title: Evaluation of Cast Re-Orientation on a Dental Surveyor Using Three Tripod Techniques: A Survey and In Vitro Study.
abstract: OBJECTIVE
  To survey different educational levels (i.e., students, interns, technicians, and prosthodontic faculty) with regard to their opinions, attitudes, and adoption of three selected tripod techniques. The study will also investigate the accuracy of these techniques to reposition casts on the dental surveyor in anterio-posterior (AP) and lateral directions at both technique and educational levels.
  
  
  METHODS
  Tripod points, scored lines, and cemented post tripod techniques were used in this study. Three Kennedy class II modification I stone casts, duplicated from a standard cast, were assigned to each of the tripod techniques. The tilt angles of all casts were set on the dental surveyor to 10° (control angle) in AP and lateral directions using a digital angle gauge with an accuracy of 0.2°. The casts were tripoded accordingly. A total of 243 participants were involved in this study. Participants were first asked to remount the three casts on three different dental surveyors using the tripod technique noted on each cast. Questionnaires were then given to each participant in an individual interview setting; this assured a 100% response rate. The angle differences were calculated. All data were coded and entered into an Excel Spreadsheet file. Statistical analyses were performed using a paired Chi-square, Wilcoxon Matched-pairs, ANOVA, and Tukey post hoc tests at 5% level of significance.
  
  
  RESULTS
  No significant difference was found between the educational levels relative to the responses to technique demands, sensitivity, and time required for reorientation (p = 0.08202, 0.8108, 0.6874, respectively); however, the majority of respondents reported low technique demands, low sensitivity, and time saving for technique C in comparison to techniques A and B. Significant differences were noted among the educational levels in response to preference and adoption questions (p = 0.0035 and 0.0015, respectively). The highest percentage of faculty chose technique A for inclusion into the academic curriculum. Wilcoxon Matched-pairs test revealed that technique C was the least difficult and most practical (p = 0.0001, 0.0427, respectively). One-way ANOVA revealed significance in angle differences from the set position for technique A in lateral tilt and techniques A and B in AP tilt (p = 0.0466, 0.0194, 0.0424, respectively). A comparison of positivity (overtilt) and negativity (undertilt) between the three techniques in lateral and AP tilts using Chi-square test resulted in significant differences in both directions of tilt (p < 0.0001). Technique C resulted in remounting the casts at the control position in 15.64% in both directions; this was a higher percentage than the other two techniques (A and B). Wilcoxon Matched-pairs test was used to compare between the techniques relative to angle differences from the standard position. No differences were found between technique A and B in lateral tilt position (p = 0.9271), while significance was detected in AP tilt (p < 0.0001). Significant differences were detected between technique C in comparison to A (p < 0.0001, p = 0.0303) and B (p < 0.0001) in lateral and AP tilt directions.
  
  
  CONCLUSIONS
  Within the limitations of this study, it can be concluded that technique C (cemented post technique) was more favored among the respondents across all educational levels. This technique presented high potential in accurately reorienting casts on the dental surveyor in comparison to the tripod points and scoring techniques (p < 0.0001).
authors.affiliation: Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ.|Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Mohammed E
authors.initials: ME
authors.lastname: Sayed
authors.affiliation: Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Idris A
authors.initials: IA
authors.lastname: Busaily
authors.affiliation: Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Rana J
authors.initials: RJ
authors.lastname: Nahari
authors.affiliation: Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Ruaa O
authors.initials: RO
authors.lastname: Hakami
authors.affiliation: Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Sami M
authors.initials: SM
authors.lastname: Maashi
authors.affiliation: Department of Prosthetic Dental Sciences, Jazan University College of Dentistry, Jazan, Saudi Arabia.
authors.forename: Naveen R
authors.initials: NR
authors.lastname: Ramireddy
mesh_terms: D001291:Attitude of Health Personnel; D003735:Dental Casting Technique / Q000295:instrumentation; D003779:Denture Design; D003832:Denture, Partial, Removable; D006801:Humans; D066298:In Vitro Techniques; D011795:Surveys and Questionnaires
keywords: Cast tripod; RPD diagnosis; RPD treatment planning; cast survey; education levels; reorientation accuracy