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Set Posterior Teeth Ling & Monopl.ppt
- 1. Setting Posterior Teeth Setfor Function
- 2. Philosophies of DentureOcclusion Many philosophies of arranging denture occlusion No definitive scientific studies prove one occlusal scheme clearly superior
- 3. Rationale for DalhousieApproach Principals to choose an occlusal scheme Based on clinical experience Dalhousie: two occlusal schemes : • Lingualized Occlusion • Monoplane Occlusion
- 4. Occlusal Schemes Attempts toStabilize Dentures Lingualized Occlusion: Contacts on centered on mandibular ridge minimizes movement Monoplane Occlusion: Lack of cusps minimizes lateral forces on denture
- 5. Based on theUCLA/IVOCLAR/ACP Series Lingualized Occlusion Centric contacts are maxillary lingual cusp to central fossa / marginal ridge
- 6. Lingualized Occlusion Anatomic teethused in maxilla Better esthetics than Monoplane Shallow cusped mandibular teeth Forces centered over mandibular ridge
- 7. Lingualized Occlusion Nooverbite May or may not have balancing contacts in excursions Anterior teeth - must make at least grazing contacts in excursions
- 8. Lingualized Occlusion Maxillaryanatomic (33°) Mandibular Teeth Steep Condylar Guidance Shallow cusped (Anatoline) Shallow Condylar Guidance Non-anatomic (Portrait 0°)
- 9. Denture Occlusion Options Anatomic Semi-anatomic Lingualized (lingualcontact) Non-anatomic (balancing ramp) Non- anatomic
- 10. Set mandibular premolars& 1st molar : • Level with occl plane • Centered over ridge Occlusal plane Line indicating the crest of the ridge
- 11. Balanced Lingualized Occlusion Maxillary anatomicopposing Mandibular shallow cusp
- 12. If using alingualized posterior tooth form (Dentsply Anatoline) • little or no Curve of Wilson • lingual and buccal cusps of level with plane of occlusion
- 13. Second molar elevatedby ~ 15 ° from the occlusal plane 15 degrees
- 14. Posterior teeth have ~1mm space between the buccal cusps
- 15. Lingual cusps contact withthe central fossae of the opposing mandibular teeth
- 16. Maxillary lingual cuspsfirmly contact the central fossae of the mandibular teeth
- 17. Verify centric No buccalcusp contacts • Centric • Lateral excursions Centric Position
- 18. Verify excursive contacts Anteriorteeth are in contact during lateral excursions Working Excursions
- 19. Note the balancingcontacts Balancing Excursions
- 20. Effect of MandibleMoving Downward During Excursions
- 23. Maintaining Balancing Contacts Changeocclusal plane angle Increase compensating curves Increase cusp angles
- 24. Achieving Balance • Condylarangulation Recorded with protrusive record • Cusp angle Selected by dentist
- 25. Achieving Balance • OcclusalPlane Determined by dentist with wax rims • Curve of Spee & Curve of Wilson Controlled by inclination of teeth
- 26. Checking for Balance FeelsSmooooooth in excursions - Fingers on Maxillary Canines - On Articulator
- 27. Assessing Balance • Jumpsor bumps are due to cusp tips moving over other cusp tips, inclines, marginal ridges
- 28. Occlusal Refinement Occlusal Adjustment,Selective Grinding Set teeth as close to: Maximum intercuspation Balance All setups will need some adjustment
- 29. ‘IIF’ Rule IIF youhave contacts on the Inner Inclines of Functional cusps they are balancing contacts
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- 32. What type ofContact?
- 33. What type ofContact?
- 34. What type ofContacts?
- 35. What type ofContact?
- 36. Assess Contacts Centric Stops Excursions
- 37. Non-Balanced Lingualized Occlusion Maxillary anatomicopposing mandibular non-anatomic
- 38. Mortar & pestleocclusion without maxillary buccal cusp contact
- 39. Lack of mandibularcusp angles and no attempt to balance the occlusion
- 40. No compensating curves Nooverbite
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- 42. Magnitude of Overjet Morefor Class II patients Class I Class II
- 43. Magnitude of HorizontalOverlap Class III patients Little or no overjet Class III
- 44. Setting the posteriorteeth • Teeth should end prior to the ascending ramus
- 45. • Mandibular teethset to a flat plane and on the plane of occlusion
- 46. • Maxillary lingual cuspsshould contact the central groove of the opposing teeth
- 47. The horizontal overlap should be idealand should be sufficient to prevent biting of the cheek and corner of the mouth Horizontal overlap
- 48. • All maxillaryteeth, with the exception of the lateral incisors and cuspids, should be on the plane of occlusion
- 49. • Reestablish centric contactsas necessary
- 50. Balancing Ramp If bilateralbalance is desired a balancing ramp can be generated
- 51. In lateral excursions,at least three points of contact (both balancing ramps and anterior incisor contacts) Bilateral balance with Balancing Ramps Working Balancing
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- 53. Monoplane Occlusion Cusplessteeth (0°) on a flat plane with 1.5-2.0 mm overjet No cusp to fossa relationship No anterior contacts in centric position
- 54. Monoplane Occlusion Eliminatecusps lateral forces reduced improves stability Simplifies tooth arrangement
- 55. Monoplane Occlusion Nooverbite (would cause tilting) Overjet of 2 mm is used to create an illusion of overbite
- 56. Monoplane Occlusion Excursions- may or may not contact on balancing sides Depends on condylar inclination and other aspects of the tooth arrangement
- 57. Monoplane Occlusion Anteriorteeth make contact in excursions Modifications have been proposed to minimize the tilting potential: Balancing ramps Compensating curves
- 58. Monoplane Occlusion without condylarinfluence
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- 61. Monoplane Occlusion Advantages • Technicallyeasier to achieve • Use when: – Difficulty obtaining repeatable centric records (muscle incoordination) – Skeletal malocclusion (Class II, III) – Severe residual ridge resorption – Reduces horizontal forces
- 62. Monoplane Occlusion Disadvantages • Poorer appearance •Can be unstable if condylar guidance is steep (posterior teeth separate, leaving only the anteriors in contact)
- 63. Monoplane Occlusion Clinicalremount on an articulator Practice doing a clinical remount
- 64. Adjusting Monoplane Occlusion Mainadjustment is flat If heavy prematurity near fossa, slightly shallow fossa