLE It is a stand placed over the surveying platform This stand has a base and a table to place a cast , the cast can be locked in any position on the table with a locking device. The table is attached to the base with a ball and socket joint which facilitates to tilt the table

24. 3.VERTICAL ARM It arises vertically from the surveying platform It supports the superstructure [horizontal arm and surveying arm]

25. 4. HORIZONTAL ARM It extends horizontally from the top of the vertical arm and supports the surveying arm at its free end. Differences in various surveyors: Ney Jelenko - Fixed - revolves horizontally Williams - revolves horizontally with a joint in middle

26. 5. Surveying arm It extends vertically from the free end of the horizontal arm , and is parallel to the vertical arm. It can move up and down . The lower end of this arm has a mandrel into which tools used for surveying can be locked in. Differences in various surveyors: Ney Jelenko - locking device - Spring loaded

27. Carbon marker Mandrel Analyzing rod 4 -7.Undercut Gauge 8 . Trimming Knife Dental surveyor tools

28. Surveying tools Analysing rod It used to determine relative parallelism of surfaces on a cast

29. A carbon marker also may be placed in the mandrel. The carbon marker is used to mark the greatest circumference of the teeth. The lines that result are termed survey lines. CARBON MARKER

30. 32 The height of contour, the survey line The "height of contour" is the greatest circumference of a tooth in a given horizontal plane. The "survey line" is the line which is marked on the abutment tooth by the surveyor spindle, to indicate its greatest circumference in a given horizontal plane . The survey line divides the crown of the tooth into two zones: Sometimes THE AREA ABOVE THE LINE IS KNOWN AS THE SUPRABULGE AREA THE AREA BELOW THE LINE AS INFRABULGE AREA .

31. AN UNDERCUT AREA (EVERYTHING BELOW THE LINE), A NON-UNDERCUT AREA (EVERYTHING ABOVE THE LINE). The terms " GUIDELINE" AND "BREADTH OF CONTOUR LINE " are synonyms for "survey line." 33

32. 34 Survey line - Line produced on a cast by a surveyor marking the greatest prominence of contour in relation to the planned path of placement of a restoration- GPT 9. Significance of survey line All rigid components of the partial denture must be kept occlusal to it Only the terminal third of retentive clasp arm is placed gingival to the survey line Helps to locate areas of undesirable tooth undercuts

33. 35 Influence of survey line in designing the clasp

34. 36 near zone diagonal survey line reverse action /hair pin clasp ring type akers clasp t type roach clasp

35. 37 high survey line low survey line wrought wire

36. 38 wax knife

37. 3. Undercut guages These are parallel sided tools with heads of various sizes. They are used to measure the depth and location of the undercuts. According to Mc Cracken the undercut gauges are available in 0.010,0.020 and 0.030 inches or 0.254,0.508 and 0.762. 0.01” – Base metal alloys 0.02” – Gold metal aloys 0.03” – Wrought alloys

38. . 01” . 02” . 03”

39. 41

40. 42 Objective of surveying Knowledgeable survey of the study cast will identify the structures that will need to be modified in order to make possible a design of the prosthesis that (1) can be easily inserted and removed by the patient, (2) will contribute optimally to appearance, (3) will resist unseating forces to a reasonable degree, and (4) will create no undesirable food traps when in place in the mouth.

41. 43 Purpose of surveying To identify proximal surfaces that must be prepared to serve as guiding planes To locate both dental and osseous contours that could interfere with insertion and removal of denture To record the cast position and its relation to the path of placement To transfer the partial denture design to the master cast in the laboratory

42. Surveying the diagnostic cast To determine the most desirable PATH OF PLACEMENT that eliminates or minimizes interference to placement and removal. To identify proximal tooth surfaces that are need to be made parallel so that they act as guiding planes during placement and removal. To locate and measure areas of the teeth that may be used for retention. To determine whether teeth and bony areas of interference need to be eliminated surgically or by selection of a different path of placement

43. 45 Path of insertion and removal The RPD path of insertion and withdrawal is the direction in which the prosthesis moves in relation to the support system when it is seated in or removed from the mouth, guided by the contact of its rigid parts with the abutments .

44. 46 Factors that affect the path of insertion : These factors include: Guiding planes Tooth contours, in general, and more specifically undercuts on the teeth and soft tissues. Esthetic appearance Interference

45. 47 Guiding planes Guide surfaces (or guide planes) Two or more parallel axial surfaces on abutment teeth which can be used to limit the path of insertion and improve the stability of a removable prosthesis. Guide surfaces may occur naturally on teeth but more commonly need to be prepared.

46. When the partial denture is completely seated in the mouth, the guiding planes are contacted by minor connectors or other rigid components of the partial denture.

47. 49 Functions: It minimizes the wedging stresses on the abutments. Makes insertion and removal easier. Aids to stabiize the prosthesis against horizontal stresses. Aid to stabilize individual tooth. Reduces the blockout area and eliminates the space between the minor connector and the tooth, hence improves oral hygiene along with easy maintainence . Contributes to indirect retention and frictional retention.

48. 50 LONG CYLINDRICAL CARBIDE

49. 51 Retentive undercut The term undercut (when used in reference to an abutment) is a portion of a tooth, triangular space that lies between the height of contour and the gingiva. Mesio -distal dimension, Occlusal -gingival dimension, Bucco -lingual dimension.

50. The retentive undercut on an abutment tooth that is to be occupied by the retentive terminal of a clasp may be visualized as having three dimensions: (1) a mesiodistal dimension, (2) an occlusal –gingival dimension, and (3) a dimension that is essentially in a buccolingual plane. Of the three, the buccolingual dimension is by far the most significant because when the clasp terminal enters or leaves the infrabulge area of the tooth it must flex an amount equal to the depth of this undercut. 52

51. 53 UNDERCUT may be divided into True Undercut. False Undercut. TRUE UNDERCUTS are those in relation to the common path of displacement & provide retention for the denture along this path. FALSE UNDERCUTS are those produced by tilting the cast. They provide retention along the path in which the survey has been made, but not in the common path of displacement.

52. 54 Types of undercuts established by surveyor 1- Contour: due to natural contour of the tooth. 2- Positional: due to tilting of cast on surveyor. 3- Desirable undercut: used for retaining the removable partial denture against the dislodging forces by incorporating retentive flexible clasp arm. 4- Undesirable undercut: undercuts other than those used for retention are considered undesirable and should be eliminated by: A- Tooth recontouring. B- Placing properly contoured crown restoration on the tooth. C- Tilting the cast and change the path of insertion. D- Blocking out the undercut with wax on the master cast.

53. 55 Elimination of undesirable undercut areas Block-out:  Elimination of undesirable undercuts on the cast. The process of applying wax or another similar temporary substance to undercut portions of cast so as to leave only those undercuts essential to the planned construction of prosthesis . Parallel Shaped Arbitrary Relief

54. 60 Esthetic appearance Esthetic appearance can be considerably improved, especially with anterior abutments, by trying different paths of insertion. Small changes in the inclination of the cast can be made to seat the components of the prosthesis in less exposed regions that do not impair the patient's appearance, without jeopardizing the remaining determining factors. The objective should always be to obtain an appearance as natural as possible.

55. 61 When a maxillary cast, containing an anterior edentulous area, is surveyed with the occlusal plane horizontal it will often be found that there are undercuts on the mesial aspects of the abutment teeth. If the RPD is constructed with this vertical path of insertion there will be an unsightly gap between the denture saddle and the abutment teeth gingival to the contact point . With this posterior path of insertion the saddle can be made to contact the abutment tooth over the whole of the mesiolabial surface and a much better appearance results.

56. 62 INTERFERENCES In the determination of the path of insertion, it is important to detect and resolve the presence of interference from structures other than teeth that will interfere with the placement of the prosthesis, such as exostoses, soft tissue, and undercut ridges. It is often possible to find a path of insertion that will prevent contact of the prosthesis with these anomalies when, for some reason, they cannot be removed surgically or corrected by other means.

57. 63 If a bony undercut is present labially, insertion of a flanged denture along a path at right angles to the occlusal plane will only be possible if the flange stands away from the mucosa or is finished short of the undercut area. This can result in poor retention as well as a poor appearance. If the cast is given a posterior tilt so that the rod, and thus the path of insertion, is parallel to the labial surface of the ridge it is possible to insert a flange that fits the ridge accurately.

58. 64 The prosthesis cannot be seated because of interferences created by the convex surfaces of the teeth which adjoin the edentulous space. The axial surfaces of the teeth are analyzed by the surveyor . The prosthesis now goes smoothly into place without interference.

59. 65 Determination of the path of insertion TILT refers to “the position of the cast on the surveyor table relative to the horizontal plane, at the time the prosthesis is designed” To determine, at what angle the partial denture prosthesis will seat over the remaining teeth and any other obstructions that may be present. Any exaggerated tilt must be avoided because a patient would be unable to open the mouth sufficiently to accommodate a tilt that is too far from the horizontal. 1 10 DEGREE TILT

60. 66

61. 67 INFLUENCE OF CAST TILT ON UNDERCUT CREATE AN UNDERCUT ELIMINATE AN UNDERCUT

62. 68 IS TILTING NECESSARY????? FALSE RETENTION

63. 69 Tripoding the primary cast The angle of path of insertion is maintained by maintaining the tilt determined for the primary cast. To achieve this degree of tilt for the master cast, tripoiding the primary cast is done. If the path of insertion of the primary cast is not used for the master cast, all the prosthetic mouth preparation procedures (rest seat preparation, guide plane preparation, dimpling etc ) done irt to path of insertion becomes useless. TRIPOIDING - Recording the spatial orientation of the cast Three widely spaced out points of a single plane are marked on the cast..

64. 70 After ensuring that the proper tilt has been selected, the surveying table is locked in Position. For purposes of tripodization , the 0.030-inch undercut gauge is positioned in the mandrel.

65. 71

66. 72 Each horizontal line is crossed and then circled, resulting in a crosshair configuration . When tripodization is complete, tripod marks should be positioned at three widely spaced anatomic areas of the cast and should be readily identifiable .

67. 73 CONTOURING WAX PATTERNS CONTOURING WAX PATTERNS FOR CROWNS can be contoured with specific shapes using the dental surveyor . This is particularly valuable when constructing crowns for abutment teeth for RPDs. These are called SURVEYED CROWNS and must have specific shapes for the clasp or attachment to be used on the RPD.

68. 74 Wax pattern is carved with the surveyor blade to produce a distal guide-plane surface parallel to the selected path of insertion. The same pattern is modified from the distal guide plane along the buccal surface to align the surface with the height of contour most favorable to the direct retainer specifications.

69. 75 Surveying ceramic veneer crowns Contouring crowns Metal and porcelain crown surfaces can be contoured to achieve specific shapes using a bur in a handpiece secured to the vertical spindle of the dental surveyor. The process of shaping crown surfaces parallel to the path of placement of the RPD using a bur is called MILLING.

70. Placing internal rest seat when using precision and semiprecision attachments the dental surveyor is used to align precision and semiprecision attachments 76

71. 77 SURVEYING PROCEDURE PRELIMINARY OR VISUAL ASSESSMENT INITIAL SURVEY ANALYSIS FINAL SURVEY EYEBALLING THE CAST ZERO DEGREE TILT Occlusal plane is relatively horizontal…

72. 78 Two stages of surveying Preliminary assessment of the diagnostic cast - Determine the most advantageous path of insertion - Decide upon the various types of mouth preparation that will be required Definitive design - Guidelines are drawn - Undercuts are measured and marked - Soft tissue undercuts are delineated - Design of the framework is outlined on the diagnostic cast.

73. 79 Color coding Improves communication between dentist & lab There is not at present a universally accepted color coding system Red,black,blue,brown

74. 80 RED Required action Mark teeth & soft tissues to be prepared, recontoured , relieved Rest- solid red Diagonal lines- recontour Tripod marks

75. 81 Denotes survey lines on teeth & soft tissues Instructions on base-type of tooth replacement, type of clasp, depth of undercut BLACK

76. 82 Portions that will be made of acrylic- mostly denture bases, also acrylic teeth BLUE

77. 83 All metallic portions- basically all components BROWN

78. 84

79. Review of literature

80. Kamble and Parkhedkar in 2014 suggested another device containing a "dowel pin and sleeve" that was also a modified version of the cemented pin method . A hole of 6×6×4 mm dimension was created in the center between the alveolar ridges such that it did not cause any interference with the framework. The dowel sleeve device was assembled and locked in the surveying mandrel. This dowel pin is then brought down to fit in the made perforation. The perforation was wetted, and type III gypsum was poured around the sleeve. After setting, the dowel pin could be removed and replaced for reorientation. Kamble and Parkhedkar Reorientation simplified: A device for recording and reproducing the path of insertion for removable partial dentures March 2014 Indian Journal of Dental Research  25(2):260-262 DOI: 10.4103/0970-9290.135939 PubMed

81. Lee et al. in 2017 utilized the implant impression coping and implant analog for tripoding . He selected the posterior aspect of the cast to prepare an upright groove by a tungsten carbide bur. Dimensions of the groove were made to be 10 mm deep and 20 mm long. He then connected the implant analog to a short and direct impression coping employing a long retaining screw. This retaining screw entered the vertical arm after the traditional surveying. The implant analog fit in the groove was stabilized in place using a thermoplastic adhesive (sticky wax) in a heat gun . The duplication of the cast was also simplified by simply replacing the direct transfer impression coping with the indirect transfer coping. This duplication was carried out using polyvinyl siloxane duplicating material after the reseating of the coping analog. This was then poured in a die stone (type IV gypsum). The reseating of the coping will transfers the cast orientation. The retaining screw goes in the surveyor's arm hence reproducing the cast tilt. This is the clearest and most straightforward of all the approaches. Kawade RA, Sathe S, Apte A, Bhoyar A, Jaiswal T, Dubey SA. A Systematic Review of Tripoding: A Step Towards Successful Rehabilitation. Cureus . 2022 Nov 4;14(11):e31095. doi : 10.7759/cureus.31095. PMID: 36475130; PMCID: PMC9719731.

82. Gali et al. in 2019 built a "three-point contacting device" out of triangular metal plates with a 3 mm thickness and a 5 mm diameter center aperture . A detachable Allen screw fit in this aperture. These plates were classified into sizes of the sides of the triangle 25 mm, 30 mm, 35 mm, 40 mm, and 45 mm. These measurements are based on averages of distances measured between the incisal edges and cusp points on several casts. This enabled the accommodation of arches of various sizes. The corners of the plate will correspond to the posterior and anterior reference points, and the plate itself will form the reference plane. A lead marker marked these points on the cast. For re-registration of the tilt, the cast had to be adjusted till the three points contacted the triangle plate. Even if the construction of the device could prove to be a task, the plus points embodied in the device are noteworthy. Gali shiva ranjani and hima bindu lanka .A reproducible 3-point contact device for tripoding a definitive cast July 2019 Journal of Prosthetic Dentistry  123(3) DOI: 10.1016/j.prosdent.2019.03.008

83. CONCLUSION -In sequence, 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 malting esthetically pleasing and stable RPDs that will significantly contribute to the health of the stomatognathic system. 89

84. REFERENCES -Rodney D phoenix. Stewart’s clinical removable prosthodontics.3 rd edition. Quintescnce . -Alan B. Carr, David T. Brown, McCracken’s Removable Partial prosthodontics.13 th edition. St. Louis,Missouri;2016 -Miller EL, Grasso JE. Removable partial prosthodontics. 2nd ed. Baltimore:Williams & Wilkins; 1981. p. 103-17. -O. L. Bezzon , M. G. C. Mattos, a and R. F. Ribero . Surveying removable partial dentures: the importance of guiding planes and path of insertion for stability.J Prosthet Dent 1997;78:412-18. -J. C. Davenport, R. M. Basker , J. R. Heath, J. P. Ralph, P-O. Glantz. Surveying. British Dental Journal 2000; 189: 532–541. 90

85. - Kamble and Parkhedkar Reorientation simplified: A device for recording and reproducing the path of insertion for removable partial dentures March 2014 Indian Journal of Dental Research  25(2):260-262 DOI: 10.4103/0970-9290.135939 PubMed - Kawade RA, Sathe S, Apte A, Bhoyar A, Jaiswal T, Dubey SA. A Systematic Review of Tripoding: A Step Towards Successful Rehabilitation. Cureus . 2022 Nov 4;14(11):e31095. doi : 10.7759/cureus.31095. PMID: 36475130; PMCID: PMC9719731. -Gali shiva ranjani and hima bindu lanka .A reproducible 3-point contact device for tripoding a definitive cast July 2019 Journal of Prosthetic Dentistry  123(3) DOI: 10.1016/j.prosdent.2019.03.008

86. THANK YOU