Article_5_4_7
PARTIAL DENTURES
ROTATIONAL PATH PARTIAL DENTURES: AN UNDERUTILIZED
Case Report
TREATMENT MODALITY IN AESTHETIC DENTAL MEDICINE
Adam Perry Tow1a*
1
Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
MBA, DMD Candidate
a
ABSTRACT DOI: https://doi.org/10.25241/stomaeduj.2018.5(4).art.7
Aim: To design a highly aesthetic prosthesis at low cost, which replaces maxillary OPEN ACCESS This is an Open Access
anterior teeth without showing removable denture clasps. article under the CC BY-NC 4.0 license.
Summary: Today’s clinical practice is highly dictated by the increasingly demanding Peer-Reviewed Article
aesthetic standards of the modern patient. While advances in biomaterials and
Citation: Tow AP. Rotational path partial dentures:
titanium osseo-integrated implants have made replacing missing teeth possible in An underutilized treatment modality in aesthetic
a natural-looking way, many patients are not candidates for these fixed restorations dental medicine. Stoma Edu J. 2018;5(4):263-269
due to physiological or financial barriers. In this case report, a patient with a history Academic Editor: Alexandru Eugen Petre, DDS,
of anterior maxillary incisor partial-edentulism for whom fixed restorations were not PhD, Professor, “Carol Davila”University of Medicine and
Pharmacy, Bucharest, Romania
feasible was treated using a rotational path of insertion partial denture.
With this technique, the author was able to design a removable partial denture with Received: December 05, 2018
Revised: December 07, 2018
no clasps showing, irrespective of the smile line height. Accepted: December 14, 2018
The final result completely obscures the retentive mechanisms upon smiling and is Published: December 15, 2018
highly aesthetic, on par with implant-retained fixed restoration, at a fraction of the *Corresponding author:
cost and without the associated risks and complications of surgically-driven prosthetic Dr. Adam P. Tow, MBA
Department of Restorative Dental Sciences, College
cases. of Dentistry, University of Florida, 1395 Center Dr,
Learning Points: This article will review this case and the supporting literature, as well Gainesville, FL 32610, USA
Tel/Fax: +1 970-823-2605,
as provide guidance on laboratory prescription writing and optimal case selection. e-mail: aptow@dental.ufl.edu
Keywords: Denture, Partial, Removable (D003832) Esthetics, Dental (D004955) Copyright: © 2018 the Editorial Council for the
denture, partial, removable (D003832) esthetics, dental (D004955). Stomatology Edu Journal.
1. Introduction and Background The clasping systems which attach the prosthesis
Today’s clinical practice is highly dictated by the to the dentition are generally cast metal, though
increasingly demanding aesthetic standards of the soldered wrought wire, and thermoplastic options
modern patient. While advances in biomaterials do exist [1,2]. Indeed, various components of the
and titanium osseo-integrated implants have made RPD may also be made with thermoplastic elements,
replacing missing teeth possible in a natural-looking though in cases similar to the one reviewed here,
way, many patients are not candidates for these fixed the author will suggest that the rotational path RPD
restorations due to physiological or financial barriers. design is clinically superior.
In this case report, a patient with a history of anterior The rotational path of insertion removable partial
maxillary incisor partial-edentulism for whom fixed denture was first reported on by Humphereys in
restorations were not feasible was treated using a 1935 and credited to Hallen Back [3]. The concept is
rotational path of insertion partial denture. broadly divided into two categories, Category I and
Removable partial dentures, abbreviated RPDs, Category II prosthetics [4,5]. The former are useful
are a popular, inexpensive treatment option for when mesially tipped molars do not have adequate
the partially dentate patient seeking full arch buccal undercuts for traditional clasp retention. The
rehabilitation. Generally, well-designed RPDs are latter are the subject of this article and are useful in
composed of the following basic components: (1) a Kennedy Class IV and similar situations where missing
cast metal major connector that forms the majority of anterior teeth need to be replaced esthetically. The
the body of the prosthesis, (2) areas of metallic mesh advantage of the type of prosthetic discussed herein
upon which acrylic gingiva and denture teeth are is that it has no anterior clasps, making the transition
affixed, (3) guide planes, metal areas which contact from prosthesis to natural tooth seamless.
the, often purposely adjusted, proximal teeth in Because the design of these prosthesis is considered
edentulous areas, (4) cast metal occlusal rests which “complicated” by many practitioners, this technique
fit into messio-occlusal rest seats prepped into the is seldom taught in the dental school curriculum.
teeth, (5) and metal retentive and reciprocal clasp According to Jacobson, et. al., nearly 20% of
elements which engage undercuts on the buccal surveyed prosthodontists report only a “superficial
(or lingual) surface, which are connected to the understanding” of rotational path RPDs [5].
prosthesis via connecting metal referred to as the The author believes this lack of familiarity is likely
minor connector. only increased as our profession has turned its focus
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ROTATIONAL PATH PARTIAL DENTURES: AN UNDERUTILIZED
TREATMENT MODALITY IN AESTHETIC DENTAL MEDICINE
Case Report
Figure 1. Shows patient without prosthetic after perio treatment Figure 2. Shows a simulated digital smile analysis, revealing that i-bar
clasps would likely create an unattractive metal display.
toward osseointegrated implants, new restorative
materials, and fixed treatment modalities.
As will be shown here, this treatment modality is
both accessible and attractive to patient and clinician
alike. While the rotational path RPD may lack the
‘glamor’ of newer surgical fixed treatments, it more
than compensates with highly aesthetic treatment
results which outshine other removable options and
even rival more complex treatments.
2. Case Presentation
2.1. Initial Presentation and Phase 0-II Therapy
A forty-year old female patient presented to the clinic
with a history of maxillofacial trauma, having lost her
maxillary incisors in an equestrian accident in her youth. Figure 3. The figure shows the drawn lab script for rRPD.
She presented to the clinic with an ill-fitting flipper
with which she was unhappy. Her chief complaint decreased by extensive restorative dentistry and
was her smile aesthetics and poor functioning significant improvement in patient home-care via
prosthetic, as well as some acute pain on tooth oral hygiene instructions delivered in the dental
#18. Her medical history was generally non-contri- operatory.
butory to her dental evaluation, except that she was
a 20 pack-year smoker who quit smoking over the 2.2. Definitive Treatment Planning and Phase III
course of her dental treatment described here. She Therapy
also disclosed that her smile had negative effects on With active dental disease controlled, the patient
her self-esteem and discussed the significance of her was cleared for definitive prosthetic treatment.
“semi-colon” wrist tattoo with her dental provider. Because finances were a significant factor in
(Semi-colon tattoos are a symbol of the suicide treatment, implant or traditional fixed bridge therapy
struggle awareness and prevention movement.) As were not considered. This made removable partial
might be expected, data have shown that comorbid dentures the only financially and medically viable
depression and anxiety are associated with partial treatment available. Initially, a classic metal-acrylic
edentulism [6]. RPD design was proposed, with infrabulge or i-bar
In addition to the maxillary partial endentualism, style clasps utilized on the maxillary canine teeth.
she also presented with need for acute treatment A similar design was proposed for the lower arch.
of a mandibular molar which was extracted due to Smile analysis, however, as simulated in Fig. 2
carious invasion of the pulp. The patient examination showed that this would likely cause the maxillary
classified her as high caries risk, with several anterior clasps to be visible upon smiling and
active lesions and missing teeth on both arches. functional movement. Though infrabulge clasps
The patient was diagnosed with mild-moderate are a good first instinct for the RPD architect
chronic generalized periodontal disease with attempting to obscure clasps, they are often contra-
localized moderate-severe disease around the indicated in the aesthetically conscious young
upper right first molar. Phase I treatment evaluation patient whose labial tissues and gingival show
showed substantial improvement in periodontal cause the clasps to be visible, especially in the
health after scaling and root planning therapy, anterior maxillary arch [7]. An experienced dentist
including stabilization and marked improvement of can quickly ascertain whether clasps will be visible
the periodontal health of the maxillary molar. Fig. 1 by visual inspection; however, digital prosthetic
shows a photograph of the patient after completion smile design techniques such as the one show in
of initial periodontal treatment. Caries risk was also Fig. 2 are simple and fast ways to communicate the
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ROTATIONAL PATH PARTIAL DENTURES: AN UNDERUTILIZED
TREATMENT MODALITY IN AESTHETIC DENTAL MEDICINE
Case Report
Figure 4. Shows the prosthetic on the master cast, with blue arrows indicating the conventional posterior clasp (left) and the long anterior rest
seats (right).
issue to a patient, if needed. Several options exist to the elderly or other patients with limited dexterity.
address this issue of exposed clasps and they will be Given the large comorbidity associated with low
discussed now in brief. One option is to use a Valplast dexterity and partial edentualism, this is a significant
or similar thermoplastic clasp which can be tooth limitation of these systems. As a history of high caries
colored. This option has several limitations. First, risk and significant periodontal disease virtually
the clasp is still visible. It is merely less noticeable. ubiquitous among partially edentulous patients,
Second, thermoplastic materials are more prone to there is ample reason for caution in prescribing these
fatigue and fracture [1,2]. Though most clinical studies treatment options.
support the use of thermoplastics for their aesthetic
advantages, their reported “clinical acceptability” 2.3. Rotational Path Partial Denture Treatment
does not make them equals with respect to mechanics Option
to their metal counterparts. A second option is The rotational path of insertion removable partial
the use of precision attachments. These come in denture (rRPD) was selected as the treatment
two varieties, intra and extracoronal attachment modality for this case in the maxillary arch, as shown
systems [7]. The intracoronal variety have several in the lab prescription reproduced in Fig. 3. Due to
limitations including that they require a certain level the available mandibular premolar abutment teeth,
of laboratory sophistication, i.e. the precision aspect a traditional i-bar design was possible for the lower
of the attachment requires the parts mate exactly, arch. Therefore, the discussion that follows will
without the inherent leeway about a broad tooth concentrate on the maxilla were the rRPD was used.
contour traditional bulge-articulating clasps have. The rRPD was first introduced in the 1930’s by
Additionally, these clasps require more significant Hallen Back and has been investigated by several
preparation of the teeth, and cementation, both of more contemporary authors, most notably Krol
which introduce obvious short and long-term clinical and Jacobson [4,5,8]. Unfortunately, the technique
issues for both clinician and patient. The second is virtually never taught in the predoctoral dental
subtype of precision attachment are extracornonal curriculum and it was reported by Jacobson in 1994
attachments, which function by cantilevering a hoop that nearly 20% of surveyed prosthodontist felt
off of the abutment teeth into which a pin on the they had only a “superficial” understanding of the
RPD fits. This requires a certain level of space within topic [4]. With the recent focus of our profession
the prosthesis and presents with issues of retaining on osseointegrated fixed restorations, it is doubtful
the attachment, as well as the introduction of a that this number has decreased in recent years. That
fixed, iatrogenic plaque trapping area beneath the said, especially with the risks associated with the
attachment. Though not an issue in this case, these increasingly popular bisphosphonate therapy and
attachment systems may also be contraindicated in several other financial and medical issues which
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Figure 5. Study model on surveyor, showing triangular undercut Figure 6. Shows the analyzing rod parallel to the mesial undercut
needed for rigid retainer. with the terminus at the ‘A-point’ of rotational path.
complicate or contraindicate implants, the need for are useful, such as so-called Category I rRPDs which
aesthetic removable options for patients is certainly can be used for tipped posterior molars [5]. However,
real. The rRPD relevant to our discussion is the the goal of this paper is to demonstrate what the
Category II Rotational Path of Insertion RPD. Because author believes is the simplest and most powerful use
of its usefulness in aesthetic cases and its accessibility, of the technique, the anterior edentualism situation.
it is hoped that adding a representative case study This case is a prototypical example of a straightforward
to the literature will contribute positively toward case for which rRPD is indicated: Infrabulge or
informing clinicians about this treatment option, and thermoplastic clasps are aesthetically untenable,
dispelling the notion that it is “too complicated” for and there is a single anterior edentulous space
the average dental practitioner or lab to be viable in continuous with distant posterior tooth abutments.
modern practice.
2.3.2.Surveying Concepts
2.3.1. Review of rRPD Case Selection and Basic To design the prosthetic, study models were
Components analyzed with the occlusal plane roughly parallel to
The rRPD is a fully cast framework RPD which employs the base of the surveyor. The analyzing rod is placed
a specialized guide plane called a rigid retainer to on the edentulous anterior ridge on the mesial
lock into mesial undercuts and a curvilinear path of surfaces of both abutment teeth, ideally canines.
insertion to retain a denture with no anterior clasps. A significant undercut should be identified or
The rRPD has the following basic components: created by enameloplasty or addition of resin-based
(1) anterior mesial undercuts (2) rigid retainers (3) composite, the latter being the case here where
long rest seats on the claspless abutment teeth the undercuts were augmented with composite. A
(4) conventional posterior clasps. Several of these triangular wedge of light should shine through the
features can be appreciated by examining Fig. 4, space between the rod, tooth, and gingival stone.
which shows the prosthetic on the master cast. The occlusal plane and tilted surveying are shown
Because of the non-linear path of insertion, Kennedy in Figs. 5 and 6, respectively. The cast is now tilted
modification spaces complicate the treatment. so that the analyzing rod contacts the full inciso-
To accommodate these, the clinician must cervical mesial surface of the abutments. In other
carefully assess rotational path during guide plane words, the “triangle” is now closed, with the analyzing
enameloplasty planning. There are paralleling rod placed on its hypotenuse, that is, flush to the
devices which can be used to accomplish this; mesial surface, as shown in Fig. 6. The terminus of
however, it is suggested that, especially for the the analyzing rod is now touching the gingiva at
occasional prescriber, these cases which require the “A-point,” the pivot around which the rotational
complex guide planes on modification space path of insertion will rotate in the final prosthetic
teeth be avoided. Instead, the ideal case for this [4]. The posterior teeth can now be surveyed for
treatment is a Kennedy Class IV or Class I or II with facial undercuts on the posterior abutment teeth
a single anterior modification space. In these cases, which will utilize standard cast circumferential or
the surveying can be done with relatively little CC-clasps. The author recommends a lingual arm for
additional knowledge or skill, and rRPD specific counter retention of the posterior clasp to reduce
challenges with cast framework try-in are minimized. the complexity of the metal framework and better
Of course, there are many other cases in which rRPDs accommodate adjustment, if needed.
266 Stoma Edu J. 2018;5(4): 263-269 http://www.stomaeduj.com
ROTATIONAL PATH PARTIAL DENTURES: AN UNDERUTILIZED
TREATMENT MODALITY IN AESTHETIC DENTAL MEDICINE
Case Report
Figure 7. Are pre and post treatment photographs of the patient at rest showing the highly aesthetic results.
2.3.3. Biomechanics 2.5.1. Delivery & Patient Education
The prosthetic works based on a simple principle Since the rRPD should not be inserted or removed
common to all RPDs: that vertical displacing forces along a straight-line path, it is important to educate
perpendicular to the surveyed occlusal plane must be the patient in the importance of maintaining the
resisted to keep the prosthetic engaged and prevent contour of the abutment teeth by ensuring that
dislodgment during function. In the posterior, this removal of the prosthesis does not grind the anterior
is accomplished by a traditional CC-clasp, wherein abutment teeth. In other words, and especially in
the buccal contour of the clasped tooth entraps the the cases of milder anterior mesial undercuts, the
clasp and secures it against a physiological vertical patient must always remove the prosthetic along
dislodging force. The anterior portion of the prosthetic the arc path of insertion to avoid wearing down the
relies on the ‘rigid retainer’ which is entrapped by the undercuts. Additionally, it is vital that the patient is
‘triangular’ mesial undercut, thereby also resisting the informed that s/he must inform other providers (e.g.
vertical force, as the framework is ‘wedged under’ the hygiene) that the prosthesis is an rRPD, and ideally
tooth. For the rRPD, only a rotationally directed force remove it him/herself. In this case, the patient was
about the radius defined by the A-point at the mesio- extremely pleased with the results which are shown
gingival terminus of the mesial abutment teeth can in Fig. 7. She was able to achieve a very natural
dislodge (or seat) the prosthetic. Visualizing how the looking smile that provided her the desired form
prosthetic would ‘get stuck’ by the posterior buccal and function and increased her self-confidence. Due
buldge and anterior mesial undercuts will help the to the financial constraints, a result at this level of
clinician appreciate the simple principle by which esthetics would have been all but impossible without
these prosthetics operate. the rRPD concept. It is fair to say that without using a
rotational path, the treatment would have fallen short
2.4. Teeth Preparations on its most fundamental goal to restore not only the
As discussed, the rigid retainer abutting teeth may biomechanical but the psychosocial function of the
require some adjustment to accommodate the dentition.
prosthesis; however, the natural anatomy of canines
often lends itself to this application unmodified. The 2.6. Additional Benefits and Considerations
rigid retainer teeth should be supported by long Some authors have also suggested that the
anterior rests which extend from the mesial surface claspless and flush anterior design promotes better
approximately half the mesio-distal distance of the periodontal health [9]. Given the association of
tooth. The remainder of the rest seats are prepared partial edentualism and poor periodontal health, this
traditionally. is a noteworthy consideration.
Here are clear psychological benefits of the claspless
2.5. Fabrication of Prosthesis appearance of the rRPD, both in how it looks and in
After preparation and impression, the metal that it is “different” from a traditional RPD.
framework is fabricated and the patient is reappointed In this case, the clinician made the decision to
for try-in. At this appointment, the doctor should add a pin to retain the distal molar which was also
verify the fit of the prosthesis, and ensure the partial replaced by the maxillary prosthesis. It is possible
framework fits without any occlusal interference. It to add such retention features to the entirety of the
is recommended that patient education regarding anterior segment. This is particularly useful in cases
the insertion of the prosthesis begin at this point, where the residual ridge is more posteriorly located
so the wax try-in and delivery appointments are of relative to the mandible. This will provide additional
increasing instructional value. Wax rims should be reinforcement where the denture teeth are retained
fabricated and tested after confirming the metal- by very thin acrylic embedded in the framework only.
only framework is satisfactory. Teeth should be set, However, while pins are encouraged if needed, “bead
either on-site, or by an off-site lab technician and retention” is discouraged by lab technicians as it may
the processing and delivery of the final rRPD should complicate the fabrication process and provides
proceed as in any other RPD case. relatively little benefit [10].
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aesthetic results be achieved using rotational path of
Case Report 3. Learning Summary Points insertion RPDs, but that these cases are accessible to
The case presented here should serve as a prototype the modern clinician without significant investment
for both the clinical decision tree that should be in time or any new equipment.
used to evaluate the potential rRPD case, as well as It is the author’s hope that adding this case to the
the steps to designing the prosthesis. The following modern literature serves to encourage others to
learning points should help guide the clinician. explore and utilize this technique to benefit patients
1. A highly aesthetic, claspless RPD can be designed for whom this treatment is appropriate.
easily and quickly, yielding a removable prosthesis
that rivals its fixed counterparts and is a sound
financial proposition. Acknowledgments
2. The ideal case is a Kennedy Class IV or similar The author would like to thank the faculty of
situation of a single space of anterior edentulism, the University of Florida, College of Dentistry,
such as Class I or II with only one modification Prosthodontics Department; in particular, Dr. Luis
space. Rueda, for his encouragement to learn about and
3. Smile analysis should have precluded the use of pursue this treatment modality.
infrabulge clasps or fixed solutions.
4. Standard equipment for RPD design can be
used with little additional knowledge, namely a References
1. Osada H, Shimpo H, Hayakawa T, Ohkubo C. Influence of
standard surveyor with analyzing rod. The lack of thickness and undercut of thermoplastic resin clasps on
familiarity with this technique is unfortunate and retentive force. Dent Mater J. 2013;32(3):381-389.
[Full Text Links] [Pubmed] Google Scholar(22) Scopus(8)
readily remedied by its use in simple, but effective 2. Tannous F, Steiner M, Shahin R, Kern M. Retentive forces and
treatments. fatigue resistance of thermoplastic resin clasps. Dent Mater.
2012;28(3):273--278.
5. Canines with mesial undercuts are ideal abutment [Full Text Links] [Pubmed] Google Scholar(93) Scopus(44)
teeth, but enameloplasty or addition of RBC can 3. Alikhasi M, Monzavi A, Gramipanah F, et al. Rotational path
removable partial denture: A literature review. J Indian
be used to quickly modify deficient teeth. Prosthodont Soc. 2007;7(3):143-146.
6. Long anterior rests are used on the mesial [Full Text Links] Google Scholar(2) Scopus(0)
4. Jacobson TE. Rotational path partial denture design: A 10-
abutment teeth, and traditional rests, retentive year clinical follow-up--Part I. J Prosthet Dent. 1994;71(3):271-
elements and clasps are used on the posterior 277.
[Full Text Links] [Pubmed] Google Scholar(27)Scopus(15)
teeth. 5. Jacobson TE. . Rotational path partial denture design: A 10-
7. Additional benefits may include psychological year clinical follow-up--Part II. J Prosthet Dent. 1994;71(3):278-
282.
and periodontal advantages over traditional [Full Text Links] [Pubmed] Google Scholar(18) Scopus(9)
prostheses. 6. Wiener RC, Wiener MA, McNeil DW. Comorbid depression/
anxiety and teeth removed: behavioral risk factor
8. Patient education is important to ensure that surveillance system 2010. Community Dent Oral Epidemiol.
the mesial undercuts are protected and that the 2015;43(5):433-443.
[Full Text Links] [Pubmed] Google Scholar(11) Scopus(4)
patient and any other clinicians with whom s/he 7. Donovan TE, Derbabian K, Kaneko L, Wright, R. Esthetic
interacts can comfortably insert or remove the considerations in removable prosthodontics. J Esthet Restor
Dent. 2001;13(4):241-53.
appliance. [Full Text Links] [Pubmed] Google Scholar(50) Scopus(18)
8. Jacobson TE, Krol AJ. Rotational path removable partial
denture design. J Prosthet Dent. 1982;48(4):370-376.
[Full Text Links] [Pubmed] Google Scholar(61) Scopus(41)
4. Conclusion 9. Goncalves LM, Bezerra-Junior JR, Benatti BB, Santana IL.
Improving the esthetic replacement of missing anterior
In a world increasingly dominated by fixed implant teeth: interaction between periodontics and a rotational
restorations, the RPD is often regarded as the path removable partial denture. Gen Dent. 2011;59(3):190-
194.
unaesthetic last resort for the patient who is not [Full Text Links] [Pubmed] Google Scholar(5) Scopus(2)
a candidate financially or physiologically for more 10. Ivanhoe JR. Laboratory considerations in rotational path
removable partial dentures. J Prosthet Dent. 2000;84(4):470-
popular restorative techniques. 472.
This case study shows that not only can highly [Full Text Links] [Pubmed] Google Scholar(8) Scopus(3)
268 Stoma Edu J. 2018;5(4): 263-269 http://www.stomaeduj.com
ROTATIONAL PATH PARTIAL DENTURES: AN UNDERUTILIZED
TREATMENT MODALITY IN AESTHETIC DENTAL MEDICINE
Case Report
Adam Perry TOW
MBA, DMD Candidate
Department of Restorative Dental Sciences
College of Dentistry, University of Florida
Gainesville, FL 32610, USA
CV
The author is a DMD Candidate at the University of Florida and also earned an MBA ‘with distinction’ from Cornell University.
Prior to dental school matriculation, he founded and served as chairman and CEO of a biomedical robotics startup which
produces tissue engineering research equipment. He also holds an issued and several pending US Patents and is licensed
to practice patent prosecution before the US Patent and Trademark Office. He has published academic work in business
management, biomedical additive manufacturing, and he is approaching publication of a study aid book for dental anatomy.
Questions
1. What are the unique required components of the rRPD?
qa. Long Anterior Rests;
qb. Rigid Retainers;
qc. Mesial Anterior Undercuts;
qd. All of the Above.
2. Where do the rigid retainers lock into the teeth to create retention?
qa. Anterior Rests;
qb. Mesial Undercuts;
qc. Buccal Undercuts;
qd. Conventional Posterior Clasps.
3. What case type(s) is/are appropriate for using the method described in the case
report?
qa. Kennedy Class IV RPD;
qb. Kennedy Class I Mod I RPD;
qc. Kennedy Class II Mod I RPD;
qd. All of the Above.
4. How is surveying a rRPD different from a traditional RPD?
qa. There is no difference;
qb. Specialized surveyor must be purchased;
qc. The cast must be surveyed in two planes;
qd. Surveying is not necessary to fabricate an rRPD.
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