Treatment Planning: Study Cast Decision Tree

To produce a satisfactory removable partial denture design for a patient requires the production of study casts of the patient in occlusion. Below is a decision tree that will help you determine the correct course of treatment to follow to ensure that you have all the relevant information when designing a removable partial denture. Are there sufficient teeth present that with the aid of a Wax Wafer the Study Casts could be mounted onto an Articulator in Centric Occlusion? Yes Take Intercuspal Registration of the patient using Wax Wafer and send it with the Primary Impressions to laboratory and request that the impressions are poured to produce Study Casts and mounted onto an Articulator by aid of the Wax Wafer using Split Mounting. Also ask for Special Trays to be constructed.

Are there sufficient teeth present to hand occlude Study Casts?

No

No

You will need to record the Jaw Relation using Occlusal Rims?

Yes Send Primary Impressions to laboratory and request that these are poured to produce Study Casts. Also ask for Special Trays to be constructed.

Send the Primary Impressions to laboratory and request that the impressions are poured to produce Study Casts and construct Occlusal Rims. Record Jaw Relation of the patient using supplied Occlusal Rims. Send Jaw Registration to laboratory and request that the Study Casts are mounted onto an Articulator using Split Mounting. Also ask for Special Trays to be constructed.

Question for reflection: Are hand occluded casts sufficient for the purposes of treatment planning or should they be mounted on an articulator?

Cast Analysis and Partial Denture Design Collect Study Casts from laboratory (mounted on articulator if requested). Survey the casts using a Dental Cast Surveyor and along with the information gathered from the patient, produce a Removable Partial Denture Design. A plan view of the design should be sketched onto the supplied partial denture design sheet and supported by a written prescription. Remember you Partial Denture Design needs to be approved before any further treatment is carried out

Glossary of Terms
Articulator A hinged instrument, to which the maxillary and mandibular casts are attached, and which reproduces recorded relationships of the mandible to the maxilla. [Certain articulators reproduce recorded movements of the mandible.] Articulators assist the study of occlusion and the formation of the occlusal surfaces of prostheses and restorations. See Intercuspal Occlusion An instrument used to survey casts. [It may also be used to prepare parallel surfaces on restorations] Maximal contact between opposing teeth. Between opposing occlusal surfaces. A relation of the mandible to the maxilla. Wax blocks on rigid base plates to record jaw relationship Prescription produced detailing the design and components of a partial denture An impression made for treatment planning or the construction of a Special Tray. Custom-made impression trays A method of attaching the cast to an articulator so that it can be separated from the mounting material.

Centric Occlusion Dental Cast Surveyor Intercuspal Occlusion Interocclusal Jaw Relation Occlusal Rims Partial Denture Design Primary Impression Special Trays Split Mounting

Study Casts Survey Wax Wafer

A cast used as an aid to diagnosis and treatment planning. The procedure carried out on a surveyor to delineate the contour and inclination of teeth and soft tissues. A strip of wax used in making interocclusal records.