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Short Communication Functionally generated pathways to develop

occlusal scheme for removable partial denture
Pravinkumar G. Patil, Smita P. Nimbalkar‑Patil1, Rahul S. Kulkarni2
Division of Clinical Dentistry, School of Dentistry, International Medical University, 1Department of Orthodontics,
Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia, 2Department of Prosthodontics, Nair Hospital
Dental College, Mumbai, Maharashtra, India

Address for correspondence: Dr. Pravinkumar G. Patil, E‑mail: pravinandsmita@yahoo.co.in

ABSTRACT
The functionally generated pathway (FGP) technique consists of registering the occlusal pathways of the posterior teeth in the
functional wax and has been classically described as the “three‑dimensional static expression of dynamic tooth movement.”
This clinical report describes the treatment of a partially edentulous patient, with a cast removable partial denture, in which
occlusion was developed using the FGP procedure. The FGP technique utilizes the patient’s masticatory system to develop
occlusion and has the advantages of being simple, accurate, and reliable. If the FGP technique is properly accomplished, only
minor intraoral occlusal adjustments are necessary. This article described a technique of developing the FGP occlusion for a
patient with cast partial denture with Kennedy’s Class III edentulous mandibular arch.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

The FGP is highly versatile technique of developing the occlusion-pattern in the removable and fixed dental prostheses
including implant restorations. It can be employed with equal efficacy in fabrication of relatively simple restorations such
as a single crown, or more complex full mouth reconstructions.

Key words: Fixed prosthodontics, functionally generated path, occlusion, removable prosthodontics

INTRODUCTION a stone‑occlusal‑template is formed, and artificial

teeth are arranged against it. The occlusion achieved

T he functionally generated pathways (FGP) of

occlusion refer to the registration of the paths
of movement of the occlusal surfaces of the teeth of
with the help of this technique is considered to be in
great harmony with controlling factors of occlusion
namely, the anterior and condylar guidance, occlusal
one dental arch, to the teeth or occlusion rims of the cusps, and the neuromuscular system. Classically,
opposing arch, recorded with the help of a plastic the FGP occlusion has been described as “3D static
medium.[1] The technique of obtaining such records expression of dynamic tooth movement,” since exact
consists of registering the three‑dimensional (3D) occlusal pathways of posterior teeth are captured
occlusal pathways of cusps of posterior teeth in the three‑dimensionally in the functional wax. [3] The
functional wax, with acceptable condylar and anterior technique was introduced by Meyer[4‑6] almost 70 years
guidance and normal occlusal anatomy.[2] The FGP is ago, which he termed as the “chew‑in” technique,
formed by scribing or engraving the wax recording and since then various researchers have refined the
medium or occlusion rim by the opposing cusps with procedure. Over the years, the technique has been
lateral, protrusive, and excursive border movements known by various names such as “functional chew‑in
of the mandible. After registration of the FGP record,
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DOI: How to cite this article: Patil PG, Nimbalkar-Patil SP, Kulkarni RS.
10.4103/2229-5194.181380 Functionally generated pathways to develop occlusal scheme for
removable partial denture. J Interdiscip Dentistry 2015;5:154-7.

154 © 2015 Journal of Interdisciplinary Dentistry | Published by Wolters Kluwer - Medknow

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Patil, et al.: Functionally generated pathways for occlusion schemes

technique,” “functional bite technique,” “generated path FDP. Gingival retraction, polyvinyl siloxane impression, and
technique,” and “cuspal tracing technique.”[7] The FGP is bite registration were carried out following the standard
highly versatile and has been employed with equal efficacy treatment principles.[9] A definitive cast was created with
in fabrication of relatively simple restorations such as a Type IV dental stone (Ultrarock; Kalabhai Karson, Mumbai,
single crown, or more complex full mouth reconstructions. India). After full contour waxing was completed, mandibular
It has also been used in developing occlusion for complete first premolar and molar were cut back, and surveying of the
and partial dentures and dental implant restorations. cast was carried out in a conventional manner. The occlusal
rest was carved in waxed‑up crown on second molar, and
favorable undercut was created on its buccal surface for
CLINICAL REPORT placement of embrasure clasp. Areas that could be used for
retention, and guiding planes were located on the cast, and
Case description favorable contours of abutments were obtained by changing
the tilt of the cast initially, followed by altering contours of
A 42‑year‑old female reported to the Department the abutments on the cast.
of Prosthodontics, seeking replacement of missing
teeth and recementation of a dislodged fixed dental
Design and fabrication of removable partial
prosthesis (FDP). The patient presented with a partially
denture
edentulous mandibular arch, with missing mandibular
right second premolar and first and second molars, and The design of prospective mandibular RPD consisted
a dislodged three unit metal ceramic FDP replacing the of a lingual bar major connector, onlay rest on a right
mandibular left first molar. Patient’s past dental history third molar, occlusal rests and clasps on abutments,
revealed extraction of previously mentioned teeth due appropriately placed parallel guide planes, and a
to dental caries 2 years ago, followed by fabrication of ladder loop design of minor connector for the denture
FDP to replace the left first molar. The patient complains base.[8] Mouth preparations were carried out following the
of recurrent dislodgment of the FDP. Patient’s right side surveying and designing. Fabrication and cementation of
of mandibular arch was not restored after extractions. metal ceramic FDP were carried out following standard
Spacing was observed due to small sized maxillary lateral technique [Figure 1]. A day after the cementation,
incisors; however; the patient was not concerned about impression of mandibular arch was made in a border
this. The centric occlusion position was coincident with molded special tray, with a medium body polyvinyl
the maximum intercuspal position. It was observed that siloxane impression material (Aquasil Medium Body;
there was no supraeruption of maxillary molars of right Dentsply Austenal, York, PA, USA). A functional impression
side besides the long‑term history of missing opposing was deemed unnecessary due to the presence of the distal
mandibular molars, and the plane of occlusion was abutment and firm mucosa overlying the residual ridge.
acceptable. Initial diagnostic procedures included making Impression was poured using Type IV gypsum to obtain
of diagnostic impressions and casts, radiographs, face bow the master cast. The master cast was indexed with the
transfer and diagnostic mounting, fabrication of special tripod markings and surveyed, and the undercut areas
tray, and evaluation of patient’s expectations.[8] As a part were blocked out with the blockout wax (Ney Undercut
of the treatment planning, patient was presented with Wax; Dentsply Ceramco, Burlington, NJ, USA). The blocked
the options of dental implants for edentulous areas and out cast was duplicated to form a refractory cast, and the
conventional fixed and removable partial dentures (RPDs). wax pattern was prepared. The framework was casted in a
Patient declined the option of dental implants citing cobalt‑chromium alloy (Vitallium 2000; Dentsply Austenal,
financial reasons and accepted the latter alternative.
Hence, the definitive treatment plan consisted of metal
ceramic FDP for the mandibular left first molar, and the
cast RPD for replacement of mandibular right premolar
and molars, for which informed consent was obtained
from the patient.

Preprosthetic treatment
Initial therapy consisted of oral prophylaxis, oral hygiene
instructions, diet counseling, and the provisional FDP for
missing left molar. As a part of definitive treatment plan,
replacement of mandibular left first molar with metal ceramic
FDP was undertaken. Previously treated abutments were
modified to improve retention and resistance form, as there
was a history of recurrent dislodgment with the previous Figure 1: Mandibular metal ceramic fixed dental prosthesis in place

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Patil, et al.: Functionally generated pathways for occlusion schemes

York, PA, USA) following standard laboratory procedures. matching the shade of patient’s natural dentition were
Framework was finished and polished, returned to the selected. Teeth were arranged high up initially, and
master cast, and temporary denture base was added then progressively modified to exactly fit the occluding
to the framework. Framework was tried intraorally, the template at the established vertical dimension [Figure 4b].
fit was verified, and it was confirmed that there was no Waxing and carving were done after teeth arrangement
interference by any component or the record base in and try‑in was carried out in a conventional manner. The
centric occlusion and excursion. trial denture was processed using standard laboratory
procedures, during which autopolymerizing resin of
Recording of the functionally generated denture base was replaced with the heat‑polymerized
pathway resin (Lucitone 199 Denture Base Resin; Dentsply Trubyte,
York, PA, USA). The cast partial denture was issued, and
The FGP r ecor ds wer e planned to r ecor d the the postinsertion instructions were given to the patient
maxillomandibular relationship with the cast metal regarding maintenance and use of the prosthesis [Figure 5].
framework in place. Before recording the FGP, it was During the denture delivery, the occlusal refinement
confirmed that the metal framework along with the was carried out, and the group function occlusal scheme
denture base was firm, stable, and retentive intraorally. It was confirmed. At the 6 and 12 months recall visits, no
was also examined that there were no interferences in the treatment complications were noted.
anterior guidance and the posterior teeth had acceptable
occlusal anatomy. Occlusion rim was created on the base
plate using hard inlay wax (Inlay Wax Blue Hard; Kerr DISCUSSION
Corporation, Orange, CA, USA), and visible gap was left
between opposing teeth and the rim initially [Figure 2a]. The FGP technique is highly versatile and has been
Softened inlay wax was added to the rim, and the employed with equal efficacy in fabrication of crown,
framework was placed intraorally. Patient was asked to bridge, complex full mouth reconstructions, complete,
close in centric occlusion to indent the soft wax. It was
ensured that all natural teeth were in contact, and the
framework was removed when the wax got hardened.
Wax was softened again, and the previous exercise was
repeated. Now, the patient was instructed to protrude
his/her mandible in forward direction without losing
teeth‑contact until the incisors were at edge‑to‑edge
relationship. Similarly, the lateral excursive pathways were a b
also recorded for both right and the left side [Figure 2b]. Figure 2: (a) Try‑in of partial denture framework with inlay wax attached
The patient was instructed to glide the mandible through for occlusal registration. (b) Obtaining functionally generated pathway
all possible excursive movements to ensure capturing all record in eccentric relation
border movements. The wax was repeatedly softened
between each biting episode. Once all excursive pathways
were recorded, the record was hardened by keeping
under the cold water. It was observed that the inlay wax
was smoothly carved and shaped by the stylus action of
the opposing maxillary cusps.

Mounting of the casts a b

Figure 3: (a) Functionally generated pathway record seated on master
The FGP record obtained was used to fabricate the stone cast. (b) Modeling clay used to block specified areas on the cast
occluding template.[8] To accomplish this, the record was
reseated and secured onto the master cast [Figure 3a], and
boxing was done with the modeling clay and the modeling
wax as shown in Figure 3b. Only wax registration and areas
for vertical stops were left exposed, and it was filled with
the dental stone to form occluding template [Figure 4a].
Recording the FGP eliminates the need to reproduce
mandibular movements on the articulator, and hence the a b
mounting was done on a simple three‑point (mean value) Figure 4: (a) Occluding template with functionally generated pathway
articulator.[8] The cross‑linked acrylic resin teeth (Acry record mounted. (b) Occlusal surfaces of teeth modified to fit occluding
rock; Ruthinium Dental Products, Badia Polesine, Italy) template

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Patil, et al.: Functionally generated pathways for occlusion schemes

Financial support and sponsorship

Nil.

Conflicts of interest
There are no conflicts of interest.

REFERENCES
1. The glossary of prosthodontic terms. J Prosthet Dent 2005;94:10‑92.
2. Dawson PE. Evaluation, Diagnosis and Treatment of Occlusal
Problems. 1st ed. St Louis: CV Mosby; 1974. p. 248‑74.
3. Zimmermann EM. Modifications of functionally generated path
procedures. J Prosthet Dent 1966;16:1119‑26.
Figure  5: Postoperative view with removable partial denture in 4. Meyer FS. A new, simple and accurate technique for obtaining balanced
occlusion and functional occlusion. J Am Dent Assoc 1943;21:195‑203.
5. Meyer FS. The generated path technique in reconstruction dentistry.
and RPDs as well as dental implant restorations. It is Part I. Complete dentures. J Prosthet Dent 1959;9:354‑66.
recognized that the Pankey–Mann philosophy of occlusal 6. Meyer FS. The generated path technique in reconstruction dentistry.
Part II. Fixed partial dentures. J Prosthet Dent 1959;9:432‑40.
rehabilitation was originally a combination of the Monson
7. Pankey LD, Mann AW. Oral rehabilitation: Part II. Reconstruction
spherical theory and the Meyer functionally generated of the upper teeth using a functionally generated path technique.
path technique, where they attempted to gain bilateral J Prosthet Dent 1960;10:151‑62.
balance in eccentric movements.[10‑12] The Pankey–Mann– 8. Carr AB, McGivney GP, Brown DT. McCracken’s Removable Partial
Schuyler philosophy retains the FGP technique, except Prosthodontics. 11th ed. St. Louis: Mosby, Elsevier; 2005. p. 310‑5.
that the balancing side contacts are eliminated due to 9. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed
prosthodontics. 4th ed. St. Louis: Elsevier; 2006. p. 431‑65.
their traumatogenic effect on the masticatory system. If 10. Mann AW, Pankey LD. Oral rehabilitation utilizing the Pankey‑Mann
the FGP technique is properly accomplished, only minor instrument and a functional bite technique. Dent Clin North Am
intraoral occlusal adjustments are necessary.[3] Besides, 1959;215‑29.
the availability of the sophisticated fully adjustable 11. Mann AW, Pankey LD. Oral Rehabilitation. Part I. Use of the P‑M
instrument in treatment planning and in restoring the lower posterior
articulators, the FGP still remains a technique that is simple,
teeth. J Prosthet Dent 1960;10:135‑50.
reliable, and unsurpassed in accuracy.[13,14] As outlined by 12. Mann AW, Pankey LD. Concepts of occlusion: The P M philosophy
Brecker,[15] “The human jaw, with all its limitations, with all of occlusal rehabilitation. Dent Clin North Am 1963:621‑36.
its interferences, and with all its problems created by habit, 13. Manary DG, Holland GA. Evaluation of mandibular movement
makes the best articulator. Consideration should be given recording and programming procedures for a molded condylar
control articulator system. J Prosthet Dent 1984;52:275‑80.
to the patient’s individual pattern of chewing.” Functionally
14. Winstanley RB. Observations on the use of the denar pantograph
generated path technique utilizes the patient’s masticatory and articulator. J Prosthet Dent 1977;38:660‑72.
system to develop occlusion and has the advantages of 15. Brecker SC. Clinical Procedures in Occlusal Rehabilitation.
being simple, accurate, and reliable. Philadelphia: W.B. Saunders Company; 1958. p. 3.

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