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76]

Case Report
Fabrication of fixed partial dentures using functionally
generated path technique and double casting
E Prashanti1, Suresh Sajjan2, Jagan Mohan Reddy3
Departments of Prosthodontics,
1
Manipal College of Dental
Sciences, Mangalore,
2
Vishnu Dental College,
Bheemavaram, 3Vaidehi Dental
College & Hospital, Bangalore,
India

ABSTRACT

Received
: 06-08-07
Review completed : 25-04-08
Accepted
: 21-11-08
PubMed ID
: ***
DOI: 10.4103/0970-9290.59453

Harmonious occlusion is a critical requirement for successful oral rehabilitation. Conventional

techniques of construction have been unsuccessful in producing a prosthesis that can be
inserted without intraoral occlusal adjustment. This article discusses the use of functionally
generated path technique with double casting to fabricate fixed partial dentures. The merits of
this approach and the technique involved are discussed in detail.

Key words: Functionally generated path, double casting, fixed partial dentures

In natural articulation, the mandibular teeth move over

the maxillary teeth in a harmonious manner. The cusps
move in the fossae and grooves between the opposing
cusps and, normally, there is no interference during the
various mandibular movements. Interference or a premature
contact can initiate a wave of disturbance that spreads
throughout the stomatognathic system and can even affect
the musculoskeletal system. Any prosthesis that is prepared
should not disturb the harmony of occlusion or it may
jeopardize the situation. The anatomical articulator simulates
the mandibular movements and assists in developing a
prosthesis suitable for the existing occlusal condition.
However, it cannot duplicate the whole stomatognathic
system. Intricacies in the use of a fully adjustable articulator
precludes its use in routine clinical practice.
An alternative method to reproduce a precise occlusion
that was developed way back in the 1930s and is now
becoming popular is the functionally generated path (FGP)
technique.[1] The original technique was described by Meyer
for obtaining the functional occlusal path for complete
dentures[2] and fixed partial dentures[3] fabricated by a direct
or indirect technique. Later, this technique was adapted
for use in complete occlusal rehabilitation by Mann and
Pankey.[4-7] Meyer suggested that no occlusal adjustment in
the mouth should be necessary if the technique is carried
out correctly.[8] Recently, FGP has also been used for the
fabrication of implant-retained fixed partial dentures.[9] This
case report describes the use of FGP with double casting for
Address for correspondence:
Dr. E Prashanti,
E-mail: prashantie@yahoo.com
Indian J Dent Res, 20(4), 2009

fabricating a fixed partial denture.

CASE REPORT
A 26-year-old male patient who required a three-unit fixed
partial denture for replacement of a missing first molar
reported to the Department of Prosthodontics. Atthe initial
appointment, a preliminary impression was made using
irreversible hydrocolloid impression material (Imprint;
Dental Products of India Ltd., Mumbai, Maharashtra, India)
and the diagnostic casts were mounted on a semi-adjustable
articulator (Hanau WideVue; Waterpik Technologies Inc.,
Fort Collins, CO, USA) using a facebow transfer (Hanau
Spring-Bow, Waterpik Technologies, USA). Protrusive
records were made using polyether bite registration paste
(RamitecTM; 3M ESPE, Germany). The patient was trained to
close in maximum intercuspationposition (MIP) and perform
various eccentric movements (right lateral, left lateral, and
protrusive). This was carried out to accustom the patient to
the various movements that would have to be performed
later for recording the FGP. The tooth preparation for the
abutment teeth, gingival displacement, final impression
making, and master die preparation was done following the
principles given by Schillingburg.[10] Wax pattern (Inlay wax
type IIHarvard, Gusswachs, Normal Hart, Johannesburg,
Berlin, Germany) was made with 1-mm occlusal clearance
and retentivebeads of wax (Renfert, Hilzingen, Germany)
were placed. These beads would aid in the retention of the
pattern resin during functional generation of the occlusal
morphology in the next step [Figure 1].[1] After the base
casting was obtained, it was sandblasted and checked for
accuracy of fit on the model and in the mouth[Figure2].
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Functionally generated path technique in FPD fabrication

Generation of functionally generated path

Before generating the occlusal morphology we ensured

that the base casting had adequate occlusal clearance and
proper fit on the prepared teeth. The occlusal morphology
was generated using pattern resin (GC Corporation, Tokyo,
Japan) following the technique described by Dawson.[11]
Pattern resin was mixed according to the manufacturers
instructions and applied on the occlusal surface of the metal
coping with retentive beads. The patient was instructed to
close the mouth in MIP and then perform right lateral, left
lateral, and protrusive movements in succession, ending in
the MIP. The excess pattern resin was trimmed off using an
acrylic trimmer. The occlusal surface was examined for any
exposure of the metal and if this was present the metal in
the area was trimmed, pattern resin was added in that area,
and the movements were performed once again.
Once the occlusal morphology was perfected, the MIP
contacts were marked using 50-m blue articulating
papers (Products Dentaires S.A., Vevey, Switzerland).
Zinc oxide powder (Dental Products of India, Mumbai,
India) was sprinkled and brushed onto the occlusal

Figure 1: Pre treatment appearance (a). Fabrication of wax pattern

with retentive beads for base casting (b)

The casting was placed in the oral cavity (before occlusal

correction) to check whether it felt comfortable. At the
same time the occlusion was checked to identify any
high points in the casting. It was observed that there was
absolutely no occlusal error identified in the MIP position.
Only minimal eccentric interferences were identified and
could be eliminated by selective grinding of the casting.
The time taken for metal trimming was drastically reduced
to 5min. The patient reported absolute comfort with the
prosthesis. The final prosthesis was cemented using glass
ionomer cement (GC Fuji II, GC Corporation, Japan)
[Figures 3 and 4].

Figure 2: Base casting checked in the mouth (a). Completed

functionally generated path (b)

Figure 3: Completed double casting (a). Double casting with

functionally generated path cemented (b)
493

surface to form a thin, uniform coat, and the patient was

instructed to perform the eccentric movements as before.
All eccentric contacts became visible with the wiping
away of the zinc oxide powder. Care was taken not to
grind the MIP contacts that were registered in blue. The
wiped out areas were trimmed using an acrylic trimmer to
eliminate all eccentric interferences and the FGP patterns
were completed [Figure2]. The pattern, along with the
base casting, was invested and double casted[1] [Figure 3].

Figure 4: Functionally generated path prosthesis in occlusion

Indian J Dent Res, 20(4), 2009

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Functionally generated path technique in FPD fabrication

DISCUSSION
The FGP technique is simple and can produce excellent
results. Because of its simplicity it is sometimes derided
by those dentists who do not use it. Simplicity should not
be confused with inaccuracy; the technique is capable of
producing very accurate results, but it demands great care
and meticulous attention to detail.[10]
Dawson describes the FGP technique as an extremely
sophisticated and practical method of capturing the precise
border pathways that the lower posterior teeth follow.
The technique has a distinct advantage in that it is able
to record all dimensions of such border movements at the
correct vertical as they are directly influenced by both
condylar guidance and incisal guidance.[11] The procedure
can provide accuracy with fairly simple instrumentation
and can be used in combination with almost any laboratory
method for waxing posterior restorations. It can be used
either in the actual fabrication of the restorations or as
a three-dimensional check-bite technique.[11] There are
certain prerequisites for the use of FGP for the restoration
of missing teeth;[10,11] these are as follows:
a. Presence of an optimal occlusion.
b. Appropriate anterior guidance.
c. Elimination of posterior interferences prior to making
the restoration.
d. No missing or broken down opposing teeth. Badly
rotated, carious, or poorly restored teeth in the opposing
arch will not provide the occlusal pathways needed for
shaping the occlusal surface and hence FGP should be
avoided in these cases.
The patient in this case report satisfied the above mentioned
prerequisites. We used the double casting technique, which
is better than the conventional casting in that it includes
an error compensation step. [1] This technique enables
achievement of a highly precise occlusion by eliminating the
inherent dimensional errors of the indirect (conventional)
method.
In the double casting method, the errors which occur due
to distortion of occlusal registration material, incorrect
mounting, improper impression of the opposing arch,
discrepancy between teeth and master die, and wax pattern
distortion can all be addressed before the occlusal surfaces
are fabricated on the base casting. Therefore, the errors that
could affect the final accuracy of occlusion of double-cast
restorations include only those errors that are related to
investing and castings and the polishing procedures.[1]
Even for carefully constructed conventional fixed partial
dentures, a comparatively long time is needed for clinical
adjustment. Experience has shown that metal trimming is
a tedious job and in the attempt to correct the interferences
most of the occlusal morphology may be lost.
Indian J Dent Res, 20(4), 2009

Prashanti, et al.

In the present case, the time taken for occlusal correction

was almost negligible. This may be because the occlusal
morphology was being generated directly in the patients
mouth and thus was closer to the normal anatomy of
the tooth. Hence, the time taken for correction was also
drastically reduced. This has a definite role to play in patient
satisfaction and confidence.
For more than 60 years, dentistry has recognized functional
path articulations as a viable way of developing occlusion.
The present technique has certain advantages over the
conventional functional path technique;[12] these are as follows:
1. A cast fixed partial denture with retentive beads was
used as a stable base in the present case report. Hence a
functional path tray was not required and the problems
associated with the tray, including inaccurate seating
and distortions, were avoided.
2. To overcome the drawbacks of using inlay wax[13] for
generating FGP, pattern resin was used in the present
case; this has better dimensional stability compared to
the waxes. These resins not only complement waxes but
could even, in whole or in part, replace them.[14]
3. The occlusal morphology was developed and corrected
directly in the patients mouth. The discrepancies which
can result due to differences between the teeth in the
mouth and that in the master dies could thus be avoided.
4. A functional core used routinely for the conventional
FGP technique was not utilized in the present technique.
Hence, the discrepancies which may result from the
functional core becoming slightly degraded during
waxing and metal adjustment were avoided.
5. Further, the use of the opposing functional core
to adjust maximum intercuspation and to remove
eccentric interferences presupposes that it will be
necessary to use the patients mandibular movements
to make final adjustments to the prosthesis. Moreover,
eccentric interferences were removed in the patients
mouthdirectly.
As with any technique, the FGP technique also has certain
disadvantages. Some of the limitations of this technique
are as follows:
1. The operator needs to have a good knowledge of
occlusion and of mandibular movements; otherwise it
may lead to an incomplete generation of FGP.
2. The occlusal details are not similar to the ideal anatomical
configuration although the surface is functionally ideal.
3. This technique cannot be used in cases with short
clinicalcrowns and unfavorable occlusal morphology
of the opposing teeth.
4. The FGP technique cannot be used in patients having
attrited teeth.
5. Patients lacking proper neuromuscular control cannot
be selected for this technique.
6. In patients having disharmony in occlusion (malocclusions
like deep bite and crossbite) and temporomandibular
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Functionally generated path technique in FPD fabrication

joint dysfunction, the FGP technique is destined to fail.

7. Good laboratory support is a basic requirement, without
which successful results are difficult to achieve.

CONCLUSION
If the FGP technique is carefully done, only minimal
occlusal adjustments are required during the clinical try-in
stage, which is a major advantage over the conventional
technique. Multicenter clinical trials with long follow-up
periods should be conducted to confirm the results obtained
in present case report.

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How to cite this article: Prashanti E, Sajjan S, Reddy JM. Fabrication of

fixed partial dentures using functionally generated path technique and double
casting. Indian J Dent Res 2009;20:492-5.
Source of Support: Nil, Conflict of Interest: None declared.

Indian J Dent Res, 20(4), 2009