1. 19. Occlusal Schemes - Lingualized Opposing Monoplane with Balancing Ramps John Beumer III, DDS, MS and Michael Hamada DDS Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

2. Lingualized Opposing Monoplane with Balancing Ramps

3. Lingualized Opposing Monoplane with Balancing Ramps Begin by positioning the appropriate protrusive insert. Check to ensure that the incisal guide pin is set at zero and in contact with the incisal guide table. Protrusive inserts Zero setting Protrusive insert

5. Mark the casts indicating midline, crest of the ridge, and the retromolar pad . These landmarks will be used to check your denture setup. Maxilla Midline Anterior land Mandible Ridge Retromolar pad Cast Landmarks

6. To set the remaining maxillary anterior teeth a clear glass or plastic slab is positioned on the mandibular record base to represent the plane of occlusion. Setting the Maxillary Anterior Teeth Mark indicating midpoint of the retromolar pad

7. Setting the Maxillary Anterior Teeth Soften some baseplate wax and attach some to the ridge lap portion of the other maxillary central incisor and attach it to the record base as shown. Set the lateral incisors and cuspids as shown previously (Section 13c, 1a Lingualized occlusion).

8. Setting the Maxillary Anterior Teeth Note the angulations of the anterior teeth in relation to the occlusal plane when viewed in profile. Occlusal plane

9. Setting the Maxillary Anterior Teeth “ Toed-in” Position Note how the cervical and incisal edges of the cuspid are aligned vertically (yellow line). The facial surface of the cuspid however, is canted inward and appears “toed in” (red line) due to the prominence of the cervical area of the tooth (yellow arrow). The centrals and laterals are inclined slightly towards the distal.

12. Setting the Mandibular Anterior Teeth Positions of the anterior teeth. The lateral incisors should be placed similar in angulation and position to the central incisors. Note that the cuspids are towed out at the cervical.

13. Setting the Mandibular Anterior Teeth The horizontal overlap should be consistent throughout the anterior region. In this setup it is about 1.5 mm.

17. Lingualized Opposing Monoplane with Balancing Ramps Note that the distal surface of the most posterior maxillary tooth extends 1-2mm distal to the distal surface of the most posterior mandibular tooth.